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

2. At the beginning was the patient

3. 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 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

4. 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

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

6. 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

7. ? 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

8. How to make this efficient?

9. 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

10. How to do it?

11. Use an Interoperability Platform!

12. 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

13. 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

14. 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

15. Thank you for attention