Dubais leader, Sheikh Mohammed bin Rashid al Maktoum, said in a February news conference that the emirates economy grew at an average of 13.4% per year between 2000 and 2005. The pace of growth has been fueled by free zonesthe emirates busy airport and container ports fall within themthat allow 100% foreign ownership and provide incentives for economic investment and activity.
They felt the same thing could happen in healthcare, Crone says.
Organizations and companies working in Dubai Healthcare City are exempt from taxes, including personal income tax, as well as duties on goods they produce, and theyre free to repatriate profits and wages for 50 years.
The HMI team, working with partners in Dubai, established regulations and licensing rules for companies, physicians, nurses, pharmacists, dentists and allied health professionals. A tribunal handles claims of medical malpractice, with noneconomic damages capped at less than $300,000; the maximum award is reserved for the most extreme cases, according to the published regulations.
Not having a legacy system does in fact give you a very substantial advantage as you begin to think about redeveloping something, Crone says. You can develop a new culture, and you dont have the system pushing back all the time.
The HMI-affiliated hospital will be one of several hospitals in Dubai Healthcare City. Designs call for 1.45 million square feetwith nearly 1 million square feet of parking underneathto be constructed with few load-bearing walls to accommodate changes in healthcare delivery and nimble responses to competition.
About 40 Harvard faculty members were asked what the future of their medical specialties will demand of a hospital of the future, says Solomon, who is leading the plans for the medical centers operations and recruiting a leadership team. As a result, for instance, the hospital planners omitted operating rooms and instead created what they call an invasive platform that will flexibly support surgery, cardiac catheterization, interventional radiology and interventional diagnostic imaging, Solomon says.
Construction is well under way on the Harvard Medical School Dubai Center, which will open its doors in the fall of 2008 to physicians, other healthcare professionals and research scientists seeking postgraduate training. The $75 million, 350,000-square-foot facility will feature interactive classrooms, a 300-seat auditorium, a computer training center, a professional library and a high-tech simulation training center.
Even with these plans yet to be realized, HMIs influence is reaching beyond the boundaries of the free zone. The UAEs Ministry of Health has hired consultants from Dubai Healthcare City and HMI to overhaul the 230-bed Al Baraha Hospital, one of five government hospitals in Dubai.
The emirate of Abu Dhabi likewise has lured U.S. talent and prestige to transform the healthcare system in the city of Abu Dhabi into a regional leader, potentially in competition with the projects rising in neighboring Dubai.
The Cleveland Clinic last September announced a 15-year deal with Mubadala Development, a company owned by the government of Abu Dhabi, to design, build and operate a world-class hospital in the city. The Cleveland Clinic Abu Dhabi is scheduled to open by 2010, with a regional health and economic survey driving the array of specialty services and size of the project.
In June, the health system made another commitment to the emirate, signing an agreement with the health authority of Abu Dhabi to operate its established Sheikh Khalifa Medical City, which includes a 700-bed hospital, a behavioral sciences pavilion, a rehabilitation center and a network of specialty clinics and primary-care centers.
Ken Ouriel, who until June was the Cleveland Clinics chief of surgery, was dispatched to be the medical centers CEO. The Cleveland Clinic team will include, along with Ouriel, a chief medical officer, chief operations officer, chief information officer, chief purchasing officer and director of human resources.
Ouriel has set about integrating the Cleveland Clinics medical and administrative procedures and capabilities into the system in Abu Dhabi. His first steps have included recruiting staff from around the world and beginning to tackle significant technology challenges, Ouriel wrote in an e-mail responding to a recent query about how things were going so far.
Fortunately a large electronic medical-record project was already in process, Ouriel wrote. Other systems, however, including financial, decision-support management, inventory control and productivity software are virtually nonexistent.
Johns Hopkins International, a unit of Johns Hopkins Medicine similar to Harvards HMI, has been doing similar work in Abu Dhabi since last year under an agreement to manage the health authoritys existing 469-bed Tawam Hospital.
The president of the UAE, Sheikh Khalifa bin Zayed al Nahyan, in May pledged an undisclosed sum of money, described as a transformational gift, toward one of two 12-story towers under construction on Johns Hopkins Baltimore campus. The building, to be called the Sheikh Zayed bin Sultan al Nahyan Cardiovascular and Critical Care Tower in honor of Sheikh Khalifas late father, is scheduled for completion in 2010.
Acts of generosity notwithstanding, the UAE leaders expect to make money on healthcare rather than subsidize services for its fast-growing population. The country is working toward compulsory health insurance paid by employers for foreign workers. In a symbol of growth perhaps more stunning than any of the new buildings going up, foreign residents represent more than 80% of the UAEs population. In 2006, Dubais population alone grew by more than 25%, to 1.4 million, the government reported. Thats largely driven by the frenzied construction of buildings and infrastructure. Men make up 75% of Dubais total population.
Care at public hospitals in Dubai has been free for nationals and cheap for residents who have paid a small fee for a health card, and its hospitals have been running with revenue covering just 20% of costs, an official in Dubais Department of Health & Medical Services recently told a local newspaper. The department, the official said, plans to overhaul its billing structure and work toward generating a profit.
And government officials are looking far beyond their borders when they envision whom these projects will serve. The Abu Dhabi Chamber of Commerce & Industry this year projected that the country can capture $1.9 billion a year from medical tourism by 2010, citing Dubai Healthcare City and Sheikh Khalifa Medical City as critical to capitalizing on the growing demand.
The university hospital in Dubai Healthcare City must support itself eventually, Harvards Crone says. They are very rigorous about getting a return on their investment.