Ministry of Health

A. Problem Analysis

 1. What was the problem before the implementation of the initiative?
• There was a late detection of communicable disease and outbreak • Reduced capacity to respond to communicable diseases. • Ineffective use of public resources and standardization of public health information policies. • Poor quality care delivered in terms of cases and their contacts. • Significant mortality and morbidity rates from communicable diseases and other public health concerns. • The cycle for delivering information is cumbersome and currently requires a number of manual processes that allows for more mistakes. Paper work complicates and delays and the retrieval of information and data verification. • Inefficient communication exists between different levels of health care centers and headquarters. Also, illegible hand writing of health care providers that might lead to misinterpretation and result in late applying of required medical interventions.

B. Strategic Approach

 2. What was the solution?
HESN (Heath Electronic Surveillance Network) is a web-based electronic health solution that was proposed by Public Health Agency in MOH and implemented in the Kingdom of Saudi Arabia. HESN is the KSA MOH configured solution of the Public Health Solution for Disease Surveillance and Management (PHSDSM). The MOH is committed to improving the quality, access, and safety of the health care delivery system. The KSA E-health Strategy vision is a safe quality health system based on patient centric care guided by standard, enabled by health. It includes comprehensive health care service delivery model. The Ministry also has health objectives that will be supported by the implementation of HESN. The health objectives are: • Earlier detection of communicable diseases and outbreaks, early intervention and early prevention. • Improved capacity to respond to communicable diseases. • Improved use of public health resources and standardization of public health information policies. • Improved immunization management. • Improved management of cases and contacts. • Decreased morbidity and mortality form communicable diseases and other public health concerns.

 3. How did the initiative solve the problem and improve people’s lives?
The public health solution for disease surveillance and management is an integrated electronic system that provides frontline health care providers and public health decision makers with critical information that will enable the effective delivery of public health services. The solutions adopted by MOH in response the high need of surveillance of communicable diseases including avian flu, pandemic H1N1 flu, SARS, and MERS-Corona. Also, addresses immunization and other program and services provided by public health and primary health care such as family health wellness assessment. It provides real time, quick information and transmission of data across different levels of health care systems

C. Execution and Implementation

 4. In which ways is the initiative creative and innovative?
The Ministry of Health in Saudi Arabia has an ambitious plan that aims to utilize MoH Health Electronic Surveillance Network implementation project referred to as HESN, Immunization and communicable diseases functionalities across every single health facility in the Kingdom of Saudi Arabia. Accordingly, HESN is planned to be rolled-out across all the different structural levels of the Ministry of Health. This includes rolling-out HESN across the regions, sectors, hospitals, and the PHCs that are there in the Kingdom. Having the large number of facilities to be covered, that reaches to 2,240 across 20 regions in the kingdom, the rollout activity requires having a clear strategy with a high-quality defined approach that can be applied on these different levels in a smooth way.

 5. Who implemented the initiative and what is the size of the population affected by this initiative?
The Public Health Agency has played a crucial role with the support from other departments like IT and development and improvement strategy agency. We have stakeholders from those sections with the supervision of the Minister and both Vice Ministers.
 6. How was the strategy implemented and what resources were mobilized?
This project is funded by the Ministry Of Health (Moh). An approved budget with more than 250,000,000 S.R has been set to contribute in making the project implemented and running.

 7. Who were the stakeholders involved in the design of the initiative and in its implementation?
What makes this project a success is : 1. The support from the Minister and other decision leaders in MoH. 2. A clear, written plan including all the phases for implementing the project. 3. The budget that has been set for the project. 4. A qualified, enthusiastic team from both MoH and IBM. 5. An excellent communication channel between the teams of the project and the leadership.

 8. What were the most successful outputs and why was the initiative effective?
One of the project phases is the initiation and analysis phase. In both these phases, MoH assesses and evaluates our work and creates a recommendation and plan to monitor and implement the project. (see attachment Project Charter).

 9. What were the main obstacles encountered and how were they overcome?
We have encountered different obstacles related mainly to manpower, infrastructure, and business processes.

D. Impact and Sustainability

 10. What were the key benefits resulting from this initiative?
We have benefited from this project in our existing sites. We improved our reporting system, we trained our employees with different skills to run and use the program. We standardized our business process in the implemented sites. And we have the chance to learn from different level of health professionals and other specialties.

 11. Did the initiative improve integrity and/or accountability in public service? (If applicable)
Our plan is to roll out this program to be running in the entire Kingdom. We started with MoH health facilities and we are planning to apply it on other private and non-governmental facilities. Also, we are planning to integrate with other health systems used in the kingdom and in the gulf region.

 12. Were special measures put in place to ensure that the initiative benefits women and girls and improves the situation of the poorest and most vulnerable? (If applicable)
• Most issues were anticipated and documented. • Issues that were underestimated: • Saudization The social climate changes are exciting to HESN. There is an increasing workforce comprised of younger and more technically savvy employees who are less resistant to changes. This means that PHC’s and Hospitals are hiring people who are more comfortable with converting from paper to electronic systems. Short-term – Creates some hiccups. Slows our ability to rapidly deploy HESN. Long-term – The actual results are very promising as younger, more educated and technologically savvy Saudis are starting to fill the workplace roles. • Aligning financial resources with regional implementation schedules and other allied projects • Absence of governance and poor communication in some programs: Recommendations:  The governance structure formed in implementation phase should be re-enforced  Engage Regions more fully in both governance and implementation of sites  Form groups for disease management, MoH, Regional, Section and local with clear reporting structure  More communication channels should be formed and more frequent meetings should take place  More follow up procedures should be initiated and maintained  Involve Regional coordinators in regular meetings with IBM team  Solid reporting process within programs governance, and frequent ( monthly) checkpoint • Poor Infrastructure Recommendations:  Better planning for relocation to ensure no interruption to service  Reliable internet services  More on-site IT support • Leakage of human resources Recommendations:  More training sessions  Better selection criteria  Incentives for data entry team • Poor data quality Recommendations:  Regular checkpoints and random evaluation of data samples  Recognition of precise data entry personnel and rewards  Follow instructions provided by IBM team, with some fine tuning at region level • Weakness in defect reporting mechanism Recommendations:  Follow the process of defects reporting on ticketing system Full defect details should be provided

Contact Information

Institution Name:   Ministry of Health
Institution Type:   Government Agency  
Contact Person:   Walaa Khayyat
Title:   Business Development  
Telephone/ Fax:   +966112124679
Institution's / Project's Website:  
E-mail:   wkhayyat@moh.gov.sa  
Postal Code:   11176
City:   Riyadh
State/Province:   RIYADH

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