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An online interview has been organized with the Director General of the National Strategy for e-Health, Dr. Ahmed Bel-Khair, wherein some inquiries regarding the MOH's approach towards the electronic transition have been discussed. The interview that lasted for a whole hour was conducted on October 17th, 2011 (corresponding to Dhul-Qe'dah 19th, 1432H). This service is reckoned one of the manifestations of the effective electronic contributions to developing policies and making health-sector-associated decisions.

Following is the text of the interview:

Let's get started with what is meant by strategy?

It is art, science, and way of thinking directing plans and means; and it is the comprehensive, fully fledged plan which addresses the whole situation with its dimensions; in order to achieve a specific goal at the long term, depending on the tactics and procedures with regard to using and capitalizing on the available sources and capabilities.

And it is the bridge that takes us from "Where are we?" to where we want to be "to Where?"

What are the objectives expected to be achieved through the e-health strategy?

At the beginning, let's review the MOH's e-health vision which looks forward to: "safe, efficient health system, based on the care centered on a patient, standard-oriented, and supported by the e-health."

The work objectives and its needs come as the core of this multi-dimensional vision:

- Patients' care and continuously makes it at the spotlight, and interest and focus on the health care developments.

- Linking all the service providers at all levels; in order to obtain a health system more safe and more efficient and effective.

- Evaluating what we are doing and managing the performance in order to provide the health system, consider it, plan it, and continuously upgrade it.

- Moving to a safe, efficient health system, and obtaining the health services in a fair, equal way.

Tells us about the e-health strategy ideology and how far it copes with the changes.

The ideology of the e-health strategy moves in a gradual way "from general and inclusiveness to depth and specialty" along with providing the data of the e-health registry first for the biggest number of beneficiaries from the health services in the Kingdom as much as possible, then directing the job of the e-health registry at a wide scale to some of the service providers and its recipients with regard to the sub-groups of beneficiaries. As far as the detailed strategy of the hospitals' information systems is concerned, the automation of the hospitals' operation processes, transferring along with tabulation, is to start, then concentrating on repeating this at a wide scale through the new hospitals, followed by additional job capacity and aptness for exchange in the clinical field. This in turn enhances the MOH's goal with regard to providing fair health care, and its focus on meeting the minimum of the health care standards for all the service beneficiaries; in order for the MOH's work motives its requirements to cope with the e-health objectives and its initiatives. Thus, the latest approaches which put into priorities the stage requirements and considerations have been adopted, in light of the roadmap leading the strategic development process in line with developments, and the aim of covering the beneficiaries which the Ministry of Health serves and achieving results swiftly.

What about the phased approach and is it directed with the work needs in order to spread solutions and have them approved and used?

There is a phased approach for change management directed with the work needs, and a strong desire for the Ministry of Health to achieve the tangible objectives in the short timeframe and realize the benefits of the investments in the e-health as fast as possible. But the scope of achieving the e-health vision is still tremendous, and the technology is usually the less complicated side of the e-health, and it is often the fastest part in terms of achieving the vision. As for the benefit from the clinical solutions, they are more complicated and take time due to the change factors, work and training procedures, and skill development. And as for projects, we support an approach distinguished with resilience and fitness in order to overcome barriers and achieve results as following:

- Determining realistic objectives that can be evaluated in order to spread the appropriate solutions.

- Analyzing the status quo, and detecting and analyzing deficiencies and evaluating them; in order to start the correcting and addressing processes for these deficiencies such as standard, policy, and person deficiencies, and the addressing process and technology associated with solution.

- Finding the appropriate solutions for these deficiencies and spreading and applying them in a gradual way coping with change policies.

- Objective-oriented implementing according to the approved solutions, in line with the service requirements and levels, and achieving benefits.

- Evaluating what has been applied of solutions in order to know how far improvement has been made and how far specific objectives have been achieved.

Is there a roadmap leading the strategy and its courses to its final results?

A roadmap has been drawn according to the strategic objectives and initiatives for e-health, and its annual intervals: from 1 to 5; and from 6 to 10. And within each initiative, there are a number of designated projects, and each project has a solution or a final result associated with it contributing to the e-health vision.

How was the e-health strategy prepared and its roadmap?

A lot of considerations have been adopted with regard to preparing the strategy; of which are the Kingdom's traits, the MOH's system considerations, e-health strategy work requirements.

All over the world, countries adopt the e-health system in order to provide a clinical value and improve health care providing and its planning. There is a database rich in lessons learnt in the e-health scope in the general field, which the Ministry of Health managed to rely on them. Also, the experiments and pioneering best practices on the field of e-health for states with similar visions have been analyzed and used to be as introductions for e-health strategies and its roadmap.

What are the challenges and restrictions facing the roadmap during strategy application?

The Ministry of Health has a pressing desire to achieve the utmost that can be achieved within the next five years, in spite of its need for a permanent roadmap for what can be achieved on real ground, taking into consideration the existing situation and restrictions,i.e. the challenges and deficiencies. The most outstanding of which are:

- The peculiar broadness of the MOH sector in the Kingdom, continuous geographical expansion in the health facilities, and diversification of the tremendous clinical labor force which has effect on change and implementing solutions.

- Difficulty of applying e-health comprehensive governance to all health levels and domains.

- Lack of competencies in the field of e-health.

- Difficulty of setting certain criteria for medical terminology, practices and technology; which requires long time, and prompt participation of specialists and senior officers.

- Most workers in the health field are not fully aware of how to employ technology as an integrative, inseparable part of their performance; not to mention that they are not accustomed to working within the framework of unified work policies and processes, all of which subject to accountability. And as a matter of fact, they don't have extensive experience in the field of e-health.

- So far, many health sectors at hospitals and primary healthcare centers, especially of the first and second levels, are not yet automated. Besides, we're still in need of a well-connected health network that is expanded throughout the Kingdom.

- In order for “change” to be brought about, we need promising plans, more ambitious than those attempted in any other place in the world. It will be pivotal to develop an effective strategy, aided with the needed resources, to manage change; thus attaining the potential benefits of the e-health program.

And finally, from your point of view, what are the potential benefits of the e-Health Program?

The e-Health Program is expected to yield a wide range of benefits; to mention some:

- Concerning patient care: as manifested in the health care solutions to be adopted by hospital and primary healthcare centers, for conducting a variety of work processes, as well as facilitating many procedures regarding public health and diagnosis. That's to be added to the performance level of clinical services. Such automation is expected, also, to allow health sectors to get into telemedicine in terms of all aspects, in addition to the higher accessibility to the medial information of persons by means of the e-Portal.

- Concerning connectivity and integration: by which we mean connectivity, interdependence and integration among health systems, with the aim to help exchange health data and information electronically, by means of the Unified Electronic Medical Record.

- Concerning measurement and evaluation: which may be referred to as “health analysis”, upon which information could be electronically handled, and thus easily utilizing it, by way of applying a series of analytical steps that yield several readings and indications to be depended upon when taking important decisions, as well as improving the ability to control diseases by way of facilitating the performance assessment process, at the level of practices / services, for the purpose of enhancing performance. That's to be added to promoting the health systems' capacity, compared to the nationally and internationally adopted preset criteria, performance variables, and key performance indicators (KPIs).