Good Practices and Innovations in Public Governance 2003-2011

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Good Practices and InnovATIONS in Public Governance duplicate diagnoses and medication. Doctors, nurses and paraprofessional staff spent huge amounts of time preparing statistical and administrative reports that were not very accurate, and there was no way to audit and track those reports. There was also a lack of raw data available for researchers, due to a significant number of files misplaced or lost. The Solution The Al Shifa system became fully operational in 1997. The system maintains an audit trail that begins with the patient’s initial records and documents all new information about the patient’s condition and treatment, noting the date and time that changes are made to the file and who made the changes. The system has been built to fit the local environment, comply with user requirements and allow easy electronic exchange of medical information among health institutions. The system was developed by following international standards and considering interoperability during the design and implementation phases. The entire system, including the source code, is owned by the Ministry of Health, so any modifications and customization can be done in a cost-effective manner. E-mail and message services have been integrated into the system, and they are used to inform and remind patients about their health-care appointments. Appointment management is fully handled. Al Shifa also provides comprehensive, online data reports in response to inquiries. Users can define search criteria for retrieving and displaying only the desired information, which can be viewed from any workstation. Thanks to interfaces with laboratory and radiology equipment, diagnostic test results are fed to the system automatically, reducing human errors in data entry and saving technicians time. The system handles all procedures of transferring patients from one institution to another (say, from a health centre to a polyclinic or hospital). An “e-referral engine” automates functions like appointment requests, consultation feedback reports, requests for a second opinion. In addition, the system takes care of administrative tasks like out-of-office replies. Because Al Shifa is meant to simplify the work of health professionals, the system is continuously enhanced to make it friendlier. It includes a billing module that calculates fees and treatment costs, taking in consideration exempted groups (like birth spacing, immunization). Finally, the system includes drug expiry management. A few months before the expiry date of each medication in stock, the system generates an alert about how much supply is still available, so excess quantities can be used by other institutions. 166
2010 Category 4: Oman Replicability and Sustainability Regarding sustainability, the medical and technical expertise needed to build and maintain Al Shifa has, since the start, come from the internal staff of the Ministry of Health. From time to time there has been some turnover in staff, but competent replacements are always assured. Therefore, the movement of staff has never been a serious threat to the continuity of the programme. The system is highly scalable and can be customised for other organisations. Already it is in operation in over 80 percent of Ministry of Health health-care institutions and some other Omani Government health-care delivery systems. Lessons Learned The primary lesson is to appreciate the many benefits of information technology to organisational efficiency. The use of information technology in health-care institutions is almost indispensable; health-care institutions can hardly operate appropriately without it. The Al Shifa system has created transparency in the processes of Oman’s health-care delivery system while reducing duplication of work and inefficiency, thereby improving health care and at the same time containing costs. Contact Information Mr. Nasser Al-Shamli Director, Hospital Information System P.O. Box 393 Muscat 100 Oman E-mail: dir-net-com@moh.gov.om 167
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