the challenges and opportunities in british libyan collaboration dr saleh el-gadi, mph, frcp (lond),...
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The Challenges and opportunities in British Libyan
Collaboration
Dr Saleh El-Gadi, MPH, FRCP (Lond), FRCPI, Dip GU Med
Director
Bushra Group
Tel: ++218 (0) 91 780 1097 (Mobile) E-mail: [email protected]
www.bushra-group.com
Economic Indicators
Indicators Libya Tunisia Egypt
Saudi Arabia
UK
GDP (USD billion) 56 33.1 111.8 403.4 2552.7
GDP per capita (USD) 9305.8 3180.3 1519.7 16612.2 41959.8
Inflation rate(consumer
prices,annual %
change)
3.5 2 4.16.2 1 2.4
Source : IMF - World Economic Outlook Database 2007
Health Expenditure indicators Libya
Libya Tunsia
GDP per capita US$ exchange rate 11,322 3,390 2007
Total expenditure on health (per capita) US$ exchange rate
298 174 2007
Government expenditure on health (per capita) US$ exchange rate
214 77 2007
Total expenditure on health of % of GDP 2.6 5.1 2007
General government expenditure on health as % of total health expenditure
71.7 44.1 2007
Out-of-pocket expenditure as % of total health expenditure
28.3 45.6 2007
General government expenditure on health as % of total government expenditure
5.4 6.7 2007
Ministry of health budget as % of government budget 7.5 7.1 2007
Source: World health statistics 2009
The Good Stuff!!
• Growing foreign and Libyan business community.
• Surge in oil prices.
• Privatise the health care.
• The Libyans are very health conscious
• Bushra has considerable clinical and management experience in the
UK
• Bushra has the insight and contacts in Libya
• Bushra is uniquely positioned to provide a valuable and successful
business partner.
IT in the Health Sector - Libyan perspective
Dr Saleh El-Gadi, MPH, FRCP (Lond), FRCPI, Dip GU Med
Director
Bushra Group
Tel: ++218 (0) 91 780 1097 (Mobile) E-mail: [email protected]
www.bushra-group.com
Why change from paper?
• Timeliness: scheduling and provision
• 24hr access, 24/7, 365
• Safety: reduces risk
• Effectiveness:
• Multi -disciplinary practice
• Enables planning, development, evaluation and
evidence use
• Efficiency: productivity improvements, waste reductions,
resource utilisation, cost containment
• HMIS Infrastructure
Network Topology & Network Topology & OSOS
HardwareHardware
Application Application ServersServers
HMISHMIS
HIT Applications
• System wide e-mail with external access via
web
• System wide calendaring
• Intranet
• Shared file systems
• Security (virus protection, firewalls, retinal
scans, thumb prints)
• Personnel systems
Management of information System in healthcare industry
Patient
Doctor
Clinical data systems:Lab system ,EPR
ClinicalFindings
ReasonedProgrammed
Knowledgebase
Decision support system
Advice
Clinical Finding
Clinical Finding
AdviseActions
Forces Demanding Work TransformationR
esu
lt1
24
567
3
8
Management of information System in healthcare industry
Quality
Cost
Managed Care
AccreditationRequirements
Outcomesmanagements
TimelyDecisionMaking
NewTechnologies
Research
Work Transformation
Health Reform
Forces Demanding Work Transformation
Management of information System in healthcare industry
Traditional mode ofpractice
Managed Care
Health Reform
Forces Demanding Work Transformation
Management of information Decision-making levels within an Organization
StrategicDecisionMaking
TacticalDecisionMaking
operationalDecisionMaking
Managed care
Developed of CPR
•Order Entry•Results Reporting•Clinical Data•Network communication
What Goals are to be achieved
How Goals are to be achieved
How goals are implemented
HMIS
Improve Internal communication
CR
M
O
nlin
e c
ata
log
& o
rder
Aft
er
sale
s S
up
port
Fu
ll
Pap
erl
ess
en
vir
on
men
t
Improve Communication
Decision Support
ADMINSTRATION
Financi
al
Clin
ical
Messaging & middle ware
Web
access
Impact on Patient Safety and Risk Management
• In 2000, 44,000 to 98,000 Americans die/year from preventable medical errors1. The number may be twice as high2.
• Medical errors are killing more people per year, in the U.S., than breast cancer, AIDS, or motor vehicle accidents3.
• The lack of immediate access to patient healthcare information is the source of 1/5 of these errors4.
1Kohn, L., J. Corrigan, and M. Donaldson. To Err Is Human: Building a Safer Health System. Committee of Health Care in America, Institute of Medicine. 2000. 2HealthGrades. In-Hospital Deaths from Medical Errors at 195,000 per Year, Health Grades Study Finds. July 27, 2004. 3Institute of Medicine and Centers for Disease Control and Prevention. National Center for Health Statistics: Preliminary Data for 1998 and 1999. 2000. 4Health Research Institute & Global Technology Center. Reactive to Adaptive: Transforming Hospitals with Digital Technology, Price Waterhouse Coopers. 2005.
80% of errors were initiated by:
• missed communication between physicians
• missing information in medical records
• mishandling of patient requests and messages
• inaccessible records
• mislabeled specimens
• misfiled or missing charts
• inadequate reminder systems1.1 Smith, Peter, et. al. “Missing Clinical Information During Primary Care Visits,” The Journal of the American Medical Association. February 2005.
Impact on Patient Safety and Risk Management
Order Entry
Val
idat
ion
Financial RECORDS
Results Reporting
Network communication
Clinical data
Results Reporting
Results Reporting
LABRadiology
Pharmacy
Blood bank
diet
O/R
Drug to Drug interactionDrug to food interactionDrug to allergy Drug to diagnosis Drug to medicationAvoid spilling errorsMaximum dose for high-risk drugs
Review orders results from Medical record
Forces Demanding Work Transformation
Clinical knowledge Data Base
Contract rules & exceptions
Management of information System in healthcare industry
Quality
Work Transformation
MonitorCreate Standards for health procedures or use DRG
Compare actual practice against standards
Generate Key performance indicators
Corrective action
Forces Demanding Work Transformation
UK
• Electronic Patient Record – a Detailed Care Record to be shared locally and a Summary Care Record available nationally
• Electronic Transfer of Prescription Service, • Choose & Book system (enabling patients to
choose when and where they receive treatment) • Picture Archiving and Communications Services
(PACS) systems in Acute services• Secure e-mail (NHSmail)
Management of information System in healthcare industryIs it Worth it?
Improve Quality, productivity, capacity, access
Reduce cost
Goals