With HIMSS last week in the United Arab Emirates (UAE) and Arab Health just weeks away Data, Innovation and Integration are the key words making headings in Gulf Healthcare.  This is not only in the Gulf, it’s reminiscent of the global Healthcare market.

The UAE Healthcare system is still in a steep growth curve both in the public and private sector.  Mandatory Health Insurance in two out of the seven Emirates (accounting for 70% of the population) is a large driver in the growth of the private healthcare market. Individual healthcare operators are still entering the market alongside larger corporations procuring existing healthcare groups, which is evidence of multiple expansions by major investors in the UAE.

Health Information Systems (HIS) have been a main stay for many years, now the drive is to move to Electronic Medical Records (EMR).  The public healthcare operators have all implemented or are implementing the traditional big player EMR’s, but for the private sector the decision is a lot harder to make.  Many have been integrating 3rd party applications with their HIS for years in order to meet the current need for compliance, be it regulatory, financial or quality driven.

EMR Procurement – best of brand vs best of breed

The EMR procurement process is lengthy and it’s a significant investment that will form the backbone of the hospitals organisation for years to come.  The internal requirements gathering, prior to the public tender being released has been known to take 12 months plus for many hospitals.  The drive for “best of brand” over “best of breed” is strong due to legacy years managing multiple vendors for numerous applications and with varying levels of integration.  Is this the right approach?

The UAE currently has 13 HIMSS Level 6 Hospitals, and the Kingdom of Saudi Arabia 3. This is significant when there are only 30 across the whole of Asia.  

The key component going forward in the Gulf is the Health Information Exchange (HIE) that will connect healthcare regulatory authorities, healthcare providers, insurance companies, pharmacies and residents. With the private sector catering to a significant percentage of the population they need to be able to tap into the HIE for it to have the desired effect.  With the National eHealth strategy still being defined across the three governing bodies, this adds an extra conundrum to the private sector procurement process.

1. The ‘best of brand’ – Is a hard ask

Selecting a “best of brand” solution that meets ‘today’s needs’; fully integrated from the Patient Administration System to Revenue Cycle Management, incorporating relevant specialities, enabling all clinical capture, compliant with ICD-10 coding standard and current insurance requirements, yet have the malleability to grow with organisations and incorporate the compliance requirements for the next five years without crippling fees, is a hard ask.  Add to that, ideally wanting a system that is already proven in all of these areas, proven in the region and is also within budget, it seems an impossible task.

2. The ‘best of breed’ Consortium

The consortium approach appears to be gaining momentum, enabling hospitals to incorporate “best of breed”, but with a one contract, prime vendor approach. With the private sector taking a more specialist approach to their growth, aiming at niche markets and opening speciality clinics, the “best of breed” with affordable customisation will enable them to get the most from their EMR without requiring them to procure standardised content and modules they don’t need.

How many companies are currently ready to head these consortiums, taking responsibility for the bond and to project manage this multiple vendor approach?  How much extra are hospitals paying for this single vendor security peace of mind?  Does it really enable “best of breed” or offer hospitals a multiple vendor approach from their already defined group of accredited vendors?

3. The ‘best of breed’ In-house

Or is it in the hospitals best interest to continue with the status quo procurement architecture.  Multiple contracts with vendors that meet their business needs.  Incorporating an integration engine to meld these applications together keeping the IT and project management of these critical decisions in-house?

Procuring the application that best suits the Hospitals business today and going forward, is a priority.  Coordinating the design of the architecture and the project management with their own team – ensure the governance and financial strings stay firmly controlled by the Hospital, an obvious benefit.  Using integration to be innovative in their approach provides the Operator with the Data requirements that best suit their needs.   While this approach does require more resource input from the Operator, it also ensures the decision makers are driven by the best interests of the Hospital.  

Fast Healthcare Interoperability Resources (FHIR) combine modern, RESTful web services with an easy-to-consume data model which provides plug ‘n’ play interoperability between conformant systems.  It replaces the reliance on point-to-point, or even point-to-hub integration alleviating the legacy integration concerns.  

Jessica is Branch Manager of Sláinte Healthcare’s UAE Operation, based out of our offices in Abu Dhabi. Jessica has primary responsibility for the management of the Operational and Administrative functions for our activities in the Middle Eastern region. With over 10 years experience in high value customer and vendor management, as well as a background in FMCG, Jessica brings a wealth of experience to our team, having worked in roles across most business disciplines including sales, marketing, communications, national category and account management. Jessica has represented Sláinte at the HIMSS, Hospital Build and Infrastructure and other eHealth conferences in the UAE and worked with clients including SEHA.