1. The Challenges and opportunities in British Libyan Collaboration Dr Saleh El-Gadi, MPH, FRCP (Lond), FRCPI, Dip GU Med Director Bushra Group Tel: ++218 (0) 91 780 1097 (Mobile)E-mail: drelgadi@bushra-group.comdrelgadi@bushra-group.com www.bushra-group.com

9. Economic Indicators IndicatorsLibyaTunisiaEgypt Saudi Arabia UK GDP (USD billion) 5633.1111.8403.42552.7 GDP per capita (USD) 9305.83180.31519.716612.241959.8 Inflation rate (consumer prices, annual % change) 3.524.16.212.4 Source : IMF - World Economic Outlook Database 2007

10. Health Expenditure indicators Libya Tunsia GDP per capita US$ exchange rate 11,3223,3902007 Total expenditure on health (per capita) US$ exchange rate 2981742007 Government expenditure on health (per capita) US$ exchange rate 214772007 Total expenditure on health of % of GDP 2.65.12007 General government expenditure on health as % of total health expenditure 71.744.12007 Out-of-pocket expenditure as % of total health expenditure 28.345.62007 General government expenditure on health as % of total government expenditure 5.46.72007 Ministry of health budget as % of government budget 7.57.12007 Source: World health statistics 2009

18. 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.

19. IT in the Health Sector - Libyan perspective Dr Saleh El-Gadi, MPH, FRCP (Lond), FRCPI, Dip GU Med Director Bushra Group Tel: ++218 (0) 91 780 1097 (Mobile)E-mail: drelgadi@bushra-group.comdrelgadi@bushra-group.com www.bushra-group.com

21. 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

22. HMIS Infrastructure Network Topology & OS Hardware Application Servers HMIS

23. 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

24. Management of information System in healthcare industry Patient Doctor Clinical data systems: Lab system,EPR Clinical Findings Reasoned Programmed Knowledge base Decision support system Advice Clinical Finding Advise Actions Forces Demanding Work Transformation Result 1 2 4 5 67 3 8

25. Management of information System in healthcare industry Quality Cost Managed Care Accreditation Requirements Outcomes managements Timely Decision Making New Technologies Research Work Transformation Health Reform Forces Demanding Work Transformation

26. Management of information System in healthcare industry Traditional mode of practice Managed Care Health Reform Forces Demanding Work Transformation

27. Management of information Decision-making levels within an Organization Strategic Decision Making Tactical Decision Making operational Decision Making Managed care Developed of CPR Order Entry Results Reporting Clinical Data Network communication What Goals are to be achieved How Goals are to be achieved How goals are implemented

28. HMIS Improve Internal communication CRM Online catalog & order After sales Support Full Paperless environment Improve Communication Decision Support ADMINSTRATION Financial Clinical Messaging & middle ware Web access

29. Impact on Patient Safety and Risk Management In 2000, 44,000 to 98,000 Americans die/year from preventable medical errors 1. The number may be twice as high 2. Medical errors are killing more people per year, in the U.S., than breast cancer, AIDS, or motor vehicle accidents 3. The lack of immediate access to patient healthcare information is the source of 1/5 of these errors 4. 1 Kohn, 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. 2 HealthGrades. In-Hospital Deaths from Medical Errors at 195,000 per Year, Health Grades Study Finds. July 27, 2004. 3 Institute of Medicine and Centers for Disease Control and Prevention. National Center for Health Statistics: Preliminary Data for 1998 and 1999. 2000. 4 Health Research Institute & Global Technology Center. Reactive to Adaptive: Transforming Hospitals with Digital Technology, Price Waterhouse Coopers. 2005.

30. 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 systems 1. 1 Smith, Peter, et. al. “Missing Clinical Information During Primary Care Visits,” The Journal of the American Medical Association. February 2005. Impact on Patient Safety and Risk Management

31. Order Entry Validation Financial RECORDS Results Reporting Network communication Clinical data Results Reporting LAB Radiology Pharmacy Blood bank diet O/R 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 Review orders results from Medical record Forces Demanding Work Transformation Clinical knowledge Data Base Contract rules & exceptions

32. Management of information System in healthcare industry Quality Work Transformation Monitor Create Standards for health procedures or use DRG Compare actual practice against standards Generate Key performance indicators Corrective action Forces Demanding Work Transformation

33. 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)

34. Management of information System in healthcare industry Is it Worth it? Improve Quality, productivity, capacity, access Reduce cost Goals