4. In which ways is the initiative creative and innovative?
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a. Matching the profiles of a patient's health status with existing network-based health information resources among the medical centers in Bahrain. This eliminate the problem of transferring all the papers manually in case of going to another medical center for any reason.
b. Support e-mail exchanges between patients and physicians for any inquiry. This help in improve the customer perceptions.
c. Delivering the documents directly to customer house by Bahrain post. This will save the time and the effort of customers instead of vising the hospital again to collect the documents.
d. Utilizing the smart devices features, so the services will be more creative, e.g., using the location service to route a specific hospital or pharmacy, receive notifications if a medical result is ready, reminder for an appointment and the other health tools imbedded on the smart devices. This all will save the customer time and effort and will create patients that are more informed.
e. The backend integration between the ministries will create a comprehensive service that will save the time and the efforts on the customers. E.g., the birth system integrated with IGA to create the CPR automatically and integrated with Bahrain post so the birth certificate will be deliver directly to the customer.
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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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The solution was implemented by various parties working collaboratively to progress in implementing the strategic objectives. These entities include the Information & eGovernment Authority and the Ministry of Health. The First deputy prime minister office played a role in formalizing the strategic vision and supervise its implementation. The target audience of the initiative were all citizens and residents of the kingdom, which are around 1.4 million people.
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6. How was the strategy implemented and what resources were mobilized?
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The key component of the health care strategy is to set the long-term objectives of the kingdom and the organization. The Strategy includes both the solidification of the objectives as well as establishing the medium to be used to realize those objectives. Thus, the strategy is focusing in the manner of deployment of the resources to achieve the objectives. The strategy established since 2010, gradually developed, maintained and updated. The implementation followed the traditional method with various phases: initiation, planning, execution, monitoring and controlling; and closing.
a. The initiating phase: The strategy started first by analyzing and evaluating the organizational surrounding environment, then by analyzing the conditions and the environment within the health organizations.
b. The planning phase: all the business and functional requirements related to the health care services were collected in this phase. The project plan and the stakeholder register were created. Several meetings were conducted with different stakeholders to collect the details requirements for all the services and their business rules.
c. Executing phase: in this phase, all the business requirements and business rules were converted to codes and real implementation. The process workflow is finalized; the design and the prototype of the services were created and finalized. The backend is updated based on the requirements from the health organization side, the frontend (screens) designed by iGA team was integrated with the backend system.
d. Monitor and control phase: in this phase, the quality team and control initiate the services testing for all the services (migrated and developed) to insure that all the standards and ground rules are applied on the services. Furthermore, the performance analysis is performed in this phase to discover and analyze the gap between the planned and actual performance and do the needed action.
e. The closing phase: in this phase, the implemented services are moved to production for the public. A proper training is given to the support team who will be mainly responsible to support users of the service and register the cases and a proper training for the user of the service and concerned stakeholders. Finally, the lesson learned document must be created that will include preventative point for future projects.
f. After implementation phase: in this phase, a checkup is done for the services on regular bases. This to insure the availability and reliability to the services. The feedback collected from the users are listed and converted to enhancement action plan, which will again go through the previous phases.
As for the resources, the strategic health services were funded by the FDPM office. Shared resources from HID and iGA are collaborate in the entire cycle of the project to share the knowledge and to save cost. Sometimes, the need of third party solution is effective.
The variable costs have varied between migrated a service already exist and services developed from the scratch. At its cheapest, for the migrated services that already exist and just need to link them with the National portal, needs the cost of inspecting the services by using quality Assurance software and the cost of the resources who work on the inspection and adhering to the applied governance, follow up of fixing the defects, and the technical migration development. On the other hand, developing services from the scratch have more costs; more human resources are involved during the project life cycle. At least, the individual project need a project manager, project coordinator, an analyst, three developers, business process reengineer person and a tester. In general, the cost can be reduce by optimization of the resources and the cost saving the variables and direct cost when possible.
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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. First Deputy Prime Minister Office as an essential party providing regulations, directions, policies and procedures for Bahrain vision 2030.
b. Health information directorate (HID) as main part owning the customers medical data and accountable for the services backend development and services business rules
c. Information &eGovernment authority (iGa) as a main party providing services for all citizens, residents, visitors, businesses and governments in Bahrain. HID and iGa are collaborate to integrate the services to provide them in different channels.
d. Private hospitals as minor party providing services that may need some integration with other health system. E.g., birth system.
e. Other entities as minor party providing services that may need some integration with other health system. E.g., pre-employment services.
f. Information technology workers who are skilled in new technical areas.
g. Business process reengineer team responsible for capturing the while picture and processes of the service.
h. Project manager or leader that insure the proper development of the services within schedule and budget with strong institutional leadership skills and a shared vision of what the organization is trying to accomplish.
i. Project coordinator working in correlation with project manager, helping in administrative tasks, arrange for meeting, writings minutes, helping in drafting the projects documentations and other tasks.
j. Project analyst responsible for creating the design of the service based on the given requirements, business rules with adhering to any ISO and Quality Assurance standards.
k. Developers that are responsible to develop the service and integrate with other systems
l. Testers that are responsible for inspecting the services and increase the quality and the security
m. Public relation team that are responsible for marketing for the service in different social media and trying to reach the customer directly by sending emails and SMSs about the services
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8. What were the most successful outputs and why was the initiative effective?
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- Delivering health services of high value and quality directly to the community. We were keen to provide services that have reach content and great benefits to the society. Our services enable the people to complete different kinds of transactions online in the most flexible, efficient and effective way and with less time, effort and cost. This output came in line with the UN SDG 3 “Ensure healthy lives and promote well-being for all at all ages”
- All our health services are aligned with the set of global standards. All standards required and related to the quality of service, security of data, stability of infrastructure were implemented and enforced. Clear enhancement and maintenance strategy was established. Plans have been created to make sure that an enough attention is given to the services after going live. Maintaining the service is a key success factor. A dedicated support team is established to make sure that the services are running at the best performance level and without any issues. Also, a change management team has been created a consists of number of specialists whose their main focus is to look into how service provider manage the work and the processes of the workflow and reengineer and change the deficiencies toward the smoothness of the work and the dependent services.
- Facilitated processes and comprehensive studies for all of the implemented health services. Detailed study took place to measure the benefits of each service and how it can be provided online to the public in the most proper and effective way. As a conclusion for this effort, a clear process was drawn for each individual service that takes care of all the service aspects and to ensure the perfect utilization of resources (service duration / ease of use / accessibility / transparency).
- Pursuing the public benefit principle by achieving the cooperation between the parties. Successful Integration between the systems of all the involved parties, all the needed systems were integrated together and the databased and legacy systems were maintained.
- creating solid partnerships with other related organizations in an effort to leverage strengths (e.g., FDPM office, MOH, private hospitals, NHRA, LMRA, third party companies and other health organizations
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9. What were the main obstacles encountered and how were they overcome?
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The main obstacle encountered during implementing the services the resistance to change from people, they do not want to do their transactions online since they trust the manual process. But since we have a clear plan in mind and through a proper change management we were able to change the mindset of people gradually. Many marketing campaigns took place to introduce the services to people and tell them about the great benefits that these services are bringing to them.
It is important to make sure that your services are reachable and close to the hands of the intended users. One of the difficulties that we faced when implementing some of the services is the limitation of channels through which a service can be accessed. For example, Request for Birth certificate service was available online only through Bahrain.bh portal, but the same service is currently available on the eGovernment Kiosks that are distributed in the different areas of the kingdom. Also, many services are currently available through the mobile app like Check Outpatient Clinics Appointments and Radiology Result Status.
Non-availability of the required infrastructure was a main problem that we gave priority. We have provided all the needed system and infrastructure required in order to deliver services that are stable, secure, and compliant to the standards.
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