How Qatar Can Develop eHealth Initiatives
01 Jan 09:13 AMSector : Healthcare Country : Qatar
By Booz & Company
Governments need to rethink their health systems if the sector is to keep up with the digital revolution. Gulf countries in particular will need to examine how they can harness the power of electronic healthcare (eHealth) to grapple with their specific challenges. Healthcare provision in the Gulf is becoming more sophisticated, thanks to rising prosperity and more educated, demanding, patients. It is also growing more costly given risen incidence of lifestyle-related diseases, such as obesity.
The Benefits of eHealth
Digitization of healthcare is an attractive path for Qatar. An eHealth policy can lead to greater efficiency, in terms of cost and time, and lead to improved patient outcomes - the main goal of any health system. Additional attractions are that eHealth will promote private sector participation in the economy and encourage the development of high-tech, knowledge-based activities, both of which are national development goals.
Health systems that have implemented digitization have made impressive efficiency gains. The US Department of Veterans Affairs (VA), for example, has employed automated data processing systems for decades. This allows the VA, which deals with around 6 million patients a year, to keep track of records through databases, standardize the prescription prohealthy cess, and ensure continuity of care. The VA can look at any patient’s records, alter them as needed, and the system immediately captures the changes. There is no need to transfer files or documents, and the patient can walk into any VA clinic or hospital and their up-to-date records are already there. The efficiency gain to the VA has been ongoing, with annual improvements of 6 percent. Quality of care is also enhanced because there are fewer avoidable errors. VA prescriptions are accurate to a rate of 99.997 percent.
Such efficiency improvements lead to substantial savings. In Canada, for example, the national eHealth program is projected to offer gross savings of more than $80 billion over a 20-year period. Qatar already recognizes the importance of eHealth. The National Development Strategy 2011-2016 includes a National Health Strategy and a National ICT Plan 2015. These aim to reinforce and accelerate existing eHealth initiatives. As part of these plans, Qatar will introduce a National Health Card that will provide administrators, chemists, and physicians and with immediate and easy access to a patient’s insurance details and health records.
What the Government Can Contribute to eHealth
To meet its eHealth goals, Qatar will need to bring together a complementary mixture of public and private capabilities. Digitization and healthcare are complex, multi-year endeavors. They require capabilities that neither the public nor private sectors uniquely possess, along with substantial investment.
In particular, eHealth programs require extensive technological expertise and capabilities in highly specialized fields such as coding, standards, and system integration and interoperability. As eHealth is an evolving ecosystem that requires frequent updates and upgrades, the government will need to acquire the capability to manage and oversee these projects so that the result is innovation as well as implementation.
From the government’s side, the existing capabilities that it can contribute stem from its position as a licensor, regulator, and funder. The government has the necessary overarching legal and regulatory powers, the capability to facilitate eHealth regulation, to issue licenses, and define appropriate fee levels. By focusing on the governance of eHealth initiatives, the government can ensure that public and private stakeholders, and the ultimate beneficiaries, the patients, understand and support changes to healthcare provision. If patients trust the eHealth solutions on offer, trust that can be reinforced through government oversight and regulation, the more likely they are to willingly use the new digital health system.
The government can also make eHealth projects financially viable by guaranteeing volumes of patients. Private sector firms need to know that there will be enough customers before they enter the eHealth business because of its large, upfront costs. This is particularly important in Qatar where the government is already the largest healthcare provider with over 60 percent of the market. Similarly, the government can actually cover some of the costs of eHealth thanks to its strong fiscal position. In Qatar funding is available for eHealth as part of the National ICT plan. Although official funds can kick start eHealth, the attraction for the government of combining with the private sector is the prospect of introducing private financing over the long-term.
The Private Sector Role
The government can determine its choice of private partners by their capability to offer technological support and provide the range of services, infrastructure, and innovation that eHealth demands. The government’s private partners will need the ability to reach customers instantly, to transmit the full range of relevant information, and enable interaction with the health provider. These partners will need to possess the capability to plan, structure, and implement eHealth solutions. Above all, given the pace of change in the digital field, they will need the capability to innovate.
In most countries, including Qatar, telecom operators are well placed to provide these capabilities to the health system. Telecom firms have technological expertise that includes a proven record of accomplishment of designing, deploying, and operating large scale ICT infrastructure, as well as providing end-toend program management and handling customer care. These firms can leverage their extensive humancapital capabilities to support governments in such national scale digitization initiatives as eHealth. Telecom operators have the technological expertise and resources to make large scale investments. Moreover, they possess a deep understanding of both publicand private-sector operations.
Telecom operators also have much to gain from an alliance with the public sector to provide eHealth. These companies are seeking new opportunities for growth because their conventional voice and data services markets are nearing saturation. Teaming up with the government to support eHealth programs can give telecom operators the entry to digital services that they need to create value over the long term.
The Right Model for Public–Private Cooperation
Bringing public and private capabilities together requires the correct model. One method is to use public– private partnerships (PPPs). What a PPP does is divide up risks and responsibilities between the public and private sectors. Developed countries started using PPPs decades ago to finance expensive infrastructure, a practice now followed by developing economies.
By contrast, a fiscally sound government like Qatar is in a strong position to customize PPPs to promote its national development goals of diversifying the economic base and offering more opportunities to the private sector. In Qatar, a PPP would allow the government to retain control of the regulatory responsibilities of healthcare, while handing the financial and operational risks of building and maintaining the eHealth systems to the private sector.
Although PPPs are often associated with large-scale infrastructure projects, they are being successfully implemented in healthcare. In Europe, governments have used PPPs to create regional programs, such as in Italy’s Lombardy region. The Lombardy regional government formed a PPP with telecom operators and other private-sectors players. They have launched a national health and social services electronic card that serves Lombardy’s 9.5 million residents at an investment cost of $534 million.
In addition to improving the role and capabilities of the private sector, PPPs also build government capabilities and cultivate an ethos of public-private cooperation. Governments seeking to implement eHealth PPPs will need the capabilities to manage, oversee, and learn from these highly complex projects.
By marrying the strengths of the public and private sectors, Qatar will improve its health care system and share implementation risk with private partners. Telecom operators will have a valuable opportunity to be part of the next big wave of growth in digital technologies. Patients, providers, and payers will be part of an efficient digital ecosystem that boosts innovation and leads to improved health outcomes.