Hospital Information Systems

Gaining insight into the IT needs of hospitals

IDC Health Insights’ Central and Eastern Europe, Middle East and Africa Healthcare Technology Strategies do research and analysis of IT trends in healthcare in the region with a specific focus on electronic health records, health information exchange and patient management systems. Middle East Health spoke Mahmoud Mounir, Director Information Intelligence Group (IIG), Turkey, Emerging Africa, and Middle East, EMC, about recent research conducted by IDC in the region.

Recent research in hospital IT carried out in the Middle East region by EMC and IDC has made a number of findings. The study is based on interviews with 188 hospital IT and non-IT executives from across Western Europe, the Middle East and Africa (EMEA) as well as with 12 national and regional government executives in charge of eHealth programs.

The Key Findings
The key findings IT – in particular patient data integration – is seen as an integral strategic platform for the delivery of better healthcare outcomes for patients in EMEA:

  • Patient care and satisfaction enhancement top priority for hospitals in EMEA: 4.1 for Western Europe, 4.4 for Middle-East and Africa.
  • The IT organisation’s contribution to business goals (3.8 in WE and 4.1 in MEA) is rated as more important than reducing operational costs (3.8 in WE and 4 in MEA) and procurement efficiency (3.8 in WE and 3.9 in MEA).
  • 51% of hospital executives – (46% in WE and 57% in MEA) expect to see their organisation’s total IT budget increase in 2014, while only 7.5% in WE and 9% in MEA expect to see it decrease.
  • Integrated and secure access to data and applications (4.2 in WE and 4.4 MEA) ranked as most important hospital IT priority, well above lowering the cost of IT (3.9 in WE and 3.6 in MEA). The IDC-EMC study notes that when it comes to delivering on integrated patient care, hospitals need to be able to effectively and securely share information with other healthcare providers such as GPs and specialists. Document management capabilities will be essential for this as they allow organisations to archive, combine, extract and analyze patient information in an integrated way:
  • 56% of hospital executives – 71% in WE and 46% in MEA already have a document lifecycle management solution in place.
  • Hospital executives in WE that plan to invest in document life-cycle management solutions in the next 12 months are also more likely to invest in Electronic Health Records (EHR) (50%).
  • However, only 7% of WE hospital executives plan to invest in a new document life-cycle management solution over the next 12 months The research has revealed that several barriers may be holding back the wider adoption of document lifecycle management solutions to enable integrated patient care. This is particularly true of budget allocations which remain focussed on maintaining legacy systems:
  • 46% of 2014 IT budget allocation in EMEA – 54% in WE and 39% in MEA – is set aside for maintenance of systems.
  • Only 18.5% - 19% in WE and 18% in ME – is set aside for enhancements or upgrades and 19% to innovate: 12% in WE and 23% in MEA.

Middle East Health: In an effort to establish the credibility of this research, can you tell me a bit about it – where it was conducted, with whom and when? How was the interview conducted and with how many people?

Mahmoud Mounir: The study was conducted by IDC amongst leading hospitals in Western Europe and selected emerging markets such as Saudi Arabia, Turkey and South Africa. It is based on interviews with 188 hospital IT and non- IT executives as well as with 12 national and regional government executives in charge of eHealth programs. The research emphasizes the increase of long term chronic illnesses and how hospitals need to look beyond their borders to provide an improved quality service and cost effective patient care.

Middle East Health: In a summary of the research findings it states – as you say – that hospitals will need to look beyond their borders to deliver improved and cost effective patient care in an environment where long term chronic illness is on the increase and that structured data and unstructured document management capabilities will be essential to meet this challenge. Can you explain the difference between structured and unstructured data and explain in some detail how an improved, more efficient IT network will improve healthcare and make it more cost effective?

Mahmoud Mounir: Nowadays, the new IT solutions available have helped us in organizing unstructured data and making it an op-portunity for the healthcare providers rather than having a big pile of data with no value. Unstructured data is now seen as a valuable portion of the medical record and with the help of eHealth programs it can be used to extract valuable medical history elements which can assist different entities to provide better services to their patients. With the help of the analytical tools available, the unstructured data can also be used to uncover historical patterns of cause and effect and indicators of disease that weren’t known earlier. By combining both structured and unstructured data the result is immense improvement in the healthcare services as well as drastically reducing their costs. This way a lot of manual work is saved as it saves clinicians from filling forms and provides a better experience to the patient, helps doctors make better decisions and provide quality services that put the patient at the centre of the nexus.

Middle East Health: Clearly an efficient IT network is an ideal solution, but there are some real hindrances to this – such as the unwillingness of hospitals to share information in a competitive field, particularly across borders; insufficient financial resources on the part of some hospitals to implement a new IT system and; in some places, poor public IT infrastructure, which makes cloud storage of hi-resolution images, for example, unfeasible. What do you suggest can be done to counter these hindrances?

Mahmoud Mounir: Sharing patient’s data across care providers will lead to better results and would improve patient well-being. This will provide different care providers with access to patient history, allergies, exam results, past episodes and drug prescription to prescribe treatment and continue care monitoring and follow ups without having to do repetitive work. This enables the healthcare providers to do remote monitoring, pill reminders, follow up appointments and vital readings even after the patient has left the hospital and clinic. This drastically reduce costs on the ICT side as this will put an end to the usual time consuming process where the data is locked and several steps are required to generate patient data. This will actively reduce costs and enable the care providers to focus on innovations. Keeping this in mind, this actually provides an opportunity to improve the cost structure and enhance the specialised cost effective care delivery units where the mistakes are minimized, advanced and efficient care is provided.

Middle East Health: What do you suggest hospitals that have legacy systems in place do? They will be reluctant to change their system for fear it too will become obsolete.

Mahmoud Mounir: There are several ways to introduce the change in a gradual manner. First, is to establish central integrated patient record (IPR) system and start to capture the data that are generated by the dedicated care system. Most of them communicate via HL7 messages. Those messages that are passes today between care systems via communication servers could be placed in the central registry and stored in the IPR using HL7 2 XDS adapter. Once new system will be introduced then those systems will be obliged to communicate via XDS protocol and then there won’t be a need to continue with messages transformation. Once new systems are introduced then the old systems can be off-loaded via an EMC clinical Archive tool, which will move the patient’s data from source system to IPR and make it available for sharing with the newly introduced systems. In such a way we could start to capture ongoing patient data and have a migration strategy in mind. This will be the last introduced migration step; from this point onwards patient data will be managed independently in IPR and will be available for sharing with any other care application in the hospital (or with any other parties in the health or social systems as long as patient consent has been provided).

Middle East Health: How do you ensure that any new system implemented now at considerable cost will not be considered a legacy system in 10 years with the current rapid advancements in technology?

Mahmoud Mounir: Our strategy of managing patient data in IPR, independently of the source system that generated the data (decouple the data from the Application as recommended by IDC) will ensure that the organization won’t be challenged any longer with application decommissioning and data migration as they would be able to ingest quickly and more frequently new innovative applications which will join the shared IPR. The patient data will become the integration tissue of all those applications (inside and outside the hospital). IPR will enable the complete eHealth Ecosystem to collaborate, with no need for point-to-point integration and communication.

Middle East Health: The research summary notes: ‘The research has revealed that IT – and especially document lifecycle management capabilities – will play a key role in this transformation [to integrated, cost-effective healthcare], with many healthcare providers in the region already looking to invest in key technologies.’ Can you explain what these key technologies are and how they will facilitate a transformation in healthcare (the operative word being transformation)?

Mahmoud Mounir: Over the recent years, interoperability has become a serious concern in the healthcare sector and has been blamed for the huge cost of keeping systems in sync. Thus, EMC has been delivering a document lifecycle management solution since the mid-90’s and has invested heavily to embrace open standards to support healthcare protocols such as HL7, DICOM and XDS in its leading Documentum ECM brand in order to enable smooth integration into the healthcare ecosystem. Document lifecycle solutions are essential as they help the healthcare providers facilitate a more efficient provision of medical care as a result of rapid and secure information shared across hospitals at a local, regional or state level. The ability to manage, store, secure and share the right information effectively is critical for the future of the healthcare industry in order to help doctors provide accurate diagnosis.

Date of upload: 16th May 2014

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