Objective for today 2 Review and recommit to strategic direction + road map for eHealth in Abu Dhabi
What is eHealth? 3 eHealth is anything electronic that we find useful in healthcare
Technology already implemented Minimal investment needed Minimal clinician change required What is (relatively) easy to achieve? 4 Use existing assets and processes differently KEH Post Office Emirates ID card
KEH Post Office Emirates ID card You Exchange coded data Streamline internal processes Use existing assets+processes differently 5 HAAD Collects data Uses data Shares data EIDA Creates identity card Authenticates securely Shares person information Registration Enrolment eRecord Eligibility
What has HAAD regulated in terms of priorities Transactions defined by DSP HAAD infrastructure ready Standard Contract requires it 7 eAuthorisation ePrescription eRecord eLicensing Healthcare entities to start… Users propose business rules Transactions defined by DSP PBM standard released Users propose business rules Payers to begin enforcing… Data available in KEH Access clarified by Access Panel EIDCard MoU signed with EIDA EIDA web service missing Providers submit claims late Process automation under way PQR under review Privileging framework released Based on feedback still a long way to go AchievementsNext steps
Detail PriorRequest PriorAuthorization Facility Request Is Member active? Is Facility in network? Does network cover [elective]? Is condition covered? Authorization Prescription 8 Facility submits PriorRequest MemberID+PayerID FacilityID EncounterType Diagnosis Activity Observation Payer submits PriorAuth`n Response [Comment]
Technical Detail ePrescribing *Can also be the Pharmacy, if the Doctor did not him/herself e-Prescribe 9 PriorAuthorization Payer Pharmacy Doctor* RemittanceAdvice ClaimSubmission Post Office PriorRequest Prescription Prescription
What Abu Dhabi’s CEOs voted for in 2009 11 www.weqaya.ae Mandatory observations (e.g., HbA1c) Provider rating system www.haad.ae CPT codes activated Significant regulatory progress Public Cube + free HAAD software
Remaining regulatory road map 12 EmiratesID card authentication Turnaround time Reconciliation Devices Explore interoperability of health record
Regulation “done” (except EID card) Execution is key Capturing Benefits is [too] slow* Provocative thoughts * Providers: Who is still photocopying insurance cards? Payers: Who auto-adjudicates <80% of claims? 13 Do you agree? Why? How can HAAD help?
I am comfortable with the strategic direction as set out in 2009 Voting in workshop Voting on 4 May by stakeholders – Payers, Providers, HAAD and Vendors 14
My biggest challenge in capturing value from eHealth is Voting on 4 May by stakeholders – Payers, Providers, HAAD and Vendors 15
Focus regulatory efforts on ensuring the EmiratesIDCard can be used for healthcare as a top priority Limit brand-new regulations for a while, until the bulk of the changes started have been digested Invest in further strengthening governance for making operational tweaks to existing regulations –Increase lead times, and pre-decision discussion (in general) –Develop an orientation roadmap with indicative timelines for changes –Apply any changes to all healthcare entities concurrently, to ensure a level playing field (whenever possible) Review eHealth Strategy at least annually to maintain alignment Actively suggest and shape the detail of new eHealth regulations – specific rules for the PriorRequest/PriorAuthorisation transaction set, and electronic prescribing in particular. (On the basis of strong content suggestions from stakeholders, Andrey Timoshkin, Chair of the Data Standards Panel, will invite for a workshop to develop the relevant business rules) Next steps 16 HAAD Stake- holders
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