1. Ministry of Health E-Health Initiatives in Trinidad and Tobago presented by Minister of Health, Senator the Honourable Jerry Narace Commonwealth Business Forum Innovative Solutions to Healthcare

2. Health Sector in TT  The Ministry of Health leads the Health sector by setting the national health agenda, developing legislation, regulation and financing  Health care at public institutions is provided free of charge at the point of contact (primary, secondary and tertiary health care facilities)

3. Public Health sector in TT

4. Vision 2020 for Health A Nation empowered to live long, healthy, happy and productive lives New Model of Health Care Management needed to realize vision

5. MoH’s 3 Strategic Objectives 1.To foster a healthy and productive population through preventive care. 2. To create and maintain a First World health care delivery system; and 3. To develop and manage a comprehensive population based public health system.

6. Nine Transformational Strategies 1.MOH Institutional Reform 2.Strengthen Vertical Services 3.Upgrade Services and Infrastructure 4.Skills Development and Availability 5.Quality Service 6.Information and Communication Technology 7.Health Financing 8.Strengthen RHAs and other bodies 9.Continuous Improvement

7. Health Care Business  Health is the third largest public sector expenditure item in Trinidad and Tobago.  For fiscal year 2010, government’s recurrent expenditure allocated to the health sector is $TT 3.34 billion. Total recurrent spending on health (public and private) is estimated at $TT 6 billion.  5 year transformational business plan (2008-2013) -- $TT 30 billion  The health care business is a large, complex industry comprising diverse service providers and hundreds of patient encounters daily.

8. Health Care Business (cont.)  Effective management requires:  Collection of information for decision-making process.  Monitoring productivity, cost of services to improve efficiency  Improving the assignment of human and technical resources  Quality control using international standards

9. E-Health in the Commonwealth Source: Massiah, E. (2008) Progress on eHealth in the Commonwealth, in ehealth in the Commonwealth. London: CBC

10. p.10 E-Health transition in T&T From this:To this: “One patient, one record, anywhere, anytime”

11. NIB Civil Registry CDAPPassport Other Web GP Practices Local Pharmacy Regional Hospitals, Health centres & Diagnostics centres Insurance companies Ambulance E-Health Vision Schools

12. p.12 Current E-Health Projects  Surveillance system –Stage 1: A web enabled platform to capture treatment data in all HIV facilities, featuring: Central Lab Information System Clinical Management System, Business Intelligence package Data Export Systems (it will feature e-health records, CM, a central database and on target for a 2012 date of completion) –Stage 2: extend the functionalities to all CNDC’s  In all facilities and Chronic Disease Patients  In operations: On-line system with private Pharmacies to deliver Chronic patients drugs  (training, 70 million Illuminat contract on target for a 2010 competion )  CDEMS  CDEMS (Chronic Disease Electronic Management System)  Implemented in some RHAs and will roll-out to all

13. Current E-Health Projects (cont.) TTele-medicine TTele-radiology (being implemented in ERHA to be expanded to other RHAs) TTele-medicine for paediatrics TTele-pathology EE-Health Initiative (planning pilot sites implementation) EE-Health Card WWeb based on-line patient eligibility and service validation PPatient’s basic EMR access and Transaction data capture GGeneral Patient’s Appointment system DDrugs Prescription registration and local pharmacy dispensing.

14. General Appointment System Appointment is registered in the NHIS required professional at the The operator assigns an appointment with the most convenient location (Health Care Facility) :   HC Facility’s ID   HC Service Code  Appointment Data Patient’s ID Doctor’s ID Date&Time System validates the Patient’s eligibility and: Requests an appointment with a Health Care Professional(GP,Health Center,Hospital,etc) Patient calls NHIS Call Center

15. Patient Administration Patient arrives and shows e- health card The clerk validates the patient’s identity and confirms the appointment (if any). Co pay is determined if applicable EMR are retrieved from the system and handed to the doctor

16. The Patient’s Healthcare Service Process NHS HC Service Data Patient’s ID HC Services ID Doctor’s ID Diagnostic Medical Records are updated and HC Services are registered Drug Prescriptions Diagnostic Service Request Referrals Coded Data Entry

17. p.17 Benefits  Improved healthcare services –Decrease in waiting time –Better tools for doctor’s review and diagnosis –System guarantees confidentiality –Access to E-Health portal - customized information and health tips  Improved cost-efficiency  Eliminate duplication of services  Improve provider productivity  Improved quality  Assess compliance with established medical protocols  Identification of patient risk-groups for improved management  Control expenditure patterns  Reduce adverse events

18. E-Health & NHS  E-Health is a KEY enabler of NHS  The National Health Service (NHS) will be a health care system of the Government of Trinidad and Tobago that will provide an Essential Package of health care services to all eligible persons at any public or private health institution of their choice.

19. E-Health & NHS (cont.)  Registration of provider and beneficiaries  Payment of claims to providers for services delivered  Collection of contributions from employers, employees and the self employed  Auditing collections and claims processing system and ensuring efficiency  Provide information for Actuarial Reviews of the NHS Fund

20. Outcomes Synergistic and integrated health care IT system –Ease of use –Comfort with experience –Confidence in outcome Bringing us closer to first world status

21. Q&A Thank you