CAIRO: Khadiga is a heart patient who often needs intensive care services on the spot. This need can't always be met because the number of intensive care units (ICUs) cannot cope with increasing demand. ICUs are usually fully occupied and patients end up moving from one hospital to the other in search of an empty bed. However, the last time an emergency arose, Khadiga was able to find the treatment in time thanks to a new system instituted by her health provider, the Health Insurance Organization (HIO). She was transferred in less than 20 minutes from Tulbet Abu El Rish Hospital in Sayyeda Zeinab, where an ICU vacancy was not immediately available, to Sidnawi Hospital on Gomhuria Street, where one was, thanks to HIO's new emergency coordination center, known by the staff as ''the emergency room.'' Realizing that its hospitals were in need of some kind of coordination to streamline services, HIO decided late last month to launch the center to collect and process data relating to vacancies and services available at each of its seven Cairo hospitals. "Prior to the creation of the emergency center each of our seven hospitals used to operate in isolation, Dr Essam Anwar, HIO head, told Daily News Egypt. "Due to the fact that each hospital was a self-sufficient unit, some hospitals were not able to attend to emergency cases immediately, either because they were fully booked or because the kind of services required were not available, he explained. "You have to realize the time and effort involved in securing the required bed or service, all of which puts the life of the patient at risk, noted Anwar. The new center is no more than a small room in HIO's Downtown head office building, containing two beds for the physician and a telephone operator in charge. There are two mobile lines available, as well as a landline, a fax machine, and a computer for online communications. At the end of each working day, each hospital reports to the center all the data necessary regarding vacancies and services, cutting down on time wasted on inter-hospital communications in cases of emergency. The center directs patients to the nearest HIO service. "It is still too early to assess the pros and cons of the emergency room, said Anwar, "but after less than a month of implementing the new system, initial indications show that it's bound to be very useful, both to the organization as well as the beneficiaries. He added, "Slowly we're being informed about the shortages in each and every hospital and the means to remedy it. We have also been able to cater immediately to the needs of ICU patients, as well as others in requiring blood donations. We discovered that the biggest shortage is in ICUs, followed by a shortage of incubators for newborn babies. Anwar is optimistically waiting to study the practicality of the experience so that it can be implemented later in all HIO branches in different governorates. The services of the Health Insurance Organization are only available to HIO subscribers, and if it mushrooms into a real success, it would certainly be envied even by the beneficiaries of private hospitals. "I think that such a unit is becoming a must, said Dr Adel Ashur, a pediatrician at the National Research Center. "Many patients die as a result of that kind of shortage in medical care institutions. Last month, Daily News Egypt reported that Hussein Ibrahim was turned down many times in his search for a free hospital bed in an ICU unit for his mother. Even though he had the money to pay for the kind of medical help his mother urgently needed, the lack of data coordination between hospitals could have cost Ibrahim his mother's life. He eventually found an empty bed at an expensive private hospital. Money, according to Anwar, isn't the issue anymore. All social sectors are now bearing the brunt of the crisis in medical care, he said. Yet, within the context of business competition, there are doubts as to how many private hospitals would be willing to cooperate to share patients according to clinical need. Inundated as they are with crowds of beneficiaries and self-insured patients, private hospitals are perceived as no more than profit-hungry business ventures. Dr Samir Mousa, of Dar El Fouad Hospital, applauded the idea of sharing information, but had reservations. "The idea sounds great, but what's the interest of the owner in providing such a service? "I think this idea will face a lot of obstacles and will be met with objections. Forget about hospitals - the owners of any private business would shun any type of close interaction with competitors, he added. Emad Saad, public relations officer at Misr International Hospital, cited a different reason for why such an idea won't work with private hospitals. "I don't think it is a question of financial gain. This is simply because our hospital, as well as others, is fully booked around the year; we aren't in need of business. Saad explained that hospitals already do this type of coordination when they can't accommodate the patients. "We provide first aid while contacting neighboring hospitals to check on the needed vacancy or service. Emad also raised the issue of covering the costs of these emergency rooms. "Provided the idea is accepted, who is going to bear the cost of a room that operates around the clock? Ashour, however, had a solution. "If some are worried about the cost, they can set up their unit linked to a paid hotline that can cover the expenses required to start the service. But to rule it out completely would endanger the essence of the medical profession, which should provide healthcare to all groups regardless of their position or status. Nodding in agreement, Motaz Ali, of El Shabrawishi Hospital, said that there is no harm in considering the idea, especially since the struggle to find a vacancy in some departments is becoming a real nightmare. Some private hospitals told Daily News Egypt that they are already studying a project aimed at implementing the central coordination of private medical services. However, they have refused to reveal their plans. People that are torn between public and private hospitalization are afraid that one day all medical organizations will be satiated with business and financial gain, and patients will be treated on a first-come-first-served basis.
