In Kazakhstan, the implementation of a long-term framework in the National eHealth Development Strategy (first wave: 2005-2015 and second wave: 2016-2019) witnessed the digital health focus being shifted from collecting data to the formation of an integrated information environment.
Despite progress being made, the country has experienced common challenges to others across the globe, such as a fragmented process in collecting electronic health data. Furthermore, difficulties with data linkage for the purposes of deeper analysis have proved problematic.
The aim is to drive a digital transformation strategy by embedding digital technologies to improve current processes and provide new opportunities to increase value while also enhancing the patient journey throughout the system.
Interoperability should help to support the larger focus on patient-centred care and also reduce barriers between levels of care or healthcare facilities. The overarching objective is to achieve a sustainable healthcare system by developing an institutional framework and making investments in standards, data and use-cases.
At the HIMSS & Health 2.0 European conference in Helsinki last month, Dr Abishev spoke with us about some of the plans in more detail and offered his perspective on how digital can improve healthcare for a country of 18.6 million people.
Q. What are the key challenges you’ve experienced so far?
A. From 2005 the government tried to implement different IT projects, but these included a number of different systems and databases which were not connected. We therefore had to find a solution to support data flow and so three years ago we focused on creating a digital ecosystem in healthcare and creating an interoperability platform from a government level to provide a data flow that ensures wherever the patient travels, the data follows seamlessly. This should ensure that the EHR is easily accessible by the private or state hospital. We are about to launch the ‘National EHR’ concept which will mean that all data can be accessed by the doctor via an electronic one time password.
Secondly, we need to shift our thinking from reactive to proactive. This should allow us to leverage data analytics to predict potential health concerns in our citizens. In theory, this will allow us to connect with our citizens and request they attend a GP appointment for any extra tests required. This aligns with the Universal Health Coverage strategy, as outlined by the World Health Organisation. Better medical services are simply not possible without early prevention, which is in turn only viable by leveraging big data. Health data is not enough, as the healthcare stakeholders do not necessarily have access to lifestyle information. If we can connect patient data from wearables and apps, this will help us to improve public health by using predictive analytics in alignment with big data and thereby succeed in early prevention.
Q. How will interoperability play into the overall strategy?
A. We have focused on the harmonisation of international standards such as HL7 and clinical documentation architecture which have been recommended by the WHO and the UN for the last two years. We have created the interoperability platform and are now focusing on how the data should be harvested, stored and shared between systems, but the private hospitals can choose what they want to use based on the internationally recognised standards. Since 2018, we approved six national standards based on international recommendations. Moreover, our team at the Ministry has harmonised more than 12 data technical protocols using open APIs to help exchange data between the systems and improve data access. We’re proud of achieving this by working with organisations such as SNOMED, HIMSS and HL7.
Q. Have you experienced any cultural barriers in implementing your digital strategy?
A. It’s not so much a cultural issue, but more of a digital literacy challenge among the population. Some of the older pockets of the population don’t have access to a phone, and so these ‘passive digital patients’, as I like to refer to them as, can be difficult to derive data from. But the ‘active digital patients’ from around the ages of 20-40 years old can be easily reached and we can therefore help them to sustain their health and stay as a citizen for as long as possible, rather than being treated as a patient.
The mentality is interesting with the younger generation at times, as they can be open to sharing data with social media platforms who monetise their data, but when we ask for data to be shared from a healthcare perspective – data privacy can be raised as a concern. It’s therefore imperative that we educate our population to understand that we’re trying to use their data to improve and sustain their health.
Q. What have you learned from the HIMSS & Health 2.0 European Conference?
A. I’ve participated in some great sessions, but the one that sticks out was around artificial intelligence (AI) with some use cases referenced in the UK and Spain. The take out was that new technologies would not replace medical staff in the near future, but medical staff that are effective in their use of AI will replace those that are not. This is interesting as it reinforces the need to embrace technology and AI, rather than work against the support that technology can offer healthcare.
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