Dr Ahmed Al-Musaed, Executive Leader, Transformation, Strategy and Business Development, Assistant to CEO for Clinical Affairs Eastern Health Cluster, explains how the Eastern Cluster fits into the KSA healthcare transformation
Vision 2030 is a comprehensive plan for reform of the entire economic structure of Saudi Arabia. While aiming to reducing the Kingdom’s reliance on oil as the main income stream, it has also been put in place to decrease public spending by inviting partnerships with the private sector.
For healthcare in particular, Vision 2030 has created the possibility of an entirely new healthcare system. By reorganising its structure and separating the regulator from the provider, more than 21 Clusters will be formed that will essentially be Accountable Care Organisations or ACOs. Healthcare leaders across Saudi Arabia have been examining ways to transform their existing structure into a modern, digitally enabled system that will change the way healthcare is provided while allowing its population to manage its own health via new and innovative methods.
The offering of Vision 2030 is to deliver a comprehensive transformation for the whole country, focusing on the existing governmental processes, including all services such as education, hotels, municipalities, and housing. There is a massive focus on optimising and transforming the services delivered for these activities.
Prior to Vision 2030, the government-based health care system formed the main part of the sector, with 60 per cent. The second was the military and the non-governmental part, and the third was the private sector at around 20 per cent. The goal of Vision 2030 is to transform the government practices and increase the private sector participation in the health sector to more than 55 per cent.
The government sector is led by the Ministry of Health which used to be the regulator as well as the provider under one entity. With Vision 2030 the plan is to separate the regulator from the provider, so the Ministry of Health will focus more on the regulatory side and will transform into the National Centre for National Health Insurance, separate from the Ministry of Health. The providers, which have more than 250 hospital and 2,200 primary care centres, will migrate under the umbrella of the health holding company and divided into some 20 regional clusters, along the geographic distribution of the country.
The Eastern Cluster was the first to launch in 2017 with 22 secondary and tertiary hospitals and 133 primary healthcare centres which are public facilities. The university medical school teaching hospitals and the health care systems of the three administrative arms, the National Guard, the armed forces, and the Minister of Interior have their own health care systems. And then there is the private sector.
The Eastern Cluster developed its two year business plan in 2018 and developed a five year long term strategic plan which was approved by His Excellency the Minister in 2020.
The vision for the cluster is to transform into a world class health care provider, creating an integrated practice with one medical city, 21 secondary hospitals and a specialised hospital, and 133 primary care centres. This arrangement will begin to transform into a comprehensive, accountable care organisation for roughly around 4m population in the Eastern Province.
The ultimate goal of the cluster is to develop and transform to become an accountable care organisation based on total transformation, population health management, partnership with the private sector and NGOs locally and internationally in cooperation and delivery of hospital and primary care services, and optimising our capital planning and investment for the long term. It will become responsible for the overall population health, including prevention. This requires us to think differently about the delivery of care from facility-based delivery to population health-based delivery, running facilities and running accountable care for the beneficiaries that we are responsible for.
The role of digital in Vision 2030
Digital transformation has been an essential component of driving this change. There are a number of dimensions we need to consider in putting all these providers under one umbrella, creating the sense of accountability not only for the people coming to their doorsteps, but also for the overall community. Integrated practices are key, including community and primary care centres especially following in-hospital care.
Digital transformation has been used as an important enabler in the past to provide health information for health systems. It’s essential that digital also transforms the way we conduct business, not only through virtual care and telemedicine, but also relying on digital health for mobility, personal devices and more that can enforce the self-care goal that we are trying to achieve with our population.
The focus on prevention has been growing, especially around the screening programme for most chronic diseases. We are increasing accessibility to the system for people, aiming for a unified health record and a single form for appointments and follow up. In addition, we are moving to our service line practices, such as bringing specialist care outside the referral system into a closed system to involve community practices by connecting through a single platform and a single team.
The Eastern Cluster is taking the lead with regard to transplant services, especially for pancreas, liver and kidney. We would like to have more room for cancer diagnostics and widen our ground for preventative screening. We would also like to maximise our capacity for paediatric and adult care, as well as learn more about outpatient diagnostics and therapeutics because that is the modality for today’s cancer care. Equally, the associated home care will help us anage our hospital beds. There is also a transformation required to move from interventional cardiology to more imaging cardiology, and we plan to rely more on primary care for patients with hypertension as well.
Ultimately, the Eastern Cluster will be a leading provider of healthcare services through KSA, striving for innovation, accountability and delivery in its provision to the community.