A decade of experience in helping United Arab Emirates’ (UAE) healthcare providers manage the impact of diabetes on their service delivery models has given Hicom valuable insights into the benefits of implementing fully integrated information systems.

The global diabetes epidemic might be giving healthcare providers a major challenge in terms of management and prevention, but it is also driving innovation and investment in technology and processes, which will enable them to deliver new standards of efficiency and patient care.

In the UAE, for example, one in five adults suffer from type 2 diabetes – a significant factor in a healthcare market expected to be worth $28 billion by 2021 (source: Mena Research Partners/MRP) when the government’s Vision 2021 aims to deliver a world-class set of healthcare facilities based on clear national and international standards.

Reducing the prevalence of lifestyle associated diseases such as diabetes, cardio-vascular conditions and cancer is one of the vision’s key drivers. And in a country where almost a third of its adult men and half of its women are clinically obese, and up to 30% of its male population smoke, the solution lies as much in prevention and lifestyle education as it does in treatment. Without a more granular approach to service provision, the diabetes rate could double within the next 20 years.

Health and efficiency

Throughout the UAE, healthcare facilities have seized on this new approach as an opportunity to improve efficiency and productivity, as well as patient care, in a highly competitive market. At its heart, data integration and analysis hold the key for them to fully understand the impact of the rise of diabetes on their processes and systems.

“We’ve been working with some of our customers in the UAE for more than ten years – which means a decade of innovation,” says Jon Elburn, Product Manager for Clinical Information Systems at Hicom. “What we’ve been learning is that there is always more you can be doing. If you improve the quality of the data that you’re capturing, you can analyse it more closely – and learn even more.”

“By analysing the data that has been collected, our customers can become more efficient, which helps them to understand the scheduling of resources more clearly, and the knock-on effects when they aren’t available. It also makes the patient’s experience so much better. We’ve got a huge amount of data around arrival times, waiting times, time with a doctor, and time with nurses. That information can unclog bottlenecks in the whole process. And that helps everybody, particularly in the UAE – a competitive market driven by insurance. It’s important for both sides.”

Elburn says the technology which enables this innovation goes beyond patient management systems themselves and entails a high degree of integration: with pathology devices, for example, so that the results go directly to the doctor without the need to double-key data: with pharmacy systems, so the pharmacist can have prescriptions ready for a patient and cut waiting times: integration with third party stock levels are constantly up to date. It also extends into the operation of the clinic itself, using software to govern the flow around the patient – down to smartcards that allow a doctor to switch on the light outside the room to show they are in a consultation.

“We’ve deployed a fully integrated system in three clinics in the UAE now – two for diabetes and one for eye-care – and they fulfil that holistic function, from patient registration all the way to billing, pharmacy and follow up treatment,” says Elburn.

Cutting the cost

“Because they’ve been developed over 10 years or so, there wasn’t a massive up-front cost. We’ve worked with customers constantly to improve the systems, so the R&D has been done along the way. Also, we work on a Software-as-a-Service (SaaS) basis. Rather than a significant procurement cost for hardware and a licence, then support, the leasing approach has to replace those traditional financial models in a market driven by the need for the cost-effective implementation of technology.”

This comprehensive approach to providing clinics with all the facilities they need to manage patient care effectively and efficiently is also now making inroads in the UK, where the demand for improved efficiency and patient-focused care is a constant challenge for IT strategists. Extracting maximum value from budgets is a priority. Here, too, the rise of lifestyle-related diseases is putting pressure on those funds. According to Diabetes UK, there are an estimated 4.5 million people with the disease – one million of whom have yet to be diagnosed.

“We’ve been providing clinical information systems for paediatric diabetes service providers on a SaaS basis for nearly five years now,” says Elburn. “The biggest barrier here is around governance and patient data security, and we’ve been working with the NHS to overcome these issues. We’re ISO 27001-compliant, which is a great starting point. Sixty NHS trusts access the paediatric systems on servers in our datacentre over the Health and Social Care Network (HSCN). Good internet connections mean we can share resources and pass on significant cost savings to trusts. And that’s enabled us to provide a solution in an area of healthcare where there is less funding due to smaller patient cohorts.”

Virtuous circles

The impact on process efficiency has been significant, helping to build a virtuous circle: best-practice tariffs around diabetes treatment mean that a clinic can prove it is delivering more than the standard patient contact will attract more funding, facilitating better care and resources for the patient.

This degree of integration delivers efficiencies throughout the patient cycle, avoiding the need for key staff – often skilled nurses and clinicians – to be distracted by time-consuming, duplicated data entry. Consistent data means that processes such as insurance claims – crucial in the UAE market, for example – can be completely automated, cutting the rate of rejections and re-submissions, and ensuring a free-flowing revenue stream.

“Particularly with diseases such as diabetes, a lot of our customer requirements centre on audit data,” says Elburn. “But it’s the insights that come from the very precise data that we can provide, which really enable innovation. CIOs need to step back and understand what they’re trying to achieve in terms of inputs. Changing a process can unlock capability and time for people. Systems integration might cost a few thousand pounds but the saving in the next two or three years will be enormous – and a highly trained nurse won’t be spending their time needlessly re-keying data.”

The value of this enabling technology is also revealed through increasingly sophisticated reporting. Drilling below the surface allows trusts to see how patients have responded to particular drugs or which doctors and treatments are achieving improved outcomes. The impact of process changes on patient care can be verified based on real data rather than speculation. In other words, it allows the clinic – large or small – to analyse performance and efficiency across the entire business.

“It needs a mix of skills: someone who can look at data and identify emerging trends, and a clinician who can interpret the trends, identify its cause and explain why it’s happening,” says Elburn. “If we can get both sides working together, that’s where the real power of data discovery will lie for prevention and improved patient care as these diseases continue to rise.”

The challenge for IT is clear. Decision makers need to find ways to facilitate a new age of cooperation between clinicians and data analysts, which will help them to strengthen the case for investment in innovative technology, and to capitalise on the virtuous circle.