x Abu Dhabi, UAEMonday 24 July 2017

Set healthcare rules 'will prevent abuse of system' in Abu Dhabi

Standardising health care treatment will benefit patients, doctors and insurance companies.

Patients, doctors and insurance companies in Abu Dhabi will soon benefit from guidelines that will help standardise healthcare.

Stakeholders - including healthcare providers, insurers and the health authority - are working towards developing 68 evidence-based guidelines, known as clinical care pathways, in priority areas.

These include cardiovascular disease, cancer control and prevention, and occupational health.

The pathways are meant to ensure that patients receive exceptional care regardless of the medical facility they choose to visit.

The guidelines will also ensure compliance by insurance companies in covering the costs associated with required procedures.

This step in improving the health system could prevent its abuse, said Dr Ayham Refaat, a maxillofacial surgeon and medical director of AccuMedPM, a medical billing solutions consultancy.

"The core issue is not money but the difference in the clinical approach," he said. "A doctor will try to treat a patient one way and then the insurance company says no, clinically it should work another way."

Streamlining the way patient care is approached will also help reduce the trend of "doctor shopping", where people visit a series of medics.

"You're more likely to be treated from the first time," Dr Refaat said. "You are most probably going to get the right procedure, so you have less tendency to seek another opinion if you have overall guidelines that everyone is following."

An online portal will allow physicians to access the care pathways, which will recommend diagnostic tests and provide information on drugs and alternative therapies.

Such guidelines are also important because they take into consideration the needs of the population, said Dr Youssef Shawki Hassan, a consultant endocrinologist at Al Noor Hospital.

Because of the high prevalence of Vitamin D deficiency, Dr Hassan requests that his diabetic patients have their levels tested.

Obesity means a younger population of diabetics who require medication to control their blood sugar.

Ensuring that physicians follow the pathways is equally important to developing them, Dr Hassan said.

"We really need to dig it out and spread the message … reward those who are following the pathways and encourage them to do more," he said. "And educate those who are not following them so that they can improve their standard of care."

Work began on the three-year programme last December, with the first pathways being introduced this year.

Electronic access to the protocols will be made available to doctors in Abu Dhabi next year.

mismail@thenational.ae