First Databank

First Databank and NAS forge Middle East healthcare alliance

In 2013, global provider of clinical drug knowledge, First Databank™ (FDB) announced a new partnership with NAS, one of the largest healthcare benefits management firms in the region.

In support of its goal to deliver world class claims processing and efficient management, NAS is licensing FDB’s market leading electronic drug database, Middle East Drug Knowledge (MEDK). MEDK integrates with the NAS technology and assists with the automation of NAS clinical solutions, including claims processing. FDB and NAS are pleased to share this jointly developed Case Study on their partnership.

Electronic Healthcare Claims Management Case Study

About NAS United Healthcare Services

Headquartered in Abu Dhabi, United Arab Emirates, NAS is a third party administrator providing expertise in healthcare claims management and cost containment techniques. Since 2002, NAS has carved a unique niche in the regional healthcare sector due to its excellent service standards and innovative, customer focused solutions to the benefit of about 1m members. NAS has staffed offices across the Gulf region and has adopted a highly innovative approach, being the first third party administrator to develop an online e-claims and e-prescribing solution within the UAE.

Online e-claims

Historically, most healthcare claims have been processed manually, creating a significant operational overhead. NAS wanted to develop a system to automate their clinical solutions and integrate them into their existing portfolio of healthcare services.

A mandated deadline had also been introduced by the Health Authority of Abu Dhabi (HAAD) to provide Pharmacy Benefit Management (PBM) services to all insured members of the Emirate while meeting internationally recognised standards.

By automating its systems NAS became able to adjudicate a much larger volume of claims, in a faster more efficient way. Ensuring that patient safety was not compromised was an essential pre-requisite for the company.

NAS’s short-term goal was to have a full e-prescribing system available with online Drug Utilisation Reviews (DUR’s) within the mandated deadline imposed by HAAD. Longer term goals were set to provide an ever increasing depth and breadth of integration in clinical rules/claims within the e-prescribing solution.

Harnessing technology to achieve efficiencies

Demonstrating value to NAS’s customers was also a key requirement to the company. MEDK from FDB was recommended to NAS as a trusted drug knowledge base which incorporates all Gulf Cooperation Council (GCC) drugs.

MEDK was selected as it can be fully integrated with open tools and supported in NAS’s online solution. It also provides regular monthly updates of all newly licenced drugs for the region, as well as a clear product development roadmap into the future. This ensured that the knowledge base remained up-to-date and relevant.

More importantly, MEDK provides dynamic alerts to ensure the safety of the patient through cross-checks regarding drug prescription data which include drug-drug interactions, duplicate therapy, contraindications and indications.

Using the Medication Names Concepts ™ feature ensures that all data can support the clinical workflow in the NAS e-prescribing system.

“FDB offered a superior product which met the true needs of the Middle East market. It is the only one that provides a comprehensive solution that allows us to implement fully localised solutions to each individual GCC market. NAS clients and about one million members are seeing great results in both the quality of care and cost savings through our PBM/e-prescribing solutions.” – Tom O’Connor, RX Strategists LLC, PBM Consultant to NAS.

Achieving Measurable Results


The new online e-claim and e-prescribing system met the goals of compliance, but also improved the system overall.

The new system helped NAS understand the constituents of what goes into a drug and a drug claim. It has allowed NAS to put a coding structure together giving a better view of the business from both safety and quality perspectives.

NAS became the first third party administrator to meet the mandated standard in Abu Dhabi within deadline underlining its position as an innovator in the region.

From an economic point of view, the new system achieved the stated objectives by increasing the volume of claims handled, particularly around DUR’s. This has provided significant cost and efficiency reductions. These savings are passed onto the insurers, while demonstrating clear benefits to the members themselves.

Other tangible results in drug usage safety were also achieved. MEDK provides enhanced capability around the active checking of drug prescriptions against the electronic patient record, highlighting possible areas for concern such as drugdrug interactions or duplicate therapy.

The insurance related records are held in a central database. This is not a complete clinical record, but does represent primary, secondary, pharmacy and any other information pertaining to a patient episode from an insurance point of view.

This single database provides valuable data to the pharmacy and GP community in understanding the types of drugs being prescribed as well as prescribing behaviour in general. Understanding this type of information ultimately means that NAS is able to make well-informed strategic decisions regarding its current and future planning.

More importantly, it also means that significant improvements have been made to the quality of care and communications provided to their customers.

“NAS built the PBM/e-prescribing engine to benefit our clients and members across the UAE and other GCC countries. MEDK from FDB has been a critical part of our overall solution to improve quality and reduce costs across the prescription medicine delivery system. We are very excited about building on the great success we have seen in Abu Dhabi and rolling this solution out in other GCC countries. NAS looks forward to continue working with FDB in implementing world class solutions for these markets.” – Joe Boulos, Group CEO, NAS United Healthcare Services.


 

Sheikh Khalifa Medical City
 

Sheikh Khalifa Medical City’s Nuclear Medicine Department brings new technology to capital’s residents

State-of-the-Art SPECT/CT Gamma Camera provides instant, precise information

Specialist physicians at Sheikh Khalifa Medical City (SKMC) have shed light on a new state-of-the-art machine being utilised in the hospital.

The machine, which blends two essential and complementary medical imaging technologies on one innovative scanner, provides the ability to capture two types of medical images with the one machine – single photon emission computed tomography (SPECT) and computed tomography (CT).

The SPECT/CT system combines the two images into a single image, and presents combined results to aid physicians in making treatment decisions instantly, and with the most precise information available.

“This machine, the only one available in the country, allows for better diagnosis of conditions due to better images,” said Dr Raqwana Baharoon, Consultant Physician in Nuclear Medicine at SKMC.

“It acts like a navigator – rather than a surgeon having to go in and undertake a significant amount of exploration, the SPECT/CT machine localises exactly where the issue is, which the surgeon can then target. It’s able to convert life threatening cases into much simpler ones,” Dr Baharoon added.

Dr Baharoon commented that this kind of specialised technology expands the role of nuclear medicine into routine surgical planning, orthopaedics, advanced cardiology and much more.

“For example, prior to the introduction on this machine, if we had a very obese patient going into surgery, cardiac studies would only provide defect images and we could not be totally sure that the patient’s heart could sustain surgery. The SPECT/ CT machine removes this uncertainty. It offers a precise diagnosis, the exact location of any lesions, as well as attenuation correction,” she added.



Arab Heath 2014 Review
 

New generation of Operating Room Management Systems: more flexible application, secure data

Medical instrument manufacturer Richard Wolf presents `core nova´ at this year’s Arab Health

Operating Room Management Systems have made a significant contribution toward increasing efficiency in hospitals through central control of all equipment in the operating room, digital access to all preoperative patient data, and direct documentation of operations. The new generations of Operating Room Management Systems offer users a significantly more flexible area of application, simplified installation and they are also intended to permit safe and authorized access to patient data and medical devices in compliance with the latest data protection guidelines. A unique feature of this system is the newly developed Operating Management System `core nova´ which medical instrument manufacturer Richard Wolf is presenting in the public domain at this year’s Arab Health. According to information provided by the manufacturer, `core nova´ sets new standards for system scalability and data security.

“By contrast with the previous model, `core nova´ is ideally suited to operating theaters in hospitals and larger medical practices because it has the option of individual, scalable adjustment to suit individual requirements. This means that the system can be integrated in existing IT and server infrastructures. It can also be deployed for mobile applications on a conventional video cart. Irrespective of whether it is a mobile or fixed application of the system, the exchange of all patient data takes place exclusively over an encrypted and secure network. For example, access to the connected devices and data is restricted by certificates to authorized users. Operations can also be monitored and logged,” according to Timo Haller, Head of Product Marketing Integration at Richard Wolf.

Functions which are distributed over lots of individual devices in the management systems currently on the market have been integrated within a few units in `core nova´. This has made the footprint of the system noticeably smaller. Power consumption has been noticeably reduced and purchase costs have been brought down significantly. The proven simple operation of the system from the previous `core model has been further improved. For example, `core nova´ uses a simple network cable to link up the instruments and systems being controlled, ranging from documentation, through operating-room lamps and tables, to several user workstations, and software providing independent recognition without any adjustments having to be made (“Plug & Play”). This significantly reduces the workload for IT managers.

When IT managers in particular are assessing the new system, they are likely to be very interested in the fact that the integrated data-protection and data-security concepts used in `core nova´ lay the foundations for operation in compliance with the DIN EN 80001 standard published in 2011. This standard defines principles for risk management in networks connected to medical devices. It is intended to preclude network failures and prevent malware from impacting negatively on the network.

The first launch of `core nova´ is taking place on the exhibition stand of Richard Wolf at Arab Health in January in Dubai (booth 6G10/Dubai International Convention & Exhibition Centre). On request, the company’s field staff will then be presenting the system to doctors, purchasers, medical technicians, and IT managers in hospitals. The first installation of the system is planned in a German hospital for the beginning of 2014.

Richard Wolf

Richard Wolf GmbH is a mid-sized company manufacturing medical instruments. It employs a workforce of more than 1,500 and maintains a global network of fourteen subsidiaries and 130 foreign representatives. The company develops, manufactures and markets a large number of products for minimally invasive surgery and endoscopy in human medicine, and for extracorporeal shock wave lithotripsy and technoscopy.


 

Roche Diagnostics Middle East sets the standard high for automation, blood safety and medical value at Arab Health 2014

Under the theme of Doing now what patients need next, Roche Diagnostics was one of the largest exhibitors with its unrivalled exhibition booth and lounge at the 39th Arab Health congress, held from January 27- 30th. With a booth located front and center at Arab Health, Roche Diagnostics displayed its varied innovative solutions in an impressive state-of-the art laboratory set-up including: Total Lab Automation (standalone cobas 4000, connected MPA, cobas 6000, cobas 8000, cobas p 501) combined with the future of Molecular Diagnostics (cobas 6800 with a dedicated cobas p 312), the complete Roche Tissue Diagnostics product range, the Point-of-Care portfolio and Diabetes Care.

A new era in blood safety, automation and training

The first of Roche Diagnostics’ notable launches during Arab Health was the Roche Blood Safety Solutions (RBSS). The RBSS is a comprehensive portfolio of blood safety testing that combines the previous success of the widely adopted Nucleic Acid Testing with serology testing in just one source. The launch of RBSS and unveiling of the cobas 6800 garnered support from several industry professionals, who were present to support Roche Diagnostics. Alongside Dr Michael Heuer, President of Europe, Middle East, Africa and Latin America Roche Diagnostics, Dr. Paul Brown, President of Roche Molecular Diagnostics, and Moritz Hartmann, General Manager of Roche Diagnostics Middle East was an exclusive guest from the local healthcare industry. Dr Amin Hussain Al Amiri, Assistant Undersecretary for Medical Practices and Licensing at the UAE Ministry of Health, applauded Roche Diagnostics’ contribution to the region’s healthcare. He said: “This solution will improve the quality of services to blood banks in the Middle East.”

The unique position of Roche Diagnostics as the only company to provide Serology and Nucleic Acid Testing, both relevant technologies for blood banks, was highlighted to a selected group of Key Opinion Leaders at the RBSS Dinner. Special guests included Her Excellency Andrea Reichlin, Ambassador of Switzerland to the UAE and Dr Harry Bos, Director of the Sanquin Division of Diagnostics, who shared his evaluation of the cobas 6800 at Sanquin, a well-recognized reference in blood transfusion safety.

In addition, the cobas u 601 was launched by Jean-Claude Gottraux, President Roche Professional Diagnostics, as a solution that meets the growing automation trend and quality standards.

Furthermore, at the annual Roche Symposium, 400 customers heard directly from Hartmann, Dr Heuer, Dr Brown and Gottraux how novel diagnostic solutions can facilitate treatment decision-making and Roche’s dedication to improve diagnostics. The event was the ideal platform for the launch of Roche Diagnostics’ training catalogue, a one-of-a-kind service for customers across the region.

Roche Lounge introduces Medical Value and Personalized Laboratory Consultation Away from the crowds in the exhibition hall, the Roche Lounge provided customers an intimate location to interact with the Roche team with a Medical Value Room and the Personalized Laboratory Consultation. The Medical Value Room took visitors out of the congress and into a closed and quiet dark room to experience patient stories and medical facts of differentiated assays. With examples of the cobas TnT–hs test in acute myocardial infarction, Elecsys sFlt-1 and PlGF in pre-eclampsia, cobas EGFR test in lung cancer and cobas HPV test in cervical cancer, the medical value of Roche Diagnostics products was demonstrated. For customers who visited the Personalized Laboratory Consultation area received a personalized brochure of customized workflow solutions and the respective system specifications optimized for their needs.

Arab Health once again reaffirmed the growth opportunities in the Middle East’s healthcare sector, which Roche Diagnostics has been able to capture as an industry leader and role model that others will eventually follow.


 

Arab Heath 2014 review

ARC Devices showcases new range of non touch digital infrared thermometers

Established in 2013, ARC Devices is pushing the boundaries of medical device technology to deliver the latest benefits in health care through their range of vital signs monitoring devices.

With global market expansion and a new range of thermometers planned for 2014, ARC Devices continues to lead the way in vital signs monitoring by bringing new technology to today’s connected, health conscious world.

Debuting in the Middle East at Arab Health 2014, ARC Devices joined exhibitors to showcase their exciting new range of innovative non touch digital infrared thermometers in the region. Maria Archer, Chief Operating Officer of ARC Devices, explains more about the highly anticipated product range.

Market leaders

First in the range and sold extensively within the UK and the USA, VeraTemp is currently the market leading non touch digital thermometer for both consumer and clinical use. As used in UK NHS hospitals and in a number of US hospitals, the non touch functionality and unparalleled accuracy of the device sets a new standard in patient care, contributing to cross infection and contamination control in the clinical setting.

By simply pointing the thermometer at the forehead at a distance of approximately three finger width’s away (5-8cm / 2-3.4 inches) and clicking the activation button, a stable and accurate temperature reading is immediately generated.

For families, it delivers accurate and rapid readings for peace of mind and the handy traffic light system allows worried parents to check their child’s temperature is within a normal range without having to disturb a sleeping child or cause unnecessary distress.

Lightweight, colourful and reassuringly accurate, ARC’s stylish new product range, coming in 2014, features the most advanced sensor technology and a host of new features to improve the user experience.

Improved sensor technology for faster, accurate readings

With a sleek new look and built with new sensor technology for improved accuracy and ease of use, the new consumer range of devices, ARC temp1 and ARC temp2, are a must-have for any household. Complete with a handy ‘WallNut’ mountable holder for easy storage, temperature taking has never been so easy.

The ultimate tool for the pioneering professional

The new clinical range of thermometers, ProTemp1 and ProTemp2, raises the bar in setting the standard of patient care, allowing a patient centric approach to vital signs monitoring for the first time.

With enhanced standard features as seen in the current market leading device, the new range will also boast dual sensor technology, allowing the clinician to take readings not only from the forehead but also from the throat for further core body temperature accuracy.

In addition, the ProTemp1 will include patient profiles for improved accuracy, including gender and age profiles, as well as multiple memory functions to capture more patient data.

The ProTemp2 will deliver the ultimate in professional vital signs monitoring, featuring an anti-microbial finish to further reduce risk of contamination or cross infection and induction charging for rapid recharge and reduced consumable costs.

Five to ten times more cost effective

Cost savings are increasingly important to all healthcare providers, something ARC has been cognisant of when developing their new range of non touch devices. ARC’s thermometers are stand-alone and do not require any consumables, providing significant cost and time savings.

In a cost comparison of the ‘whole cost’ of different thermometers currently used in hospital and clinical settings, ARC’s new product range was shown to offer between five and ten times more cost effective temperature measurements over a two year period than any other clinical thermometer.

The future for connected health

ARC Devices are continually striving to engineer new technology for patient centric application in vital signs monitoring to meet the needs of both consumers and clinicians. Marking the shift in the treatment paradigm towards connected health monitoring, future developments will embrace ‘Connected Health’ infrastructures and wireless connectivity with patient record systems, offering accelerated ease of use and substantial cost savings to clinical and remote monitoring.


 

Masimo announces CE marking of O3 Regional Oximetry

Masimo returned to Arab Health with another breakthrough technology – O3 regional oximetry for the Root patient monitoring and connectivity platform.

O3 regional oximetry is a new technology developed by Masimo and uses near-infrared spectroscopy (NIRS) in Masimo Open Connect (MOC-9) modules and up to four sensors, each with four light-emitting diodes (LEDs) and two detectors, to continuously measure both tissue oxygen saturation (rSO2) and arterial blood oxygenation (SpO2) on Root. NIRS can monitor tissue oxygenation in unstable patients, and may provide early indication of deterioration in circulatory function.1 Some evidence suggests NIRS can be used to guide treatment in patients with brain injuries, severe anemia, as well as cardiac surgery patients and preterm newborns.2-9

O3 will allow clinicians to detect regional hypoxemia that pulse oximetry alone can miss. In addition, the onboard pulse oximeter on the O3 sensor means that clinicians can readily calculate the difference between central and regional oxygen saturation.

O3 monitoring is as simple as applying two O3 regional oximetry sensors to each side of the forehead and connecting the O3 MOC-9 module to any Root through one of its three MOC-9 ports. Root offers unprecedented, high-impact innovations including: l Radical-7 with Masimo’s breakthrough rainbow and SET measurements l Instantly interpretable, high visibility, intuitive navigation touchscreen display l MOC-9 flexible measurement expansion with SedLine EEG brain function monitoring and Phasein capnography, in addition to O3 regional, including cerebral, oximetry and future measurements l Iris for built-in connectivity gateway for standalone devices such as IV pumps, ventilators, hospital beds, and other patient monitors l MyView for automatic display of parameters, waveforms, and viewing configuration based on the clinician’s presence

In an abstract presented at the Society for Technology in Anesthesia 2014 Annual Meeting in Orlando, Fla., Dr. Daniel Redford from the University of Arizona evaluated cerebral oxygen saturation on 23 subjects and 202 paired measurements of rSO2 from O3 regional oximetry and reference arterial and venous blood samples (SavO2). Reference blood samples were taken from both an arterial cannula placed in the radial artery and a catheter placed in the internal jugular bulb vein, obtained at baseline and after a series of increasingly hypoxic states induced by altering the inspired oxygen concentration while maintaining a normocapnic arterial pressure of carbon dioxide (PaCO2) level. O3 regional oximetry had an absolute accuracy of 4.0% and trend accuracy of 2.1%. In addition to O3’s regional oximetry absolute accuracy, O3 also provides the ability for clinicians to measure pulse oximetry simultaneously from the same sensor, which can automate the differential analysis of regional to central oxygen saturation monitoring.

The ability to connect two O3 modules on the Root system offers a total of up to four sensors. Other devices’ validation studies had titrated the PaCO2 to 40, which is not real-world. O3’s accuracy of 4% comes despite allowing the PaCO2 of the patient to be whatever it normally is. In this study, PaCO2 ranged between 30 to 45, which suggests clinicians are more likely to get accurate measurements with O3 than other regional oximeters.

O3 regional oximetry is currently intended for use in subjects larger than 40 kg (88 lbs) and has not yet received FDA 510(k) clearance.

Joe Kiani, CEO and Founder of Masimo, said: “O3 regional oximetry delivers again on Masimo’s mission to improve patient outcomes and reduce cost of care by taking noninvasive monitoring to new sites and applications. We look forward to partnering with key hospitals around the world to demonstrate O3’s technical and clinical advantages.”

References

1 Scheeren TW, Schober P, Schwarte LA: Monitoring tissue oxygenation by near infrared spectroscopy (NIRS): background and current applications. J Clin Monit Comput 2012, 26:279-287. 2 Beynon C, Kiening KL, Orakcioglu B, Unterberg AW, Sakowitz OW: Brain tissue oxygen monitoring and hyperoxic treatment in patients with traumatic brain injury. Journal of neurotrauma 2012, 29:2109-2123. 3 Zheng F, Sheinberg R, Yee MS, Ono M, Zheng Y, Hogue CW: Cerebral near-infrared spectroscopy monitoring and neurologic outcomes in adult cardiac surgery patients: a systematic review. Anesth Analg 2013, 116:663-676. 4 Mittnacht AJ: Near infrared spectroscopy in children at high risk of low perfusion. Curr Opin Anaesthesiol 2010, 23:342-347. 5 Bronicki RA, Chang AC: Management of the postoperative pediatric cardiac surgical patient. Crit Care Med 2011, 39:1974-1984. 6 Bellapart J, Boots R, Fraser J: Physiopathology of anemia and transfusion thresholds in isolated head injury. The journal of trauma and acute care surgery 2012, 73:997-1005. 7 Cerbo RM, Cabano R, Di Comite A, Longo S, Maragliano R, Stronati M: Cerebral and somatic rSO2 in sick preterm infants. The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstet 2012, 25 Suppl 4:97-100. 8 Seidel D, Blaser A, Gebauer C, Pulzer F, Thome U, Knupfer M: Changes in regional tissue oxygenation saturation and desaturations after red blood cell transfusion in preterm infants. Journal of perinatology : official journal of the California Perinatal Association 2013, 33:282-287. 9 Hanson SJ, Berens RJ, Havens PL, Kim MK, Hoffman GM: Effect of volume resuscitation on regional perfusion in dehydrated pediatric patients as measured by two-site near-infrared spectroscopy. Pediatr Emerg Care 2009, 25:150-153. 10 Redford D, Paidy S, Kashif F, STA 2014; 46 (abstract);

 Date of upload: 09th Apr 2014

 

                                  
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