Middle East Successes, Challenges and Trends

Several months ago, KLAS visited the Middle East region. Over the course of five days, we were fortunate enough to have site visits across Saudi Arabia and the United Arab Emirates (UAE) with nine healthcare provider organizations using several different EMR solutions (Cerner, Epic, InterSystems). Our provider friends not only were very welcoming hosts but also detailed many of their successes, challenges, and future trends regarding the delivery of healthcare in their organizations and the impact of their IT vendors and solutions. Here are just a few highlights from some of the conversations we had.

SUCCESSES

1. One provider organization reported a successful 9-11 month rollout of InterSystems TrakCare that included CPOE, LIS, OR, inpatient pharmacy, ADT, scheduling, and registration functionality. This same organization reported many measurable benefits they have already attained from the rollout, including a decreased length of stay because of automated reminders that remind the physicians to check on patients.
2. A provider organization live on Cerner reported very high-level integration with the pharmacy and medication administration systems, including the integration of a large number of Alaris® pumps with the system. With the help of Omnicell, this organization will also be able to define the cost of unit doses. That will be particularly helpful when the supply changes from order to order.
3. A provider organization that chose Epic mentioned the vendor was living up to one of the reasons they were chosen in the first place-their proven implementation methodology.

CHALLENGES

1. More local support. Universally, almost all providers mentioned that they expect more local support from their EMR vendors. While some vendors, like Cerner, have made significant investments in the region, providers still feel the pinch of not having enough feet on the ground. This is amplified by feedback from providers in both countries (Saudi Arabia and the UAE) that finding their own internal qualified resources is also a major issue.
2. Globalization of software. Providers would like vendors to pay more attention to the nuances of their local cultural, workflow, and business practices. This not only helps make the software more usable but also proves the vendor's dedication to the region. While several InterSystems and Cerner clients did mention some country-specific functionality, they still want to see more.
3. Infrastructure. Most providers mention that lagging infrastructure has been a challenge for their new implementation and EMR upgrade pursuits. When underestimated, acquisition costs and supply chain constraints that affect how quickly the technology can be implemented become huge liabilities to the success of a project.
4. Interoperability. The struggle for interoperability is clearly a global problem. Providers in the Middle East report challenges accessing information from other organizations that are running different systems. Providers report difficulties exchanging information between different acute care facilities within the same organization, but they also have problems with ambulatory-to-acute care interoperability.

FUTURE TRENDS

1. Increased patient engagement. One IT leader said, Patients expect high quality of care and feel it is an entitlement. They are also asking for access. Most providers feel a sense of urgency to deliver patient engagement tools, such as patient portals, at the same time that they roll out an EMR. It appears the acceleration of these technologies will be faster than it has been in the U.S. market.
2. Enterprise content management. Even the providers that have implemented electronic medical records still have many years of paper documents that need to be captured and utilized as part of the electronic record.
3. Business intelligence/analytics. Many of the providers we met with are only using very basic reporting that generally comes from the EMR vendor. Most, however, mentioned the need to leverage analytics as a critical “next step” in their organization's electronic journey.