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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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