Good Practices and Innovations in Public Governance 2003-2011

2010 Category 4: Oman
Western Asia
Oman
2010 category 4 – 1st Place Winner
Al Shifa: An e-Health System
Ministry of Health
Description
A comprehensive health-care information-management system designed to maintain
an audit trail of patients’ medical histories.
Summary
Oman’s e-health application, called Al Shifa, is an in-house system designed and
owned by the Ministry of Health. It is the result of consultation and collaboration
between in-house developers and end-users (medical staff) who adapted the practices
of other renowned medical facilities in the world to suit Oman’s operational environment.
Al Shifa is implemented in over 170 of the country’s health-care institutions,
including all secondary- and tertiary-care institutions and all important primary-care
facilities.
The system maintains an audit trail that includes a patient’s initial records and all
subsequent information, including documentation of the date and time that changes
are made to the file and who made them. Because patient data is complete and presented
in a clear, standard format, the system allows medical professionals to quickly
understand a patient’s health situation and provide appropriate treatment. This has
resulted in savings of 60 percent of the time previously spent tracking down the personnel
who last treated the patient to obtain clarification and follow-up.
The Problem
The problem of keeping medical records manually is quite complex. A distinguished
American physician has commented, “The [paper] medical record is an abomination
… It is a disgrace to the profession that created it. More often than not, the chart is
thick, tattered, disorganized and illegible; progress notes, consultant’s note, radiology
reports and nurses notes are all co-mingled in accession sequence. The charts
confuse rather than enlighten; they provide a forbidding challenge to anyone who
tries to understand what is happening to the patient” (H. Bleich, “"Lawrence L. Weed
and the Problem-Oriented Medical Record”, Computing vol. 10, no. 2, p. 70, 1993).
These words sum up the condition of patient records in Oman before the Al Shifa
initiative. Each patient had multiple files, and it was very difficult to get a complete
picture of a patient’s medical history. Treatment costs were very high as a result of
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