The COVID-19 pandemic has highlighted the extent to which our fates are intertwined. The lines between individual and community have become increasingly blurred; and it is now more evident that the health of one is dependent on the other. In such an environment, we have witnessed the immense value of data-driven decisions in enabling the healthcare system to adequately prepare for challenges that could impact upon the entire community–whether that’s in the form of global pandemics, such as COVID-19, or even lifestyle diseases.
In Abu Dhabi, the Department of Health (DOH) recognised the need to have an electronic health information exchange (HIE) system that will enable the exchange and centralisation of patients’ data across the sector. Hence in 2019, the DOH launched Malaffi as the region's first HIE platform, allowing public and private healthcare providers to exchange key patient health information in real-time. When clinicians have access to a longitudinal medical record and 360° view of the patients, they are empowered to make quicker and better-informed decisions, avoiding duplication and medical errors, improving patient safety, experience and outcomes. To put the patient–and by extension the community–first, it is essential to have data-driven collaboration across the entire industry.
This January, Malaffi celebrated its 3rd anniversary, during which in record breaking time the platform connected all hospitals in Abu Dhabi, 99% of all patient episodes and collated 660 million unique clinical records of medical information, from patient visits and lab results to radiology reports, vital signs, medications and more. Over 45,640 doctors, nurses, pharmacists, and other staff members from the 1,919 healthcare facilities across Abu Dhabi have secure access to Malaffi and are empowered to make better-informed, safer, and more efficient decisions.
But further to providing the information to clinicians on a single provider level, the power of HIE is truly unleashed when we think about the immense potential of having aggregated health insights for an entire population, as a basis for digital transformation of any healthcare system.
Enabling a data-driven pandemic response
For Malaffi, the pandemic was a great opportunity to showcase this potential. When the pandemic started in early 2020, mass testing for COVID-19 was one of the initial strategies to help manage the dire situation. At that time, in parallel with the rollout of the testing capacities, Malaffi provided solutions to manage COVID-19 laboratory results in the Emirate centrally. Leveraging the existing infrastructure, the platform swiftly scaled to capture most of the COVID-19 testing. The solution included databases that are quick and easy to search, multiple dashboards for public health decision-making, and access to test results to the frontline workers, thus becoming an essential factor in the Emirate’s successful pandemic response.
Later, when the vaccination program was rolled out, Malaffi started supporting the massive operation via expanded searchable databases and expansion of public health dashboards. The robust response placed the UAE amongst the countries with the highest rates of vaccinated population and Abu Dhabi on top of the list of global cities with a successful response to the pandemic, according to a report by the London-based Deep Knowledge Group.
Due to the vaccination information being centralised in Malaffi, the government and the DOH now have real-time insights into the Emirate's vaccination status. Access to this information enables the authorities to generate operational reports, plan vaccination capacities, streamline logistics and supply chain, and inform public outreach programmes. Healthcare professionals in Abu Dhabi have access to the COVID-19 vaccination information in Malaffi, which improves clinical decision making, enhances safety and the efficiency of the vaccination program.
During the pandemic, Malaffi centralised 83,378,108 PCR test and 10,709,509 vaccination records. The DOH had real-time insights and was able to make data-driven critical pandemic decisions to protect its residents, globally recognised for its effectiveness and success.
Predicting population risk
Aside from the pandemic, Malaffi is enabling the DOH to draw population health insights based on the analysis of the consolidated clinical data of the entire population in Abu Dhabi.
For example, in 2021, Malaffi premiered a demonstration of a population risk management platform that will empower the healthcare sector to support care management, improve population health and assist in ensuring continuity of care.
The platform uses artificial intelligence (AI) and machine learning, to build predictive models based on two years of historical clinical data and run algorithms to predict future population risk across different categories such as emergency room visits; development of chronic conditions such as diabetes and hypertension; and the potential costs of treatment.
The insights help identify specific cohorts of patients that are at significant risk to develop a certain condition or complication, understand the contributing factors to his or her risk score, which can then appropriately be targeted with specific preventative measures and interventions to reduce their risk and drive the cost down.
These insights help track the effectiveness of a screening program and how it reduces risk over time, as well as the risk of readmissions which is a significant measure of quality and cost ticket.
Standardised data is key
What we also realised is that the availability of quality and accurate data is crucial for ensuring patient safety and making the data effective for decision-making, population health and interoperability. Standardisation of data requires a collaborative effort at all data touchpoints across the healthcare facilities, starting from the front desk, that will ensure that all patients information is captured correctly.
Having access to clinical data and based on the assessment of its overall quality, our team has looked at ways to enhance data quality. As a result, in late 2021 the DOH issued guidance and requirements to the healthcare facilities for adopting key coding standards (e.g. SNOMED, LOINC) and ensuring the providers are adhering to the minimum data standards and quality. The wide adoption of these standards is expected to significantly improve the quality of data captured at the site of the providers which will eventually help improve the accuracy of the population health analytics, for the better of everyone in the Emirate.
A look to the future
Malaffi will contribute significantly to creating advanced systems tailored for syndromic and pandemic surveillance and response. Such systems will be of the utmost value for early alerts and increased readiness to handle any potential future outbreak, ensuring Abu Dhabi remains at the forefront of public health and safety. Over time, trends in population health can be determined to ensure a more intuitive, data-driven approach to healthcare at an individual level, and a community level. Other solutions will also be developed to take advantage of advanced analytics to generate insights based on the robust population health data in Malaffi, to improve the quality of care and health outcomes for everyone in the Emirate.
An HIE, when utilised to its full potential, can completely transform healthcare as we know it–from empowering clinicians to make safer and more efficient decisions to enabling providers and Governments to adequately prepare for major community health challenges. Whilst the technology and platforms exist, the onus is on the entire healthcare system to drive synergies and ensure better collaboration to optimise the use of these game-changing, innovative solutions.
