International experts convened at the ‘Interoperability Forum’ session to discuss standout interoperability deployment projects across the Middle East and deep dive into the Health Information Exchange (HIE) initiatives that have ensued. As one of the founding partners, HIMSS, along with HL7 International and IHE International of the Global Consortium for eHealth Interoperability, highlighted how national governmental agencies, health systems and their partners must leverage emerging interoperability standards to improve clinical and financial outcomes.
The speakers were Dr Charles Jaffe, CEO at HL7, Tareq Hakeem, National eHealth standards interoperability manager and Hessa Ibrahim Al-Abbad, Vision and digital transformation director from the National Health Information Center, Saudi Health Council, Rob Havasy, managing director, Personal Connected Health Alliance, HIMSS, Lydia Lee, Partner and national leader, Digital Health KPMG, Charles Parisot, Principal & chief executive, InteropEhealth, Chair IHE services, IHE Europe, as well as Atif Al Braiki, CEO, Malaffi, Abu Dhabi Health Information Exchange.
Leveraging interoperability standards
With the key aim of widespread eHealth interoperability at its heart, the Global Consortium for eHealth Interoperability enables national governmental agencies, health systems and their stakeholders to leverage emerging interoperability standards and the latest implementation guidance to achieve better health outcomes. The consortium aims to do this by decreasing barriers and accelerating the rapid and efficient deployment of next-generation, API-based interoperable standards.
Havasy explained: “Around the world, the lack of interoperable data and information exchange has slowed health information and made obtaining care more difficult for many people.
“Earlier this year, HIMSS, HL7 international and IHE international joined forces and established the Global Consortium for eHealth Interoperability to advance digital health interoperability for patient care globally.
“Adoption of standards across the healthcare community, as well as proactive local leadership are keys to successful large scale, interoperable initiative.
Parisot continued by divulging more on the structure of the initiative: “This consortium is in a sense, unique because you have HIMSS which has a very strong reach in the education, in the awareness, in bringing a lot of thought leaders together.
“You have IHE that has experience in testing, deployment and in organising the governance of such interoperability projects. You have HL7 that is one of the major standard developing organisations that has invested a very significant effort in standards like FHIR that have been quite successful.
“We are welcoming the emergence of such a consortium because many countries have been struggling and we want to make sure that we bring a level of efficiency in deploying eHealth worldwide, which is an even higher priority after the pandemic,” added Parisot.
Health Information Exchanges across the regions
In the UAE region, Malaffi prides itself for being the region’s first unified HIE, tasked with enabling the meaningful exchange of patient health information between healthcare providers and creating a centralised database of patient records.
Similarly, the Saudi Health Information Exchange (SHIE) delivers capabilities to enable the electronic sharing of health information and services across the Kingdom of Saudi Arabia. The panel recognised learnings from leading deployment projects across the Middle East and Gulf region and how the work of Health Information Exchange (HIE) initiatives have been consequently refined.
“What we really want to achieve is to use the information that has been exchanged. That’s what semantic integrity is really more about,” noted Hakeem.
“Before the launch of our Health Information Exchange, we did an eHealth standards-based interoperability project for a number of key use cases back in 2014. This actually specified the interoperability specification in terms of standard profile messaging terminologies.”
On the promising results accomplished through the IHE, Parisot said: “Today after 20 years of IHE, we have hundreds of millions of patients around the world, 150 million alone in the US and about the same number in Europe whose records are being shared every day today using IHE profiles and products.
However, Parisot conceded that: “A challenge that we have noticed is that to make interoperability work effectively you need robust governance of interoperability.
Imparting effective strategies used to set up governance within interoperability, Parisot explained: “We assist by providing the experience of about 15 different countries that have had different governance models, understanding what has worked, what has not worked and driving also the development of policies, and making sure the requirements for interoperability are well defined.”
The panel also touched on the ways Saudi Arabia has taken advantage of the relatively open governance climate. Hakeem said: “We actually customised coding to the context of Saudi Arabia. In addition, we created IHE Saudi Arabia in the context of Saudi Arabia and the UAE.
“We also participated in the Global Digital Health Partnership (GDHP) and in the published white paper regarding interoperability. All of these standards now will be used.”
All speakers shared the opinion that interoperability goes beyond technical standards and decision-makers across organisations and countries need to work together to establish governance structures that facilitate collaboration.
What’s next for interoperability?
Data flow provisions have been noted as a key factor of robust interoperable services being deployed across the Kingdom in the coming months. Discussing patient portals, Hakeem said: “One feature we would like to have is the integration with the medical devices.
“But it’s more than this, the patient should have access to a library and education. We’re really considering this, but the standards in this area might be limited somehow, as they are applicable to certain models of medical devices. So this is my real concern.”
Talking about patient centred services and the way data could flow from and to personal connected devices, Dr Jaffe said: “I think the COVID pandemic has driven a different viewpoint about patient adoption, certainly, virtual office visits have become the norm as patient access to the clinical environment is limited.
“It’s always been an issue of policy and governance. To understand the way patient contributed data or patient originated data could be both enabled in an electronic health system.
“It is not seamless, yet. The process of making that seamless is a challenge and it will take the wisdom of the people who operate the systems to overcome,” concluded Dr Jaffe.