GREEN & GROWING

UAE, Dubai 2015 | HEALTH | REVIEW: HEALTH

The Emirate's healthcare sector is thriving amid new hospital construction, a focus on preventative care, a burgeoning medical tourist sector, and noticeable patient satisfaction.

Healthcare in Dubai is closely connected with the Dubai Health Authority's (DHA) strategic 12-year plan centered on initiatives to support Dubai's growth as a wellness hub for residents and medical tourists. DHA launched the Dubai Health Strategy 2013-25 under the approval of HH Sheikh Mohammed Bin Rashid Al Maktoum, Vice-President and Prime Minister of the UAE and Ruler of Dubai. The strategy aligns itself with HH Sheikh Mohammed's Dubai Strategic Plan 2015. The Dubai Health Strategy has a special focus on providing the Dubai population and the Emirate's visitors access to internationally-recognized healthcare. It also lends particular attention to increasing medical tourism in Dubai, improving customer service and making strides in preventative care.

Director-General of the DHA, HE Engineer Essa Al Haj Al Maidoor, outlined the Dubai Health Strategy's vision in a 2013 address to DHA employees at the Rashid Medical Library, at which he stated, “Medicine is a noble profession, and we are all lucky to be in a position where we can, through our individual roles, take care of the health of our community members. For us all, going forward, customer care has to be priority." In attendance were HH Sheikh Mohammed Bin Rashid Al Maktoum, HH Sheikh Maktoum Bin Mohammad Bin Rashid Al Maktoum, Deputy Ruler of Dubai, and HH Sheikh Hamdan Bin Mohammad Bin Rashid Al Maktoum, Crown Prince of Dubai. “Patients and their families need our outmost care and compassion," said Al Maidoor. “Excellence in healthcare services and customer care must go hand-in-hand."

The Dubai Health Strategy's main objective is to meet the World Health Organization's motto of the twenty-first century: “Healthcare is for everyone." According to the DHA, this will be obtained through 17 operational goals and the delivery of 43 initiatives supported by an enhanced control plan and Key Performance Indicators (KPI). There are five main pillars of the strategy: raising awareness and prevention; increasing access to services; enhancing quality of care; growing investment; and increasing competitiveness.

There are about 20 health centers and peripheral clinics throughout the Emirate, providing a ratio of one center or clinic for every 30,000 individuals. One of the DHA's top priorities is to increase hospital capacity, achieved through the construction of three new hospitals and 40 additional primary healthcare centers. In addition, the strategy aims to increase hospital catchment areas to a 12km radius and to have all healthcare centers within a 5km radius.

In March 2014 the DHA announced that it plans to build 22 hospitals in order to attract 500,000 medical tourists per year. In 2012, 107,000 medical tourists visited Dubai, and numbers are expected to increase in 2016 to 170,000. The UAE's Ministry of Health has predicted that by 2020 over a million medical tourists will visit the country every year. In order to support this influx, the DHA has embarked on long-term collaborations with the Department of Tourism and Commerce Marketing, the Department of Economic Development, and the General Directorate of Residency and Foreigners' Affairs in order to provide visitors with visas, accommodations, and city tours.

The DHA has also found a valuable partner with Dubai Healthcare City (DHCC). Launched in 2002 by HH Sheikh Mohammed to meet Dubai's demands for patient-centered, high-quality healthcare, DHCC is the largest healthcare free zone in the world. It is home to two hospitals and more than 120 outpatient medical centers and diagnostic laboratories, as well as the Mohammed Bin Rashid Academic Medical Center.

DHCC received a record 1.2 million patient visits in 2014, up 20% from 1 million visits in 2013. Patients included 15% medical tourists out of which 45% came from the GCC, 32% from the wider Arab World, 26% from Eastern and Western Europe, and 23% from Asia. The most popular procedures were infertility treatments, cosmetic treatments, and dental procedures. Last year the DHCC recorded 748 new licensed healthcare professionals bringing the total number of healthcare professionals working in the City to 4,534. Nine new healthcare facilities became operational.

INCREASING ACCESS

In line with the goals of the Dubai Health Strategy 2013-25 to increase hospital catchment areas, the DHA will build three new hospitals; Sheikh Mohammed Bin Rashid Hospital on Sheikh Mohammed Bin Zayed Road, Al Maktoum Hospital in Jebel Ali's Al Maktour Airport area, and Al Khanwaneej Hospital. The DHA has already embarked on the $800,000 million (AED3 billion) expansion of the 100,000sqm Rashid Hospital, with the first phase scheduled for completion in 2Q2015. Rashid Hospital will offer 24/7 services. The expansion, focusing on green technology utilization and sustainability, will also triple capacity.

Initiatives include the opening of six new specialized health centers, including centers for day-care surgery, oncology, ophthalmology, and hematology. The project will also include expansion of Rashid Hospital's Trauma and Emergency Center with the addition of 160 beds and 116 treatment rooms. Development will be based on the concept of a pre-engineered building where the center can continue to function as usual, while expansion work is underway. In addition, the hospital has opened a new gastrointestinal and oncologic surgery outpatient clinic focused on providing effective treatment of benign and cancerous gastrointestinal conditions. Expansion at Rashid Hospital will also include the building of two hotels on either side of a 500-bed rehabilitation center to accommodate patients' visitors, numerous amenities including green, open spaces for families, as well as staff housing. Lastly, there will be the addition of a dedicated outpatient building with a floor dedicated to dentistry.

Under new legislation signed in November 2013 by HH Sheikh Mohammed, health insurance has become compulsory for all Dubai residents. The law went into effect in February 2014, and implementation will happen in phases through mid-2016. The first phase, implemented October 2014, requires companies with 1,000 or more employees to provide healthcare to employees. According to DHA Director of Health Funding Dr. Haider Al Yousuf, this phase affected over 200 companies in Dubai, including those within the free zone, and more than 1,000 employees. In phase two, smaller companies (with 100-999 employees) will have until the end of July 2015 to provide insurance. The final phase will be completed by the end of June 2016, by which companies with fewer than 100 employees have to comply with the law.

“Overall there has been a lot of cooperation," explained Dr. Haidar Al Yousuf. “Dubai is looking to have one of the best health insurance systems out there." Known as the Insurance System for Advancing Healthcare in Dubai, or Isahd, meaning “happiness" in Arabic, mandatory health insurance will both increase access to services for Dubai residents and draw in medical tourists. “Health insurance is a big issue because it is a vital mechanism which will keep this big engine that we have moving," says Director-General Al Maidoor.

CUSTOMER SATISFACTION

In line with the Dubai Health Strategy to make substantial improvements in customer satisfaction, last year the DHA launched the new Customer Service Index (CSI). The CSI is a live mechanism based on customer feedback, which measures patient and visitor levels of satisfaction. As customers depart health centers and hospitals, they press a “happy" or “unhappy" button, whereby the results are calculated denoting levels of satisfaction or dissatisfaction with services received. The ratings appear in the form of two bars, green for “happy" and red for “unhappy", displayed on screens refreshing every 30 seconds. Sheikha Al Rahoomi, DHA Director of the Customer Relations Department said, “Having a robust customer feedback mechanism and a clear focus on customer satisfaction, helps to raise the bar in health service delivery and helps us implement better and effective systems, as feedback is an invaluable resource for any organization."

The annual patient satisfaction survey has indicated that people are generally leaving DHCC happy with services. The most recent survey, conducted by independent external consultant AC Nielsen, showed patient satisfaction at a level of 89%. As Nielsen explains, 70 is the set target score for High Customer Satisfaction, thus a score of 89 demonstrates that the DHCC has exceeded objectives for providing quality patient care and is achieving high levels of customer satisfaction.

The DHA Call Center became operational 24 hours a day, 365 days a year as of March 1, 2015, significantly increasing customer access to information. Since its inception in December 2011, the center has answered over 450,000 calls. Agents are fluent in multiple languages, including English, Arabic, Urdu, Hindi, Farsi, and French.

The DHA has also been in the multi-phase process of uploading all medical records to a completely computerized system. According to Director-General Al Maidoor, electronic medical records will better protect the patient from individual mistakes, and increase patient control over his/her treatment.

INTERNATIONAL RECOGNITION

Over the last year the UAE has gained special international recognition for efforts made in the areas of professional training and development. Attention has also been paid to the Emirates' efforts to increase public access to testing and services, provide effective treatments, and raise public awareness regarding the dangers of tobacco use. Specifically in Dubai, health professionals and institutions have gained international recognition through their focus on trauma training and care, and intensive energy towards preventative care and education. Significant steps have been taken to educate the public on the importance of exercise and a healthy diet for wellness.

The prevalence of cardiovascular illness and diabetes remains a major problem in the Emirates. According to latest figures by the International Diabetes Federation (IDF), almost 19% of the UAE population and an average of 20% of the total GCC population live with diabetes, with a marked increase in type 2 diabetes diagnoses. Dubai hosted the largest ever diabetes screening campaign on May 25, 2014, making it into the Guinness Book of World Records. Over the course of eight hours, 8,675 diabetes screenings were conducted in the Dubai Mall by a team of 80 nurses. In conjunction with the One Heart Healthy Community project, the campaign was intended to educate Dubai residents about the risk of diabetes and heart disease, the importance of early case detection, and to promote a healthy, more active lifestyles.

In accordance with the strategy's goals of offering access to internationally recognized healthcare, the DHA signed a historic agreement with Berlin last September. The agreement is part of a collaboration with Germany to provide Dubai's doctors and health care professionals with trauma and orthopedic surgery training. “This is a moment of pride for us," said Director-General Al Maidoor at the signing. “This is the first time the German Board has signed such an agreement with an international health entity." The agreement provides a way for resident doctors in Dubai to complete their six-year German board residency training without moving abroad for the first five years.

Recently the DHA's Trauma and Emergency Center at Rashid Hospital was featured on a top ten list in Germany's polytrauma registry. The German registry, the largest in the world, lists over 300 trauma centers. In 2011, Dubai became the first country in the Middle East to be included in this registry.

Ibrahim  Abu-Gharbieh
IBRAHIM ABU-GHARBIEH
Managing Director, Salamatak Healthcare Management
If doctors want to come to Dubai, it can be a challenge for them because they have an attachment to their local patients. Many healthcare providers are offering allocated practice ties for those to come and practice here twice a year for four weeks each time. They can arrange for patients to have a one- or two-month window in which to be seen. Furthermore, the UAE has good experience at bringing in the practice itself.