Onboarding of HIEs in the GCC – the physician’s perspective

Key territories in the GCC are making progress with the implementation of their health information exchange (HIE) systems, a subject that will be delved into in more detail at the upcoming 6th GCC eHealth Workforce Development Conference (eHWDC 2023).

Scheduled from 31 October to 2 November 2023 at Jumeirah Emirates Towers, the event will focus on critical digital health topics, with a particular emphasis on the examination of different HIEs and their clinical onboarding.

But just where do key markets stand at present?

In the United Arab Emirates, Abu Dhabi’s HIE, Malaffi, will eventually fully combine data with Dubai’s Nabidh under the country’s national Riayati programme.

Earlier this year, Ali Juma Alajme, then Director of Digital Health at the UAE’s Ministry of Health and Prevention told HIMSS that the country is on track to provide a unified medical record through a national HIE.

“It’s for better healthcare services and better outcomes for the community,” he said.

Over in Saudi Arabia, the launch of part of the National Platform for Health and Insurance Exchange Services (NPHIES) is scheduled to take place before the end of the year.

Dr. Ahmed Balkhair is Advisor to the Saudi National Health Information Center. He is one of the region’s prominent figures in healthcare appearing at eHWDC 2023.

Ahead of the event, Dr. Balkhair reveals that, for the Saudi healthcare sector, NPHIES is a “dream” project.

“This project is a significant achievement, a dream for us,” he says. “It is a unique project of its kind, as for the first time, [we will see both] clinical and financial data exchange centrally managed by the NPHIES platform nationwide, providing practitioners with a comprehensive 360-degree view of every patient. The HIE will no doubt contribute to more efficient healthcare management, reducing costs and times, while enhancing patient satisfaction and safety, and sustainability.”

In Qatar, while there’s a simpler HIE currently in operation between the two of the country’s largest healthcare organisations, Hamad Medical Corporation and Sidra Medicine, there are plans to launch a national one in the coming months. Managed by the Ministry of Public Health, the Qatar Health Information Exchange (QHIE) is anticipated to connect both public and private healthcare entities.

Another well-known figure in digital health attending eHWDC 2023 is the Chief Medical Informatics Officer and Senior Attending Physician of Emergency Medicine at Sidra Medicine, Dr. Khalid Alyafei. Sharing Dr. Balkahir’s sentiments, he believes that a national HIE would be beneficial for the nation.

“The QHIE will add a lot of value; it greatly benefits healthcare by providing doctors with comprehensive patient information, such as previous visits, complaints, treatments, medications, allergies, and procedures performed, ensuring faster and safer care delivery,” he says. “The prospect of a national-level HIE, which will be able to exchange images and implement e-prescriptions in the future, holds great promise.”

Dr. Balkhair also believes that Saudi’s NPHIES will greatly enhance a physician’s ability to provide superior care, as well as enhance billing processes.

“With a unified record, a physician gains a holistic view of a patient’s healthcare journey, streamlining processes like insurance approvals,” he explains. “This system allows the physician to access data from various sources, enabling more informed decision-making. The system will also ensure that all relevant processes and financial transactions run smoothly, ultimately making the physician’s work more efficient, improving quality, speed, safety, and patient satisfaction.”

HIE CHALLENGES

Like any implementation of new technology, the adoption of an HIE is bound to come with its share of challenges, both physicians agree.

For Dr. Balkhair, the first hurdle is the sheer volume of data to be managed.

“Challenges are an inherent part of implementing such systems. In some countries, one major challenge has been the sheer volume of data collected,” he explains. “In clinical settings, physicians may encounter a flood of results from various sources; so it may require introducing pop-up visual interface agents to assist physicians in identifying the most recent patient results or using AI as a co-pilot to support the physician in their decision-making process.”

A second challenge is getting providers enthusiastic about using it.

“The system should be user-friendly, and healthcare organisations could be incentivised to adopt it efficiently,” Dr. Balkhair continues. “Initial adopters may encounter some challenges, which can be addressed through a soft launch, but it’s important to acknowledge that such projects tend to be time-consuming and budget-intensive.”

For Dr. Alyafei, the quality of patient registration is also a concern.

“An HIE heavily relies on automated matching, where it seeks specific criteria such as the Qatar Identity [QID] number, full name, and date of birth,” he says. “If there are errors during the registration process, like missing or incorrect information, it can lead to problems with the automated matching.”

One final consideration that organisations need to make, adds Dr. Alyafei, is “technical failure”.

“This can include system downtime or power outages; we are constantly working on development to anticipate and address future challenges.”

AI WITHIN HIEs

The role of artificial intelligence (AI) in healthcare has been a topic of great debate this year. And its usage is not to be underestimated within HIEs, states Dr. Balkhair, who has already highlighted its role as a co-pilot.

“The vast amount of data of an HIE can be significantly streamlined with the assistance of AI. It can serve as a valuable co-pilot for physicians, providing clinical support,” he says. “AI can also benefit financial systems by enhancing fraud protection and supporting policymakers in working with various stakeholders.”

IMPACTING THE FUTURE OF HEALTHCARE

In the GCC, particularly within the UAE, KSA, and Qatar, both precision medicine and value-based healthcare are considered of great importance in shaping the future of healthcare in the region.

At present, Qatar runs a national newborn screening programme that checks for potential issues such as metabolic and endocrine diseases.

Having this information centralised via the QHIE will shape precision medicine going forward, predicts Dr. Alyafei.

“A family doctor having access to a family’s genome enables them to provide comprehensive counselling and better patient management,” he says. “The national newborn screening includes metabolic and genetic screening, and this information can help us predict future health issues and facilitate early intervention. Having this centralised can help us detect and manage earlier and reduce emergency cases.”

HIE data will also help shape future medical programmes in Saudi Arabia, says Dr. Balkhair.

“When we aggregate data from various sources – clinical, socio-economic, genomic, environmental, and mental health data – it enables us to better understand how to support precision medicine in clinical services and gain insights into population health trends and changes,” he says. “It will also support the shift toward value-based healthcare services, focusing on outcomes rather than just outputs.

“The proliferation of data from sources like our HIE has the potential to transform the entire healthcare landscape in the region.”

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