King Hamad University Hospital modernizes healthcare

King Hamad University Hospital offers national healthcare for all residents of Bahrain, an Arabian Gulf island nation. The core healthcare information system, HOPE (Healthcare Operating Environment), spans every aspect of the healthcare system, from scheduling, admissions, electronic medical records, lab testing, specialty care, pharmacy, catering, and revenue management, among other patient and staff services. 

The hospital, which offers more than 40 specialties and is a secondary and tertiary national referral center for general and oncology patients, was struggling with rigid, legacy hospital management information systems.

However, making functional changes is challenging in the highly dynamic and complex healthcare environment. Hospital executives tried two different local systems which used Adobe Flash then Oracle Forms, but adding new requirements and integrating data was prohibitively expensive and difficult to administer, causing project delays. The hospital considered buying an industry-standard hospital application, CERNER, or building its own system another way.

King Hamad University Hospital chose Oracle Application Express (APEX) because it offered a superior application development framework for enhanced performance and productivity at a fraction of the time, cost, and errors compared to the previous two attempts at building a custom health information management system. The intuitive, low-code APEX framework is a no-cost option within Oracle Database that enables development at lightning speed compared to traditional Java and .Net application programs. It allowed the hospital to incrementally build its own system, HOPE, and phase out legacy modules. This enabled the hospital to continuously deliver new healthcare innovations.

The hospital modernized its operating environment using Oracle APEX by creating one large application that spans a suite of more than 40 modules. Application development speed increased 5X, from months to weeks, and even days. Not only is the hospital in a better situation with paperless, modern information systems that are integrated and accurate, but it also has saved at least 80% in costs, or more than $27 million, during a 10-year budget period. 

The cost savings are reinvested into innovation, with the goal of being the first and only hospital group to connect to National Electronic Medical Records (NEMR), National Healthcare Insurance Information System (NHIIS), Drug Utilization Review (DUR), plus a fully automated robotic pharmacy for outpatient and inpatient dispensation, as well as chemotherapy preparation. In response to the pandemic, it quickly developed testing and vaccination services and created telemedicine services to provide remote care. 

HOPE staff expanded from 4 to 23 in order to build new modules and showcase them to stakeholders on the spot. One hallmark of excellence is the Bahrain Oncology Center (BOC), a fully integrated chemotherapy protocol workflow. It is a sophisticated and unique module, with 175 hospital protocols already integrated. Its target is 205, to ensure safe medication management from prescription, dispensation, preparation, to administration without adding any IT costs or support.

Hospital service quality improved with significantly fewer errors and incidents reported, including extremely sensitive chemotherapy protocols, due to the seamlessly integrated development and deployment process. 

“It is the operational information systems like HOPE that make our vision come to life. We are constantly surprised by the quality and agility of development HOPE demonstrates, rightly aligned to our vision and our strategic objectives,” says H.E. Lieutenant General Dr. Shaikh Mohammad Bin Abdullah Al Khalifa, chairman of supreme council of health.

The Oracle APEX app engine is also optimized for high performance at very low cost because it is included in Oracle Database licensing. Also, it is automatically integrated for less manual interaction and computing resources.  The hospital app serves 5,000 users, including all physicians and staff. Even though the app handles 4 to 5 million hits per day and 8,000 to 10,000 sessions per day, Oracle’s database runs at only 25% capacity on 2 CPUs and 64 GB of RAM on commodity server hardware, with peak reporting periods at 30%.

Access to real-time data and reporting has provided transparency in hospital finance and accounting, helping to identify waste and inefficiencies. Budget controls are now in place, with notifications to management and physicians to analyze procedure costs. The increased visibility of hospital finances and operations helps prioritize patients and alleviate waiting periods.  

“After trying many other systems, we realized we had to build our own. Today, we are very proud to have developed HOPE. It has shown that it is a robust, user-friendly system with proven excellence over the years,” said Major General Dr. Shaikh Salman Bin Ateyatallah Al Khalifa, Commander, King Hamad University Hospital.