National Healthcare Technology Platform Interoperability concern in healthcare François Gros, Beirut, July, 10th

At the beginning was the patient

An actor of his health Aging population Chronic diseases Empowerment Involvement Expectation Disruptive? Life Expectancy raised from 71,6 in 1994 to 79,4 in 2014 in Lebanon Uberization of healthcare? Hospital/GP Rating? The most frequently observed non communicable diseases are asthma, chronic obstructive pulmonary diseases, diabetes, hypertension and cardiovascular diseases.(source WHO) Self-assessment Web booking Apps Millions à websites dedicated to healthcare iOT Patient social networks Quantified self Wellbeing

With different kind of risk Level 3 Highly complex patients Case management 3 to 5% Level 2 High Risk patients Disease management 15 to 20% Level 1 Well controlled patients Supported self-care 70 to 80% Global population Healthy people Health improvement & promotion The Kayser-Permanente Pyramid

Using different kind of facilities General Practitioner Primary care center Hospitals Emergency Pharmacy Insurance

All working together General Practitioner Insurance Reimbursement Assessment Insurance Primary care center Claim Medical report Drug consumption Pharmacy Hospitals Referral Letter Emergency Prescription Discharge letter

? Where is the patient? General Practitioner Insurance Reimbursement Assessment Insurance Primary care center Claim Medical report ? Drug consumption Pharmacy Hospitals Referral Letter Emergency Prescription Discharge letter

How to make this efficient?

How to make this efficient? Share information Medical information Insurance information Demographic information Route information The right information To the right person At the right time Focus on use case Dedicated clinical pathway Step by step approach Identify every stakeholder Don’t forget anyone

How to do it?

Use an Interoperability Platform!

Back office main components MPI: Master Patient Index Give an unique patient ID for a territory Each healthcare facility keeps its own ID but medical information can be gathered around a single ID XDS: Cross Document Sharing Build an index of each piece of medical information (XDS Registry) Can store the information and provide consumer with it (XDS Repository) MCI: Master Code Index Manage a lookup feature to translate local codes into a common repository Every healthcare facility can keep its own repository LDAP: Lightweight Directory Authentication Protocol Central repository of every user of the platform SSO: Single Sign On When switching from one module to another, the user does not have to re-identify himself RBAC: Role Based Access Control Centralize the access right management based on the role of the user when carrying out certain tasks

Organizing the clinical pathway Medical assessment Drug Prescription Referral Letter GP Receive prescription and dispense medicine Retail Pharmacy Receive the referral letter Knows about the dispensation Hospital Knows about the actual pathway Insurance Using big data enhances public health management MoH Is the new stakeholder of his clinical pathway Patient

Benefits Citizen Access an abstract of his medical record regardless the hospital he went to Added value services (online booking, online payment…) Insurance Comprehensive vision of the clinical pathway of the patient Better coverage offering Primary care Considered as a stakeholder of the clinical pathway Can easily access the comprehensive patient history Research center Access detailed anonymous information (big data) Ministry of Health Can set up a Public health policy using big data Social Security Better governance of public health facilities

Thank you for attention