/CHILDREN’S CANCER HOSPITAL IN EGYPT

DIGITAL HEALTHCARE

THE CHILDREN’S CANCER HOSPITAL IN EGYPT BUILDS OUT A NEW BRANCH IN TANTA CITY WITH A VISION OF CREATING THE COUNTRY’S FIRST TRULY DIGITAL HOSPITAL BY TOM PAYE 42

ARABIAN COMPUTER NEWS January 2016

Eng. Mohamed Abdelfattah, infrastructure & consulting services director, CCHE (left); Eng. Ayman Ibrahim, clinical informatics director, CCHE (right).

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The main hospital in Cairo has over 320 permanent beds.

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n recent years, the healthcare system has been thoroughly modernised, thanks largely to the development of electronic healthcare records (EHR) and health information systems (HIS). These have enabled plenty of hospitals around the Middle East to go effectively paperless, due to the fact that records are entered, processed and managed electronically through these systems. And while the first EHR and HIS systems were fairly rudimentary, modern systems are full-featured, user-friendly and extremely powerful. That said, the Middle East has only seen widespread adoption of these systems in recent years. Previously, as usual, the United States led the pack in this area, but this region has since leapfrogged the more developed markets and implemented cuttingedge technologies that enable hospitals to go paperless and provide better information to patients and doctors. One early adopter of HIS in the Middle East was the Children’s Cancer Hospital in Egypt (CCHE). Located in the Sayeda Zeinab district of Cairo, the hospital has 320 permanent beds and is planning to expand to 620 beds, following the construction of a new extension. It has been designed to facilitate familycentred care, while meeting the most stringent requirements for immuno-compromised patients and infection control. It was founded and is maintained entirely on donations, with a mission of providing free-of-charge cancer care to children. And in 2009, the hospital became the first in the country to adopt HIS, with a deployment of a solution from healthcare specialist Cerner. Indeed, according to Eng. Mohamed Abdelfattah, infrastructure and consulting services director, CCHE, the hospital prides itself on providing state-of-the-art care to its patients. “This state-of-the-art facility includes diagnostics and laboratory support (including scans, nuclear medicine, blood bank, cytogenetics, virology, and stem cell collection and storage), a fully equipped radiotherapy department, and intensive care and bone marrow transplant units. Complicated tumour procedures, such as neuro, micro, and ophthalmic surgery, can all be carried out on-site. There is also a specialised clinical pharmacy and large outpatient facility that can accommodate up to 500 patients per day,” he says. “The new hospital infrastructure design embodies the core principles of Medical-Grade Network architecture. This sets out best practices in building the network foundation required by clinical applications, thereby securely connecting people, processes, infor-

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mation, and devices.The hospital uses mobility solutions, enabling doctors, engineers, nurses and others to move freely around the hospital and stay connected to medical data and healthcare applications.” CCHE’s operations have been so successful in recent years that the hospital has been able to expand its branches. Recently, the hospital set up a new branch at Tanta City, meaning that the IT department was once again challenged to provide the right systems to doctors, nurses and patients.

Business challenge To meet international standards of children with cancer, CCHE had to select and upgrade systems such as the Cerner one. Following successful improvements at the hospital’s headquarters in Cairo, CCHE was encouraged to build another branch at Tanta City to help and support patients in that area. The operations of the new branch, dubbed ‘57357’, had to be totally integrated into the main

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“THE INFRASTRUCTURE DESIGN EMBODIES THE CORE PRINCIPLES OF MEDICAL-GRADE NETWORK ARCHITECTURE. THIS SETS OUT BEST PRACTICES IN BUILDING THE NETWORK FOUNDATION REQUIRED BY CLINICAL APPLICATIONS, THEREBY SECURELY CONNECTING PEOPLE, PROCESSES, INFORMATION, AND DEVICES.” ENG. MOHAMED ABDELFATTAH, INFRASTRUCTURE AND CONSULTING SERVICES DIRECTOR, CCHE

hospital in Cairo, and CCHE wanted it to be a fully digital hospital. “57357 was founded on a vision for connected healthcare using the power of technology to improve clinical efficiency and effectiveness, make better use of scarce resources, and remove the limitations presented by geographical boundaries. In addition, it is free of charge for all regardless of ability to pay,” explains Eng. Ayman Ibrahim, clinical informatics director at CCHE. Indeed, Ibrahim adds that, for the new branch, CCHE wanted to use the most advanced technologies in the world.

The solution For the new branch, CCHE called on the leading technology vendors to help create and integrate the architecture. Vendors such as Cisco, Microsoft, HP, Oracle and Dell each contributed to the new, next-generation network, which was built using the Medical-Grade Architecture. The network had to be highly secure as well, as an objective of the deployment was to allow BYOD, which allows doc-

tors and employees to access the hospital’s systems from anywhere in the world. “In an environment where every second counts, three-dimensional (3D) scans can be viewed, shared, and stored online. This makes it easier for doctors to consult together on each patient case, enabling faster and better group decision making and efficiency. It also releases valuable space that had been used to store X-rays and patient files to be re-used for better purposes. The network also provides ubiquitous access to the HIS, the central system for patient care management, as well as other business applications, such as ERP,” explains Abdelfattah. However, just as much attention had to be paid to the HIS itself, which would form the backbone of the digital services delivered at the hospital – indeed it would be the backbone of all the services, given that this was to be a digital hospital. In terms of the HIS, CCHE had already developed a relationship with Cerner, whose HIS runs the headquarters in Cairo. Therefore the new branch also had to be running on Cerner. However, it wasn’t just the ease of integration that won over CCHE — the hospital was convinced that Cerner provided the most advanced solution for its needs. “The foundation of the day-to-day healthcare given by the hospital is the Cerner HIS. High availability is, therefore, absolutely critical. In a digital hospital, where all medical equipment is network-oriented, you have to architect for 100% uptime. For example, doctors can only monitor patients in intensive care through their medical reports that are stored on the network, so

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CCHE’s objective is to use technology to deliver better patient care.

the system has to be up and running 24 hours a day. Our Cerner solution allows us to carry out monitoring the patient’s workflow for any of the equipment online, with no need for physical interference,” says Abdelfattah. “We were looking for a partner who was sharing our vision for connected healthcare and had the same passion to build a digital hospital. WithCerner’s renewed expertise in HIS,it was important to do that with a company that has the experience to maintain our dream, which provided us with added confidence.” The roll-out of the Cerner solution at the new branch took two years. And that process was not without its problems. According to Ibrahim, there were issues in getting hospital staff trained up on the system so that they could use it effectively. “We had a problem that most of our physicians were not committed to the class due to the high number of patients in our outpatient clinics. To overcome this issue, we arranged one-on-one training for each physician, who had an option of selecting his or her preferred time for their training,” he says. “We use our HIS to manage patient cases throughout the whole diagnosis and treatment process and across different ven-

“THE NEW BRANCH WAS FOUNDED ON A VISION FOR CONNECTED HEALTHCARE — USING THE POWER OF TECHNOLOGY TO IMPROVE CLINICAL EFFICIENCY AND EFFECTIVENESS, MAKE BETTER USE OF SCARCE RESOURCES, AND REMOVE THE LIMITATIONS PRESENTED BY GEOGRAPHICAL BOUNDARIES.” ENG. AYMAN IBRAHIM, CLINICAL INFORMATICS DIRECTOR AT CCHE 46

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CASE STUDY SUMMARY OBJECTIVE With the creation of a new branch in Tanta City, the Children’s Cancer Hospital in Egypt (CCHE) wanted to build a ‘digital hospital’, which would be linked to the headquarters in Cairo via a next-generation network infrastructure, and run on the most advanced healthcare information system (HIS). SOLUTION For the infrastructure, CCHE turned to a number of the world’s top technology vendors, and built out the network as per Medical-Grade Architecture standards. For the HIS, CCHE enrolled Cerner, which provided a robust system that allows the tracking of patient care from enrolment to discharge. BENEFITS CCHE succeeded in creating its robust infrastructure. On top of this is a thoroughly modern hospital, powered by the Cerner HIS. Thanks to the new systems, the hospital has upped its cancer cure rate to 74%, and doctors now have access to much more information, allowing them to spot trends.

ues — including labs, pharmacy, surgery, radiology, and medication administration. In addition to using our system forclinical research purposes.”

Business benefit The CCHE believes that it is now the first example in Egypt of an end-to-end connected healthcare facility. Ibrahim says that it has set new standards for planning and operating hospitals, defining future best practice for healthcare-related institutions and providers. Abdelfattah adds that the digitised hospital environment, based on a converged, wireless intelligent IP network and advanced Cerner solution, is already helping to make new breakthroughs and reduce the threat of cancer. “It is far easier to spot trends now,” says Dr Sherif Aboelnaga of CCHE. “Having received three similar leukaemia cases in one month, we quickly identified that the three patients were residents of the same street. With a little research, we were able to do an epidemiology study there. Such information would most probably have gone

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undetected before without using such an HIS solution.” Indeed, according to the two engineers, CCHE has, through the new technology, managed to achieve a 74% cure rate for children with cancer. There have been other benefits, too, but the pair do not measure them in terms of return on investment, which they believe does not provide a good benchmark for an organisation like CCHE. “ROI studies usually focus on the monetary savings (since we treat kids for free, we don’t have direct revenue) and the savings happen, but how much is the monetary value for saving a live or getting a patient to cure faster? These are priceless achievements

which will overweigh any ROI study. So we look at our projects from a cost-benefit analysis rather than financial ROI studies,” says Ibrahim. “With a next-generation, advanced infrastructure, systems, technologies, and the Cerner HIS solution, we give doctors and nurses the ability to access critical patient records, every time, everywhere. Easier communications enable medical staff to be more productive, respond to patient needs faster and reduce call charges.The solutions are very critical for us, especially we are dealing with patient records, and this — directly and indirectly — will affect patients’ lives.”

“HAVING RECEIVED THREE SIMILAR LEUKAEMIA CASES IN ONE MONTH, WE QUICKLY IDENTIFIED THAT THE THREE PATIENTS WERE RESIDENTS OF THE SAME STREET. WITH A LITTLE RESEARCH, WE WERE ABLE TO DO AN EPIDEMIOLOGY STUDY THERE. SUCH INFORMATION WOULD MOST PROBABLY HAVE GONE UNDETECTED BEFORE WITHOUT USING SUCH AN HIS SOLUTION.” DR SHERIF ABOELNAGA OF CCHE January 2016 ARABIAN COMPUTER NEWS

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