Ehealth strategy review
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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 abu dhabi s ceos voted for in 2009

What Abu Dhabi’s CEOs voted for in 2009


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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