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Case Studies
SEHA (Abu Dhabi Public Health System Operator) operates 12 hospitals with 2,644 beds, 62 Primary and Ambulatory Health Clinics and 2 blood banks. It employs a bout 17,000 physicians, nurses, technicians, allied health and administrative personnel. SE HA is working to earn the trust of the public and be their healthcare partner for life. We a re partnered with international healthcare leaders recognized for their outstanding performance in their markets. Our partners include Johns Hopkins Medicine, Cleveland Clinic, Fresenius Medical Care and Dell.
IT plays a critical role in health care reform. Health IT includes front office services (doctor and nurse), traditional back office functions, quality reporting, patient safety systems and direct use by our customers, patients and families.
Many health locations worldwide have IT systems deployed in a fragmented manner, many instances of software located i n many locations. Prior to 2007, SEHA had multiple stand-alone Health Information Systems, with different solutions in different facilities. This was a result of a strategy as directed by HAAD (Health Authority Abu Dhabi) to support individual facility autonomy and possible future private sale. In 2009 the SEHA strategy was changed to a journey towards an integrated health system. SEHA group ITD was re -formed and aligned in 2009 to support this health business directive. ITD started a strategy to establish central enterprise solutions that supports all facilities.
Today, all primary care facilities and all hospitals are serviced by a single Cerner domain. The Abu Dhabi Cerner ranking (data provided by Cerner) in 2011 compared to all Cerner AMS/OMS clients worldwide is:
The The profession of IT is more than technology components, it is the job of improving and delivering IT itself. 2012 introduced the next evolution of SEHA ITD (Information Technology Division), recognizing the need to expand SEHA IT footprint from physician experience to increased support of the patients’ direct experience, to continue standarizing and to systematically guide the department’s ITD maturity.
To support this direction, a new ITD function of Enterprise Architecture was established. An RFP was issued for the acquisition of an EAMS (Enterprise Architecture Management System), with Orbus Software’s iServer EA tool based on TOGAF 9 being selected.
“It is fundamental for Information Technology to take as close a view of how it delivers technology as it does to the technology itself. This has to star t by taking a close look at what does SEHA require moving forward and where i s IT trying to progress the company”
Robert Pickton
SEHA Group Chief Information Officer
Enterprise architecture and improving the Patient Experience
A program in 2012 was planned to look at the ITD (Information Technology Division) maturity and approach toward s enterprise systems management. In relation to assessing the ITD maturity some specific challenges facing SEHA ITD in 2012 needed to be addressed. These included:
Today, all primary care facilities and all hospitals are serviced by a single Cerner domain. The Abu Dhabi Cerner ranking (data provided by Cerner) in 2011 compared to all Cerner AMS/OMS clients worldwide is:
1) The role of IT in patient experience and self-help is described by the term eHealth. eHealth is a global movement t hat is happening as we speak. eHealth is the use of internet technologies used directly by patients, families and care givers with their health and wellness. The use of eHealth IT can help to transform the patient experience and offers new opportunities for provider assisted patient centered care options.
2) Communicating IT value is often a challenge in many organizations. At SEHA we recognized how public appreciation can assist executives understand how IT can be a strategic differentiator. SEHA I TD looked for ways that IT communication could support SEHA brand awareness and positive community messaging.
3) Revenue management required transformation at SEHA, to adapt to the regulatory and economic environment. Revenue management also needed to be adding value by maximizing revenue generation and capture, and avoid leakage. Some challenges in developing a revenue management program included:
4) It was determined that a ref resh to the service desk was required for IT Infrastructure Operations.
5) It was determined that an Enterprise Architecture (EA) function was to be established to assist the Office of the CIO wit h IT Strategy, Governance and Standardization and eHealth planning. Previously technology was often were run as individual projects but as many of us have learned the hard way, launching new technology initiatives in isolation, no matter how promising they may seem, is a recipe for disaster. You have to have a master plan.This is why SEHA decided to start an E A approach to managing the Enterprise IT Package / Solution set.
The solution for assessing the ITD maturity was to start the CIO analysis and Enterprise Architecture with a review of the business architecture, an in depth look of w here SEHA IT was targeting to support over a three year and a five year journey. Within this context, solution components focused on the following four tactics:
1. Role of IT to help transform the patient experience, support a healthy society
When developing the strategic role of IT, SEHA includes the following factors:
Supporting this objective component, the solution was delivered in two broad initiatives.
Initiative 1: HIMSS
To give validity to IT programs, people must trust the solutions and services provided. The approach by SEHA to instill trust in the integrated internal (health provider) IT system is for SEHA to utilise the international healthcare information accrediting organisation, HIMSS. HIMSS is a global organization that collects and analyzes healthcare organization data relating to IT processes and environments, products, IS department composition/costs, IS department management metrics, healthcare delivery trends and purchasing related decisions. HIMSS accreditation covers the use of IT in hospitals for Quality, Safety & Efficiency improvements.
Initiative 2: eHealth Strategy
To initiate the strategy and planning of patient experience and community care as a health system. Providing community- wide systems is much more complex than deploying smaller or short-term pilot projects, since, to avoid fragmentation, poor communication and poor interoperability, integration wit h existing systems becomes vital. Systems intended to work in large settings need to em body an architecture that supports unique identifiers for patients, as well as open standards for data coding and exchange, to make it possible to integrate the novel systems with existing information systems and other new initiatives.
2. Promote awareness of the contribution of IT
SEHA has successfully built an integrated clinical support system that combines Cerner technology and a three year program to customise Cerner for local conditions. The solution for IT awareness and communication was to establish a new brand an d marketing campaign to communicate the EMR (Electronic Medical Record, used by Physicians and Nurses) IT solution. A plan was built for SEHA to unify the EMR (electronic medical record, health information solution)under one brand. The IT marketing plan included t he following:
ITD made significant progress i n it planning and strategy function in 2012. Some of the specific outcomes that demonstrate SEHA’s ITD
1. Role of IT to help transform the patient experience, support a healthy society
Diagram: Demonstrating H IMSS Adoption in the US. SEHA achieved 3 0% of all hospital reaching Stage 6 in 2012.
SEHA initiated a health sector conversation on the role of eHealth and included planning across business divisions, clinical affairs, and strategy division and with external stakeholders. Development of the eHealth concepts was progressed along side discussions of primary health care transformation, for an integrated and coordinated approach towards World Class healthcare.
Awareness of opportunities to i mprove patient experience was established and an approval for developing an eHealth strategy was received.
2. Promote awareness of the contribution of IT
The EMR (Electronic Medical Record, used by Physicians and Nurses) system will now be known as Malaffi in both English and Arabic. Meaning “my file” in English, the name ‘Malaffi’ preserves the essence of confidentiality and patient privacy.
Diagram: The SEHA Malaf fi IT brand and an example of newspaper article
3. Supporting revenue management to minimize lost revenues;
The revenue management prog ram executed and launched in one major facility for analysis of success before rolling out to all facilities. The launch and post analysis w as successful and roll-out to remaining facilities in 1Q 2013 was given.
Some of the benefits and outcomes of the revenue management program were:
4. Implement IT Infrastructure Operations service desk and ITIL.
An RFP was successfully completed for the selection of a service desk vendor and a consultancy to assist the implementation of ITIL in IT infrastructure operations. The project implementation started late 2012 for a 2013 delivery.
5. Establishing a new EA function to support standardization.
The initiation of an EA function was successful. An RFP for an EAMS (Enterprise Architecture Management Tool) was successfully executed and completed. Orbus iServer was the selected winner of the tender. Some of the benefits that SEHA will lo =ok to develop within IT EA (Enterprise Architecture) and the Orbus iServer platform are:
