Healthcare in Saudi Arabia: The E-Health Program - Case Study Example

Healthcare in Saudi Arabia (The E-Health Program) Project case paper Lecturer The case study analyses the healthcare state in Saudi Arabia, the challenges facing the sector and discusses on ways of improving the situation through the implementation of the eHealth program as a measure of enhancing quality care delivery to the patient to reduce cost and time spent in the healthcare facilities. The Saudi Arabian government has undertaken positive steps and invested abundantly in the healthcare sector in an effort to improving healthcare sector in the country. However, despite of its efforts a number of obstacles do not allow the enhancement of total quality care in the country. This entails the shortage of health personnel, limited finances in the sector, high demand for healthcare resulting from health carefree services, lack of a national health information system as well as the underutilization of the electronic health strategies. The study focus is the implementation of the eHealth program to enhance total quality care delivery. Thus it analysis the implementation of the eHealth program, it describes the product, industry description and market analysis, challenges facing its implementation, it stipulates the revised objectives and mission statement in regards to the product implementation and puts forward recommendations based on the case review. Governmental and non-governmental institution in enhancing the healthcare in Saudi Arabia will use the case study. The study can be further used in complementing and supporting further related research. In order to meet the healthcare needs of the increasing population, it is important to improve quality care delivery, time and cost of care provision that can be achieved through the implementation of electronic health strategies. The e-health program is aimed at ensuring the provision of a safe, quality health care system that focuses on the patients care guided by standards stipulated by e-health. Keywords: health care, electronic health systems, total quality care, e-health program, Ministry of Health, medication errors Interview summary I selected Dr. Abdulaziz Alsaif for my interview that is an assistant professor of surgery, an endocrine and breast surgery consultant and is the King Khalid University, Hospital Director. Dr. Abdulaziz has worked in the healthcare sector in Saudi Arabia for a long time; thus, he is well experienced and knowledgeable about the state of health sector in Saudi Arabia. He has attained a M.B.B.S in Saudi Arabia at the King Saud University did his internship at the King Khalid University Hospital and King Saud University in Saudi Arabia and as well is the senior registrar of surgery at King Khalid University Hospital, King Saud University and Riyad Medical complex. Moreover, he is the chief medical staff, assistant professor of surgery, endocrine and breast surgery consultant in the surgery department at the College of Medicine, King Saud University and King Khalid University Hospital Saudi Arabia. His residency is at the surgery department at King Khalid University Hospital, King Saud University, and Riyadh Medical Complex. The interview was conducted at the King Khalid University Hospital on the 19 th of March 2015. I interviewed Dr. Abdulaziz on the state of health sector in Saudi Arabia, the challenges facing the sector and on the ways of improving the health sector. Below is the list of questions that I used for my interview and the summary of the responses obtained. 1) What is the state of the healthcare sector in Saudi Arabia The health care of Saudi Arabia is ranked in the 26th position among the 190 world healthcare systems coming in front of other health care systems such as in Australia and Canada. However, in the recent days, the health services have improved and increased significantly after the government gave high priority to the development of health services at all levels. i.e. the secondary, tertiary and primary levels. The key player in the provision of health care is the ministry of health (MOH) owing about 60 percent of all the healthcare services with the 40 percent involvement of the private sector and non-governmental organizations. The state has a population of 27.1million residents, and it is expected that by 2025, the population will reach about 40 million. With improved and free health care services, the state has experienced and increased life expectancy, birth rate and a decreased mortality rate especially the fewer than 5 mortality rates that fell from 250 deaths in a 1000 births in 1960 to 20.0 per 1000 in 2010 attributed to the childhood vaccination implanted by the government. However, the increased population growth rate has increased the demand for the health care services. 2) What are the challenges facing the Healthcare sector in Saudi Arabia The government has taken steps and invested abundantly in the healthcare sector in an effort to improving healthcare sector in the country. However, despite of its efforts a number of obstacles contrary to the expectations of many do not allow the enhancement of total quality care in the state. These entail shortage of health personnel, limited finances in the sector, high demand resulting from health carefree services, lack of a national health information system as well as the underutilization of the electronic health strategies. The advances in the health sector have not been however, accompanied by the advancement of the electronic health field such as electronic ID cards especially for individuals who visit Saudi Arabia to work and it becomes difficult to know their medical history. The electronic ID cards are important as they provide access over the patient’s electronic health records making medical follow-up easy especially when they meet a medical emergency where patient’s health history is unavailable reducing the occurrence of medication errors. 3) What are the ways of improving the healthcare sector in Saudi Arabia? Improvement of the health sector in Saudi Arabia is a key priority by the MOH. It is important to ensure that there is total quality care delivery in an effort of enhancing the health sector. The sector needs the implementation of the electronic health records and ID cards to enhance quality care delivery. Despite the witnessed progress over the recent days, the advancement in the electronic health field has lagged behind whose application is a necessity for hospitals in achieving total quality healthcare as well as in the reduction of cost and time for healthcare delivery. The case study is very important as it determines the state of the healthcare sector in Saudi Arabia, the challenges it is facing and proposes a solution for the improvement of the healthcare sector in Saudi Arabia. It focuses on the eHealth program as a measure of enhancing quality care delivery to the patient to reduce cost and time spent in the sector. Governmental and non-governmental institution in promoting healthcare in Saudi Arabia will use the research study. The case study can be further used in complementing and supporting further related research studies and can be used by private stakeholders. In an effort to meeting the healthcare needs of the increasing population, it is important to improve quality care delivery, time and cost of care provision. The eHealth programs have been underutilized in Saudi Arabia as thousands of patients die every year because of medication errors that are preventable. Major case theme The state of the health sector in Saudi Arabia has witnessed a significant progress in the recent days. However, the advancements have not been accompanied by the advancement of the electronic health field that is essential in enhancing quality healthcare as well as in reducing the cost and time involved in healthcare delivery (Altuwaijri, 2008). Every year, thousands of patients die because of medication errors that could have been prevented with the utilization of e-health programs. When medication errors occur, they increase the cost of hospitalization as well as the time of hospitalization. These errors are caused by the utilization of faulty systems in healthcare delivery, processes and conditions that lead to medication errors. E-health systems are thus, important in reducing medication errors, in improving the healthcare outcomes, eliminate unnecessary costs involved and enhance healthcare efficiency (Alkhamis, 2012). With the increasing complexity of the healthcare system in Saudi Arabia and as more healthcare providers are being involved in the care delivery, files and paper-based records on patients clinical records cannot keep the clinicians completely informed. These files can only be available at only one location and will be difficult to share with different healthcare specialists in different locations. To improve patients care, it is important to have the patients’ health records available in electronic format for essay access and review of the patient’s medical history such as allergies, laboratory test performed, previous diagnosis, medications and investigations (Aldossary, While, & Barriball, 2008). Moreover, e-health programs enable information sharing across different organizations and ensure security and privacy of the patient’s information to enhance quality care delivery and patient’s safety (Wilson, 2009). Situation Adoption of e-health programs is a trend that is growing in all the countries especially those, which have adopted advanced health care systems in an effort to improving healthcare effectiveness and delivery. In regards to the vital role that is played by communication and information technological systems, the healthcare stakeholders and providers have started their adoption on the advanced technological systems in an effort to improving the patients care (Al-Ahmadi & Roland, 2005). However, this adoption has not been accompanied by a coordinated effort to set up a strong national network in e-health care system adoption. There is a great number of different health information systems that are in use independently without being interconnected making implementation of e-health programs a challenge (Alkhamis, 2012). Context In the kingdom of Saudi Arabia, the electronic health programs has been identified as a strategic objective of improving the quality of care delivery by the ministry of health and the ICT has been mandated with implementing the program (Fahd Mohammed, 2010) . The program is expected to transform the healthcare sector in Saudi Arabia and in the last six months; the strategy is underway, and it involves key project consultants and key stakeholders in the ministry of health. The program is structured in a three works team that includes the program strategy, technology, and governance. Stakeholders and players The implementation of the program is under the support of an executive steering team committee that is headed by Dr Koshaim, international and national advisors and task groups who work with each other in collaboration to ensure success and full implementation of the program (Altuwaijri, 2008). The ministry of health is the major stakeholder and has been involved in connecting MOH hospitals with the electronic health program. However, this objective is yet to be fully achieved due to lack of proper funds and the little efforts that have been exerted in promoting minor systems are limited to use because they have not been based on clear policy of information technology; therefore, their interconnection becomes a challenge. The private hospitals are also adopting the program but have laid more emphasizes on financial applications such as the billing system since they are profit making organizations. Analysis The implementation of the electronic health services program is the key to improving the quality of care delivery in Saudi Arabia. The program implementation is crucial to enhancing the patient’s access to credible and comprehensive health information to improve care. The program is a conduit for faster and improved sharing of health information records enhancing care delivery; decrease the disease management costs, lowering the wellness program costs and medication associated costs (Almalki and Clark, 2011). Through adoption of the program physician orders will be placed electronically preventing dispensation and medication errors, as healthcare practitioners will have the full control of the ordering process enhancing the quality of care delivery (Al-Ahmadi & Roland, 2005). The hospital management will be freed up from its administrative tasks, and it will have more time to provide higher quality care value to its clients. Healthcare practitioners such as nurses will spend lesser times in entering orders and spend more time in clinical care. Moreover, the program will enhance the security and safety of the patient’s information. Electronic health systems help in the movement of information instantly across organizations, and this saves time for medication delivery, processing and obtaining laboratory work and other tasks thus standardizing the healthcare process. At the national level, healthcare information from different healthcare centers can be easily combined in support of public health research. Recommendations based on the case review The healthcare sector in Saudi Arabia has undergone major advancements over the recent years but little progress has been achieved on electronic health field progress that is essential in enhancing quality healthcare as well as in reducing the cost and time involved in healthcare delivery. The ministry of health is committed towards provision of a comprehensive and integrated healthcare delivery model to ensure the highest quality care to the patients. Therefore, it has taken responsibility for enhancing the implementation of the program fully. Support from the government and other private stakeholder and investors is important to ensure full implementation of the program especially financially as funds shortage is a major challenge. To ensure change in the health care sector, organizations and hospitals should address change management processes in an effort of aligning electronic health programs with the existing processes for full implementation of the program. In regards to case scenario, the MOH has developed an e-health program with revised objectives and a mission to improve care delivery. Revised objectives and mission statement of the program E-health program mission The motivation for the electronic health program is strengthening the healthcare system through the provision of an integrated comprehensive health care system delivery model that is effective to enhance quality care with the highest international levels of practice E-health program vision Ensuring the provision of a safe, quality health care system that focuses on the patients care guided by standards stipulated by e-health E-health program objectives 1) Improving the care delivery of the patients in a 10 years period to enhance total quality care delivery 2) Defining the MOH policies, coordinating, monitoring and measuring them in an effort of ensuring compliance towards total quality care delivery 3) Transforming the workforce and MOH services in a 10-year period to ensure total adoption of e-health programs 4) To ensure that there is connection and integration of the health care systems through e-health technological support in a 10-year period to improve care provision. Key success factors towards implementation of the program This section articulates ways of achieving the stipulated program objectives. It explains how the process will be achieved and stakeholders to enhance the achievement of the program. Thus, in creation of a solution I will: 1) I will be involved in hiring outside agencies with the relevant funds and machinery to bring the electronic records and ID cards to everybody in the Saudi Arabia 2) I will ensure that the Saudi Arabia embassy’s outside the country will not issue visit visa’s to visitors if they do not have ID cards with complete medical history 3) I will call for an establishment of a new office that has medical staff in international airports to issue electronic ID cards for visitors lacking the cards. 4) I will enhance campaigns for electronic health systems adoption through the social and mass media through channels such as T.V, Facebook and Twitter pages as well as print advertisement. Description of the company’s product and Differentiation The e-health system is composed of a health information record that stores the patient’s information electronically making it easy to connect the patient’s information through different technical and medical departments. It makes it easy to store the patients records enhancing a more integrated and harmonious interaction with patients care in the different hospital departments in an effort of providing excellent health care services (Hoerbst & Ammenwerth, 2010). The electronic health systems program consists of a patient management system utilized for making patients appointments, patient follow-up system and a bed management system. It also comprises of a pharmacy management system that manages drugs automatically to reduce drug dispensation errors as well as for notifying the physicians of any patient’s drug reaction that is bound to occur to prevent associated medication errors. Part of the electronic health system is a laboratory system that is essential for managing the patient’s laboratory requests and storing the results automatically in the e-health records. The insurance and billing system and staff scheduling systems are part of the program that helps in billing and managing the scheduling process of the clinical team (Caligtan & Dykes, 2011). A computerized physician order entry as part of the system involves a process of entering the physician’s orders electronically as well as instructions for the patient’s treatment. The system makes it easy to communicate orders to the medical personnel and other staff that are responsible for documenting the orders. It represents a workflow design rather than a system in the clinical process that utilizes technology in optimizing the physician medication ordering, laboratory test and other medical procedures (Sittig & Singh, 2012). Telemedicine that is part of the e-health system is a technology allowing the physicians to provide patients care at a distance through electronic communication systems. Treatment involves remote medical examination of the patients, automated forwarding of the results, provision of treatment and operations and other medical procedures. This system uses communication systems and computers in exchanging and transferring medical information from one location to another (MITRE Center for Enterprise Modernization McLean Virginia & Resources, 2006). A multipurpose smart card is a card that is used for storing the patients’ medical records and will be used at any location worldwide that has access to electronic health systems. Utilization of the card will be important in saving time and cost that would be used in obtaining the patients’ medical history and laboratory tests. Industry description, marketing and Market Analysis The ministry of health has stipulated a three-component model for the implementation of the e-health programs in organizations and healthcare institutions. To ensure a successful adoption of the program, the model has been based on diffusion of innovation theory, barrier theories to innovation, studies of critical success factors for projects as well advancement of project management theories (Aldossary et al., 2008). The first component involves the organizational stages taken in the deployment of the e-health programs that entails visioning, matching the program vision, evaluation, deployment and improvement of the programs systems. In the vision phase, the organizations and healthcare facilities are involved in defining and understanding the program mission, strategy and objectives (Al-Sughayr, Al-Abdulwahhab, & Al-Yemeni, 2010). The second phase of the model is concerned with the interconnection between the need identified in the first phase and the proposed innovation. This phase is involved in identifying the effectiveness of the program in solving the identified problem and in the end of the stage, the facility will make a decision on whether or not to incorporate the program. The third phase of the model entails the deployment of the program and all the decisions and actions related to the incorporation of the program are taken into consideration at this stage. To ensure the effectiveness of the process, evaluation of the performance is a crucial step as well as in ensuring quality of the innovation deployment. In to gain a competitive advantage, the model has emphasized in the process of flow optimization and continuous expansion of the systems (Alkhamis, 2012). The electronic health programs has been identified as a strategic objective of improving the quality of care delivery by the ministry of health but has experienced a slow adoption in the recent decades. The ministry of health has emphasized on the importance of adoption of the e-health program across the health care system to enhance quality delivery of care. In regards to this, the e-health program has been launched, an adoption model has been stipulated and e-health program adoption campaigns are underway (Aldossary et al., 2008). To enhance quick adoption of the program, I will call for external support from outside agencies, be involved in enhancing campaigns for adoption of the records such as ID cards through social media channels such as newspapers, Television, Facebook and Twitter pages. I will also ensure that the Saudi Arabia embassy’s outside the country will not issue visit visa’s to visitors if they do not have ID cards with complete medical history and call for an establishment of a new office with medical staff in international airports to issue electronic ID cards for visitors lacking the cards. SWOT analysis and revenue projections One of the major strengths of the program is the government support for the program implementation through the ministry of health. The MOH has stipulated a model for the program implementation to help organizations and facilities in the implementation process. However, the program implementation faces a number of obstacles such as knowledge barriers to the information technology diffusion of innovation ideas such as economic barriers to implementation, technical barriers for the technical infrastructure readiness, organizational barriers in the change management process and behavioral barriers of clinical resistance to the e-health program adoption (Walston, Al-Harbi, & Al-Omar, 2008). Thousands of patients in Saudi Arabia lose their lives every year due to medication-related errors that are avoidable and the e-health program presents with an opportunity of enhancing quality care delivery by reducing the time and cost of care delivery. The main threat facing the implementation of the program is inadequate funds as the adoption of the e-health systems is expensive an expensive task but the profound results of the systems utilization will be important in saving billions of medication-related costs and improving patients care (Alkhamis, 2012). Conclusion The state of the health sector in Saudi Arabia has witnessed a significant progress in the recent days. However, the advancements have not been accompanied by the advancement of the electronic health field that is essential in enhancing quality healthcare as well as in reducing the cost and time involved in healthcare delivery. Every year, thousands of patients die as a result of medication errors that could have been prevented with the utilization of e-health programs. When medication errors occur, they increase the cost of hospitalization as well as the time of hospitalization. E-health systems are important in reducing medication errors, in improving the healthcare outcomes, eliminate unnecessary costs involved and enhance healthcare efficiency. Commentary 1) The e-health program is aimed in ensuring the provision of a safe, quality health care system that focuses on the patients care guided by standards stipulated by e-health 2) The e-health system is composed of a health information records that stores the patient’s information electronically. 3) It makes it easy to store and connect the patient’s records enhancing an integrated and harmonious interaction during patients care in the different hospital departments in an effort of providing excellent health care services. 4) E-health systems are important in improving the healthcare outcomes, eliminating unnecessary costs involved in healthcare delivery and enhance healthcare efficiency References Al-Ahmadi, H., & Roland, M. (2005). Quality of primary health care in Saudi Arabia: a comprehensive review. Int J Qual Health Care, 17, 331–346. Almalki, M and M. Clark. (2011). Healthcare in Saudi Arabia: An overview. Journal of healthcare, 17 784-793 Aldossary, A., While, A., & Barriball, L. (2008). Health care and nursing in Saudi Arabia. International Nursing Review, 55, 125–128. doi:10.1111/j.1466-7657.2007.00596.x Alkhamis, A. (2012). Health care system in Saudi Arabia: An overview. Eastern Mediterranean Health Journal. doi:10.1111/j.1466-7657.2011.00890.x Al-Sughayr, A. M., Al-Abdulwahhab, B. M., & Al-Yemeni, M. R. (2010). Primary health care physicians’ knowledge, use, and attitude towards online continuous medical education in Saudi Arabia. Saudi Medical Journal, 31, 1049–1053. Altuwaijri, M. M. (2008). Electronic-health in Saudi Arabia. Just around the corner? Saudi Medical Journal. doi:Comparative Study Review Caligtan, C. A., & Dykes, P. C. (2011). Electronic health records and personal health records. Seminars in Oncology Nursing, 27, 218–228. doi:10.1016/j.soncn.2011.04.007 Fahd Mohammed Albejaidi, ( 2010). Healthcare System in Saudi Arabia: An Analysis of Structure, Total Quality Management and Future Challenges. Journal of Alternative Perspectives in the Social Sciences. Vol 2, No 2, 794-818 Hoerbst, A., & Ammenwerth, E. (2010). Electronic health records: A systematic review on quality requirements. Methods of Information in Medicine. doi:10.3414/ME10-01-0038 MITRE Center for Enterprise Modernization McLean Virginia, & Resources, N. I. of H. N. C. for R. (2006). Electronic Health Records Overview. Health (San Francisco) (p. 30). Sittig, D. F., & Singh, H. (2012). Electronic health records and national patient-safety goals. The New England Journal of Medicine, 367, 1854–60. doi:10.1056/NEJMsb1205420 Walston, S. L., Al-Harbi, Y., & Al-Omar, B. (2008). The changing face of healthcare in Saudi Arabia. Annals of Saudi Medicine, 28, 243–250. Wilson, J. F. (2009). Making electronic health records meaningful. Annals of Internal Medicine. doi:10.7326/0003-4819-151-4-200908180-00026 Read More