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eHealth Strategy review

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

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  1. eHealth Strategy review CEO conference 4 May 2011

  2. Agenda Introduction McKinsey eHealth maturity diagnostic HAAD’s perspective General Discussion Moving forward

  3. Objective for today • Review and recommit to strategic direction + road map for eHealth in Abu Dhabi

  4. What is eHealth? • eHealth is anything electronic that we find useful in healthcare

  5. 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

  6. 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

  7. What Abu Dhabi’s CEOs voted for in 2009

  8. 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

  9. 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]

  10. 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

  11. Technical Detail: Authentication with EmiratesIDCard Providers ADSIC Device/driver Payers Authenticate Authentication Log Submit claim HAAD Audit authentication event Remit claim

  12. 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

  13. Remaining regulatory road map • EmiratesID card authentication • Turnaround time • Reconciliation • Devices • Explore interoperability of health record

  14. 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?

  15. 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

  16. My biggest challenge in capturing value from eHealth is Voting on 4 May by stakeholders – Payers, Providers, HAAD and Vendors

  17. 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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