Abdulaziz Saddique Pharm.D.

, CPHQ, CSSMBB
Executive Director for Quality Management , C.O.M. and the University Hospitals, King Saud University, Saudi Arabia

Why ?


Escalating cost of Healthcare. Patients demands (more informative patients) Aging populations contribute to increase cost. IOM reports: Efficiency, safety, patient centeredness, timeliness, effectiveness, and equity: high cost, preventable errors especially in the system/episode of care and following discharge. Globalization.

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Factor Contributing to Increased Cost of Healthcare



Aging Population New Technologies development High technology drugs (Genetically Engineered products)

Increased competition (Higher Salaries) Demand for Quality Services ( 5 star service) Demanding Patients

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The Good News- We are Living Longer News-

Source: Statistics Bureau, MIC, Government of Japan; United Nations; The Japanese Ministry of Health, Labour and Welfare 4

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The Bad News: As We Age We Become More Chronically Ill

Almost 75% of the elderly (> 65) in the U.S. have 75% 65) at least one chronic disease.1  About 50% in the U.S. have at least two chronic 50% disease.1  This is not just a U.S. concern


Almost 72% in Hong Kong have at least one chronic 72% disease. Almost 80% in Turkey have at least one chronic disease. 80% 10-30 % of the Saudi population are Diabetics, and 5 % 10are Hemophiliacs, 7% has thallasaemia major.2
E, Boult C, Wagner E, et al. New ways to care for older people. Building systems based on evidence. New York: Springer; 1999. 2 Ministry of Health and Saudi Diabetic society.
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1Calkins

Todays Situation


Governments are paying for all Healthcare expenditure No mandatory Insurance for Expatriates. No mandatory insurance for the Citizens of the gulf region. Increasing Healthcare cost. The quality of care is very poor in most government hospitals. Low paid doctors contribute to the problem. Poor Nursing quality which increase the morbidity and mortality of patients. Lack of standards of care in most Gulf countries.
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Signs of a Transformation in Healthcare

But no single initiative ties together all key drivers
  

Call for Healthcare insurance by the governments. New ruling for mandatory insurance for Expatriates. Government Agencies are requesting Healthcare Insurance. Proliferation of Private Sector. Continual efforts to reduce cost and provide basic care by governments hospitals. EvidenceEvidence-based Decision Making Efforts for Administrative Cost Reductions. Interoperability & Connectivity
National Health Information Network (NHIN)

 

  

Patients escape to private care.

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Impact of Transformation


Government will stop providing secondary and tertiary care. Government will concentrate on Primary healthcare. Insurance companies will flourish. Patients with chronic diseases will be denied insurance, Government will be forced to support them.

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Impact of Transformation
  

Long waiting list for surgeries. Infant mortality will increase Compliance will decrease leading to more intensified medical problems The cost of healthcare will remain the same if not more.

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Impact on Quality


Private sector will flourish. Accreditation and seeking higher standards among private sector will increase. Competition will increase and the cost of healthcare will increase too. Government hospitals quality of care will initially improve. Later due to the increased cost of caring for chronic cases the cost will be unbearable and quality will deteriorate.
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SOLUTIONS OVERVIEW

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Our Vision
Accelerate the retail transformation of healthcare with a platform for exchanging and leveraging individualized health information in real-time real-

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Proposed Strategy


Implement the standards of care. Rent out services to qualified organizations Provide Nation-wide network for patients and Nationallow accessibility throughout the country. Allow maximal utilization of the current resources. Make insurance for expatriates mandatory and set the standards for healthcare organizations that provide that care.
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Proposed Strategy


Collaborate with the private sector for major conditions.  Set indicators and monitor the utilization of the services.  Enhance quality and support its efforts to minimize cost.

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Proposed Strategy
For Private Sector:  Secure, user-definable web portal solution user


Health Plan Employees Employers/Members/Dependents Providers Brokers/Agents

Setup and maintain views of your business

Customer Service/Provider Relations Eligibility, Benefits, Claims, Authorizations

Customize content and communication

Document Access, Health Information News & Events, FAQs, Secure Messaging FAQ

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Thank you