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eHealth Strategy review. CEO conference. 4 May 2011. Agenda. Introduction McKinsey eHealth maturity diagnostic HAAD’s perspective General Discussion Moving forward . Objective for today. Review and recommit to strategic direction + road map for eHealth in Abu Dhabi.

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Ehealth strategy review

eHealth Strategy review

CEO conference

4 May 2011


Agenda
Agenda

Introduction

McKinsey eHealth maturity diagnostic

HAAD’s perspective

General Discussion

Moving forward


Objective for today
Objective for today

  • Review and recommit to strategic direction + road map for eHealth in Abu Dhabi


What is ehealth
What is eHealth?

  • eHealth is anything electronic that we find useful in healthcare


What is relatively e asy to achieve
What is (relatively) easy to achieve?

  • Use existing assets and processes differently

  • Technology already implemented

  • Minimal investment needed

  • Minimal clinician change required

  • KEH

  • Post Office

  • Emirates ID card


Use existing assets processes differently
Use existing assets+processesdifferently

  • HAAD

  • Collects data

  • Uses data

  • Shares data

You

  • Exchange coded data

  • Streamline internal processes

  • Eligibility

  • KEH

  • Registration

  • Enrolment

  • eRecord

  • Post Office

  • Emirates ID card

  • EIDA

  • Creates identity card

  • Authenticates securely

  • Shares person information



What has haad regulated in terms of priorities
What has HAAD regulated in terms of priorities

Achievements

Next steps

eAuthorisation

  • Healthcare entities to start…

  • Users propose business rules

  • Transactions defined by DSP

  • HAAD infrastructure ready

  • Standard Contract requires it

ePrescription

  • Transactions defined by DSP

  • PBM standard released

  • Users propose business rules

  • Payers to begin enforcing…

eRecord

  • Data available in KEH

  • Access clarified by Access Panel

  • EIDCardMoU signed with EIDA

  • EIDA web service missing

  • Providers submit claims late

eLicensing

  • Process automation under way

  • PQR under review

  • Privileging framework released

  • Based on feedback still a long way to go


Detail priorrequest priorauthorization
Detail PriorRequestPriorAuthorization

Facility Request

Is Member active?

Is Facility in network?

Does network cover [elective]?

Is condition covered?

Authorization

Prescription

Facility submits

PriorRequest

MemberID+PayerID

FacilityID

EncounterType

Diagnosis

Activity

Observation

Payer submits

PriorAuth`n

Response

[Comment]


Technical detail eprescribing
Technical Detail ePrescribing

Doctor*

Payer

Post Office

PriorRequest Prescription

PriorAuthorization

Pharmacy

Prescription

ClaimSubmission

RemittanceAdvice

*Can also be the Pharmacy, if the Doctor did not him/herself e-Prescribe


Technical detail authentication with emiratesidcard
Technical Detail: Authentication with EmiratesIDCard

Providers

ADSIC

Device/driver

Payers

Authenticate

Authentication

Log

Submit claim

HAAD

Audit authentication event

Remit claim


What abu dhabi s ceos voted for in 20091
What Abu Dhabi’s CEOs voted for in 2009

Significant regulatory progress

Public Cube + free HAAD software

www.weqaya.ae

Mandatory observations (e.g., HbA1c)

Provider rating system

www.haad.ae

www.haad.ae

CPT codes activated


Remaining regulatory road map
Remaining regulatory road map

  • EmiratesID card authentication

  • Turnaround time

  • Reconciliation

  • Devices

  • Explore interoperability of health record


Provocative thoughts
Provocative thoughts

  • Do you agree?

  • Why?

  • How can HAAD help?

  • Regulation “done” (except EID card)

  • Execution is key

  • Capturing Benefits is [too] slow*

* Providers: Who is still photocopying insurance cards?

Payers: Who auto-adjudicates <80% of claims?


I am comfortable with the strategic direction as set out in 2009 voting in workshop
I am comfortable with the strategic direction as set out in 2009Voting in workshop

Voting on 4 May by stakeholders – Payers, Providers, HAAD and Vendors


My biggest challenge in capturing value from ehealth is
My biggest challenge in capturing value from eHealth is

Voting on 4 May by stakeholders – Payers, Providers, HAAD and Vendors


Next steps
Next steps

HAAD

  • Focus regulatory efforts on ensuring the EmiratesIDCard can be used for healthcare as a top priority

  • Limit brand-new regulations for a while, until the bulk of the changes started have been digested

  • Invest in further strengthening governance for making operational tweaks to existing regulations

    • Increase lead times, and pre-decision discussion (in general)

    • Develop an orientation roadmap with indicative timelines for changes

    • Apply any changes to all healthcare entities concurrently, to ensure a level playing field (whenever possible)

  • Review eHealth Strategy at least annually to maintain alignment

  • Actively suggest and shape the detail of new eHealthregulations – specific rules for the PriorRequest/PriorAuthorisation transaction set, and electronic prescribing in particular. (On the basis of strong content suggestions from stakeholders, Andrey Timoshkin, Chair of the Data Standards Panel, will invite for a workshop to develop the relevant business rules)

Stake-holders


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