Ministry of Health E-Health Initiatives in Trinidad and

Ministry of Health E-Health Initiatives in Trinidad and Tobago presented by Minister of Health, Senator the Honourable Jerry Narace Commonwealth Business Forum Innovative Solutions to Healthcare

Health Sector in TT ÷ The Ministry of Health leads the Health sector by setting the national health agenda, developing legislation, regulation and financing ÷ Health care at public institutions is provided free of charge at the point of contact (primary, secondary and tertiary health care facilities)

Public Health sector in TT

Vision 2020 for Health A Nation empowered to live long, healthy, happy and productive lives New Model of Health Care Management needed to realize vision

Mo. H’s 3 Strategic Objectives 1. To foster a healthy and productive population through preventive care. 2. To create and maintain a First World health care delivery system; and 3. To develop and manage a comprehensive population based public health system.

Nine Transformational Strategies 1. MOH Institutional Reform 2. Strengthen Vertical Services 3. Upgrade Services and Infrastructure 4. Skills Development and Availability 5. Quality Service 6. Information and Communication Technology 7. Health Financing 8. Strengthen RHAs and other bodies 9. Continuous Improvement

Health Care Business ÷ Health is the third largest public sector expenditure item in Trinidad and Tobago. ÷ For fiscal year 2010, government’s recurrent expenditure allocated to the health sector is $TT 3. 34 billion. Total recurrent spending on health (public and private) is estimated at $TT 6 billion. ÷ 5 year transformational business plan (2008 -2013) -- $TT 30 billion ÷ The health care business is a large, complex industry comprising diverse service providers and hundreds of patient encounters daily.

Health Care Business (cont. ) ÷Effective management requires: çCollection of information for decision-making process. çMonitoring productivity, cost of services to improve efficiency çImproving the assignment of human and technical resources çQuality control using international standards

E-Health in the Commonwealth Source: Massiah, E. (2008) Progress on e. Health in the Commonwealth, in ehealth in the Commonwealth. London: CBC

E-Health transition in T&T “One patient, one record, anywhere, anytime” From this: To this: p. 10

Web NIB Civil Registry CDAP Ambulance Other Schools Local Pharmacy E-Health Vision Passport Insurance companies Regional Hospitals, Health centres & Diagnostics centres GP Practices

Current E-Health Projects ÷ Surveillance system – Stage 1: A web enabled platform to capture treatment data in all HIV facilities, featuring: • Central Lab Information System • Clinical Management System, • Business Intelligence package • Data Export Systems (it will feature e-health records, CM, a central database and on target for a 2012 date of completion) – Stage 2: extend the functionalities to all CNDC’s ÷ In all facilities and Chronic Disease Patients ç In operations: On-line system with private Pharmacies to deliver Chronic patients drugs ç (training, 70 million Illuminat contract on target for a 2010 competion ) ÷ CDEMS (Chronic Disease Electronic Management System) ç Implemented in some RHAs and will roll-out to all p. 12

Current E-Health Projects (cont. ) ÷ Tele-medicine ÷ Tele-radiology (being implemented in ERHA to be expanded to other RHAs) ÷ Tele-medicine for paediatrics ÷ Tele-pathology ÷ E-Health Initiative (planning pilot sites implementation) ÷ E-Health Card ÷ Web based on-line patient eligibility and service validation ÷ Patient’s basic EMR access and Transaction data capture ÷ General Patient’s Appointment system ÷ Drugs Prescription registration and local pharmacy dispensing.

General Appointment System Patient calls NHIS Call Center Requests an appointment with a Health Care Professional (GP, Health Center, Hospital, etc) Appointment Data : · Patient’s ID · HC Facility’s ID · Doctor’s ID · HC Service Code · Date & Time The operator assigns an appointment with the required professional at the most convenient location (Health Care Facility) System validates the Patient’s eligibility and : Appointment is registered in the NHIS

Patient Administration The clerk validates the patient’s identity and confirms the appointment (if any). Co pay is determined if applicable Patient arrives and shows ehealth card EMR are retrieved from the system and handed to the doctor

The Patient’s Healthcare Service Process Drug Prescriptions Diagnostic Service Request Coded Data Entry Medical Records are updated and HC Services are registered HC Service Data Patient’s ID HC Services ID Doctor’s ID Diagnostic Referrals NHS

Benefits ÷ Improved healthcare services – – Decrease in waiting time Better tools for doctor’s review and diagnosis System guarantees confidentiality Access to E-Health portal - customized information and health tips ÷ Improved cost-efficiency ç Eliminate duplication of services ç Improve provider productivity ç Improved quality ç Assess compliance with established medical protocols ç Identification of patient risk-groups for improved management ç Control expenditure patterns ç Reduce adverse events p. 17

E-Health & NHS ÷ E-Health is a KEY enabler of NHS ÷ The National Health Service (NHS) will be a health care system of the Government of Trinidad and Tobago that will provide an Essential Package of health care services to all eligible persons at any public or private health institution of their choice.

E-Health & NHS (cont. ) ÷Registration of provider and beneficiaries ÷Payment of claims to providers for services delivered ÷Collection of contributions from employers, employees and the self employed ÷Auditing collections and claims processing system and ensuring efficiency ÷Provide information for Actuarial Reviews of the NHS Fund

Outcomes • Synergistic and integrated health care IT system – Ease of use – Comfort with experience – Confidence in outcome • Bringing us closer to first world status

Thank you Q&A