How is HAAD working to address the capacity gaps in healthcare in Abu Dhabi? What role can the private sector play in addressing gaps in specialties with significant capacity gaps?
SIKSEK: The Health Authority is working on a number of initiatives that will help us understand the gaps in the health system and its capacity needs. First and foremost, we have a fully-fledged implemented health insurance system by which 98% of all residents of the emirate of Abu Dhabi have a health insurance card. The relevance of this information is that with the health insurance scheme, a lot of the data reporting is electronic and all of the claiming between provider and pair is entirely electronic, which means that we have a data bank on all of the transactions in healthcare and all of the demands within healthcare. On top of that, the Health Authority plays a vital role in working with the providers and pairs to understand where the gaps are in the market. In combination of those two aspects, we are able to identify the gaps in terms of capacity needs and where the areas of improvement are, whether it be in facilities, technology, or healthcare professionals – be it physicians, specialists, consultants, dentists, etc.
The private sector can play a major role in this because the government has its areas of focus and the government has its areas of difficulty in being able to attract certain private investments in clinical specialties that require a high level of investment or that require rigorous and continuous amounts of subsidy. In its entirety, the first thing that we try to do is to be totally transparent, and give the private sector the information up-front. So we say, ‘here are our capacity needs’, and we publish this on our HAAD website. On the website, you can look as an investor at where the areas of gap are and whether or not this is an area you would like to see yourself participate in or add value towards this community and government. The numbers are there and the financials are there so the return on investment can be calculated by product of capacity versus cost and reimbursement rates and other numbers. So I think the private sector can add a lot of value in closing some of that gap, and that is currently being done. We are seeing a surge in the total number of private sector investors, private hospitals, and clinics. The number of these has skyrocketed in recent years.
How does Abu Dhabi compare with other places in the region on key healthcare benchmarks?
SIKSEK: On the benchmarks we compare quite well with regard to quality indicators. Unfortunately, I do not think we have enough data from the region on health coverage, cost of healthcare, quality of care, outcomes and access. I don’t want to say that we are leading, but what I have seen from statistical analyses by consultants, other government agencies, and other ministries of health, I think that we do not have the ability to make an apple-to-apple comparison with the other systems in the region. A lot of the systems continue to remain where we were a few years ago and struggle with larger populations. We used to be a regulator and a provider as a health authority. Now we just focus on being a regulator, and as such, we have a much more refined view on the importance of data, quality outcomes, and holding the providers accountable to the kind of work that they deliver and the kind of customer service they provide our patients and our customers.
What investment opportunities exist for private sector players in healthcare in Abu Dhabi?
SIKSEK: There are lots of opportunities for the private sector in the provision of healthcare, in the areas of gap that we discussed earlier: specialties, pediatrics, psychiatry, women’s and children’s healthcare, disease management. There is a lot of openness these days to innovation in healthcare, in mobile applications and Arabic translated services such as WebMD in Arabic. There is a lot of opportunity because it is not just for Abu Dhabi, it is for the entire region when you look at some of those more technologically related applications. There is also an insurance market that was created in 2006 and has progressed to where we are today. There is a lot of opportunity for billing companies, third party administrators, clinical coding auditors, continuing medical education – we are now asking for a minimum level of CME certifications for healthcare professionals – so there is a lot of opportunity for education both in medical education and from a management perspective as well.
Additionally, there are new opportunities these days in terms of R&D and we don’t talk about that much these days because we are not well known for having much R&D. Now that we have the data, a lot of organizations and health industry experts are seeing that this is an interesting and refined pool. This is probably the most refined area in terms of data availability and the access to that data is relatively easy. As a result there is more interest to seek out these opportunities and to try new things. There is a much more quantifiable risk getting into this industry here compared to other countries or some of the other regions.
There are lots of opportunities for the private sector in the provision of healthcare, in the areas of gap that we discussed earlier: specialties, pediatrics, psychiatry, women’s and children’s healthcare, disease management. There is a lot of openness these days to innovation in healthcare, in mobile applications and Arabic translated services such as WebMD in Arabic. There is a lot of opportunity because it is not just for Abu Dhabi, it is for the entire region when you look at some of those more technologically related applications.
What challenges persist in the recruitment and retention of medical professionals? How can recruitment and licencing procedures be streamlined?
SIKSEK: Recruitment of healthcare professionals is what keeps us up at night in the health industry in Abu Dhabi. There is no easy solution. Our ratio of national physicians to foreign physicians is not to our advantage; there are many more foreign than there are nationals. We need to start at the schools. We need to start to empower, and create, and increase the number of the national healthcare workforce. As much as we try, it is a question of sustainability and it is a question of self-dependency. Whilst recruitment is a challenge in this industry, in the UAE, that challenge is magnified because most of our health professionals do not come from within the UAE.
What do we do about that? We start off with capacity planning; we look at where our shortages are and we adopt the licensing standards that help us to ensure we meet the minimum thresholds that are required to deliver the right level of quality and the right amount of access to healthcare whether it be in the urban areas or the rural areas. We take these things into perspective and we automate a lot of the processes. We put in more staff and more technology to help us ease and streamline this information. We have tried to create a more interactive process with those that are interested in applying. We have created outreach programs. The evaluating systems in terms of examinations in particular do not reside in Abu Dhabi alone; you do not have to come to the UAE to be qualified or examined to obtain a license to work in Abu Dhabi. We have 19 test centers around the world. We have a contract with Pearson VUE, a company that delivers exams like the GMAT, LSAT, GRE, etc. and so they deliver our HAAD exams at their test center locations in 19 countries globally. This really helps us gain access to foreign professionals that want to work. It is a continuous process; we have people that are working in our healthcare system from 137 different countries. There is no easy solution; to understand the credentialing requirements for every single country that we consider for licensing. Whether it is an Asian country or an American country, we have to keep updating what the latest and newest requirements are from that particular country so that when a person comes from that country, we can make sure that person is qualified enough to practice medicine or healthcare.