The Business Year

Carl Stanifer

UAE, ABU DHABI - Health & Education

Say Hello to SEHA

Group CEO, Abu Dhabi Health Services Company (SEHA)

Bio

Carl Stanifer has a degree in Accounting and Finance from the University of the Cumberlands and conducted graduate studies in Health Planning and Administration at the University of Cincinnati. Prior to joining the Abu Dhabi Health Services Company (SEHA) in August 2007, he was CFO of Bumrungrad Hospital in Bangkok from January 2004. He has worked in the healthcare sector for over 42 years.

What is the overall goal and strategy of Abu Dhabi Health Services Company (SEHA)? It goes back to 2006 when the government of Abu Dhabi hired McKinsey & Company to […]

What is the overall goal and strategy of Abu Dhabi Health Services Company (SEHA)?

It goes back to 2006 when the government of Abu Dhabi hired McKinsey & Company to look at the health sector and how healthcare was provided, how financing was done, and the level of health coverage for the population. It was a major study and one key recommendation was that the provision of healthcare, funding, and regulation of healthcare should be separated into three autonomous organizations. The Health Authority of Abu Dhabi (HAAD) was formed to deal with regulation, Daman as the national health insurance company, and SEHA as the provider of public health services. Our job was to own and operate all of the government’s healthcare assets. We combined them in one organization that became operational in January 2008. We own the assets, land, buildings, equipment, vendor contracts, and all the employment agreements. The objective was to instill the discipline of a private company—in terms of accountability—to stakeholders, and the production of financial statements and budgets, through a legally private, albeit 100% government-owned, company.

Do you observe rising trust in health services?

I do feel that there is a rising level of confidence, but one of our biggest challenges remains winning back the credibility lost in the years prior to SEHA. This takes time, and receives our constant efforts. The issue of people going abroad is not an area of responsibility for SEHA; this falls under the purview of the HAAD, but if you break the data down, there are many reasons why people go abroad. One reason is the local lack of certain services that would require unique and specialized physicians. It is simple to assemble the infrastructure, but the physician and ancillary staff to come are another, challenging, matter. Secondly, we might have the service, but lack client confidence. We have an immense potential to improve our offering and reduce the number of people looking abroad for treatment. This remains one of our key goals in assisting the government.

How do you bring international standards to the workforce and transfer knowledge to locals?

On the clinical front it begins with education. We do not run medical or nursing schools, but one requires special qualifications to work for us. Not enough Emiratis are pursuing medical careers, and so we have started a promotion campaign at high schools, for instance, while working with the Tawteen Council and other Emirati organizations on this. Secondly, we provide post-academic training at our hospitals. Once nurses graduate, we offer structured, formal graduate nurse training to help develop sub-specializations and round off their education in a practical setting. We do the same thing for physicians through residency programs. We recently received ACGMEI Accreditation for these residency programs, so now when our physicians complete the program they have better-documented educational provision through which to become specialist doctors. Today, less than 2% of our nurses are Emiratis, while almost 22% of our doctors are as a direct result of these training programs. We have looked long term at where our Emiratization rates will be in 2030 regarding doctors, nurses, and allied health professionals, and I doubt that we could exceed the 20% mark. There are only so many Emiratis pursuing clinical work. Our longer-term goal is in the 20% range for the clinical side of our business. On the administrative side, we have very structured programs for the senior management. We work with them on a mentoring basis, involving considerable on-the-job and structured training to enhance leadership skills. As a result, the percentage of Emirati administrative personnel has risen from about 33% to over 50%, and we anticipate a 75% rate by 2030.

“We will be opening a new Mafraq Hospital in 2015, and are set to replace the Al Ain Hospital. “

Are there opportunities for further international partnerships?

We are changing our model for partnering with international organizations. Initially, we started partnering at the hospital level. For example, when we took over Mafraq Hospital, we partnered with a Thai company. We partnered Al Ain Hospital with an Austrian company, while Sheikh Khalifa Medical City was partnered with the Cleveland Clinic, and we partnered Tawam Hospital, Corniche Hospital, and Al Rahba Hospital with Johns Hopkins. When SEHA was established, we had few management and system tools, and so one of the reasons for these partnerships was to rapidly advance our ability to implement computer systems and accounting regimes. Instead of partnering at the hospital level, we are asking these organizations to partner with us in treating a patient population of medical services. They will no longer be management contracts, but are migrating to clinical affiliation agreements. We will work with Johns Hopkins, for example, to clinically support our women’s health services across all of our hospitals and clinics. They will not manage our hospitals, but will help us clinically support managing a population of medical services. We have identified 15 of these clinical service lines and, of those, we will partner five or six with international organizations. We are currently tendering pediatrics, having identified seven or eight top organizations whose response we await. Over the next three or four years, we will be working with existing partners to migrate from these hospital-specific to clinical, population-specific contracts. We are also in discussions with Cleveland Clinic.

In the short term, what will we see in Abu Dhabi in terms of the standard of healthcare and the kind of facilities available?

First of all, many of our hospitals are 30 or 40 years old and are being replaced. We will be opening a new Mafraq Hospital in 2015, and are set to replace the Al Ain Hospital. We are building and expanding hospitals in the Western Region. A new Corniche Hospital will be developed on the campus of the new Sheikh Khalifa Medical City. We have already done much in the outpatient setting, and also for dialysis care. We have opened the new Mafraq Dialysis Center, as well as one at Tawam and another at Sheikh Khalifa Medical City. The facilities side is well planned with a six-year road map in place. The real challenge is getting the right staff to make that difference, and so we must boost the skills of our current workforce. We need more physician consultants to upgrade the skills of our GPs, and obtain more nurses specially trained in areas such as neo-natal, pediatric, and surgical intensive care. Care quality is directly related to the number of nurse and physician hours per patient, which we are constantly improving. We have systems in place to monitor clinical outcomes that allow the monitoring of our performance.

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