CHANGING CARE
TBY talks to Dr. Haitham Alfalah, CEO of King Saud Medical City (KSMC), on structural changes to the sector, new models of care, and KSMC's leading trauma center.

BIOGRAPHY
Dr. Haitham Alfalah is currently CEO and a consultant bariatric and endocrine surgeon at King Saud Medical City (KSMC). Dr. Alfalah established the Bariatric & Metabolic Surgery Center in KSMC, which was recently recognized as a center of excellence in bariatric and metabolic surgery by the International Federation for the Surgery of Obesity and Metabolic Disorders and from the Surgical Review Corporation, US. The center is the first in the Kingdom recognized as a Center of Excellence with back-to-back international accreditations in 2017. He also chairs the Obesity Program in the Ministry of Health, which supports the ministry’s strategic initiative on obesity management.How does KSMC fit into not only the sector, but particularly the National Transformation Plan (NTP) and changes to the sector?
The NTP 2020 was launched across 24 government bodies operating in the economic and development sectors. This aims to build the institutional capabilities needed to achieve Vision 2030; the Ministry of Health is one of the key government bodies that underwent a restructuring process to align to the requirements of the program and to enable to perform its tasks and expand its competencies. In 2016, KSMC was tapped to share its expertise and experience in the design of the health transformation program. The transition was initiated with the assessment of the situation on the ground and formulated a gap analysis to convert into Accountable Care Organization (ACO). Leading the patient pathway through the new “Model of Care” methodology will lead to increased efficiency and ultimately decrease the waste in time, efforts and costs. In June 2017, the Minister Council approved the NTP to form five health-providing companies, and KSMC will be the core for implementation. This actually means a broader spectrum of responsibility for KSMC in terms of providing excellence in health care to a larger population. The new initiative changes the model of care and patient flow. The change in governance, organizational structure, and financial model is created to fit the new Vision 2030. All these things start to impact on our manpower plan and structure design.
How do the plans to reform the healthcare system affect your plans and operations?
Previously, we were responsible for the patients who arrived at our Emergency or Outpatient Departments. Now with the new model of care, populations are divided into clusters and each medical city is then responsible for a specific sector comprising of primary health centers and secondary hospitals. KSMC takes the lead for Cluster 1 that is responsible for 10 primary health centers and four hospitals (King Salman bin Abdelaziz Hospital, Al Iman General Hospital, Imam Abdul Rahman Al Faisal Hospital, and Al Naqaha Hospital). Cluster 1 covers the west and south sector of Riyadh, or rather approximately 3 million people. It provides patients faster access to care between primary, secondary, and tertiary levels of care, which makes our operations more efficient in terms of utilization of our capital and manpower resources. This also an effective model for enhancing access to care and providing greater proximity for patients. In addition, there are many projects that include the NTP budget to upgrade the existing system to meet patients' expectations. Before, we were talking about the patient; now we are talking about the population.
KSMC is one of the key trauma centers in the country, and specializes in trauma. How does your acquisition of the new hospitals affect that specialty?
Trauma care is one of the core competencies of KSMC. We are moving fast towards being the Level 1 trauma center. This year we signed an agreement with The Alfred Hospital, Australia under the patronage of the Minister of Health. The agreement covers redesigning of the trauma system starting from pre-hospital care to post-discharge long-term care. A large part of the agreement relates to training and research, and redesigning of the trauma services to cover all health facilities in Cluster 1, which means concentrate more specialized specialties in KSMC like spinal, neurosurgery, and more training in refining the service of trauma in other facilities creating safe environment to deal with trauma patients and rapid access of highly specialized centers. As a Level 1 Trauma Center, this will increase the coverage outside Riyadh, and the medical city will continue to play its role as the national center for trauma. Likewise, we will continue to complement and support preventive measures and initiatives initiated by the Ministry of Health like traffic safety initiatives, which is a part of the NTP2.

TABLE OF CONTENTS
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