The impact of National Health Information Exchange on KSA’s Healthcare system

The future of the healthcare in Saudi Arabia, in line with Vison 2030 of the government will be driven by ‘value-based care’ where the system is built around the patient rather than the health institutions. A value-based care empowers the patient since in this system the payment is based on successful outcome of the procedures rather than of their number. A National Health Information Exchange (NHIE) can play an important role to achieve the vision of value-based care by fuelling this system with necessary data. An Electronic health information exchange (HIE) allows doctors, nurses, pharmacists, other health care providers and patients to appropriately access and securely share a patient’s vital medical information electronically- improving the speed, quality, safety, and cost of patient care.” HIE can help in building a database for the medical data of the whole population of a country. This data can enable country to transform its healthcare sector, creating a better ecosystem for the patient, accelerate innovations and applying latest technology in healthcare. A central medical database of the nation will also help in addressing transnational heath issues such as a pandemic. 

NHIE has been successful in many countries where it has been implemented, however its potential must be assessed in the context of the local environment, which may differ significantly from other countries where it has been effective. Patient data is generated throughout the healthcare organization, in all departments and at all stages of treatment, making it a highly information-intensive sector. It will be vital to offer reliable information technology solutions to integrate enormous volumes of data to produce complete and trustworthy patient records.

Potential Benefits:

Data on one platform: The goal of the government by implementing the Health Information System is to bring the medical data of all the citizens of the kingdom on one platform. This will give government access to the public health data and in turn help them in planning new healthcare programs and formulating health policies. The NHIE will increase the speed and ease for the transfer and retrieval of data and will improve the efficiency and accuracy of the data by minimizing the errors. It will also minimize the possibility of loss of data due to misplacement.

Applying Data Analytics:  The NHIE will create a centralized repository of medical data, which will be helpful in applying Descriptive, Diagnostic, Prescriptive and Predictive analytics. This will help in diagnosis of chronic diseases, identifying trends of diseases, people who are at highest risk of certain diseases and the lifestyle factors contributing to specific disease. It will also be helpful in prediction and early identification of the outbreak of the diseases.

Research and Development: The data from NHIE will be very helpful for the research and development in medical, pharmaceutical, and medical equipment industries. It will enable scientist to apply Artificial Intelligence and Machine learning to make break through research in treatment of complex diseases, developing new drugs, keeping track of effectiveness or ineffectiveness of existing drugs, identifying patterns and subtle trends in specific diseases. It will also help in developing next generation medical equipment that will provide more accurate and detailed insights for diagnosis and performing complex surgeries.

Supporting Medical Decisions: The NHIE will enable point-to-point transfer of data enabling different practitioner to retrieve data when necessary. In case of emergency the practitioner will be able to timely access the medical data of the patient. All important information (like medical history, allergic details like drug, food allergy, etc.) will be available to the practitioner which will help in making better decisions in diagnosis, prescription, and prognosis of the patient. The on-time availability of information will also reduce duplication of tests and procedures on patients.

Risk Management: Due to poor eating habits a big portion of the population of KSA is susceptible to risk of chronic illness at earlier age. According to Global Obesity Observatory, Obesity Risk Rating of KSA is 7 out of maximum 10 and 42.7% men and 32.7% women are overweight. The Children Obesity Risk Rating is 7.5 out of 11. The NHIE system will help in keeping track of overall health of the population in the kingdom and controlling the outbreak of any contagious disease. It will also help in keeping track of the health of people who are at high risk due to chronic illness.

Patient Satisfaction: The aim of healthcare is not the cure but to prevent the disease in the first place. The NHIE will help in early diagnosis of the diseases, timely scheduling of appointment of patients, access to better medical practices and reduce the time spent by patients in hospitals. It will help in delivering the treatment to the patient on time and increase the life expectancy of the people. Overall, it will put patients at the centre of healthcare system.

Implementation in Saudi Arabia:

NHIE implementation in Saudi Arabia is sponsored by Ministry of health (MoH). Continuous technology advances in the healthcare system are anticipated on two fronts within the Saudi Health Information Exchange (SHIE) framework. The first is the deployment of secure technological solutions that allow for more efficient patient care through online health records. The second step is to make de-identified patient data available so that research may be conducted. This may be utilized by both the public and private sectors to guide public health policy responses (e.g., epidemic containment and prevention, or targeted health awareness programs), as well as to create novel therapies and medications. Both public and private-sector researchers will profit. The government is also replacing traditional Fees-for-Service (FFS) model of health care with Value-Based care model to provide a ‘People-Centred’ healthcare system. This will directly benefit the patients and improve the delivery of treatment while simultaneously decrease the cost bared by them. 

 The traditional fee-for-service v/s Value-Based Care model

Source-: Fakkert, M, Eenennaam, F. V., & Wiersma, V. (2017). Five reasons why value-based healthcare is beneficial. HealthManagement.org

Saudi Arabia has appointed New Zealand based global software company Orion Health to build world’s largest Health Information Exchange for the Kingdom. Orion Health provide healthcare solution across 15 countries globally. In 2019, Orion Health launched the Middle East's first NHIE platform. It won the contract to create the Malaffi NHIE from Abu Dhabi Health Data Services, a joint venture between Abu Dhabi's Department of Health and Injazat Data Systems. According to the press release by the government of Saudi Arabia the NHIE system will take data from 5,000 government and private health institutions to build a data repository of around 32 million people with a capacity to cover 50 million people.

The NHIE will play a vital role in the future of Healthcare in Saudi Arabia. The upcoming trends in healthcare such as Telemedicine heavily relies on the availability of the reliable data. The implementation of telemedicine or telehealth will further enhance the effectiveness of the healthcare system of the Saudi Arabia. But government need to make sure that there is a reliable information technology system in place to support it.

Kingdom of Saudi Arabia still lacks the talent pool and adequate number of medical professionals. The government need to heavily invest in medical and pharmaceutical educational institute to back the healthcare department. Future infrastructure will need a collaborative and adopt a unified approach, which includes all the stakeholders. The government will need to involve private players to make sure that sufficient funding and cutting-edge technology is available to give the people of KSA the best possible healthcare solution.