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UAE health system

&
Daman insurance
A thesis submitted to Sarhad University

By
Sajjad Hussain
Dissertation submitted in partial fulfillment for the degree of BBA

Faculty of Business

Dissertation Supervisor

SIR Abdul Qayyum

NOV-2013

The Sarhad University


IN THE NAME OF ALLAH MOST GRACIOUS AND

MOST MERCIFUL
Statement of submission

This is to certify that Sajjad Hussain holding Roll No. 09-SP-23058 and SUIT

No. SUIT-09-02-21060 has successfully completed the final project named as

UAE Health System & Daman Insurance. At the Sarhad University of Science
& information technology, Peshawar, to fulfil the partial requirement of the degree
of Bachelors of business Administration BBA

External supervisor Internal Supervisor

Name of external supervisor SUIT, Peshawar

Designation

Organization Name

External examiner Dean, Faculty of

Name of External Examiner SUIT, Peshawar

Designation

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Acknowledgement

I truly acknowledge the cooperation and help extended by Sir Abdul Qayyum, Supervisor of
MAS Education Center, Abu Dhabi UAE. He has been a constant source of guidance throughout
the course of this project. I am also thankful to my friends and family members whose silent
support led me to complete my project

I would like to thank the people who participated and helped me a lot from the beginning of my
research to its end. I would like to thank my father MR. Iftikhar Hussain who helped me
throughout the research and give me different references and books to refer from.

Then most importantly I am really thankful from the depth of my heart to The Sarhad University
that gave me the opportunity to make the research on motivation. I am also very thankful to the
university for the way they helped me to complete my bachelor and I am hoping to take master
degree.

I was advised and guided by different people and I want to thank all those people for helping me
successfully complete the research.

Finally I would like to thank all the companies and other professional who gave me chance to
conduct the research. I dedicate this dissertation as an excellent achievement of my educational
life to all members of my family, especially to my dearly parents and wife who were so patient
and helpful.

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Abstract

HAAD is the regulatory authority of health in the UAE. On the other hand Daman is the insurance
broker company that provides health insurance for its citizens in the UAE. Daman is a semi
government organization that insures individuals as well as larger organizations.

The Health Authority Abu Dhabi (HAAD) is the regulative body of the Healthcare Sector in the
Emirate of Abu Dhabi and ensures excellence in Healthcare for the community by monitoring the
health status of the population.

HAAD defines the strategy for the health system, monitors and analyses the health status of the
population and performance of the system. In addition HAAD shapes the regulatory framework
for the health system, inspects against regulations, enforce standards, and encourages adoption of
world class best practices and performance targets by all healthcare service providers in the
Emirate.

HAAD also drives programs to increase awareness and adoption of healthy living standards among
the residents of the Emirate of Abu Dhabi in addition to regulating scope of services, premiums
and reimbursement rates of the health system in the Emirate of Abu Dhabi

On the other hand Daman is the primary health insurance company in the UAE and the region of
the Middle East. We will be emphasizing on the strategy, planning and working of Daman in the
UAE. It complies and works according to the rules and regulations of HAAD (health authority
Abu Dhabi).

Daman provides health insurance facility to almost 3 million people in the UAE alone. Daman has
emerged as one of the most prominent insurance brokers not only on private personal level but
also on the organizational level of many multinational organizations. They provide insurance for
aerospace, oil and gas, energy sector, construction companies, investment companies and media.

Daman is a semi government organization where the government holds the larger share. It is a joint
stock venture. The government of Abu Dhabi owns 80% of the company whereas the remaining
20% is owned by Munich Re. the government of Abu Dhabi backs the company with reliable
support. Munich Re is the world leading reinsurers. They play an important role as reinsurers and
a valuable source of knowledge transfer.

Daman has many different types of insurance policies according to the need and requirements of
the people. They vary in price according to the age category, business category, health needs etc.
this helps Daman and the people to address their issues and get insured accordingly. Daman is the
leading health insurer in the UAE.

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Contents
Statement of submission .................................................................................................................... i
Acknowledgement ............................................................................................................................ ii
Abstract ............................................................................................................................................ iii
Chapter 1 ........................................................................................................................................... 8
Introduction to HAAD .................................................................................................................. 8
Vision ............................................................................................................................................ 8
Mission.......................................................................................................................................... 8
Values ........................................................................................................................................... 8
Chapter 2 ......................................................................................................................................... 10
The UAE health care sector ........................................................................................................ 10
UAE growing health care sector ................................................................................................. 11
Chapter 3 ......................................................................................................................................... 13
Hospitals by the numbers in the UAE......................................................................................... 13
Priorities for Healthcare sector improvement ............................................................................. 16
Chapter 4 ......................................................................................................................................... 20
Organizational chart of HAAD ....................................................................................................... 23
Patients charter ................................................................................................................................ 24
Patient responsibilities are: ......................................................................................................... 24
Patients Rights: .......................................................................................................................... 24
Patients feedback ....................................................................................................................... 25
Public health priorities and goals ................................................................................................ 25
Health insurance law ....................................................................................................................... 26
Objectives ................................................................................................................................... 26
Obligations of health care providers in case of an emergency ................................................... 27
Employers obligation ................................................................................................................. 27
Duration and terms of the policy ................................................................................................ 27
Oral Health .................................................................................................................................. 28
Oral care focus on schools .......................................................................................................... 29
Abu Dhabi smiles oral health promotion project ........................................................................ 29

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Key messages of Abu Dhabi smile project ..................................................................................... 30
Children....................................................................................................................................... 30
Parents ......................................................................................................................................... 30
Chapter 5 ......................................................................................................................................... 31
UAE healthcare regulatory bodies .................................................................................................. 31
The ministry of health MOH....................................................................................................... 31
The ministry of finance ............................................................................................................... 31
The federal health insurance authority........................................................................................ 31
Health authority Abu Dhabi HAAD ........................................................................................... 32
Abu Dhabi health service company SEHA ................................................................................. 32
Dubai health authority DHA ....................................................................................................... 32
Mubadala Healthcare .................................................................................................................. 32
Chapter 6 ......................................................................................................................................... 35
Partnership towards progress ...................................................................................................... 35
Cerner Corporation ..................................................................................................................... 35
Childrens national medical center ............................................................................................. 35
Cleveland Clinic.......................................................................................................................... 36
GE healthcare .............................................................................................................................. 36
John Hopkins .............................................................................................................................. 37
Partners Harvard healthcare ........................................................................................................ 37
The New England center for children ......................................................................................... 37
Chapter 7 ......................................................................................................................................... 39
Chapter 8 ......................................................................................................................................... 47
Introduction to Daman .................................................................................................................... 48
Mission........................................................................................................................................ 49
Vision .......................................................................................................................................... 49
Values ......................................................................................................................................... 49
Performance ................................................................................................................................ 50
Innovation ................................................................................................................................... 50
Customer focus ........................................................................................................................... 50
Social responsibility .................................................................................................................... 50

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Trust ............................................................................................................................................ 50
Daman key benefits......................................................................................................................... 51
Daman Insurance Cards .................................................................................................................. 52
Daman members rights .................................................................................................................. 53
Daman members responsibilities ................................................................................................... 53
Chapter 9 ......................................................................................................................................... 54
Daman health insurance plans .................................................................................................... 54
..................................................................................................................................................... 54
..................................................................................................................................................... 55
..................................................................................................................................................... 56
..................................................................................................................................................... 57
..................................................................................................................................................... 58
..................................................................................................................................................... 59
..................................................................................................................................................... 60
..................................................................................................................................................... 61
References ....................................................................................................................................... 66
Summary and conclusion ................................................................................................................ 68

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Figure 1 HAAD office ................................................................................................................ 10
Figure 2 Expenditure spent on healthcare in UAE ......................................................................... 13
Figure 3 Number of hospitals in every emirates ......................................................................... 14
Figure 4 UAE healthcare market ................................................................................................ 15
Figure 5 Forecast for demand of beds in hospitals...................................................................... 16
Figure 6 UAE healthcare industry outlook ................................................................................. 16
Figure 7 Dubai health care city ................................................................................................... 18
Figure 8 UAE health care survey ................................................................................................ 20
Figure 9 Executive committee of HAAD.................................................................................... 22
Figure 10 Organizational chart of HAAD ..................................................................................... 23
Figure 11 Public health programs ................................................................................................. 26
Figure 12 Oral health problems..................................................................................................... 28
Figure 13 Problems of teeth and gums .......................................................................................... 29
Figure 14 Problems caused by poor oral health ............................................................................ 30
Figure 15 Mubadala and its groups of companies......................................................................... 33
Figure 16 Healthcare regulations in UAE ..................................................................................... 34
Figure 17 Cleveland clinic ............................................................................................................ 36
Figure 18 Sheikh khalifa medical city SKMC .............................................................................. 36
Figure 19 TWAM hospital ............................................................................................................ 37
Figure 20 Health professionals in the UAE .................................................................................. 38
Figure 21 Licensed facilities ......................................................................................................... 38
Figure 22 Cancelation insurance of healthcare ............................................................................. 39
Figure 23 Changing type from outpatient pharmacy to 24 hour pharmacy .................................. 40
Figure 24 Changing type of healthcare facility ............................................................................. 41
Figure 25 Cancelation of healthcare facility preliminary approval/ permanent license ................ 42
Figure 26 New licensing/ relicensing ............................................................................................ 43
Figure 27 New licensing/relicensing of pharmacies ..................................................................... 44
Figure 28 Registration of insurance of healthcare facility ............................................................ 45
Figure 29 Renewal of ambulance for healthcare facility .............................................................. 46
Figure 30 Daman values ............................................................................................................... 49
Figure 31 Daman insurance card .................................................................................................. 52
Figure 32 Daman branches ........................................................................................................... 53

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Chapter 1
Introduction to HAAD

HAAD (health authority Abu Dhabi) is the regulatory authority for health issues in the UAE. Every
organization like pharmacies and hospitals or any other heath care unit has to abide by the laws of
the health authority.

Vision

A healthier Abu Dhabi. This is the vision of HAAD (health authority Abu Dhabi.

Mission

HAADs main and primary mission is to develop and regulate the healthcare sector to its highest
level. A world free of any disease or sickness. It aims at protecting the health of each and every
single individual by ensuring better access to services. They also aim at improving the quality of
health care continuously. Sustaining the resources is another prime mission of HAAD.

Values

Commitment to the societys needs and expectations is one the core values of HAAD
Innovation and creativity in the healthcare sector. HAAD encourages creative thinking and
continuous improvement of the services.
Accountability of each and every individual
Abiding by the laws, rules and regulations of HAAD.
Excellence in promoting and expanding the corporate performance.

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HAAD introduced its policy manual in December 2012. This manual was aimed at improving and
regulating the overall performance and outcomes of healthcare facility in Abu Dhabi. This policy
manual provided with a simple layout for health organizations to follow. They included hospitals,
pharmacies, and health insurance providers (private and public). These policies are to be followed
by each and every health providing organization in Abu Dhabi.

Figure 1HAAD office

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Chapter 2
The UAE health care sector
The united Arab emirates UAE is always moving forward in all sectors of life. Healthcare is another
important aspect of that way forwards. They emphasize heavily on the health care of its citizens.
This is because a healthy environment will lead to a healthier and prosperous society. This also
helps support economic diversification. There are numerous amount of corporations, academies
and medical centers which are playing a vital role in this process. There are a total of 7 states in
the UAE. Each and every one has to offer the best possible health care to its citizens. This is
inclusive of hospitals and clinics. There are three regulators that are involved in the process of
health care. Ministry of health, Ministry of finance, federal health insurance authority, Dubai health
authority and health authority Abu Dhabi.

All these entities regulate the laws, condition and implement rules in the healthcare industry. To
achieve this there are a lot of partnerships of the UAE with the US. This partnership includes many
entities like Cleveland clinic Abu Dhabi, GE healthcare, john Hopkins and childrens medical
center. All these entities help the UAE in moving forward in infrastructure, workforce and
integration etc. the collaboration or partnership of the government of UAE and US goes back to
the 1960s. Dr.pat and marian Kennedy were American missionaries that set up a makeshift
hospital in a mud block in Al Ain that was donated to them by Sheikh Zayed Bin Sultan Al Nahyan.

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UAE growing health care sector

Since the independence of the United Arab Emirates in 1971, the UAE has made progress in ways
unimaginable. The country has made infrastructure, security and health available to each and every
individual that lives here. However with the passage of time and development UAE is facing
problems for its citizens that are usually found in well developed countries. These diseases include
obesity and diabetes etc. on the other hand the older people are suffering from problems like cancer
and heart attacks. The use of junk food and fast food is also becoming common among UAE
citizens. However each and every state in the UAE is working hard to fight these issues in order to
achieve a healthier society.

The UAE health sector is divided into two areas public and private sector. Public healthcare service
providers fall under the government entities like Dubai health authority, Abu Dhabi health
authority and SEHA. This means that any public healthcare service provider is governed and
maintained by the government. All of these entities have to abide by the laws, rules and regulations
that have been outlined by the authorities. Each and every company has a partnership with different
hospitals and medical centers that perform daily operations of hospitals throughout the private
healthcare sector in the UAE

The other sector is the private healthcare centers. One of the biggest private healthcare centers are
the NMC (new medical center). These sorts of healthcare centers are also obliged to follow the
rules and regulations of the health authorities but they are not managed by them. They are run
solely by themselves. These healthcare centers are providing state of the art facilities and services
to citizens of the UAE. Some of the other hospitals or health care centers are the Noor hospitals
and NMC etc. these private hospitals or health care providers are important in the overall health of
the UAE citizens.

However as a nation the UAE strives to improve its healthcare continuously. This means that all 7
states will follow the systems made by the ministry of health but each state has to play its part
individually. An example of this is the development of healthcare units in the states of Ras al
khaima and Fujairah. These two states have established themselves as the states for the best high
quality healthcare in the region. There are 8 of the best hospitals in these two states. In short
healthcare facility is an important part of the UAEs federal plan. According to the vision of UAE
UAE will invest continuously in building world class healthcare infrastructure, expertise and
services in order to fulfil its citizens expectations and needs. On the other hand the emirate of Abu
Dhabi has explained in its vision 2030 plan that the growth of the medical sector is dependent upon
large investments in technology, which Abu Dhabi is in a position to make. Abu Dhabi will have to
attract medical scientists, doctors and medical staff.

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The healthcare plans of Dubai in 2015 is focused on the international U.S healthcare providers.
Many other countries also tend to improve health care like this but UAE stands out because all
other countries from the GCC and the states of UAE are supporting this vision. In the year 2013 the
amount of money spent on health care in the UAE was 16.8 billion dollars. This shows the
commitment of UAE towards the healthcare of its citizens.

Even after the small population of UAE the government has spent a huge bulk of money on health
care. But there are still some areas that need to be addressed in the field of healthcare. Some of
them are women care, oncology, pediatrics and diabetes. These are some of the major problems
that are still to be addressed in the healthcare industry. People are visiting other countries like
Thailand and Singapore to get treated for these problems. However this doesnt mean that the UAE
has neglected or forgotten about these issues. As a result the governments of UAE and health
authorities are rapidly improving their healthcare sector in order to provide in-country treatment.
This means that their citizens will not need to travel to other countries for treatment. This means
that more and more healthcare centers from around the world will be coming to UAE in search of
partnerships and collaborations to improve health care.

Given below is a figure that will clearly help us understand the amount of expenses spent on
healthcare in the UAE:

Figure 2expenditure spent on healthcare in UAE

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Chapter 3

Hospitals by the numbers in the UAE

According to the population survey conducted in the year 2010. The population of the UAE was
estimated at 9,206,000. Out if these numbers a total of 19% representation was that of the UAE
nationals. The UAE has a total of 104 hospitals as of now. According to the reports of the world
health organization there are 19.3 physicians and 40.9 nurses and midwives per 10,000 persons in
the UAE. Given below is a figure of the division of hospitals from the government and private
sector in each emirates of the UAE.

We will be discussing on the hospitals amount in the UAE cities. We shall also be mentioning the
number of beds combined in every state and how many people it services. There are government
hospitals as well as private hospitals with both having their own importance in the country.

Figure 3 number of hospitals in every emirates

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Abu Dhabi has a total of 39 hospitals. 14 government hospitals, 25 private and 26 are JCI
accredited. A total of 4226 beds.
Dubai has 38 hospitals. 6 governments, 32 private and 20 JCIs. There are a total number
of 3857 beds. This means that there is 1 bed for every 532 of the population. These beds
are of service to almost 2.1 million people.
Sharjah comprises of 15 hospitals. Out of the 15 hospitals 5 of them are government, 10
private and 1 JCI. There are a total of 898 beds.
Ras Al Khaimah has 5 hospitals out of which 4 are government and 1 private and 1 JCI. It
has a total of 562 beds which make it 1 bed for every 533 of the population that services
300,000 people.
Ajman has a total of 3 hospitals. There is 1 government hospital and 2 private hospitals and
1 JCI. There are 189 beds in total.
Fujairah also has 3 hospitals like Ajman. There are 2 government hospitals and 1 private
hospital with 358 beds in total that service 200,000 people. This means 1 bed for every 558
of the population.
Umm Al Quwain has got just 1 hospital that was made by the government. It has 165 beds
those services 100,000 people which mean that there is 1 bed for every 606 of the
population.

Figure 4 UAE healthcare market

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Given below is figure that will illustrate the demand for beds

Figure 5 Forecast for demand of beds in hospitals

The figure below is the health care market size forecast

Figure 6 UAE healthcare industry outlook

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Priorities for Healthcare sector improvement

1. Integrated continuity of care for the individuals

Individual care throughout life


Access to all sorts of care. Primary care, secondary care, quaternary, tertiary, home
care, pre-hospital care, rehabilitation and vaccination etc.
Capacity planning
Addressing healthcare issues specific to the UAE

2. Safety and drive quality to enhance the experience of the patient

Tracing outcomes and process from healthcare providers


Publish outcomes and process once data is validated

3. Attract, retain and trained workforce

UAE national in particular


Encourage
Research
Innovate
Educate
Train

4. Emergency preparedness

The Abu Dhabi health authority has to be prepared for any sort of major disaster or
disease outbreak

5. Wellness and prevention

Enhance wellness and awareness

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6. Ensure value for money + sustainability of healthcare spent

Reduce waste
Encouragement of private sector
Elimination of loss transfer for non-mandated healthcare
Effective management of funded mandates
Ensuring the appropriate reimbursement framework

7. Integrated health informatics and E-Health

Telemedicine
Tools to drive that have been discussed above

As a part of the improvements discussion we will show the commitment of the UAE towards health
care through the figure below that will show the Dubai healthcare city overview.

Figure 7Dubai health care city

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HAAD is aimed at improving its healthcare services by implementing all these changes. The health
authority Abu Dhabi aims to increase the customer satisfaction and the health standards. This is
the core reason why HAAD implements new law every now and then to improve the health issues
in the UAE.

For this sole purpose HAAD has drawn an outline for every organization related to health. It can
be doctors, hospitals, pharmacies, clinics or insurance brokers. Each and every one has to follow
the rules made by HAAD and work accordingly. Given below are some of the public health
programs that are run by HAAD in the larger interest of the public health and awareness.

Although a lot of success has been tasted by HAAD but there is still room for improvement in its
performance. They are focused on achieving more and more goals efficiently and responsibly.
While increasing their efficiency people also have an increased level of expectation. Their
expectations rise.

HAAD (health authority Abu Dhabi) is the regulatory authority Abu Dhabi that is committed to
planning, monitoring and maintaining quality healthcare in Abu Dhabi. They are committed to the
better health of Abu Dhabi residents and citizens.

HAAD has emerged as the most important part of health in Abu Dhabi in the past decade. This is
because of their consideration towards human development in the state of Abu Dhabi. HAAD
considered human development as a pre-eminent objective for all their policies. Its highest priority
is to provide high quality healthcare to the people of Abu Dhabi. Priorities of the health care sector
are being discussed so we will have a look at a survey that will illustrate the problems faced by the
UAE citizens and the causalities caused by it.

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Figure 8UAE health care survey

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Chapter 4

Dr. Mugheer Khamis Al Khailis message


I am honored to be part of Health Authority Abu Dhabis
family and I look forward to achieving Health Authority Abu
Dhabis vision and providing a system that encompasses the
full spectrum of health - protecting, promoting, sustaining and
restoring services across the Emirate for a better, healthier
generation, for the good of Abu Dhabi

21
Executive Committee

H.E. Prof. Maha Taysir Dr.Asma Al Mannaei Dr. Khaled Al Jaberi Dr.Omniyat Al Hajri
Barakat Director, Strategy Director, Health Director, Public Health
Director General, HAAD Division Regulation Division and Research Division

Helal Al Muraikhi Marwan Al Naboulsi


Mohamed Al Hameli
Director, Customer Care Mashaal Al Hameli Acting Director, Health
Director, International
and Corporate Head, Legal Affairs System
Patient Care Division
Communication Division Financing Division

Hamed Al Hashemi
Khalid Al Hameli Director, Corporate
Director, Administration Performance &
and Finance Division Enterprise Risk
Management Division
Figure 9 executive committee of HAAD

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Organizational chart of HAAD

Figure 10 organizational chart of HAAD

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Patients charter
This charter is basically a users manual. It provides practical information to the individuals that
the health authority Abu Dhabi will be useful to the individual in the emirates of Abu Dhabi. This
charter reflects the policies and laws of the health authority Abu Dhabi. It also outlines the needs
and requirements of any individual according to his/her health needs and issues.

Likewise the patients have their rights to health care. Some of the responsibilities of the patients
are mentioned below:

Patient responsibilities are:


Patients must bring along their health insurance cards when visiting a health care facility.
Following the rules of the facility you are visiting
Patients should follow the instructions given by the health care professional
Inquire about any doubts that rise in your mind
Considering the rights of other patients and health care providers
Avoiding abusive language or behavior towards other patients or service providers or
visitors.
Consideration towards the needs of others
Using emergency services for any urgent problems
Providing accurate information
Facing any outcomes for not following the appropriate instructions
Safeguarding ones belonging
Booking appointments and informing if not attending
Informing the staff for any special needs
Accountability for any payments

Patients Rights:
Treatment to the highest professional standard.
Right to be treated by the best and licensed professionals that can be held accountable for
their job as well.
Patients have the right to know and be involved in any sort of decision that is made in their
treatment and care.
Refusing any sort of treatment or accepting it on the base of the patients decision.
All patients have the right to access their medical records and history.
Informing the patient regarding admission
Safety
Second opinions according to the patients wish

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Privacy
Information about all uncovered costs of expenditures
Patients have the right to receive treatment in the state of emergency. Irrespective of the
status of the insurance card.
Receiving information in order to make a complaint against the facility if any of the rights
are not fulfilled.

Patients feedback
Patients can provide their feedback on how good or bad was the service of the healthcare facility.
Patients can make a complaint to the management of the hospital on any other health care facility
or HAAD (health authority Abu Dhabi)

Public health priorities and goals


Cardiovascular disease is one of the top priorities of HAAD they aim to prevent the onset
and improve control of risk factor for CVD. This includes obesity, overweight, smoking,
diabetes and blood pressure.
Decrease in smoking and a smoker in the Abu Dhabi is another priority of HAAD.
HAAD aims to maintain the prevalence of communicable disease to a lower level. They
prefer to do this through preventive interventions and early response systems effectively
Reduction of environmental diseases and injuries among the working class of the state of
Abu Dhabi.
Reduction of morality related to pregnancy, childbirth and postpartum. They also want to
enable school going children to adopt a healthy lifestyle.
Controlling cancer among the citizens. This involves treatments as well if necessary.
Reduction of road accidents and control in deaths or injuries relating to road accidents.
People with chronic condition are to be given greater quality of life.
Improvement of the oral health of the citizens of the emirates of Abu Dhabi.

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Public Health Programs

Figure 11 public health programs

Health insurance law

Objectives
HAADs insurance laws are made to produce an effective and competitive industry of
insurance in the emirates of Abu Dhabi
Protection of the interests of all the people that are involved with the health insurance plan
One of the key objectives of HAADs laws is to ensure the complete utilization of the
Insurance policy in order to attain optimum levels of the benefits covered
Safety of all the people in the health insurance scheme
Providing optimum health care for all the participants in the insurance policy
Support for the private sector
Free choice of access

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Obligations of health care providers in case of an emergency
Providing medical care in the state of an emergency is mandatory for every health care
organization. HAAD has made and implemented this law for each and every citizen of Abu Dhabi.
All organizations are obliged to provide any sort of immediate care to the patient in order to save
their lives. The settlements can be made later on. If a person is insured then the cost will be incurred
by the insurance company. Likewise if there is no insurance then it can be recovered by the patient
himself. In another case if it is a work emergency and the worker is not insured then the amount
will be collected by the employer or sponsor of the respective patient.

Employers obligation
Each and every employer in the state of Abu Dhabi is obliged to provide health insurance for their
employees and their families. This includes 1 spouse and 3 children. Anything after this will be
the responsibility of the employee himself. This includes the registration fees and the cost of the
policy. Any employer that does not provide a health insurance for their employees after 15 days
of arrival will face a daily fine of 10 DH. Neither will he be able to paste employment visas for the
employees without a proper health insurance card; neither will he be able to renew any other visas.
This means that the employees will be considered illegal immigrants. The law also states that no
employer is allowed to transfer the cost of insurance or registration to their employees. Who so
ever commits to doing such a thing will be party to crime and will face serious consequences and
hefty fines. Employees that are affected by this can file a complaint at GAHS complaint units.

All commercial business man and companies in the state of Abu Dhabi are expected to adhere to
the health insurance laws. As there is enough time and notice provided. HAAD has regulated a fair
and sever list of punitive measures that can be taken against anyone that fails to comply with the
laws of HAAD.

Duration and terms of the policy


Each insurance policy has a validity of one year from the date of its issuance. They need to be
renewed annually. There will be no claims for the previous year that ends. Policy holders can shift
their policy from one policy to another by paying the difference of the charge. Each policy contains
the following services:

Basic health care


Additional services
Excluded services
Total coverage
Emergency coverage

Procedure of complaints, guidelines are to be paid by the insured.

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Oral Health
Oral health is usually taken for granted in a lot of places
in the world. However oral health is something that
should not be neglected and needs to be paid attention to.
There is a famous quote that oral health is overall
health. This is one of the top 10 priorities in the list of
HAAD. Good oral health enables us to eat, smell, smile,
chew and swallow in a better way without any active
disease. It is a fundamental to general health and
wellbeing which eventually impacts the quality of life.

Oral health is usually taken for granted but it needs to be addressed in a far better and serious
manner. About 60 to 90 % of the children in the developing countries face dental problems. These
include several Asian and Latin American countries. In addition to pain and discomfort oral health
can also affect a childs ability to learn or communicate. Over 50 million school hours are lost
every year from all over the world in developed and developing countries due to bad oral health.
Bad oral health is associated directly to decrease school performance, poor social relationships and
less success in life. Children experience pain which leads to distraction and concentration in
school.

The WHO world health organization conducted a survey in the UAE in 2010. This global health
school survey was carried out on 2580 students from the UAE. Results shocked everyone as they
found out that 15% of the students had not brushed their teeth from the past one month. 23.3%
male students were more likely than 8.5% female students not to clean or brush their teeth.

In the same year of 2010 SEHA


school health care services also
conducted an oral health
screening in school children.
These school children were
collected from grades 1, 5 a n d
9 from 18 different schools in
Abu Dhabi and Al Ain. The
screening was done on 2500
students. Out of these 2500
students 59% were referred to a
dentist for advanced treatment.
Students that were referred to a
dentist were considerably
higher in Al Ain than Abu
Figure 12 oral health problems
Dhabi with rations of Al Ain (67.1%) and Abu Dhabi (49.4%)

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Oral care focus on schools
Oral care is a very basic and essential part of healthcare. The main reason to focus on schools is
because of the vast number of children that can be addressed. Another reason to focus on schools
is that students can be trained at an early age to maintain hygiene and therefore evolving with a
healthy lifestyle in oral care. Billions of students worldwide can be taught about the importance
and importance of oral care. This helps establish good habits or oral care at an early age. Therefore
resulting in better levels of concentration on education. This is the primary reasons why we see
hygiene posters and brochures usually found in schools. Children can be equipped with better
knowledge and maintenance of hygiene.

Figure 13 problems of teeth and gums

Abu Dhabi smiles oral health promotion project


Abu Dhabi smiles is a school based oral health promotion projects that are run by the health
authority Abu Dhabi HAAD. This project focuses on children from the age group of 5 to 11 years
of age. This project is aimed at improving the childrens oral health practices. The emirate of Abu
Dhabi has a total of 451 schools out of which 268 are public and 183 private. This project will be
available for all of these schools. The main purpose of this project is to improve the knowledge
and behavior of the students from the age group of 5 to 11 year in Abu Dhabi by 10%.

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Key messages of Abu Dhabi smile project

Children
Brush your teeth twice a day
Usage of floss once a day
Dentist checkup twice a year
Brushing the teeth with only a pea sized amount of toothpaste
Avoiding sweets

Parents
Encouraging the process of teeth cleaning from the age of 2
Supervising children while they brush their teeth until they are properly trained and
comfortable with the process
Fluoride toothpaste helps prevent teeth decay
Consulting with your childrens dentist
Healthy food = healthy teeth

Given below is a figure that shows the risks involved with bad oral care

Figure 14 problems caused by poor oral health

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Chapter 5

UAE healthcare regulatory bodies

The ministry of health MOH


The ministry of health is the regulatory body that is responsible for unifying the UAE health
policies and it is the primary regulatory authority in the UAE that covers the entire country. They
have to make policies that design the layout of healthcare in the country that each and every
individual has complete access to healthcare services. All the northern emirates are dependent on
the ministry of health because of lack of infrastructure. To provide better healthcare in the northern
emirates the FHA (federal health authority) handles the executive responsibilities alongside the
MOH to increase the competiveness of healthcare in the UAE.

The ministry of finance


The ministry of finance is involved with the insurance aspects of UAE citizens. They regulate each
and every aspect of health insurance and its providers. They make sure that each and every
individual is insured and receives better health care. This is why the ministry of finance has made
a law that mandates federal compulsory health insurance in all the seven emirates of the UAE.

The federal health insurance authority


This authority is responsible for looking into health insurance issues. It is overseen by the ministry
of health, ministry of finance and other health authorities in the UAE. It covers all aspects of health
insurance including licensing registration and code of conduct for all healthcare providers in the
UAE.

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Health authority Abu Dhabi HAAD
HAAD is the regulatory authority of health in the emirates of Abu Dhabi. They are responsible for
all health care and insurance providing for the citizens of Abu Dhabi. HAAD has its own rules and
regulations according to the needs and requirements and population of Abu Dhabi but they are still
answerable to the ministry of health as well. But they are not influenced much by the ministry of
health. This is why they are considered an independent organization.

Abu Dhabi health service company SEHA


SEHA is the health service company of Abu Dhabi. It owns and manages health service providers
directly and indirectly in Abu Dhabi. They have been under severe pressure in the recent past to
cut costs of operations. Hence they had to compromise of competitiveness and cut costs to keep in
to their budget. Every individual that arrives in Abu Dhabi has to get his blood tested from SEHA
and get cleared of any dangerous disease.

Dubai health authority DHA


The DHA serves in two ways. It is basically an operator and regulator for the emirates of Dubai. It
has to oversee hospitals, medical centers, health care facilities and free trade zones. H.H Sheikh
Hamdan bin Rashid Al Maktoum deputy ruler of Dubai is the president of Dubai Health Authority.
This shows the deep concerns and commitment the rules have towards the health of their people.

Mubadala Healthcare
Mubadala is related to healthcare in Abu Dhabi. This company builds new infrastructure and
supports UAEs strategy of economic diversification. Their assets and services are made to meet
the requirements of the emirate of Abu Dhabi. Their main focus is on diabetes, orthopedics, spine,
physiotherapy, rehabilitation, primary care, visceral medicine and medical diagnostic testing. This
shows that mubadala is focused on providing physical healthcare that is mostly growing with time.
In the pursuit of fitness it is providing with the best possible infrastructure and health options. One
of the biggest achievements of Mubadala is the Cleveland Clinic Abu Dhabi which is a state of the
art hospital with the best health care for patients.

Cleveland clinic Abu Dhabi offers a number of important health care services some of which are
mentioned below:

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Heart treatment
Vascular treatment
Neurological treatment
Digestive disease
Critical care
Eye and respiratory treatment

There are over 30 medical and surgical specialty centers in Abu Dhabi. Given below are some of
the most prominent groups associated to Mubadala

Figure 15mubadala and its groups of companies

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Given below are the healthcare regulations in the UAE

Figure 16 healthcare regulations in UAE

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Chapter 6
Partnership towards progress

Cerner Corporation
Cerner Corporation is an IT company and healthcare technology provider. Cerner is in direct
partnership with SEHA which is the Abu Dhabi health service provider. Their partnership is aimed
at improving electronic processing, reducing cost, increasing efficiency and protecting patient
records. Their IT solutions help Abu Dhabi hospitals to perform effectively and efficiently by
meeting daily targets and requirements and data to provide better healthcare delivery on daily
purposes.

Childrens national medical center


This medical center performs collective research and educational programs. They attain help from
the Sheikh Zayed institute for pediatric surgical innovation. They are working day and night with
UAE healthcare entities to shape healthcare policy and procedures in all areas of child care.

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Cleveland Clinic
This is a specialty
hospital that is in
partnership with
Mubadala
healthcare. They
bring a wide variety
of treatments to the
UAE. They address a
wide range of
complex and critical
care from the worlds
Best health care
Figure 17 Cleveland clinic
Provider. This means

That the citizens of Abu Dhabi can have access to quality treatment without having to travel abroad.
This is a huge entity that provides almost 500 beds, 5 clinical floors, 3 diagnostics and treatments
level and thirteen floors of critical treatment.

GE healthcare
This is a collaboration that provides transformational medical technology and services in patient
care in the UAE. They specialize IT, imaging, diagnostics, patient monitoring systems,
improvement in performance and discovery of drugs. Sheikh Khalifa medical center is one of the
most prominent collaboration of GE healthcare.

Figure 18 sheikh khalifa medical city SKMC

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John Hopkins
This is a 12 story sheikh Zayed tower in Baltimore, Maryland. This is a heart and vascular institute
and was once the largest hospital construction projects in the US history. It used 4700 construction
hours and it took 3 years for it to complete. They provide a number of hospital management services
to hospitals in the UAE. One of the most prominent collaborations of them is the TWAM hospital
in the Emirate of Al Ain.

Figure 19 TWAM hospital

Partners Harvard healthcare


This healthcare facilitator offered advisory services for several projects. In 2006 they conducted a
review of the national rehabilitation center in Abu Dhabi. This is the first facility of the UAE that
treats abusive substance. They also provide services to the military healthcare systems. They have
been serving for the past six years as a lead planner for a university hospital in Dubai healthcare
city.

The New England center for children


This organization has been working with SEHA since 2007. They have launched a comprehensive
education program for children. This center focuses on the treatment and welfare of children with
autism spectrum disorder. This ensures that children with this sort of problem get high quality
education and access to all healthcare facilities in the UAE.

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Given below is a table that illustrates the health professionals in the UAE

Alternative Clinical Support Physicians &


Total Nursing Pharmacy
Medicine Services Dentist

Total 13530 59 1647 3434 2034 6347


Hospital 7258 9 833 2516 0 3899
Clinic 497 1 21 152 0 322
Polyclinic 1387 17 153 369 0 845
Rehabilitation Center 379 25 337 7 0 10
Center 1837 7 235 381 0 1211
Diagnostic Center 113 0 66 0 0 47
Provision of Health
25 0 2 9 0 13
Service
Office 21 0 0 0 21 0
Pharmacy 1862 0 0 0 1862 0
Store 151 0 0 0 151 0
Figure 20 health professionals in the UAE

Figure 21 licensed facilities

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Chapter 7
In this chapter we will be showing a few figures that will elaborate the few functions of the
Health and insurance authorities in the UAE.

Figure 22 cancelation insurance of healthcare

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Figure 23 changing type from outpatient pharmacy to 24 hour pharmacy

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Figure 24 changing type of healthcare facility

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Figure 25cancelation of healthcare facility preliminary approval/ permanent license

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Figure 26 new licensing/ relicensing

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Figure 27new licensing/relicensing of pharmacies

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Figure 28 registration of insurance of healthcare facility

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Figure 29renewal of ambulance for healthcare facility

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Chapter 8
In this chapter we will be highlighting the main and primary health insurer in the UAE. We shall
be discussing it as health is related directly to insurance in the UAE.

CEOs Message
Dr.Michael bitzer
Daman is UAEs primary health insurance provider. We serve more than 3 million members. All
the members of Daman enjoy a vast array of healthcare services. Daman is the UAEs first and
biggest healthcare network in the UAE. It is also growing rapidly across the Middle East, Asia, Africa,
Europe and America.

Daman also offers disease prevention programs. These programs are managed by a qualified team
of individuals from Daman. We have also created our active life initiative, which aims to mobilize
the public of UAE to have a health and active lifestyle.

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Introduction to Daman

This is UAEs primary and national health insurance provider. It is also the leading insurance
company in the region. There are almost 3 million people that are insured by Daman in the UAE.
Hence making Daman the biggest insurance company not only in the UAE but also all over the
region.

It was established in 2006 in UAE. Its headquarters are in Abu Dhabi. They have a lot of insurance
programs according to the needs and requirements of the individuals. Daman also provides
insurance for organizations. They offer a special program for the locals of the UAE that is known
as THIQA. THIQA is an insurance plan specially made for the government and locals health.
Where THIQA is the insurance plan for UAE nationals. Daman also provides basic plans for
expatriates. Each and every individual can enjoy healthcare from the largest healthcare providing
organizations and an extensive international network of over 45 countries.

This company has been the primary choice of many multinational organizations and national
organizations that have been established in the region and UAE. Some of the most prominent
organizations include:

Oil & gas


Energy
Construction
Investments
Media

Daman is not a government insurance firm. It is a semi government institution where the
government has a higher percentage of stock. The government of the UAE has 80% joint stock
shares whereas on the other hand Munich Re owns the remaining 20% of the shares. But the
company is backed and supported by the government entities. They are the worlds leading
reinsurers. Reinsuring and providing a valuable source of knowledge transfer is an important role
of Munich Re.

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Mission
We deliver world-class health insurance solutions that facilitate the development of the UAE
healthcare system and support Abu Dhabi achieving its 20130 vision.

Vision

To become the most trusted partner in health for the community

Values

Figure 30 daman values

Daman values honesty and integrity. They continuously aim at setting new standards bring about
improvements in the health industry. Striving to keep their performance at the best standard to
maintain their position in the health industry.

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Performance

Daman is focused on providing the best performance to its customers and members. This
means that each and every individual will have the best possible treatment weather it is
mental or physical. Each and every member will be treated appropriately. Daman sets hard
targets for itself. They strive to achieve these targets and then surpass them in order to
achieve greater heights of efficiency and performance.

Innovation

Daman is not just aimed at providing health insurance or disease prevention for the citizens.
They are innovative. Daman not only values innovation but also promotes it. Their services
and products both are a live example of damans innovation. Their innovation is not just
limited to insurance but also in the field of healthcare.

Customer focus

With each products and service that Daman is providing, they keep their customers in mind.
They strive to produce a commodity or service that is best for its members. This means that
their customers are happy and satisfied every time they benefit from Daman.

Social responsibility

At Daman people dont just think about Insurance policies. They believe that they have a
huge social responsibility of health and humanity at first. They have the responsibility of
providing a good healthcare for every individual.

Trust

Trust is one of the strongest traits of Daman. Their outstanding service and consumer
friendly policy makes people trust it and come back again and again. Daman values
honesty and goodwill. They strive to be a trusted ally rather than a trusted company.

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Daman key benefits

Daman offers a dedicated number to its customer that answers any queries of customers
through a 24 hour call center which is handled by multiple representatives.
Daman has an amazing system that approves any demands for a specific treatment that
needs to have pre authorization. This helps prevent any severe problem.
Members can make in-house claims within 15 working days.
Daman also provides direct billing
Daman has an online service website that provides a track for members to submit online
claims or request or complaints and track endorsements. Members can also take advantage
of many more services.
Case management is another service provided by Daman. This service guides members
through the medical services that are provided and ensures that the people are receiving the
best possible service and care.
Daman also offers disease management programs. It helps its consumers to manage chronic
conditions with the help of well trained personal. They help the patients by motivating and
educating the patients to lead a healthier lifestyle and improved quality of life.
Active life program is a very unique yet useful program offered by Daman. This program
is basically designed for the members to have a platform to support them and lead a
healthier lifestyle and be more active in life.

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Daman Insurance Cards

Daman health insurance card is the prime insurance policy for the citizens of UAE. It is mandatory
for each and every individual in the UAE to have insurance. Good or bad, cheap or expensive
insurance has to be made. This is also mandatory because the government of UAE doesnt paste
the residence visa onto the passport if the person does not have a valid insurance. If a person is an
employment visa then his/her insurance will be paid for by the company.

The insurance card carries important information like the persons name, date of birth, nationality
and insurance policy number etc. Then there will be the type of insurance plan that will be
mentioned on the card. Whenever a patient will visit a healthcare facility they will present the
insurance card to the facility to avail benefits from the insurance card. Given below is a figure of
Daman insurance card.

Figure 31daman insurance card

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Daman members rights

Daman members have the right of information. Information regarding insurance plans and
services.
Members have PBM pharmacy benefits management services.
Treatment with respect and dignity.
Rights to privacy
Confidentiality of records of patients.
Voice complaints
Claim settlement
Members have the rights to receive services in Arabic and English.
Information about ones insurance plan, benefits and exclusions.
Commenting to help improve the performance of daman

Daman members responsibilities

Read all the insurance policies for details of all the benefits.
Know all terms and conditions
Present daman card at any healthcare facility
Knowledge of how to access covered health services
Payment of the applicable co-insurance
Demonstration of mutual respect and courtesy towards the providers

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Chapter 9
Daman health insurance plans

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Glossary of terms
Term Full Definitions

Accident Something that happens all of a sudden or by accident or


mistake

This is the surgery that is done to construct any cause that


happened during the accident
Accident related Constructive Surgery

This is the surgery that is done to construct any dental cause that
happened during the accident
Accident related Dental Treatment

An employee that is working full time and is on a fixed salary


Active at Work

Any changes that are made to a policy or a contract is called


Amendments an amendment

This is a form that needs to be authorized by the attending


Authorization Request for Hospitalization
physician.
Form

The extent of the coverage on an insurance provided to a


Benefit
person

This is a manual for the user which explains all the benefits that
Benefit Plan
the consumer will get.

A disease that can last for 3 months or longer, can disable a


Chronic Disease person.

This is a form that must be filled out by a physician in order to


Claim Form allow the covered person to attain his insurance claim

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Clerical Error Computing error or mistake.

The percentage of every claim that has been paid by the policy
Co-Insurance
holder after paying off the deductible amount.

Overnight stay at the hospital.


Confinement and Confined

Congenital Anomaly A physiological disease or illness

Consumable Medical Supplies Supplies that are usually disposable and cannot be used more
than one time.

Levels of benefits that are categorized according to the


Coverage Category employees needs and salary.

Coverage or Covered The insurance that is provided to the policy holder

A person that is insured.


Covered Person

All services that are provided in the insurance policy.


Covered Services

Insurance card.
Daman card

Treatment that needs to be done inside the hospital


Day Treatment

Deductible The amount that is deductible before providing any insurance


claims

The hospital or healthcare facility that is a designated or advised


Designated Facility facility by the insurance company.

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The person that donates any or a pair of organs that can be of use
to some other patient and result in the saving of the life
Donor

Durable Medical Equipment Any equipment that is not disposable. It can be used one or more
times

Effective Date The date when the coverage or insurance becomes effective from

Charges for any covered health service.


Eligible Expenses

Eligible Person Someone that is eligible for insurance claim or treatment

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References

Tom Doerr, The benefits of Evidence-based Medicine in EMR Systems , 2008,


www.EMRscope.com

Hgglund M, Scandurra I, Mostrm D, Koch S. Bridging the gap: a virtual health record for integrated
home care. International Journal of Integrated Care [serial online] 2007 Jun 27; 7. Available at:
http://www.ijic.org/.

Maryati Mohd. Yusof, Ray J. Paul, Lampros K. Stergioulas, Towards a Framework for Health
Information Systems Evaluation, School of Information Systems, Computing and Mathematics, Brunel
University, Uxbridge, UK

Lowes, Robert, 50 reasons to get an EHR. Sep 16, 2005, published by Medical Economics, Available
[http://www.memag.com/memag/content/printContentPopup.jsp?id=179083]

Richard J. Baron, MD; Elizabeth L. Fabens, MD; Melissa Schiffman, MD; and Erica Wolf, MD,
Electronic Health Records: Just around the Corner? Or over the Cliff?, 2 August 2005, Annals of
Internal Medicine - Volume 143

Terhilda Garrido, Laura Jamieson, Yvonne Zhou, Andrew Wiesenthal and Louise Liang, Effect of
Electronic Health Record; study ambulatory care: retrospective, serial, cross. BMJ, VOLUME
330, 12 MARCH 2005

Peter Littlejohns, Jeremy C Wyatt and Linda Garvican, Evaluating computerised health information
systems: hard lessons still to be learnt, BMJ, Volume 326 19 APRIL 2003

Richard Hillestad, James Bigelow, Anthony Bower, Federico Girosi, Robin Meili, Richard Scoville, and
Roger Taylor, Can ElectronicMedical Record Systems Transform Health Care? Potential Health
Benefits, Savings, And Costs, HEALTH AFFAIRS ~ Volume 24 , Number 5, September/October 2005

Amalia Miller and Catherine Tucker, Privacy Protection and Technology Diffusion: The Case of
Electronic Medical Records, University of Virginia

Committee on Data Standards for Patient Safety, Key Capabilities of an Electronic Health Record
System, Institute of Medicine

Tom Doerr, MD, "The Benefits of Evidence-based Medicine in EHR Systems", 2008

IT Challenges in Physician Practice Management, Hospital and Health Network publication;


Available [http://www.hhnmag.com/hhnmag_app/jsp/printer_friendly.jsp?dcrPath=HHNMAG/Art]
Accessed 13/11/2009

"HAAD Data Dictionary", Available [https://keh.haad.ae/Insurance/Datadictionary/webframe.html],


accessed [16th July 2009]

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Waegemann, C. Peter. Thought Leaders: The Year of the EMR? Health Management Technology,
May 2004. Found at
www.healthmgttech.com/archives/0504/h0504thoughtleaders.htm, Accessed [16th July 2009]

"Tawam Online Intranet, accessed [16th June 2009]

Bates DW, Pappius E, Kuperman GJ, Sittig D, Burstin H, Fairchild D, Brennan TA, Teich JM. Using
information systems to measure and improve quality. Int J Med Inform. 1999 Feb- Mar;53(2-3):115-
24. Partners Information Systems, Boston, MA 02115, USA.

Mark D. Smith, M.D., M.B.A. President and CEO, CHCF, Health IT: Hope, Hype, and How to Avoid
the Road to Hell, American Medical Informatics Association Annual Symposium November 15, 2009

Scott, Mary Kate, MBA. Health Care Without the Doctor: How New Devices and Technologies Aid
Clinicians and Consumers, California Health Care Foundation, May 2009

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Summary and conclusion
There are various aspects of the UAE health care system which have been discussed in the
paper. UAE has been seen to have challenges such as few number of specialists, low nurse
to patient ratio, lower remuneration of health care stakeholders and poor skills by nurses.
These effects have been discussed to lower the motivation of employees and as a result, they
are likely to make errors or perform poor quality assignments. This in turn makes patient
lose confidence in local health care provision and some seek health care services overseas.
Some health care professionals also look for employment overseas as a result. When this
happens, the UAE government loses tax revenue. It also ends up paying for patients
overseas treatment which leads to economic losses such as lost opportunity costs of payment
from patients to health practitioners, loss of tax revenue by the government and direct
expenses paid for the medical cost.
In order to solve these problems which are affecting the UAE healthcare service provision,
several steps should be taken by the UAE government in collaboration with the private
sector and international partners. The first involves better remuneration of employees in the
health care industry. The stakeholders in the health care industry should set new
remuneration which matches that from the private practice. The second step involves
building of medical schools and paying for educational needs of students to enable them
pursue various medical fields. This will increase the skills and number of health care
professionals, which is a major challenge in UAE. The third intervention is screening all
health care professionals from foreign countries before they begin working in the UAE in
order to ensure that they have adequate skills.
Although these interventions are important in improving the overall quality of healthcare
provision in the UAE, it is similarly useful to provide incentives to stakeholders in the health
care sector in order to improve service provision. Health care employees should receive
higher remuneration in order to increase motivation. Their work environment should also be
conducive and the organizational culture should feature teamwork, independence,
communication, conflict resolution and other important factors (Mugisho, 2007). Patients
on the other hand can be motivated through improving the skills and increasing number of
nurses and specialists since this will encourage them to have faith in the health care system.
Feedback should be sourced through score cards, where patients rate service provided to
them. This will enable the management improve the weaknesses of the processes. These
interventions will encourage patients to seek local health services and this will increase
government income and tax revenue thereby leading to higher economic growth and
development.

Finally Iwould like tothank my family and friends


who supported me in completing this p r o j e c t .

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