Thursday, April 17, 2014

From drinking a Corona to potentially catching the Corona virus.

Nothing tasting better than
a Corona
(except a Heineken of course)
It had been only one week since eating out in Mexico City at night and having a Corona or two, that I landed in Jeddah, Saudi Arabia during the Corona virus scare. This virus has nothing to do with the famous Mexican beer but rather is an abbreviation of Coronaviridae, the name of a family of RNA viruses. It is also known as the MERS or Middle East Respiratory Syndrome. 

Apparently when I landed in the region, a visitor had just died and the death toll was up to almost 70 people, while there are more than 200 cases reported. Unfortunately, the whole affair overshadowed the second HIMSSME conference in this city as healthcare public officials were more worried about the public unrest and concerns than paying attention to the conference. 

Interestingly enough, the advent of health care IT implementations, and especially the reporting, surveillance, and analytics of healthcare information, as shown at the IHE showcase during the conference, is exactly what would assist in the management of such outbreaks.

Talking about the IHE showcase, this year was a major improvement over last year’s first exhibit. There were two use cases shown, each with eight stations, but despite the fact that there were “only” two, it would take at least a whole hour to go through each one of them to appreciate all of the details of how these systems could communicate.

Busy booth of MOH (ministry of Health)
The good news of this show was that there was a lot of “kicking the tires,” as there are several major tenders out to be awarded in the Kingdom of Saudi Arabia, which is making a major investment in healthcare infrastructure. In contrast to the United States, where the implementation of public Health Information Exchanges (HIE’s), which will serve as the hubs to register and even be repositories for regional health care systems is still progressing very slowly, the feeling is that in Saudi Arabia there will be a very fast-paced and massive implementation in the very near term in this region. In addition to the infrastructure being put in place, the feeder hospitals and clinics will need upgrades to their PACS systems to install Vendor Neutral Archives (VNA’s) that can communicate with the infrastructure using the applicable IHE profiles (PIX/PDX, XDS).  Key to the success of this initiative is that all the Electronic Health Records need to be ready to exchange information using standard communication protocols and especially the new templates in the form of CDA (Clinical Document Architecture) so that instead of shuffling documents back and forth the data can be imported and exported electronically.

Despite the virus outbreak, the HIMSSME was very well attended, and the smaller scale made it easy to get around and spend a lot of time with the vendors that were present. Instead of relying on local dealers, many vendors are now opening their own offices, either forced by the fact that the service and support has been generally very poor by their local representatives, or because of conditions written in the outstanding tenders. I would argue that if a dealer does not perform, it is in many cases due to insufficient training and support by the parent company, but there is no question that a wholly owned operation is often managed more effectively. A potential issue is the ever-increasing requirement by the Saudi government to hire a certain percentage of Saudi nationals, which as of now is 25 percent. This may be a temporary issue as there currently is a lack of skills and training among these professionals, but with the ever increasing stream of young graduates coming back to their country after being sent abroad to study in first class universities, many of them in the USA, there should be a sufficient labor pool available, if not now, then very soon.

The virus outbreak was indeed an annoyance. The fact that many of the children were kept home from school did indirectly impact me, as many of the non-essential healthcare workers such as IT personnel, which I would have liked to visit with in Jeddah, stayed home, which was kind of a bummer. Anyway, a good reason to come back to Saudi Arabia next time, may not be Jeddah but Mecca, which is one hour away. Consequently, the plane was 90 percent filled with pilgrims, all dressed in their white loin cloths and shawls, which definitely made me feel out of place, but they were all very friendly and accommodating. This is what makes travel interesting and never boring.