Building Consensus on the Readiness for EHR in Lebanon Are Lebanon Hospitals ready to get rid of papers? July 2019 Prepared for: Ministry of Public Health (MoPH) – Policy Support Observatory (PSO) World Health Organization (WHO) – Lebanon Office Prepared by: Ghassan Hamadeh1, Joe Max Wakim1, Ali Romani2, Hossein Hamam1, Najla Daher1, and Rita Nassar1 1 American University of Beirut Medical Center (AUBMC), Beirut, Lebanon 2 Ministry of Public Health of Lebanon Acknowledgements This work has been supported by WHO – Lebanon Office (WHO Registration 2019/882381-0) The authors are grateful to all their collaborators and focus groups and conference participants for their valuable contributions. We acknowledge in particular, Dr. Yousef Bassim, Mr. Karim Hatem (Ylios-France), Mr. Ghassan Lahham (EHSI-Jordan), the Syndicate of Hospitals in Lebanon and the information technology teams at the Ministry of Public Health and the American University of Beirut Medical Center. Notice to readers This document is intended solely for the information and use of Ministry of Public Health of Lebanon. The authors assume no responsibility to any user of the document other than the MoPH. Any other persons who choose to rely on this analysis do so entirely at their own risk. Correspondence Ghassan Hamadeh, MD – CMIO, AUBMC. email: [email protected] Citation Hamadeh, G., et al., Consensus about EMR in Lebanon. 2019, Ministry of Public Health Policy Support Observatory: Beirut, Lebanon Website: https://aub.edu.lb/fm/CME/Pages/EHR-Readiness.aspx https://www.moph.gov.lb/en/Pages/6/18521/policy-support-observatory-pso- 2 Table of Contents Acknowledgements .......................................................................................................................... 2 Table of Contents .............................................................................................................................. 3 List of Tables, Figures & Boxes .......................................................................................................... 4 Abbreviations and Acronyms ............................................................................................................ 5 Executive Summary .......................................................................................................................... 6 Section One: White Paper on EHR adoption in Lebanon ................................................................... 8 Introduction .................................................................................................................................. 8 What is eHealth ............................................................................................................................. 9 Value from eHealth........................................................................................................................ 9 What do we really want out of EHRs? .......................................................................................... 10 Digital Maturity ........................................................................................................................... 12 Health Information and Management Systems Society (HIMSS) Electronic Medical Record Adoption Model (EMRAM) ....................................................................................................... 13 Digital Hospital ........................................................................................................................ 14 Certified EHR ............................................................................................................................... 15 Readiness Assessment ................................................................................................................. 17 Section Two: Lebanon Readiness & Consensus 2019 Activity Overview ......................................... 19 Focus Group Discussions .............................................................................................................. 19 Online Survey .............................................................................................................................. 21 General Meeting .......................................................................................................................... 23 Section Three: Model Request for Proposal / Information ............................................................. 26 Statement of Purpose .................................................................................................................. 26 Background and Overview ........................................................................................................... 27 High Level Requirements ............................................................................................................. 29 EHR Modules / Features .......................................................................................................... 29 Interoperability ........................................................................................................................ 35 Infrastructure requirements .................................................................................................... 36 Information to complete .............................................................................................................. 37 Terms and Instructions ................................................................................................................ 41 Information review process ......................................................................................................... 43 Definitions ................................................................................................................................... 45 Appendices ..................................................................................................................................... 46 Appendix 1: Healthcare Interoperability Glossary ........................................................................ 46 Appendix 2: Lebanon eHealth country profile (WHO Survey) ....................................................... 57 Appendix 3: A checklist in preparing for hospital-wide electronic medical record implementation and digital transformation ........................................................................................................... 60 Appendix 4: Focus Group Discussion Results ................................................................................ 61 Dimension 1: Governmental Regulations and Roles ................................................................. 61 Dimension 2: User Access and Accessibility Policies and Infrastructure .................................... 62 3 Dimension 3: Standardization, Policies, Protocols and Procedures ........................................... 62 Dimension 4: Information Communication Technologies Architecture/Infrastructure .............. 63 Appendix 5: Hospital Readiness Survey Results ............................................................................ 64 Part I - General Information ..................................................................................................... 64 Part II - EHR Current Status ...................................................................................................... 65 Part III - Organizational Alignment ........................................................................................... 66 Part IV - Human resources readiness ........................................................................................ 68 Part V - Operational Readiness ................................................................................................. 70 Part VI - Technology Readiness ................................................................................................ 71 Part VII - eHealth Readiness ..................................................................................................... 73 Appendix 6: Consensus Conference Presentations ....................................................................... 74 Appendix 7: Lebanon Health IT Stakeholders who participated in this activity ............................ 119 References .................................................................................................................................... 123 List of Tables, Figures & Boxes Table 1: E Benefits of EHRs – the 10E’s ............................................................................................ 11 Table 2: EHR FUNCTIONALITY REQUIREMENTS ................................................................................ 11 Table 3: Respondents characteristics ............................................................................................... 21 Table 4: EHR current Status in Lebanese Health Institutions ............................................................ 21 Table 5: Organizational alignment ................................................................................................... 21 Table 6: Operational & Technology Readiness ................................................................................. 22 Table 7: Awareness of eHealth issues .............................................................................................. 22 Figure 1: Suggested roadmap for transforming patient care documentation in Lebanon hospitals ..... 7 Figure 2: Price’s Model of EMR Adoption ........................................................................................
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