Kingdom of BahrainMinistry of Health

May 2005, Issue No. 14Health Information Directorate

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Bahrain e-Content Award 2005 - e-Health BEST CONTENTClick to “enlarge on page 6”

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May 2005, Issue No. 14

Health Statistics Report contains statistics and Health indicators whichillustrate the Health Status and the commitment to facilitate the provisionof health care services to all nationals and residents in the Kingdom ofBahrain. The data presented in the reports are collected from all theMinistry of Health peripherals, Bahrain Defence force, Private Hospitalsand other health institutes in the country by the Publication group atHealth Information Directorate. These data highlights the population char-acteristics, their demographic, epidemics and health status. Our MainConcern is that the accuracy of the published data, on time and has a fullcoverage of the health status. Thus, it is always necessary to review andevaluate the contents of the reports with the data sources to improve dataquality.

The main objective of the report is "To provide health statistics to healthservices decision makers internally, nationally and internationally and to actas a unified source of National Health Statistics".

The expected benefits out of publishing the report were:

o Reflecting the population Health Status in the Kingdom.

o Assessing health situation and trends.

o Highlighting needs for health services.

o A good instrument to measure population health demands.

o Source of a comprehensive NHS for all services provided in theHealth Care both government and private sectors.

o Good reference for researches & Health studies.

o Facilitate decision-making and Health Planning.

o Form a unified framework and standardize the publication of allHealth Statistics between all health institutes in the country.

The main users of the report are:o At Ministry Level: All MoH executives, middle mangers, directorates &Hospitalso At National Level: Bahrain Defence Force hospital , CentralInformation Organization, all ministries especially Ministry of Finance andNational Economies, GOSI, Traffic Directorate, universities, training insti-tutes, Ministry of Foreign affairs, Al Shura Council, Representative o Council, embassies and all private hospitals and clinicso At International Level: WHO, and Executive Board of the HealthMinisters Counci for the Gulf Corporation Council of the Arabian States

The Ministry of Health representative through Health informationDirectorate was always keen on improving of the production of the report.As a result it went through major improvement stages such as:

o A Task force was formed and was active since 1997. The member'smain objective was follow-up the production progress of the report. Theteam had to ensure that all the necessary steps are taken to enable thespeedy production of the report within the target date. However, thistime the task team objective may divert at the beginning stage to focuson reviewing and improving data quality of the book contents.

o Partially automated development process of the report.

o Continuous evaluation on the report (periodically, annually)

o Publishing the report on different media (Hardcopy, CD, MoHInternet, Intranet).

However, improvement cycle will never stop, as on 1st March 2005, TheAssistant under Secretary for Training and Planning (AUTP) Dr. Fawzi Ameenissued a circular to form a Review Committee consisted of the following:

Mr. Ebrahim Al Nawakda

Dr. Jamal Al Sayad

Dr. Khaldoon Alroomi

Dr. Randah Hamadh

Dr. Faisal Al Mahroos

Dr. Qasim Al Shboul

Dr. Manal Al Alawi

Mr. A.bdual Hameed Fathi

Mrs. Amal Al Arrayed

The main responsibilities (terms of reference) were:

1. To will provide comments on improving the reports based on thesefundamental points:

Data completeness and validity

Data comprehensiveness in term of quantity and quality

Sequence of presenting the data

Publishing Time of the report

2. The team will act as consultants and other group will take theresponsibilities of the implementation

3. A final report will be submitted to the AUTP at the end of the reviewexercise.

Health Statistics Report ReviewBy: AAmal AAl-AArrayed

Amal: Senior Technical Writer

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May 2005, Issue No. 14

By: AArif AAl-MMukhtar

There are many functions associated with patient health records. Not only is the record used to document patient care, but the record is also used forfinancial and legal information, and research and quality improvement purposes. Because all this information must be shared among many professionalswho constitute the 'healthcare team.

The electronic health record (EHR) provides the opportunity for healthcare organizations to improve quality of care and patient safety.

An EHR also represents a huge potential for cost savings and decreasing workplace inefficiencies "No longer are paper-based record systems fulfilling theneeds of clinicians, and related healthcare workers".

The EHR has several distinct advantages over paper health records. One definite advantage is the factthat there qre increasing storage capabilities for longer periods of time. Also, the EHR is "accessible fromremote sites to many people at the same time ".

The EHR can also provide medical alerts and reminders. EHR systems have some "built-in intelligencecapabilities, such as recognizing abnormal lab results, or potential life-Threatening drug interactions".

Another benefit to an EHR is that it allows for customized views of information relevant to the needs ofvarious specialties.

As a management tool, the EHR can provide information to improve risk management and assessmentoutcomes. Today, reimbursement is based on outcomes therefore healthcare organizations "must seekinnovative ways to improve quality of care and outcomes while managing costs"

An EHR can decrease charting time and charting errors, therefore increasing the productivityof healthcare workers and decreasing medical errors due to illegible notes.

Financially, the EHR will provide more accurate billing information and will allow the providers ofcare to submit their claims electronically, therefore receiving payment quicker.

Overall ,the EHR provides the essential infrastructure required to enable the adoption andeffective use of new healthcare modalities and information management tools such as integrat-ed care, evidenced-based medicine, computer-based decision support, care planning and path-ways, and outcomes analysis"

Advantages s of the Electronic Health Record

Arif: Programmer

Medical Records Tracking System

Over 1400 appointments are made every day for outpatients for variousclinics at SMC. This does not include walk-in patients. For every appoint-ment, the medical records file of the patient has to be moved from its stor-age location to the respective clinic. After the patient is seen, and thepatient services are completed, the file is returned to medical records sec-tion for filing.

With the present volume of over 250,000 CPR based files and nearly100,000 Medical Record Number (MRN) based files stored at differentlocations, the manual effort involved in pulling out these files on a dailybasis and returning them to their storage location is enormous. Keepingtrack of the location of a file at any given time using a manual procedurerequires a lot of effort and also it is error prone.

To know the location of the file at any given time, medical records sectionhas been using a tracer card. This involves printing a label with file desti-nation information with CPR/MRN number, and appointment dates. Thislabel is stuck on a tracer card which will replace the file in the shelf when itis removed for sending out. When the file comes back, the tracer card isremoved from the shelf and the medical record file is kept in its place. Thisprocedure did not provide the user with a facility to check the location ofthe file from anywhere in SMC quickly.

A computerised Medical Records Tracking system has been developed toaddress these issues. The system will track the files from the Medicalrecords storage shelves through all the locations they are sent such asOPD clinics, wards, admission office and various locations such as adminoffices, doctor's offices, insurance companies, coding, data quality, doctor'sstudy room till they are returned back to the shelves. Also the system willcater to individual doctor's requests for medical record files for study pur-poses.

To reduce the time taken for the data entry of such a large number oftransactions and also to avoid data entry errors, bar code scanners havebeen used to read the labels on the medical records files to get the CPRnumber. With the system in place, the users were able to get instant infor-mation of the location of the files and also did their work much more easilywith less effort.

With a daily appointments download, the system is updated with which clin-ic the files are destined to and it just requires a scan of the CPR numberto record the file movement. The system will help the medical records stafffunction more efficiently and help the patients by reducing errors in manualprocedures.

By: LLakshmana PPadmanabhan

Lakshmana: Senior Systems Analyst

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May 2005, Issue No. 14

By: NNooriya YYousif

The External Hospital Automation Project (EHAP)was initiated in June 2004. The project is aimedat connecting the Sitra, Riffa and Westren RegionMaternity Hospitals to the network so that it canaccess a common database and implementingthe MDIS applications such as patient registra-tion (PMI), Admission Transfer Discharge (ATD),Laboratory, Radiology systems and Imprest mod-ule of Pharmacy System.

The benefits derived from implementing this project are: building the network infrastructure, automat-ing the major functions, reducing the amount of manual work, enabling users to provide a better ser-vice to patients in terms of registering and admitting patients, getting on-line labs and radiologyresults, retrieving patient history data and getting direct, fast and more accurate statistics from thesystem directly.

The project core team consisted of Project Executive "Dr. Hassan Al Jarrodi-Administrator - PeripheralHospitals", Project Sponsor "Mr.Ali Saleh", Program Manager "Ms.Heyam Hazeem", Project Manager"Ms.Nooriya Yousif", Developers "Mr.Hussain Ahmed" and "Ms.Shareefa Ali", Technical support special-ist "Ebrahim Adam" and Quality Reviewer "Mohsin Al-Shamasi".

The project main goals and objectives were achieved such as: improving the quality of service,improving staff utilization and efficiency, providing training to the users using "train the trainerapproach" to enable them use the applications in an efficient manner and enabling staff to performmore efficiently due to quicker and improved access to information.

This project was successfully implemented by March 2005 and will be closed by April 2005. Finally,after the success of this project, more applications will be implemented very soon at maternity hospi-tals such as "MDIS Birth Registration System". The PCs available now to be replaced with higherspecification and the dial-up lines to be replaced with leased lines.

External Hospital Automation Project

Nooriya: Senior Computer System Analyst

By: NNilantha KKumara DDissanayake

Information security is a core management function to protect InformationAssets (Hardware, Software, Data, People, Documentation and Supplies)and to ensure the confidentiality and integrity of information and the timelyavailability of systems and physical infrastructure to authorized users. TheInformation Security problems can be partially solved introducing technicalapproaches such as giving better access control policy models, crypto-graphic protocols, approved firewalls, better ways of detecting intrusionsand malicious code, and better tools for system evaluation and assurance.

Effective Information Security is a team effort involving the participationand support of every employee in the Organization who deals with infor-mation and/or information systems. The first step towards establishing theInformation Security Function in an Organization is the introduction ofSecurity Policies, Procedures and Standards, informing staff on the variousaspects of their responsibilities, general use of resources and explaininghow sensitive information must be handled. To achieve the InformationSecurity objectives, the Information Security Policy must be associated withthe Standards and procedures. Once Information Security Policies,Procedures and Standards have been established it should be clearly com-municated to users, staff, and management.

Standards: The British Standards Institute (www.bsi.co.uk) has formalizedinformation security management and issued the BS7799 Standards toprovide a set of controls comprising best practices in information security.The BS7799 Standard which is accepted as ISO17799 provides a roadmapand framework for developing an Information Security Policy. It is a strongreference point for identifying the range of controls needed for most situa-tions where information systems are used in the business world.

Law: Healthcare providers face particularly difficult challenges due to thesensitive nature of the information they are responsible for safeguarding.In healthcare environment, corrupted information can have grave conse-quences. The provision of high-quality health care requires the exchangeof personal, often-sensitive information between an individual and a skilledpractitioner. The Health Insurance Portability & Accountability Act (HIPAA)is framing the Law for data protection in the Healthcare Industry.

Nilantha: Systems Analyst

Information Security Policy

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May 2005, Issue No. 14

The Health Smart Card is a credit card-sized plastic smart card embed-ded with a computer chip that con-tains the personal, medical andinsurance information neededmost in a medical setting. Thesechips can store information (mem-ory cards) or store and processinformation (microprocessorcards).

The cards can be read by SmartCard readers carried in participat-ing emergency response vehicles and by PC-based readers located inparticipating hospital emergency rooms, physician offices, clinics, pharma-cies, and retirement facilities.

Participants carry the card with them at all times, giving medical person-nel immediate access to their concise medical history, current medica-tions, allergies, the names and telephone numbers of family or friends,and other information necessary for medical treatment decisions.

The Health Smart Card allows participating medical personnel to respondto a patient's needs more effectively because pertinent information isimmediately available when and where it is needed such as:

o The last time you had to be admitted to a hospital? o The frustrating delay in admissions while you answered questions

you had already answered for your doctor? o Did you ever wonder what could happen if you accidentally gave a

wrong answer or forgot something important because you werestressed?

For these, and many other situations, the Health Smart Card is a smart,convenient and affordable solution. You choose what information goes onthe card, and you control future access to the card. That way, your priva-cy is protected.

Health Smart Card can easily be updated as new services are performedand new medications are prescribed so the card will always contain up-to-date, vital medical information. To carry a card or wear a bracelet thatlists your blood type is helpful, but it may say nothing about drug allergiesor our surgical history, what medications we're taking or how recently wewere hospitalized and why.

When we consult a new doctor, it may be difficult to remember the nameof that little white pill our family practitioner prescribed months ago espe-cially if we are taking several other daily medications. Only the HealthSmart Card can save the time and the endless frustration of filling outone long medical form after another.

By: MMohammed AAl-SShehabi

NNaattiioonnaall SSmmaarrtt CCaarrdd wwiitthh HHeeaalltthh DDaattaa

Workflow automation has been started in theHealth Information Directorate as a piloting pro-ject that addresses the leave requests. Thepiloting ended with a great success, where boththe administration and the staff appreciate theonline ability to submit, process and track therequests. The workflow automation project willautomate the major business processes andtasks within the Ministry of Health. In foloweingpoints I would like to demonstrate the concept of the Workfloe

What iis WWorkflow?

The automation of a business process, in whole or part, during which doc-uments, information or tasks are passed from one participant (human ormachine) to another for action, according to a set of procedural rules. 2

Benefits oof WWorkflow AAutomation

Responsiveness: Workflow automation ensures that tasks keep movingtowards the completion of the case and do not fall through the cracks.Workflow solution has the means to specify task times and an escalationmechanism if a task is past its deadline.

Status Monitoring: A workflow solution is capable of providing usersinstantaneous information about the status of any case.

Workflow Reports: By being able to measure and report the time and coststatistics of business processes, a workflow solution can provide vital infor-mation to identify its costs and benefits. This information allows businessmanagers to identify bottlenecks in the process and streamline it accord-ingly.

Consistency and Reliability: Workflow automation ensures that the businessprocess is executed consistently and reliably each time. Human errors andmistakes are reduced, and the solution makes sure that all steps in theprocess are consistently implemented based upon business rules.

Reduce Paper: Manual implementation of business processes is paper-intensive. Workflow automation reduces paperwork from business process-es. This increases convenience and reduces cost.

Reduce Lag Time: Studies which analyze business processes have conclud-ed that lag time ("idle time" or the time tasks are waiting in queues and in-baskets) accounts for approximately 80% of the process time. The actualtask time accounts for the remaining 20%. Therefore, to improve businessprocesses it is imperative that the lag time be reduced.

Process Documentation: Workflow automation forces organizations to ana-lyze their business processes and document them. The exercise of analyz-ing and documenting by itself often reveals redundancies and inefficienciesin the process. Workflow automation therefore forces process documenta-tion, and then ensures that the processes are implemented consistentlythe way they were documented.

1 This article is based on the summary of "Workflow automation: Thenew frontier of productivity" article By Khan, Rashid N.

2 The technical definition of workflow as supported by the WorkflowManagement Coalition (WfMC)

By: MMohammed AAtiya NNeama

Workflow Automation

Mohammed: Programmer

Mohammed: Programmer

6 May 2005, Issue No. 14

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Windows SharePoint Services is a collection of services forMicrosoft Windows Server™ 2003 that you can use to shareinformation, collaborate with other users on documents, and cre-ate lists and Web Part pages. You can also use WindowsSharePoint Services as a development platform for creating col-laboration and information-sharing applications.

SharePoint Portal Server 2003 is a secure, scalable, enterpriseportal server built upon Windows SharePoint Services that youcan use to aggregate SharePoint sites, information, and applica-tions in your organization into a single, easy-to-use portal. Inaddition to the features of Windows SharePoint Services,SharePoint Portal Server 2003 includes the following features:

o News and Topicso My Site, with personal and public viewso Information targeted to specific audienceso Powerful indexing and searching across file shares, Web

servers, secure Web servers, Exchange Public Folders,Lotus Notes, and SharePoint sites

o Alerts that notify you when changes are made to relevantinformation, documents, or applications

o Single sign-on for enterprise application integrationo Integration with Microsoft BizTalk® Server

In addition to the above features, All features of WindowsSharePoint Services are available in SharePoint Portal Server2003.

Hussain: Programmer

By: HHussain MMohd HHadi

Windows SharePoint

It is worth to mention that the implementation ofMicrosoft SharePoint will take place in HealthInformation directorate immediately after the DataMigration Project is finished�

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May 2005, Issue No. 14

Auhood farewell Party

First step to access group wise from home is to create password in your office and then take this - memories - the password to invoke the Ministrypage. And do the following steps to create your own password:

o From GroupWise Mailbox do the following steps :

1. Click on Tools button,

2. Click on Options button.

3. Double Click on Security button.

4. Choose a New Password. "e.g. hiddesk" & repeat same password in "Confirm New Password "hiddesk".

5. Click Ok.

6. Click Close.

So your password now is "hiddesk", which you will use at home or any place out of Ministry ofHealth offices.

o From Internet Explorer:

1. In the Address bar write the following address: http://mail.health.gov.bh

2. Write your User Name "Which you use for Network"

3. Write your Password "Which you created in GroupWise e.g. hiddesk"

4. Click on login to access your account and see your GroupWise mails from GroupWise.

By: HHelpDesk

How to access the GroupWise from InternetFFrroomm hhoommee oorr aarroouunndd tthhee wwoorrlldd

HID held a farewell party for Ms. Auhood Esbai, who workedat the Directorate (IIG Group) as Computer Systems Analystsince November 2001. Mr. Ebrahim AlNawakhda , gave ashort speech about her valuable contributions to HID. Hethanked her on behalf of all staff and wished her good luckin her new job.

The party ended with a short speech from Auhood where she said

“It is hard to believe that more than 3 years have just flownby, but I've enjoyed them all despite any obstacles that mighthave occurred just naturally anywhere. My time here hasbeen a very special experience of my life and that is due tothe wonderful people of HID. With all your support and friend-ships, I have grown significantly both personally and profes-sionally and I want to say thank you for that. I have madeseveral friends in no time and many of you have taught memany valuable lessons in life.

Even though I've decided to move on and take on some newchallenges in my life, your friendships have meant a lot to meand I'm going to miss you all, dearly. I would like to say good-bye to you all with the warmest of wishes. I wish you all goodluck in all your endeavors and hope that we'll meet againsometime in the journey of life.

Thank you once again and until next time”

line

HID INFOLine is published and printed by Health Information Directorate, Ministry of Health.HID Editorial: P.O. Box: 12 Manama - Kingdom of Bahrain, Tel. (+973)17289810, Fax: (+973)17246245, Email: hid@health.gov.bh

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HID �amily day inAl-Sukheer camping

SocialActivity

The social committee organized a camping day in sukheer on 4thFeb 2004 for HID staff and their families, the total attendees werearound 65 including guests, which enjoyed a full day program ofevents such as indoor and outdoor games, motorcycles, breakfastand lunch. All kids participated in these games and they weregiven gifts were given.

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