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Sun 22 Mar 2009 04:00 AM

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The cutting edge

Healthcare IT is one of the few areas in the region that is still experiencing significant growth. Piers Ford speaks to a number of prominent vendors from across the region about what is driving this boom.

Healthcare IT is one of the few areas in the region that is still experiencing significant growth. Piers Ford speaks to a number of prominent vendors from across the region about what is driving this boom.Healthcare in the Middle East is at an exciting crossroads and new technology will play a vital role both in service delivery and in supporting the streamlining and automation that inevitably comes with the business imperatives of privatisation. This is the general view of IT vendors as they survey a sector that has gone through a momentous change during the last three decades.

Numerous projects ranging from individual hospitals to initiatives like Dubai Healthcare City, a lynchpin of the emirate's drive to become a world-class healthcare provider by 2010, have challenged technology suppliers to deliver appropriate infrastructures and applications.

In the UAE, this has underpinned the evolution of the Ministry of Health's major hospital network, from the computerisation of registration, appointments and laboratory data management in the early 1990s through back office, financial and supply chain management and on to the creation of a central patent index. All of which has taken place in tandem with a strong undercurrent of privatisation and - with a steady rise in population and demand for services - cost management.

"Hospitals, their executive teams, and management companies across the region are focused on several key imperatives," says Matthew Mueller, director of services at E3, which sells Lawson healthcare management software as part of its product portfolio in the Middle East.

"Most importantly, improving patient care, followed by patient satisfaction, operational efficiency, and cost-effective management and compliance. The increasing pressure to boost revenue and control costs, all while meeting the demand for the very best in patient care, means CIOs are consequently tasked with modernising healthcare and business processes without changing the budget."

Prominent vendor Cerner entered the KSA market 15 years ago and now supplies technology to the Ministry of Health in the five northern emirates as well as doing work in Qatar and for the Children's Cancer Hospital in Cairo. Middle East VP and general manager Rich Berner says it's an exciting time to be in healthcare.

"I've been in Dubai for a year and the vision and size of projects is very impressive. The market is unique in that there is still a small number of people who control healthcare delivery and that means we have opportunities to do things that can't be done anywhere else, like the one patient/one record system in the UAE which means that wherever you go, the provider will have access to your data."

That kind of infrastructure would be the envy of many western countries' healthcare providers, but even in the Middle East, it throws up specific challenges for CIOs as they seek to integrate the benefits of new technology with legacy networks that may themselves be just a few years old.

"There are two camps within healthcare in the Middle East," says Dave Kelly, VP of international sales at wireless LAN specialist Meru Networks, which has established a strong presence in Dubai and signed a distribution deal with Oonline across the Middle East in 2008.

"The new build environments have the chance to go with the leading edge and look to the future with a pure wireless environment. For the established healthcare facilities, they are seeing more and more vendors bringing in devices in a wireless way," he says.

"So those hospitals need to be able to integrate it wirelessly into their existing infrastructure. Interoperability within the healthcare environment - whether it be PDAs or wireless medical equipment like heart monitors or automated drips - is vital. Reliability and speed of data delivery is also the key. Data is really important: patients can't afford to wait. Mistakes and unreliable communications are too costly on all levels within a healthcare environment," concludes Kelly. Perot Systems

Perot's Hospital Information Systems (HIS) have played in important role in several major healthcare projects including, most recently, the roll-out of a new system in multiple hospitals and Primary Healthcare Centres (PHCs) in Abu Dhabi and a pilot for VistA, an open source clinical and healthcare information management system in Jordan.

"Key issues affecting healthcare markets in the Middle East and on a global scale include cost, quality and the fragmentation of services," says Kevin Fickenscher, executive VP and managing director for Perot Systems' International Healthcare. "We believe these challenges can be addressed through ‘clinical transformation' - using IT as the basis for supporting change so that systems can be modernised and processes aligned through the digitisation of records.

"This is all too important in the Middle East as the healthcare market in the Gulf is changing rapidly - a growing population has given rise to a rapidly growing market for healthcare and its associated industries. To accommodate this growth and deliver healthcare of a high standard, organisations like the Abu Dhabi Health Services Company (SEHA) recognise the need to embrace technology," continues Fickenscher.

Perot Systems was asked to manage the roll out of the HIS across three public hospitals - Tawam (468 beds), Sheikh Khalifa Medical City (550 beds) and Al Corniche (235 beds) - and associated PHCs in Abu Dhabi, all of which are now run by SEHA. The system now provides a comprehensive Electronic Medical Record (EMR), supports best-practice processes in all three hospitals and enables clinical, operational and financial metric reporting.

In Jordan, VistA has been deployed at two hospitals and a clinic in Amman. Jordan is recognised as providing one of the highest standards of healthcare in the region, along with a rapidly expanding IT sector. King Abdullah II aims to build on these foundations to create an integrated national healthcare infrastructure on a single software platform.

The VistA project is intended to help Jordan become self-sufficient in managing its healthcare ICT infrastructure and take it to neighbouring countries as a commercial offering. In the longer term, it will also be used to discover, track and manage healthcare patterns, problems, issues, diseases, protocols and trends - and of course, provide live clinical data for disease research in the region.

"We expect that the HIS implementation in Abu Dhabi and our ongoing work with SEHA will not only bring great dividends for healthcare consumers in the region, but also reduce quality and costs for healthcare delivery in other countries in the regions," says Fickenscher.

E3 Corporation

As a systems integrator, Dubai-based E3 aims to help Middle Eastern healthcare organisation improve the quality of healthcare through the use of the most effective technologies. It has a best-of-breed strategy based on the selection of world-class software products and services from a variety of specialist vendor partners including Lawson, Ardentia, IBM and Stockell. Current clients include Qatar Orthopaedic Hospital.

"Changing the standard of healthcare means changing how we make decisions - big and small - in a new, connected healthcare environment," says director of services Matthew Mueller. "Vendors like Lawson deliver healthcare management software designed to help hospitals achieve margin-impacting operational improvements, thus freeing resources to invest in patient care.

In one case, E3 claims to have reduced supply chain costs for a major healthcare organisation by $16.2 million in one year - the kind of figure which will make healthcare provider CIOs sit up and take notice as they wrestle with the imperative to reduce costs through automation across the entire infrastructure. It also explains why healthcare providers are keen to see specialist IT vendors establish a presence in the Middle East.

"To meet an increasing demand for quality healthcare services in the Middle East, governments are continually encouraging global healthcare software providers to establish a greater presence here," says Mueller."Automating enterprise resource planning, supply chain management, financial, HR and talent management, to name just a few, into a single integrated suite drastically reduced the costs associated with managing the healthcare enterprise. For us, the key to this transformation is two-fold: automating best-in-class processes from over 20 years' healthcare experience, and integrating the resulting plethora of information into a new desktop platform.

Mueller says that to make sure improved process automation, tracking and best practices are adopted, it is essential that frontline managers get access to the tools; after all, they are the people who effect change.

"In many cases, these tools need to be mobile - handhelds, tablet PCs or portable workstations," he says.

"Creating change and ensuring adoption are not enough to revolutionise healthcare," says Mueller. "Automated monitoring, reporting and next generation decision support can ensure that the right change has occurred."


With 15 years' experience in the Middle East already under its belt, healthcare information technology (HIT) specialist Cerner is now at the heart of a major new project for Ministry of Health (MoH) hospitals and clinics in the United Arab Emirates (UAE) in which 14 hospitals and 60 clinics will implement a suite of Cerner solutions to optimise and automate paper-based processes.

The creation of a unified patient record accessible from any healthcare institutions is a major driver for the project. But the systems will also automate processes in the scheduling, admissions, emergency, laboratory, pharmacy, radiology, surgery, medical records and clinical supplies departments. Nurses and physicians will use Cerner Millennium solutions to manage and document patient care.

"It takes a tremendous amount of vision and commitment to move not only from a paper-based system to an automated system, but also to create a region-wide electronic patient record in the process," says Rich Berner, Cerner Middle East' vice president and general manager.

According to Berner, Millennium's strength is its single, integrated database: "I always liken it to the fact that you can do your banking or book tickets online anywhere because the systems know you," he says. "But get hit by a bus and the hospital doesn't know anything about you. This changes all that."

Berner says healthcare in the Middle East has leaped ahead in terms of IT infrastructure. "Change is always tough and we've sent the region go from virtually no automation to leapfrogging the rest of the world."

"CIOs ask us to show them the best way to optimise their processes. The number one driver for most providers is improving the quality of patient care. There's more emphasis on reducing adverse drug effects and on compliance with Joint Commission International standards," he continues.

"You have trends towards privatised hospital administration and health insurance, all of which demand improved operational effectiveness and appropriate reporting. So there is an emphasis on the quality of the information as well as financial returns," concludes Berner.

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