| 4. In which ways is the initiative creative and innovative?
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For better control and effective project management, the project was divided into four major phases:
1. The initial phase was the strategic planning, which is considered as the key factor to the project success. That includes :
a. The identification of the project vision and objectives.
b. Assessment of the current state (services, capacities, e-Readiness, institutional structure ….etc)
c. Prepare an overview documents and flowchart of the current service process (AS IS document) that should clarify the service delivery, workflow, owner of the process, legal and IT requirements.
d. Prepare an overview document and flowchart of the new service processes (To Be document) that should clarify the areas of improvements within the service in term of ease, duration …etc. in addition to redefine the process owners.
e. Prepare a detailed action plan including all infrastructure projects and services redesign.
All of the above activities were accomplished within intensive workshops with the concern stockholders.
2. The second phase was both backend and frontend design and development. Once the development was completed both backend and frontend was properly tested and validated.
3. The third phase was the implementation, which includes the communication, change management and service implementation. Where the new service design was communicated to the concern parties in Ministry of Health & Central Information Organization.
The main purpose of the communication plan and change strategy was to ensure the eService initiative Buy-In and adoption. The following tasks were addressed to develop them:
• Stockholder Identification, where all audience were addressed.
• Stockholder Analysis which includes an investigation of their main roles and responsibilities and any expected questions.
• The Communication messages and channels to address these messages based on the analysis done.
• A full marketing plan was developed to market the service within the public as well as the worker.
• Training manual and workshops was done for the key users.
Due to the criticality of the service, the huge changes done within the process and the involvements of several parties from different governmental entities, a simulation environment was created for testing purposes and that was applied at Salmaniya Medical Complex only and started on 25th May 2009. Several technical and process issues were faced and fixed; hence, the deployment of the corrected version was deployed on 22/7/2010.
Afterwards, e-Birth service was deployed in another 2 governmental hospitals which are Jidhafs Maternity Hospital & King Hamad University Hospital. The deployment criteria were carefully chosen in order to minimize a negative impact of the system substitution.
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| 5. Who implemented the initiative and what is the size of the population affected by this initiative?
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1) Ministry of Health
a. Nursing Services of Hospitals
b. Administration Services of Salmaniya Medical Complex
c. Health Centers Directorate
d. Birth and Death Registration Section
e. Directorate of Finance
f. Nursing Services for Primary Care and Public Health
g. Administration Services of External Hospitals
h. Public health Directorate
i. Health Information Directorate
2) Central Information Organization (CIO)
a) Identity Card Directorate
b) Directorate of Information Systems
Improve data accuracy and integrity by integrating the birth system with Central Informatics Organization (CIO).
3) King Hamad University Hospital (KHUH)
a. Gynecology Section
b. Information Technology Section
4) Ministry of Transportation
a. Bahrain Post Office
5) E-Government Authority
a. Directorate of Policies and BPR
b. Directorate of Service Delivery and Channel Enhancement
c. Directorate of Public Relations and Marketing
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| 6. How was the strategy implemented and what resources were mobilized?
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In terms of financial resources the funding was covered by both Ministry of Health and E-Government Authority.
However, the project team was from all organizations who are contributing in Birth Registration Process (MoH, EGA & CIO)
Resources:
• Project Management (EGA & MoH)
• Frontend Developers (EGA)
• Backend Developers (MoH)
• Integration Team (MoH, EGA & CIO)
• Key users (MoH)
Hardware & Software:
• Project Management (EGA & MoH)
• Frontend Developers (EGA)
• Backend Developers (MoH)
• Integration Team (MoH, EGA & CIO)
• Key users (MoH)
To facilitate eBirth deployment a Helpdesk system for the key users, and another one for the end users where introduced. Both systems offer support to all users and to infrastructure elements, playing a key role for the success of the project. The Helpdesk provides a wide variety of services such as preventive activities, maintenance, monitoring, channeling complaints and suggestions and troubleshooting assistance. To offer this assistance, there is a telephone hotline and email available 24 hours a day /7 days a week in both Arabic and English.
The eService was mainly sponsored by e-Government Authority (EGA).
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| 7. Who were the stakeholders involved in the design of the initiative and in its implementation?
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A) Providing better Governmental Services
• Providing high quality e-Services (Improve in the process of birth certificate issuance):
o Each citizen/residents in Kingdom of Bahrain is identified by a unique Personal Number which is used as identification to avail services in all Government/Private entities. Before the initiative, the personal number was generated manually by faxing the Birth Notification form to CIO to generate personal Number. However, this initiative automated the process of Personal Number Generation for new born; the Birth Registration Application now is integrated to CIO Application.
o Enable the Birth informants or parents to validate the information on the portal, pay the fees electronically and receive Birth Certificate via Post Mail.
Providing users with integrated, highly secured and user convenient services. (Appointments for Immunization for new born is done automatically once the Birth Registration is completed)
• Easy access to governmental services for everyone 24/7 from anywhere inside and outside the Kingdom.
• Reducing time taken to complete transactions and ensuring data integrity (Eliminate the need to pass the birth notifications between maternity hospitals and Birth & Death Registration Section)
B) Increasing level of efficiency and effectiveness in the public sector
• Centralized data accessible by concerned government agencies at any time
• User Authentication and data security
• Utilizing human resources
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| 8. What were the most successful outputs and why was the initiative effective?
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From the strategic and operative point of view several committees were created in order to follow the status of the deployment. At the highest level it was created a Steering committee composed by high representatives from the Ministry of Health, Central Information Organization and e-Government Authority. The follow-up was based on the agreed master plan. There was also a functional team to deal with any operational issues.
From the results point of view a series of evaluation tools were put in place in order to ensure a proper follow-up:
- Usage statistics. Data collected through the backend of the birth system allowed to review and draw conclusions on the usage of the system.
- Qualitative analysis. A network of key informants (key users) was created so they could report regularly. Their feedback was very valuable since they provide qualitative information that, afterwards, was contrasted with quantitative data.
- Satisfactory surveys. Number of questionnaires was delivered on regular basis to monitor the satisfaction of service providers about many issues: the usability, the speed, the quality of the training, etc.
All inputs gathered from these methods were seriously taken into consideration and actions plans were designed and implemented accordingly.
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| 9. What were the main obstacles encountered and how were they overcome?
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The eService’s are not about technology. They are about equipping organizations to reach critical business objectives by providing people with technical capabilities that make new things possible and by engaging people in changing their behavior to effectively use the new capabilities to generate results. To overcome this it was necessary to implement three different and parallel strategies:
- Create a network of key professionals (leaders in their fields, centers…) and communicate frequently and openly on the status of the project.
- Create and implement a robust internal communication plan to empower the employees and ensure they carry a unified and coordinated message. Internal communications provided the critical data points needed
- Outline the purpose and benefits of meaningful use. It was very important to find out what role each employee will play in attesting for meaningful use to help midwives, Hospital Administration, finance … to see the real and long-lasting impact (improving communication between all stockholders, eliminating errors, removing redundancy, improving the quality of care …
- The readiness of the public to request the service through the internet. That was overcome through the social centers that were distributed all over the Kingdom and the free training campaign that was offered by the e-Government to all citizens to enhance their basic knowledge to use the automated services.
The transition period was also a challenging issue. In such a complex deployment, we have encountered many situations in which both systems, the old and traditional one (paper) and the new one (electronic) live together in the same hospital, areas such as the labor room, Admin office, cashier, CIO concern personal …etc This have generated some difficulties and confusion which only could be solved with frequent training, constant communication and a strong support area (help desk) which was at the disposal of end users 24 h. x 24h. 365 days x year.
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