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Re‐engineering pre‐employment check‐up systems: a model for improving health services

Said Abdel Hakim Rateb (Cairo University, Cairo, Egypt)
Azza Abdel Razek El Nouman (Cairo University, Cairo, Egypt)
Moshira Abdel Hakim Rateb (Cairo University, Cairo, Egypt)
Mohamed Naguib Asar (Health Insurance Organization, Cairo, Egypt)
Ayman Mohammed El Amin (Health Insurance Organization, Cairo, Egypt)
Saad abdel Aziz Gad (Health Insurance Organization, Cairo, Egypt)
Mohamed Salah Eldin Mohamed (Hi.Connect Co. for Electronic Services, Cairo, Egypt)

International Journal of Health Care Quality Assurance

ISSN: 0952-6862

Article publication date: 19 July 2011




The purpose of this paper is to develop a model for improving health services provided by the pre‐employment medical fitness check‐up system affiliated to Egypt's Health Insurance Organization (HIO).


Operations research, notably system re‐engineering, is used in six randomly selected centers and findings before and after re‐engineering are compared. The re‐engineering model follows a systems approach, focusing on three areas: structure, process and outcome. The model is based on six main components: electronic booking, standardized check‐up processes, protected medical documents, advanced archiving through an electronic content management (ECM) system, infrastructure development, and capacity building. The model originates mainly from customer needs and expectations.


The centers' monthly customer flow increased significantly after re‐engineering. The mean time spent per customer cycle improved after re‐engineering – 18.3±5.5 minutes as compared to 48.8±14.5 minutes before. Appointment delay was also significantly decreased from an average 18 to 6.2 days. Both beneficiaries and service providers were significantly more satisfied with the services after re‐engineering. The model proves that re‐engineering program costs are exceeded by increased revenue.

Research limitations/implications

Re‐engineering in this study involved multiple structure and process elements. The literature review did not reveal similar re‐engineering healthcare packages. Therefore, each element was compared separately.

Practical implications

This model is highly recommended for improving service effectiveness and efficiency.


This research is the first in Egypt to apply the re‐engineering approach to public health systems. Developing user‐friendly models for service improvement is an added value.



Abdel Hakim Rateb, S., Abdel Razek El Nouman, A., Abdel Hakim Rateb, M., Naguib Asar, M., Mohammed El Amin, A., abdel Aziz Gad, S. and Salah Eldin Mohamed, M. (2011), "Re‐engineering pre‐employment check‐up systems: a model for improving health services", International Journal of Health Care Quality Assurance, Vol. 24 No. 6, pp. 484-497.



Emerald Group Publishing Limited

Copyright © 2011, Emerald Group Publishing Limited

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