The Challenges and
opportunities in British Libyan
Collaboration
Dr Saleh El-Gadi, MPH, FRCP (Lond), FRCPI, Dip GU Med
Director
Bushra Group
www.bushra-group.com
Tel: ++218 (0) 91 780 1097 (Mobile)
E-mail: drelgadi@bushra-group.com
Economic Indicators
Indicators
GDP (USD billion)
GDP per capita
(USD)
Inflation rate
(consumer prices,
annual % change)
Libya
Tunisia
Egypt
Saudi
Arabia
56
33.1
111.8
403.4
2552.7
9305.8
3180.3
1519.7
16612.2
41959.8
3.5
2
4.16.2
1
2.4
UK
Source : IMF - World Economic Outlook Database 2007
Health Expenditure indicators
Libya
Libya
Tunsia
11,322
3,390
2007
298
174
2007
214
77
2007
Total expenditure on health of % of GDP
2.6
5.1
2007
General government expenditure on health as % of total
health expenditure
71.7
44.1
2007
Out-of-pocket expenditure as % of total health
expenditure
28.3
45.6
2007
General government expenditure on health as % of total
government expenditure
5.4
6.7
2007
Ministry of health budget as % of government budget
7.5
7.1
2007
GDP per capita US$ exchange rate
Total expenditure on health (per capita) US$ exchange
rate
Government expenditure on health (per capita) US$
exchange rate
Source: World health statistics 2009
The Good Stuff!!
• Growing foreign and Libyan business community.
• Surge in oil prices.
• Privatise the health care.
• The Libyans are very health conscious
• Bushra has considerable clinical and management experience in the UK
• Bushra has the insight and contacts in Libya
• Bushra is uniquely positioned to provide a valuable and successful business
partner.
IT in the Health Sector - Libyan
perspective
Dr Saleh El-Gadi, MPH, FRCP (Lond), FRCPI, Dip GU Med
Director
Bushra Group
www.bushra-group.com
Tel: ++218 (0) 91 780 1097 (Mobile)
E-mail: drelgadi@bushra-group.com
Why change from paper?
• Timeliness: scheduling and provision
• 24hr access, 24/7, 365
• Safety: reduces risk
• Effectiveness:
• Multi -disciplinary practice
• Enables planning, development, evaluation and evidence use
• Efficiency: productivity improvements, waste reductions,
resource utilisation, cost containment
•
HMIS Infrastructure
HMIS
Application Servers
Network Topology & OS
Hardware
HIT Applications
• System wide e-mail with external access via web
• System wide calendaring
• Intranet
• Shared file systems
• Security (virus protection, firewalls, retinal scans,
thumb prints)
• Personnel systems
Management of information System in healthcare industry
Forces Demanding Work Transformation
Decision support system
Patient
1 Clinical
Findings
Result
7
6
Advise
Actions
Doctor
5
Advice
Reasoned
Programmed
8
2 Clinical Finding
Clinical data systems:
Lab system ,EPR
3
4
Knowledge
base
Management of information System in healthcare industry
Forces Demanding Work Transformation
Quality
Managed
Care
Outcomes
managements
Research
Work
Transformation
Health Reform
Cost
Accreditation
Requirements
Timely
Decision
Making
New
Technologies
Management of information System in healthcare industry
Forces Demanding Work Transformation
Traditional
mode of
practice
Health
Reform
Managed
Care
Management of information
Decision-making levels within an Organization
Managed care
Developed of CPR
What Goals are to be achieved
Strategic
Decision
Making
Tactical
Decision
Making
•Order Entry
•Results Reporting
•Clinical Data
•Network
communication
operational
Decision
Making
How Goals are to be achieved
How goals are implemented
Improve Internal communication
Web access
HMIS
Financial
Clinical
Decision Support
Messaging & middle ware
CRM
Full Paperless
environment
ADMINSTRATION
Online catalog & order
Improve Communication
Impact on Patient Safety and Risk Management
• In 2000, 44,000 to 98,000 Americans die/year
from preventable medical errors1. The number
may be twice as high2.
• Medical errors are killing more people per year, in
the U.S., than breast cancer, AIDS, or motor
vehicle accidents3.
• The lack of immediate access to patient
healthcare information is the source of 1/5 of
these errors4.
1Kohn,
L., J. Corrigan, and M. Donaldson. To Err Is Human: Building a Safer Health System. Committee of
Health Care in America, Institute of Medicine. 2000.
2HealthGrades. In-Hospital Deaths from Medical Errors at 195,000 per Year, Health Grades Study Finds. July
27, 2004.
3Institute of Medicine and Centers for Disease Control and Prevention. National Center for Health Statistics:
Preliminary Data for 1998 and 1999. 2000.
4Health Research Institute & Global Technology Center. Reactive to Adaptive: Transforming Hospitals with
Digital Technology, Price Waterhouse Coopers. 2005.
Impact on Patient Safety and Risk Management
80% of errors were initiated by:
• missed communication between physicians
• missing information in medical records
• mishandling of patient requests and messages
• inaccessible records
• mislabeled specimens
• misfiled or missing charts
• inadequate reminder systems1.
Smith, Peter, et. al. “Missing Clinical Information During Primary Care Visits,” The Journal of the
American Medical Association. February 2005.
1
Forces Demanding Work Transformation
Drug to Drug interaction
Drug to food interaction
Drug to allergy
Drug to diagnosis
Drug to medication
Avoid spilling errors
Maximum dose for high-risk drugs
LAB
Radiology
Order Entry
Validation
Pharmacy
Network
communication
Blood bank
Results Reporting
Review orders results from Medical record
diet
Results Reporting
Clinical data
Clinical
knowledge Data Base
Financial RECORDS
Results Reporting
Contract rules
& exceptions
O/R
Management of information System in healthcare industry
Forces Demanding Work Transformation
Quality
Monitor
Create Standards for health procedures or use DRG
Work
Transformation
Compare actual practice against standards
Generate Key performance indicators
Corrective action
UK
• Electronic Patient Record – a Detailed Care
Record to be shared locally and a Summary
Care Record available nationally
• Electronic Transfer of Prescription Service,
• Choose & Book system (enabling patients to
choose when and where they receive treatment)
• Picture Archiving and Communications Services
(PACS) systems in Acute services
• Secure e-mail (NHSmail)
Management of information System in healthcare industry
Is it Worth it?
Goals
Improve Quality, productivity, capacity, access
Reduce cost