BUILDING CONSENSUS ON THE READINESS FOR EHR IN LEBANON

EHR READINESS GENERAL MEETING - JUNE 15, 2019

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The Policy Support Observatory (PSO) unit at the Ministry of Public Health (MoPH) is engaging all health care providers and stakeholders to define a roadmap for eHealth in Lebanon through determining its essential pre-requisites and elements.

Building Consensus on the Readiness for EHR in Lebanon

Dr. Walid Ammar, General Director of the Ministry of Public Health, has worked hard over the past two decades to lead the health sector and achieve the investment in the quality and capabilities of the Ministry staff. Based on his initiative, the PSO was established as a joint partnership between the Ministry of Public Health, the World Health Organization in Lebanon, and the American University of Beirut. Its mission is to contribute to rational and sustainable policy formation and implementation by:• Institutionalizing the reliance of MOH and key health sector stakeholders on

strategic intelligence that contextualizes technical evidence with operational knowledge of the health sector and analysis of stakeholder and end-user expectations and interests

• Promoting effective and resilient collaborative approaches to health sector governance

• Enhancing the social consensus around shared health sector policies

PSO website: https://www.moph.gov.lb/en/Pages/6/18521/policy-support-observatory-pso-

Focus GroupsDiscussions

Surveying Stakeholders General Meeting

Main outcome: A Request for Information (RFI) document for the “clinical patient care” part of an Electronic Health Record (EHR) to be used by MoPH. The RFI will list clinical standards, Interoperability standards, etc.

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General Meeting Agenda

8:30 - 9:00 Registration

9:00 - 9:15 Welcome Note and Introduction Dr. Ghassan Hamadeh CMIO, Professor & Chair of Family Medicine at AUBMC

9:15 - 9:45 Electronic Medical Record Adoption in Hospitals, the Lebanese Experience Dr. Youssef Bassim Consultant to University of Balamand President for Healthcare and Hospital Affairs

9:45 - 10:30 Building an E-health Roadmap: Key Learnings from France, Estonia and Monaco Mr. Karim Hatem YLIOS Consulting

10:30 - 10:45 BREAK

10:45 - 11:15 Digitizing Healthcare in Jordan... How We Did It? Mr. Ghassan Laham Electronic Health Solution International

11:15 - 11:30 MoPH Interoperability Plan Mr. Ali Romani IT Project Manager, Ministry of Public Health

11:30 - 12:30 PANEL DISCUSSION Mr. Joe-Max Wakim Director, IT Medical Center Processes and Systems at AUBMC

12:30 - 1:00 BREAK

1:00 - 1:30 SUMMING UP AND CLOSING REMARKS

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IT Focus GroupApril 24, 2019

Payers’ Focus GroupApril 24, 2019

Hospitals’ Focus Group

April 25, 2019

Public Sector Focus Group May 28, 2019

Participants from MOSA, GSF, ISF, SSF, NSSF, COOP, MoPH, BMC, AUB, ITB, CAS, MoD, OMSAR, RHUH, NBUH, WHO, HDF, MoT, ACT, and Akkar hospital

Participants from GSF, ISF, SSF, IMC, YMCA, UNICEF, GlobeMed, MoPH, LIBS, and COOP

Participants from the Lebanese Order of Nurses, Hospitals’ Syndicate, and representatives from prominent hospitals

Participants from professional orders and government authorities (ministries, army, and government institutions)

Challenges, barriers, and success factors at the level of the 4 dimensions of EHR adoption were generated from these focus group discussions. The major themes discussed at the level of the “Governmental Regulations and Roles” dimension were poor governmental mandate and coordination, weakened leadership, fragmented health sector, etc. Many suggested that commitment, support, and cooperation help in overcoming these barriers. The majority believed that confidentiality issues and lack of awareness are the major barriers behind the “User Access and Accessibility Policies and Infrastructure” dimension, while “Standardization, Policies, Procedures, and Protocols” are challenged by lack of unified standards. Feedback on the “Information Communication Technologies Architecture/Infrastructure” dimension showed that high cost, database issues, and weak infrastructure are the main barriers to the implementation of EHR.

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Surveying Stakeholders

An online survey titled “Roadmap for e-Health in Lebanon - Hospital Readiness Sur-vey” was sent out to stakeholders including hospital staff, Information Technology (IT) staff and third-party payers’ staff.

EHR Current Status Percentage

Organization has an EHR 32%

Organization uses electronic internet billing with insurance companies

35%

Organization has online communication methods/tools with patients

47%

Organizational Alignment Percentage

Organization has a plan to implement an EHR or any other e-health projects

35%

Senior management views EHR as key to meeting future organizational goals

90%

Operational & Technology Readiness Percentage

Organization identifies ways in which EHR can improve current workflow and processes

58%

Top-level executives are prepared to upgrade hardware (if required) to ensure reliability of an EHR system performance

66%

Human resources Readiness

Very Advanced

or advanced

AverageMore

education is needed

No awareness

at all

Overall level of awareness and knowledge about e-health among human resources at the organization

41% 30% 27% 6%

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6

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Keynote Speakers’ Biographies

Mr. Karim HatemSenior Partner at Ylios Executive consulting, FranceEmail: khatem@ylios.com

Mr. Hatem is the Senior Associate Director and one of the founders of Ylios Executive Advisory. During his 30 years as a consultant, he developed a wide range of competencies and skills including:• Strategic planning, both at the level of the economic sectors where he has an

expertise (Healthcare, Energy, Telecom, Engineering, Infrastructure and Construction, Banking and Insurance), as well as at the level of companies and public operators

• Designing new strategic models, resulting from innovative approaches, and the establishment of new organizations and businesses, in addition to contributing to their performance improvement

• Supporting the implementation of these new models across these sectors and at company level, with a focus on digital transformation

• Consulting to Executive Teams in the Private and Public Sectors in the steering of large and complex transformations.

Over the past 15 years, he has worked with various stakeholders in the healthcare sector including: healthcare operators, pharma and medtech companies, equipment manufacturers, regulatory authorities, “New Entrants” such as La Poste with its “Silver Economy” development program.

Mr. Ghassan LahhamFounder and CEO of Electronic Health Solutions International (EHSI), JordanEmail: ghassan@ehs-int.com

Al-Lahham is a well-known expert in the use of automation in the public education and healthcare sectors. He has been recognized for his entrepreneurial accomplishments in achieving significant milestones in his career. His main asset is combining the experience of a private sector entrepreneur, with his leadership of automation in world-class education and healthcare. He presents balanced and pragmatic perspectives from both the private and public sectors. Ghassan has been directly managing a number of projects that have rapid and long-term impact on the development of healthcare and education sectors in Jordan and the local region. In addition, he managed Jordan’s biggest and most strategic IT project “Hakeem”, which is responsible for the automation of the healthcare sector covering all public, military, and cancer centers countrywide.

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Dr. Youssef BassimConsultant to University of Balamand President for Healthcare and Hospital Affairs, LebanonEmail: yrbassim@hotmail.com

Dr. Bassim is an orthopedic surgeon and HIT consultant with 20 years of experience in clinical practice and medical administration and lately was CMO in one of the prom-inent hospitals in Kuwait. He is a fellow of the American College of Surgeons and is a Certified Consultant Orthopedic Surgeon by the Saudi Commission for Health Special-ties. He chaired the Management of Information (MOI) chapters for the JCI and CBAHI accreditation systems in his previous work place and became Chief Data and Informa-tion Officer for one of the biggest university hospitals in Lebanon. He was awarded by Dr. Gro Harlem Bruntland, WHO Director General, the Tobacco Free World Award for Outstanding Contributions to Public Health. He was appointed as Project Manager by HIMSS (Healthcare Information Management & Systems Society) on Electronic Medical Records Adoption Model (EMRAM) project in Lebanese hospitals and currently, as healthcare consultant, he is supervising the construction of two big healthcare facilities and is an HIT consultant for one of the largest pharmaceutical industries in the region. Apart from his educational activities, he is teaching Business Intelligence in Healthcare for graduate students. Previously, he was part of the HIT team at the Lebanese Ministry of Public Health and was involved in coordinating with all healthcare stakeholders in Lebanon to create the blueprints and roadmap for the e-health project on a national level. Along the same lines, he put a plan to transform the MOH from a semi manual organization all the way to a real e-facility.

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Project LeadsDr. Ghassan HamadehEmail: ghamadeh@aub.edu.lb

Chief Medical Information Officer, Professor & Chair of Family Medicine at AUBMC and past president of the Arab Board & the Lebanese Society of Family Medicine. He is a consultant to WHO and advisor to the Ministry of Public Health in primary healthcare, pharmacoeconomics, and technology since 2004. He is leading the PSO initiative on “Building Consensus on the Readiness for EHR in Lebanon”.

Mr. Joe-Max WakimEmail: jmw@aub.edu.lb

Leads the AUB Medical Centre Information Technology team. His team works closely with healthcare leaders and stakeholders on strategic initiatives and clinical transfor-mation journeys. They recently implemented Epic with integrations to dozens of other solutions which were purchased or built in-house over the last couple of decades. He also serves on the national IT committee of the syndicate of hospitals in Lebanon and is also currently serving as the president of the Lebanese Healthcare Management Association (LHMA). He is also a HIMSS Certified Professional and Certified Health CIO from CHIME.

Mr. Ali RomaniEmail: a_roumani@yahoo.com

IT Project Manager at the Ministry of Public Health.Led several IT projects including: systems interoperability and unique ID, electronic health record, Primary health care network information system PHENICS…and many others.

Project CommitteeMr. Hossein HamamMs. Najla DaherMs. Rita NassarMs. Sawsan Allam

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