Oman. Al-Shifa Electronic Health Record System: From Simple Start to Paradigm Model
Ahmed Al-Mandhari, Abdullah Al-Raqadi, and Badar Awladthani
CONTENTS
Background..........................................................................................................332
Details of the Success Story...............................................................................333
Details of the Impact of the Success Story......................................................334
Implementation: Transferability of the Exemplar..........................................335
Prospects for Further Success and Next Steps................................................336
Conclusion...........................................................................................................336
Background
As part of a national 5-year annual strategic plan that began in 1976, the Ministry of Health (MoH) in Oman has instituted several initiatives to facilitate the delivery of efficient and effective healthcare services on par with international best practice. The introduction of the electronic health record system known as Al-Shifa represents a success story for Oman. Al-Shifa closely follows healthcare practices in Oman and covers a wide range of hospital administration and management processes. Al-Shifa aims to improve the quality of healthcare services and patient safety through the provision of accessible, secure, and accurate records of patient data. Such a system helps in the efficient utilization of available resources through the secure sharing of health information among healthcare providers. This has implications for lowering the cost of delivering healthcare services and creates a database that can be utilized by researchers and administrators in order to chart the pattern and trend of disease in the country (Al-Raqadi, 2013; Ministry of Health [Oman], n.d.).
The Al-Shifa system is expanding its capacity at vertical and horizontal levels. Major efforts have been made at the macro, meso, and micro levels to enhance its success. At the macro level, the MoH's Health Vision 2050 has incorporated a unified and interconnected electronic healthcare system as an important part of its plan to develop all components of the healthcare system. At the meso level, the MoH has taken steps to ensure the incremental development of the system, including recruiting skilled staff and upgrading the infrastructure of both hardware and software, in order to cater to national needs. In 2010, as an outcome of these developments, the MoH began installing the fourth version of the system (Al-Shifa 3+), which has new functionalities that facilitate interconnectivity between institutions and lay the groundwork for centralized medical records. Al-Shifa 3+, a client-server system, is a fully integrated graphical user interface application system for hospital management. It is built around Oracle 9i, using an 11g database, and was developed using Oracle Developer 6i with Java running under the Linux platform.
The MoH has developed several frameworks to ensure that all healthcare transactions, such as clinical appointments, laboratory, and radiological reports, are streamlined via electronic channels, such as e-Referral and e-Notification, thus ensuring that responsible stakeholders are notified of any disease or alerts relating to an individual patient's care.
At the micro level, the MoH has recruited qualified and skillful technicians to supervise the running of the Al-Shifa system at an institutional level to ensure that all staff understand the program's capabilities and are able to use it efficiently—thus maximizing trust in and utilization of the system.
After the inception of the National Strategy for Oman (Oman Digital Society—e.Oman) in 2003 and its revision in 2010, Oman has taken concrete steps to fulfill its national and international obligations toward streamlining information and communication technology (ICT), transforming communities, and integrating societies (Information Technology Authority, Sultanate of Oman, c.2013). As healthcare information systems have become increasingly crucial to the development of healthcare operations, Oman has worked toward moving its healthcare system into the digital era. This undertaking has been sanctioned by His Majesty (HM) the Sultan, who has urged the country to be receptive to all scientific knowledge. HM has particularly emphasized the importance of computer science as a developmental tool, with information technology (IT) as the backbone of such endeavors (Information Technology Authority, Sultanate of Oman, 2014).
Oman's growing social and cultural stability have also encouraged the development of IT within the healthcare system. As IT is rapidly evolving worldwide, particularly in the healthcare field, the MoH is recognizing the importance of IT in the healthcare system. According to an ICT survey in Oman, published in December 2012, 61% of government employees now have IT skills (Information Technology Authority, Sultanate of Oman, 2014). Furthermore, around 66% of all PCs in the surveyed government entities are connected to the internet, and over 73% of these entities have fixed broadband (Information Technology Authority, Sultanate of Oman, c.2013). An Information Technology Authority was established in 2006 to oversee the implementation of IT in all government agencies.
