The digitalisation of the healthcare sector has been an integral part of the Emirate of Abu Dhabi strategic agenda over the last years. Currently, Abu Dhabi is set to become the leading healthcare destination globally. Its acceleration of digital transformation has been inspiring in the Middle East and Africa and has empowered the globally recognised successful pandemic response of the Emirate.

In 2017, the Department of Health-Abu Dhabi (DOH) with the primary objective to enhance the wellbeing of Abu Dhabi residents through prevention and access to integrated, innovative, and high-quality, implemented a strategy to digitally transform the healthcare sector in the Emirate. Since then, the DoH has undertaken various initiatives and made significant progress in building a robust and cohesive healthcare sector with a clear vision and an ambitious strategy.

Based on a patient-centric approach, the overall goal is to provide the best insights-driven and value-based system to deliver state-of-the-art preventive, pervasive and personalised medicine to the people. In 2019 as one of its strategic initiatives to digitally transform the healthcare sector, DOH launched the first Health Information Exchange (HIE) platform in the region – Malaffi. The platform safely and securely connects all public and private healthcare providers in the Emirate of Abu Dhabi, enabling the meaningful, real-time exchange of important patient health information between healthcare providers. Malaffi has created a centralised platform of unified patient records to improve healthcare quality and patient outcomes.

Over the last three years, Malaffi has become an integral part of the healthcare sector in the Emirate, and as of December 2021, the platform connects 100% public and private hospitals across Abu Dhabi and 1,178 clinics and medical centres, which make almost 99% of all patient episodes. Over 45,600 doctors, nurses and other members of care teams have access to Malaffi and use it to make better-informed, more efficient, and safer decisions to deliver a higher quality of care. Malaffi securely stores details about patient visits, medical conditions, allergies, procedures, lab results, radiology reports, medications, vaccines records, vital signs and clinical documents, bringing into one platform over 660 million unique clinical records collated from 69 different Electronic Medical Records (EMR) systems.

Patient-centric approach

HIEs, like Malaffi, designed to be patient-centric, have a significant impact on the delivery of healthcare given they enable more efficient, safe and effective care.  whilst providing medical practitioners with instant access to real-time, essential patient health information and play a vital role in improving the quality of healthcare and patient outcomes.

With patient safety and care at its core, Malaffi supports patients through their healthcare journey as it provides practitioners at any connected healthcare facility with access to a patient's longitudinal medical file, thereby making better clinical decisions in terms of accurate diagnosis and treatment course through a centralised database, Malaffi contributes to ensuring care is effectively coordinated across the Emirate. There has been several positive feedbacks from the healthcare providers on how access to information in Malaffi helps them prevent medical and medication errors, reduce redundant duplication of tests, allows them to have more facetime with patients and ensure continuity of care.

Need for data standardisation

In order to optimally use HIEs such as Malaffi, the healthcare community must work to improve the standardisation of data in order to maximise interoperability and enhance the quality and completeness of patient data available to healthcare professionals. The pandemic highlighted the issues of limited interoperability due to the need to quickly centralise information from a multitude of medical systems used by public and private providers, laboratories, and pharmacies globally. Therefore, to streamline data exchange within a healthcare system, there is a strong need to further standardise the data.

Introducing better data standardisation will improve overall data quality and allow the health industry to speak a common language.

In this regard, the DOH  has issued guidance on coding standards to healthcare providers in Abu Dhabi in order to enhance their data quality (such as SNOMED CT and LOINC), the adoption of which is expected to significantly improve interoperability, increase the clinical value of the data and improve the accuracy and scope of population health insights.

Enabled a robust response to the pandemic

In 2020, the COVID-19 pandemic strengthened the need for healthcare providers to adopt technology and contribute to the building of a cohesive digital health ecosystem. The benefits of a centralised database were evident as Malaffi supported the DOH to tackle the COVID-19 pandemic by gaining better insights about its spread in Abu Dhabi.

In a short span of time, Malaffi established a centralised database of COVID-19 test results in the Emirate allowing real-time monitoring of the spread of the virus. Combining test results with additional health data within Malaffi ensured those who tested positive could be effectively triaged. The centralised data also allowed doctors to assess the risk level of individual patients immediately, which was crucial for those with underlying health conditions.

Additionally, it supported the rollout of the vaccination programme by centralising vaccination information from more than 100 facilities in Abu Dhabi, offering the DOH real-time insights about the Emirate's vaccination status.

These solutions enabled Abu Dhabi to formulate a swift, effective, and successful response to the pandemic. The Emirate was also recently recognised amongst the world's leading cities for their response to the COVID-19 pandemic, by London-based analytics consortium.

Next steps

Designed to scale, Malaffi is continually improving based on the feedback and needs of the users, most notably around the integration of additional data points to enrich the clinical value of the information. For example, radiology images, symptoms and appointments will be available to the users through the platform in the near future. Malaffi is also looking to finalise the onboarding of the remaining facilities and complete connecting all data points from the providers to ensure that the Emirate will fully benefit from a universal, unified, and secure source of real-time health information.

The consolidated clinical data in Malaffi enables the DOH for the first time to draw population health insights based on the analysis of clinical data of the entire population.

In 2021, Malaffi premiered an early demonstration of its population risk management analytics platform which will empower the healthcare sector to support care management, improve population health and assist in ensuring continuity of care once live.

The platform uses advanced artificial intelligence (AI) analytic technologies, such as machine learning, to build predictive models based on the clinical data and run algorithms to predict future hospital admissions, emergency department visits, readmissions, disease complications such as diabetes, and other risks. These insights will be used to action targeted measures that will reduce the risk of groups or individual patients to develop certain conditions, improve overall efficiencies of the providers and reduce cost.

Having the infrastructure of the centralised information and an analytics layer in Malaffi will also contribute significantly to future advanced systems tailored for syndromic and pandemic surveillance that will increase the readiness of the healthcare system to protect the health and wellbeing of its residents.

This year, in January, Malaffi marks 3 years since its launch in 2019. Visit Malaffi at the stand of the Department of Health-Abu Dhabi at Arab Health 2022 to experience some of their latest advancements.