Introduction

Amr is popularizing access to healthcare systems through gathering and deploying intelligent information and establishing preferred policy in Egypt.

Amr is making the healthcare industry more inclusive through the creation of SmartMed, granting access to low cost, self-managed, personalized health care programs. SmartMed focuses on the actual treatment, where he minimizes the choices and provides affordable options. Amr works with individuals who are living on less than $2/day, in addition to small workshops that contain 6-10 employees, small medium factories and small medium enterprises.

SmartMed’s main focus is to cover the supply chain of the healthcare industry through enabling individuals and organizations to pay affordable, fixed administrative costs to have access to tailored medical programs and providing Third Party Administration (TPA) to insurance companies, leading to decreasing the costs of their services and including more people in the healthcare system.

SmartMed provides access to healthcare to underserved segments of the Egyptian population with a potential in scaling in countries in MENA with similar health care systems such as Bahrain and Jordan. Amr’s mission is to ensure affordable access to quality healthcare for the +50% (50 million) of Egyptians without health care programs, instead of depending on charity to be part of the health-care system.

In a population of 100 million citizens, only 50% are covered with social health insurance, leaving 50 million behind without budget nor infrastructure and only 4 million have private health insurance, which negatively affect its economic development. According to WHO, the government is focusing on making the health insurance accessible to only the elderly. There is no focus on university students, widows, or children. Healthcare delivery in Egypt is very unorganized with lack of proper administrative, inadequate resource utilization and lack of inclusion; government provision is divided into 4 parts where the most efficient one is trade unions; however medications is not covered and you only have EGP7.5k allocated for big operations and hospitalization; nor emergency cases such as accidents and there is no ease of service. In low-income areas, there is a noticeable lack of access to quality healthcare advice, in addition that they face challenges while accessing medical specialists.

However, as with most medical services in Egypt across the private and non-profit sector, the provision of services used is scattered, complex and costly management systems that result in expensive overheads, low quality of service and significant underutilization of resources. Many barriers to entry will face any health care private industry, such as the government laws and regulations, inflation that increase the cost of MRI “Magnetic resonance imaging” device from 2.2 million EGP to 6 million EGP. Finally, private insurance only covers 4m Egyptian citizens. That is only 4% of the population.

There are three root problems that Egyptian citizens are facing regarding their health care. Cultural problems, where poor individuals perceive a good treatment by paying a lot for medications, by undergoing an operation or by doing an MRI “Magnetic resonance imaging” which is a medical test. Leading the centers such as radiology and analysis centers to use these individuals to make more profit.

Limited options, where 27 million citizens are under $2 per day (that was before inflation – that is 32.4% in pharmaceutical products and 26.8% in the healthcare sector, according to CAPMAS, after inflation that number grew), they have nowhere to go, resulting into their death out of liver and lung diseases. Regulatory, government includes a lot of people in health insurance more than he can afford, hence not able to create plans, budget and programs for these extra citizens. 80% of families earn daily/monthly income from the informal economy and only 5.5% of GDP is expended on health care, with, according to the WHO: The highest rate of hepatitis C in the world (around 25%, that is 25m); High pollution rates resulting in kidney, lung, and abdominal, and respiratory system diseases; 12m (12.5% of the population) are diabetic; High rate of obesity (70% in adults, 18+ years old) that comes with associated complications, such as coronary heart diseases, high blood pressure, stroke, cancer, type 2 diabetes, sleep apnea, gallstones and even more; According to the World Health Organization “WHO”, World Bank, USAID, Cap Mass and the Egyptian Government, the Financial Supervisory Authority; the market of health care in Egypt is worth 22 billion dollars, where 60% of it is out of pocket expenditure; which is equal to 16 billion dollars. In low-income areas, there is a noticeable lack of access to quality healthcare advice, in addition they face challenges while accessing medical specialists. The dysfunctionality between the pillars of the healthcare system: The Payers, Medical providers, Regulatory frameworks and citizens, which must be addressed by the administrative approach using technology.

Amr is focusing on two main challenges that are facing the healthcare sector in Egypt and willing to overcome it. Private multinationals are mostly the accessible industries in the health insurance sector, they are well established and with high cost. Government draft laws and work on the infrastructure, however there is no budget for the healthcare sector. Amr successfully established SmartMed and is growing; this is a way to influence the government mindset by proving the success of national companies.

SmartMed is a healthcare institution that manages low cost healthcare programs. It consists of a variety of programs with limited and unlimited options. It deals with corporates such as small and medium enterprises, individuals, families and clients such as Bupa, the international insurance company. Sehaty program is an example of the micro health care program initiated by SmartMed targeting individuals who can’t afford treatment. Additionally, SmartMed also provides services such as Call Center, consulting and access to network.

SmartMed has a variety of customers that include corporates, individuals and families. Corporates contain not-for-profit organizations, small and medium enterprises, workshops that involve a minor number of employees (6-10), and small and medium factories which is most risky for labor health and safety such as cement factories. Corporates are responsible to pay fixed cost for their customers that consists of the administrative fees that is represented by 30-50 % for corporate accounts. General Practitioners are responsible for the data collection that includes the partners, different hospitals, their location and pricing and medical stores, the quantities and prices. This reflects the variable cost since it differs from one individual to another, every month.

Shifting to the families and individuals, they deal with different programs. SmartMed offers Sehaty program and the self funded scheme. Sehaty program gives them limited options, where individuals buy a card for $6/month and families for $12/month. Individuals and families have the right to use the partnered hospitals with controlled options like diabetes treatment and dental healthcare, and excluding treatments such as cancer and skin diseases and the partnered medical entities. Another program is the self-funded scheme, where individuals, small, medium, and large enterprises are open to more options and have access to SmartMed data by being charged for administrative fees of 9-12% self-insurance.

Moreover, SmartMed deals with health insurance clients for the safety and health care of their customers. They are responsible for organizing data packages that include each customer’s information like the illness and demographics. This is where administrators are responsible for delivering clients’ services to the customers. SmartMed benefits from clients by gathering their customers and fees for the services of the data known as sub-contracting.

SmartMed provides various services to all segments of society, including university students, widows and children. Economies of scale played a major role in his success. Call Center is an example of services, where customers can call a customer service representative, or a 24/7 hotline in emergency cases, with their questions. On a quarterly-basis, SmartMed contacts its beneficiaries, via email, phone calls, or occasional in-office visits, to monitor and assess the level of satisfaction with the healthcare plan; in addition to some analysis regarding the calls where he found out that, waiting time is 26 seconds, the rate of abandoned calls is 2% and the first call resolution is above 90%. They also have access to the SmartMed medical network that includes hospitals, pharmacies, clinics, radiology and analysis centers. In Sehaty Program, discounts can range from 10% on medication up to 60% on certain medical examinations.

Although SmartMed was launched 6 years ago, he was able to reach  40k customers; 120 companies, 1 of which is a public health insurance company covering 10k employees out of the 40k and 86% revenue CAGR “Compound Annual Growth Rate”. He has 3 branches around Egypt, one in Greater Cairo, Alexandria and El Sharkeia with 75 young professional employees with medical, business and technology backgrounds, in addition to 24000 members in 2017 that is a noticeable development compared to only 5000 members in 2011.

Currently, Amr is working on expanding locally in some cities like Assiut, Dakahleia and Alexandria, through communicating with three NGOs who are potential partners, Assiut, Dakahleia and Alexandria Businessmen Association. This will be of great help to achieve his short-term goal, which is covering 10% of the 50% Egyptians without healthcare insurance. He is also scaling regionally to Bahrain and planning to create an outsourced health insurance department in the life insurance companies. In order to grant access to more citizens in Bahrain, he is planning to expand geographically to Africa to overcome the challenges, such as no ease of access to health care, high cost and diseases.

Amr was brought up in Kenya to a medical doctor who used to work for UNEP. In Africa, Amr got exposed to the nature and people that nurtured his empathy skills. When he got back to Egypt, Amr’s family started an agriculture project through which Amr understood the rural areas and saw firsthand problems and integrated with different people like peasants from lower socio-economic backgrounds.

As Amr is interested in understanding how the brain works and how this is related to emotions and mentality, he did a neurosurgery medical degree. He used to work in Qasr al-Einy hospital, where the poorest of the poor comes as patients with critical illnesses. In 2002, he decided to raise charity money to start the first Intensive Care Unit for NeuroTrauma. This was when he saw the inefficiencies and lack of sustainability of the work of charity.

He then served as the director of medical operations at Resala, one of the largest volunteer organizations and providers of free healthcare in Egypt. At Resala, he established a unified model for the services provided by the organization to facilitate cost analysis, good governance and a consistent process. He managed to set up 4 primary care facilities and a primary care hospital in addition to starting a sustainable model and laying a foundation for a larger more specialized hospital. On one hand, he recognized at that time the lack of general practitioner and family doctors. That is something that he also saw when farmers in his family’s farm got an electric shock and a general practitioner had to be there to deal with the 40 situation. On the other hand, he recognized that patients become demoralized when they are labeled as free health care recipients. To put an end to those two challenges, he decided to start SmartMed. SmartMed success lies in affordability of and access to more health care services, and is driven by the knowledge on the limits of scalability and financial sustainability of a donations-based model.