- A focus on data quality is paramount to the success of an E-Health ecosystem. Making informed decisions on patient safety through confidence in the underlying data from multiple organizations will help ensure maximum benefit to the health system while at the same time minimizing errors made with incomplete or unreliable data. Good data is a fundamental pre-requisite for supporting new advanced data analytics services that will be providing reporting and insights about the health system.
-
Data governance ensures that there is accountability and focus on data usage across the full health ecosystem. It includes oversight on data sharing policies as they relate to sensitive patient date.
- A system of policies, regulations and legislation will cover the protection of sensitive patient data for multiple purposes including primary, secondary and tertiary care and health analytics. In addition, the securing of this information from external parties will help build confidence in the E-Health system in order to maximize health system benefits.
- Terminologies provide the basis to derive meaning and knowledge from health data, especially to transform textual data into codified terms. Active management of terms and the establishment of a terminology authority (or National Product Center) will help ensure that terminologies are maintained appropriately.
- As with the E-Health Guiding Principles, a sustainable E-Health ecosystem needs to define, attract and build the necessary data management skills and capabilities in a local workforce.
E-HEALTH CONCEPTUAL MODEL
To achieve the E-Health vision that has been agreed, it is necessary that all components of the E-Health ecosystem be designed and implemented to work collaboratively towards a common goal: better health for all people in Qatar.
Each conceptual component represents the various resources, processes and technologies that will be impacted, at some form or another, by this Strategy.
Component |
Description |
Strategy Implication |
E-Health and
Data
Management
Governance | Defines the organizations, roles and responsibilities, policies and processes of the E-Health Program. | Implementation of E-Health policies and organizations is imperative for the launch and success of the National Program. |
Health Information Infrastructure | Collection of E-Health resources, including people, technologies and national services, required to support the collection and sharing of health information. | Establishment of the national E-Health services needs to be prioritized in order. Foundational services, repositories and systems need to be procured and implemented early in the program timeline. |
Electronic Medical Record (EMR) | All application systems that digitize health data at the care delivery points of services (e.g. hospital systems, pharmacy systems, lab systems, etc.). | The Strategy needs to promote the use and adoption of EMR systems in all healthcare delivery locations, both private and public services. |
Personal Health Account (PHA) | Collection of consumer health applications that include a unified personal health record and support health self-management services for individuals in Qatar. | The PHA is the centerpiece of the Strategy, as it is the primary door to the E-Health services for all individuals. Many of the envisioned benefits require active participation of patients and caretakers. |
Component |
Description |
Strategy
Implication |
Population
Health
Systems |
Collectionofsystems that monitor population-levelhealthmatters suchas, but not limitedto,non-contagious and contagious diseasemanagement, outbreakdetection,immunization management, etc.). |
PublicHealthsystems focus onhealthy lifestylepromotionandpatient empowerment, diseasepreventionand populationhealthprotection. In orderto do this effectively,thesesystems will depend on reliableinformationfrom healthcare facilities aswell as a
secure channel for direct communicationwithall providers and otheremergencyresponse agencies. |
HealthData Services |
Consistsofthecollection,quality review, aggregationand reporting of health-relateddatafor clinical and system-wide use. |
Withtheincreasing availabilityofcoded clinical
data,supportedbystandardized terminologies,it willbepossibleto create advanceddataanalytics services,forboth clinical and operationalhealth data. |
Health
Research
Network |
Collectionof organizations that perform health-specific research (e.g. evidence- basedprotocols,populationhealth management,genetics,disease prevention,healthsystem performance, etc.). |
Thehealthresearch communitywillbea key
beneficiary ofthe E-HealthStrategy onceinitialservicesareoperationaland morehigh-qualityclinicaldatabecomes available. However,newpoliciesforthe useofthis datawillrequire patient consent. |
HealthInsurance Funding |
Collectionoforganizations, policiesand processesassociatedwiththepayment forhealthcareservices inQatar. |
Significant transformationis under way
on howhealthcareservicesare funded. NHIC is thefirst organizationto collect detailed system-widedata,and willbenefit from theextendedcapabilities to beprovided bythenationalhealthdataservices. |
Population Health Systems | Collection of systems that monitor population-level health matters such as, but not limited to, non-contagious and contagious disease management, outbreak detection, immunization management, etc.). | Public Health systems focus on healthy lifestyle promotion and patient empowerment, disease prevention and population health protection. In order to do this effectively, these systems will depend on reliable information from healthcare facilities as well as a secure channel for direct communication with all providers and other emergency response agencies. |
Health Data Services | Consists of the collection, quality review, aggregation and reporting of health-related data for clinical and system-w | ide use. | With the increasing availability of coded clinical data, supported by standardized terminologies, it will be possible to create advanced data analytics services, for both clinical and operational health data. |
Health Research |
Network | . | The health research community will be a key beneficiary of the E-Health Strategy once initial services are operational and more high-quality clinical data becomes available. However, new policies for the use of this data will require patient consent. |
Health Insurance Funding | Collection of organizations, policies and processes associated with the payment for healthcare | services in Qatar. | Significant transformation is under way on how healthcare services are funded. NHIC is the first organization to collect detailed system-wide data, and will benefit from the extended capabilities to be provided by the national health data services. |
PART II: REALIZING THE VISION
TECHNOLOGY ADOPTION
The availability of quality health information in digital form is an essential pre- requisite for achieving the E-Health Vision and benefits. Most health data is still processed using paper today and significant effort and investments need to occur in order to change this scenario. The adoption of modern, standards based IT solutions must take place across everywhere, including government, semi-government and public sector organizations.
The E-Health Program will need to collaborate with the various stakeholders to find pragmatic and creative solutions to resolve this issue and accelerate the use of digital solutions while implementing the national E-Health services.
Personal Health Account (PHA)
The National Health Strategy has as one of its main goals enhancing the wellness of the people of Qatar so that a vibrant, healthy, and productive society can be established for today, and for the future. To achieve this goal, individuals need to be engaged and empowered to manage their own health status and that of other people they may be responsible for.
This is the principal purpose of the Personal Health Account (PHA), which forms the primary focus of this strategy. The PHA will not only provide the desired single point of interaction between individuals and their health data and services, it will also act as the primary guide to decisions and priorities to be made by the national E-Health Program.
Electronic Medical Record Systems
Several governmental and semi-governmental healthcare providers have embarked or are planning to embark on various programs to implement EMR systems with a defined roadmap. The current implementation of a single, EMR system across all HMC hospitals and PHCC sites is the best example of the financial and organizational commitment of these entities to automate their clinical processes and digitize their health data.
However, many other providers, mainly within the private sector, do not have such systems in place and some don’t even have immediate plans to implement them. This situation cannot be allowed to continue, both for the quality and safety of healthcare services, but also if the E-Health Vision is to be achieved.
One of the key priorities of the E-Health Program will be to find ways, through a combination of incentives and penalties, to accelerate the adoption of electronic systems in all organizations that deliver health care in the country. A robust understanding of program benefits is required for designing incentives and penalties that promote value generation by stakeholders. It will also need to establish the minimum requirements, standards and capabilities that these new systems will need to meet in order to become participants of the national E-Health services.
Population Health Systems
Population Health Systems is a category of applications that perform continuous, systematic collection, analysis and interpretation of health-related data at a population level. This data can be used for the planning, implementation, and evaluation of communicable disease outbreaks. If an outbreak is detected, contact tracing, outbreak management and case management functions are used to monitor the outbreak and help ensure the outbreak is contained. As recent outbreaks as MERS, Ebola and SARS have demonstrated, disease outbreak can move swiftly and across borders.
Therefore, it is critical to have systems in place to help detect, monitor and contain communicable disease in Qatar, and indeed, the GCC region.
Population Health Systems also include preventive measures such as managing immunizations provided to a patient group (cohort) as part of a vaccination program. Many diseases can be prevented and / or mitigated through a demonstrated program of vaccination; knowing which patients have received specific vaccines can assist in their treatment.
Population health systems will leverage Health Data Services (see E-Health Conceptual Model), aggregating and summarizing data at a population level. This can be used for identifying outbreaks, cohorts for immunization campaigns and for identifying population groups for education and preventative planning measures. Population health systems could also leverage social media in some situations to better predict trends in the population.
E-HEALTH AND DATA MANAGEMENT GOVERNANCE
The E-Health and Data Management Steering Committee has provided the leadership and guidance needed during the development of the E-Health and Data Management Strategy.
To ensure the successful implementation of this Strategy over the coming years, a permanent governance structure and respective operational business functions needs to be formally established.
The proposed governance model is composed of the following levels:
Strategic: Where overall direction to the E- Health program will be established and confirmed;
Functional: Where committees and groups will entertain specific topics such as lab exchange standards, national E-Health blueprint management, and clinical coding standards, for example;
Operational: Leveraging staff and resources from an E-Health program office to support the Strategic and Functional committees; and
Analytical: Responsible for the strategic and functional processing of health data for the purpose of reporting, analysis, policy development, system management, regulation and research.
LEGISLATIVE AND REGULATORY CHANGES
Qatar has a comprehensive and fine grained State Legal System. The MOPH is the highest authority for the supervision of medical care in the State of Qatar. The MOPH has wide authorities to achieve its role and purpose. Alongside the MOPH, in matters of importance to the E-Health Program, is the Ministry of Information and Communication Technology (MICT), which is the legal regulatory authority
in the Information and Tele-Communication sector in the country.
The national E-Health Program will have to be created and governed within this complex legal framework. New laws, policies and regulations will likely need to be created to provide the support to establish the organizations, rules and requirements, incentives and remedies required to fully execute the E-Health Strategy.
Data Privacy Laws
A Data Privacy Law is currently being developed and will provide for the first time a comprehensive set of safeguards that defines the rights of individuals to decide what can be done with and who may access their personal information that has been collected by other parties.
A key cornerstone in both draft laws is the individual’s right to grant or deny consent for data sharing and uses beyond the original purpose for which the data was collected. Under the principle of express, informed consent, the
individual must be first educated on the required use of their health data for the purpose of healthcare services, and also be advised if that information may be used for different purposes in the future (e.g. research, etc.) in the future. An explicit consent must be obtained or confirmed before personal health information can be collected and processed.
E-Health and Data Management Regulations
The Ministry of Public Health is the preferred vehicle to regulate E-Health in the State of Qatar and house a new entity which will oversee the governance of the national E-Health Program. Based on its enabling legislation, the MOPH has the powers to issue policies, adopt new organizational structures, supervise technical systems for health data, and set out policies for systems of control within the health care industry.
These policies will need to address the following areas:
• Patient Consent Policies: Defining when and how consent to process health data should obtained from an individual;
• E-Health Governance: Defining the new organization that will be responsible for executing the E-Health Strategy;
• Data Security Policies: Defining security requirements for protecting health data (e.g. Business Continuity Management, Risk Management, Identification, Authentication and Authorization, etc.);
• Data Management Policies: Defining data lifecycle responsibilities and requirements (e.g. Data Ownership / Stewardship, Audit, Creation and Collection, Retention and Disposal, Data Quality, etc.);
• Right to Use Policies: Defining the purposes for which health data can be used by providers in the direct delivery of care to the patient
(e.g. “Need to Know” rules); and
• Data Sharing Agreements: Defining the purposes for which health data may be shared between organizations and terms of responsibilities that must be observed by all custodians of that data.
LEGISLATIVE AND REGULATORY CHANGES
Qatar has a comprehensive and fine grained State Legal System. The MOPH is the highest authority for the supervision of medical care in the State of Qatar. The MOPH has wide authorities to achieve its role and purpose. Alongside the MOPH, in matters of importance to the E-Health Program, is the Ministry of Information and Communication Technology (MICT), which is the legal regulatory authority
in the Information and Tele-Communication sector in the country.
The national E-Health Program will have to be created and governed within this complex legal framework. New laws, policies and regulations will likely need to be created to provide the support to establish the organizations, rules and requirements, incentives and remedies required to fully execute the E-Health Strategy.
Data Privacy Laws
A Data Privacy Law is currently being developed and will provide for the first time a comprehensive set of safeguards that defines the rights of individuals to decide what can be done with and who may access their personal information that has been collected by other parties.
A key cornerstone in both draft laws is the individual’s right to grant or deny consent for data sharing and uses beyond the original purpose for which the data was collected. Under the principle of express, informed consent, the
individual must be first educated on the required use of their health data for the purpose of healthcare services, and also be advised if that information may be used for different purposes in the future (e.g. research, etc.) in the future. An explicit consent must be obtained or confirmed before personal health information can be collected and processed.
E-Health and Data Management Regulations
The Ministry of Public Health is the preferred vehicle to regulate E-Health in the State of Qatar and house a new entity which will oversee the governance of the national E-Health Program. Based on its enabling legislation, the MOPH has the powers to issue policies, adopt new organizational structures, supervise technical systems for health data, and set out policies for systems of control within the health care industry.
These policies will need to address the following areas:
- Patient Consent Policies: Defining when and how consent to process health data should obtained from an individual;
- E-Health Governance: Defining the new organization that will be responsible for executing the E-Health Strategy;
- Data Security Policies: Defining security requirements for protecting health data (e.g. Business Continuity Management, Risk Management, Identification, Authentication and Authorization, etc.);
- Data Management Policies: Defining data lifecycle responsibilities and requirements (e.g. Data Ownership / Stewardship, Audit, Creation and Collection, Retention and Disposal, Data Quality, etc.);
- Right to Use Policies: Defining the purposes for which health data can be used by providers in the direct delivery of care to the patient
- (e.g. “Need to Know” rules); and
- Data Sharing Agreements: Defining the purposes for which health data may be shared between organizations and terms of responsibilities that must be observed by all custodians of that data.
LEGISLATIVE AND REGULATORY CHANGES
Qatar has a comprehensive and fine grained State Legal System. The MOPH is the highest authority for the supervision of medical care in the State of Qatar. The MOPH has wide authorities to achieve its role and purpose. Alongside the MOPH, in matters of importance to the E-Health Program, is the Ministry of Information and Communication Technology (MICT), which is the legal regulatory authority
in the Information and Tele-Communication sector in the country.
The national E-Health Program will have to be created and governed within this complex legal framework. New laws, policies and regulations will likely need to be created to provide the support to establish the organizations, rules and requirements, incentives and remedies required to fully execute the E-Health Strategy.
Data Privacy Laws
A Data Privacy Law is currently being developed and will provide for the first time a comprehensive set of safeguards that defines the rights of individuals to decide what can be done with and who may access their personal information that has been collected by other parties.
A key cornerstone in both draft laws is the individual’s right to grant or deny consent for data sharing and uses beyond the original purpose for which the data was collected. Under the principle of express, informed consent, the
individual must be first educated on the required use of their health data for the purpose of healthcare services, and also be advised if that information may be used for different purposes in the future (e.g. research, etc.) in the future. An explicit consent must be obtained or confirmed before personal health information can be collected and processed.
E-Health and Data Management Regulations
The Ministry of Public Health is the preferred vehicle to regulate E-Health in the State of Qatar and house a new entity which will oversee the governance of the national E-Health Program. Based on its enabling legislation, the MOPH has the powers to issue policies, adopt new organizational structures, supervise technical systems for health data, and set out policies for systems of control within the health care industry.
These policies will need to address the following areas:
•
Patient Consent Policies: Defining when and how consent to process health data should obtained from an individual;
•
E-Health Governance: Defining the new organization that will be responsible for executing the E-Health Strategy;
•
Data Security Policies: Defining security requirements for protecting health data (e.g. Business Continuity Management, Risk Management, Identification, Authentication and Authorization, etc.);
•
Data Management Policies: Defining data lifecycle responsibilities and requirements (e.g. Data Ownership / Stewardship, Audit, Creation and Collection, Retention and Disposal, Data Quality, etc.);
•
Right to Use Policies: Defining the purposes for which health data can be used by providers in the direct delivery of care to the patient
(e.g. “Need to Know” rules); and
•
Data Sharing Agreements: Defining the purposes for which health data may be shared between organizations and terms of responsibilities that must be observed by all custodians of that data.
LEGISLATIVE AND REGULATORY CHANGES
Qatar has a comprehensive and fine grained State Legal System. The MOPH is the highest authority for the supervision of medical care in the State of Qatar. The MOPH has wide authorities to achieve its role and purpose. Alongside the MOPH, in matters of importance to the E-Health Program, is the Ministry of Information and Communication Technology (MICT), which is the legal regulatory authority
in the Information and Tele-Communication sector in the country.
The national E-Health Program will have to be created and governed within this complex legal framework. New laws, policies and regulations will likely need to be created to provide the support to establish the organizations, rules and requirements, incentives and remedies required to fully execute the E-Health Strategy.
Data Privacy Laws
A Data Privacy Law is currently being developed and will provide for the first time a comprehensive set of safeguards that defines the rights of individuals to decide what can be done with and who may access their personal information that has been collected by other parties.
A key cornerstone in both draft laws is the individual’s right to grant or deny consent for data sharing and uses beyond the original purpose for which the data was collected. Under the principle of express, informed consent, the
individual must be first educated on the required use of their health data for the purpose of healthcare services, and also be advised if that information may be used for different purposes in the future (e.g. research, etc.) in the future. An explicit consent must be obtained or confirmed before personal health information can be collected and processed.
E-Health and Data Management Regulations
The Ministry of Public Health is the preferred vehicle to regulate E-Health in the State of Qatar and house a new entity which will oversee the governance of the national E-Health Program. Based on its enabling legislation, the MOPH has the powers to issue policies, adopt new organizational structures, supervise technical systems for health data, and set out policies for systems of control within the health care industry.
These policies will need to address the following areas:
• Patient Consent Policies: Defining when and how consent to process health data should obtained from an individual;
• E-Health Governance: Defining the new organization that will be responsible for executing the E-Health Strategy;
• Data Security Policies: Defining security requirements for protecting health data (e.g. Business Continuity Management, Risk Management, Identification, Authentication and Authorization, etc.);
• Data Management Policies: Defining data lifecycle responsibilities and requirements (e.g. Data Ownership / Stewardship, Audit, Creation and Collection, Retention and Disposal, Data Quality, etc.);
• Right to Use Policies: Defining the purposes for which health data can be used by providers in the direct delivery of care to the patient
(e.g. “Need to Know” rules); and
• Data Sharing Agreements: Defining the purposes for which health data may be shared between organizations and terms of responsibilities that must be observed by all custodians of that data.