MIS Healthcare Industry

Prepared By

( Group 5 (

 Ahmed El Sayed Tohamy

 Mohamed Abo Elmagd
 Demiana Wasfy Fawzy
 Mohamed Reda FagElNor
 Mahmoud Fathy Morshed

Under the supervision of

Dr. Mohamed Kholief

CONTENTS
What Is a SWOT Analysis ............................................................................................................................................ 2
tows analysis ................................................................................................................................................................... 4
Statistics .......................................................................................................................................................................... 6
Public Healthcare Sector............................................................................................................................................... 7
Healthcare Problems ..................................................................................................................................................... 8
Recommendations ........................................................................................................................................................ 10
IHI System With Blockchain ...................................................................................................................................... 12
IHI System .................................................................................................................................................................... 13
value proposition canvas ............................................................................................................................................. 14
Business model canvas................................................................................................................................................. 15
Users and Clinical actors ............................................................................................................................................ 16
IOT ................................................................................................................................................................................ 16
User Stories ................................................................................................................................................................... 19
References ..................................................................................................................................................................... 21

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WHAT IS A SWOT ANALYSIS

SWOT stands for Strengths, Weaknesses, Opportunities, and Threats, and so a SWOT Analysis is
a technique for assessing these four aspects of your business.

You can use SWOT Analysis to make the most of what you've got, to your organization's best
advantage. And you can reduce the chances of failure, by understanding what you're lacking, and
eliminating hazards that would otherwise catch you unawares.

Better still, you can start to craft a strategy that distinguishes you from your competitors, and so
compete successfully in your market.

Using internal and external data, the technique can guide businesses toward strategies more likely
to be successful, and away from those in which they have been, or are likely to be, less successful.
Independent SWOT analysts, investors, or competitors can also guide them on whether a company,
product line, or industry might be strong or weak and why.

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Internal factors:

 Strengths:
- A primary focus on quality improvements (money saved from quality projects).
- Internal teams dedicated to research & analytics.
- High-quality medical personnel (staff & external recognition).
- Modern medical equipment and well-equipped facility.
- Huge library of medical data.
- The direction of the state in the recent period to develop Health Care sector.
- Improvement in communication and technology.
- Distribution of wide healthcare services.

 Weaknesses:
- Insufficient management training.
- Lack of funding and resources to support programs.
- Poor locations that is not easily accessible for staff & patients.
- Lack of development in government hospitals.
- Lack of training and deficiency in the management of health waste.
- Lack of interest in educational hospitals.

External factors:

 Opportunities:
- Collaborate with different healthcare organizations to share knowledge.
- Develop healthcare programs and initiatives to drive more community outreach and
engagement.
- Increase funding for analytics and researches including both staff & technology.
- Create mentor programs.
- Improvement in insurance systems.
- Improvement in education health.
- Increasing awareness among people.

 Threats:
- Economic or political insecurity.
- Policy and legislation changes that result in budget deficits.
- Pressure to reduce costs while meeting expectations of universal healthcare coverage.
- Increasing price of health care devices.
- Competition with health care systems in USA.
- Effects of COVID 19 on the medical and scientific research staff.
- Increasing poverty.

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TOWS ANALYSIS
A TOWS Analysis is an extension of the SWOT Analysis framework that identifies your
Strengths, Weaknesses, Opportunities and Threats but then goes further in looking to match up
the Strengths with Opportunities and the Threats with Weaknesses. It’s a great next step
after completing your SWOT and allows for you to take action from the analysis.

Adding the relationship between the internal and external factors makes TOWS a much more
useful matrix than a standalone SWOT and an obvious next step. The main purpose of a TOWS
Analysis is to:
 Reduce threats
 Take advantage of opportunities
 Exploit strengths
 Remove weaknesses

A well thought out TOWS can not only provide you with detail of your SWOT, but also some
data to make a decision about your overall direction.

TOWS has a number of advantages:

 It’s simple to understand and complete
 It provides a good analysis of both internal and external issues
 It focuses on the positive and negative
 It leads to actions to improve your current position

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 Strength- Opportunity:

- Development of public insurance in order to reduce paying from people’s pocket.

- Easy access of people to physicians and drugs.
- Patient findings and fast diagnosis of diseases.
- Make continuing evolution of services system
- Appropriate communication and interaction between people with society health

 Strength – Threat:

- Creating mechanisms for public participation in the supply of health care.

- Support for tariff increases of general practitioners in health centers
- Carry out systematic and rational decision-making in health care
- Health Care system (IHI) for real-time support 24/7.
- Increasing healthcare services at economic crisis.

 Weakness – Opportunity:

- Establishment of research & development

- Selection and application of efficient staff
- Increased of organizational commitment
- Creating new management system

 Weakness – Threat:

- Use of voluntary service

- Forecast and paying special bonus to employees of the sector and the induction of
effective and efficient encourage system
- Use of new technology in adoption and follow-up

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STATISTICS

Ailments/disease Urban % Rural %

Respiratory tract 21.1 38.1

Gastrointestinal 12.0 16.2

Musculoskeletal 7.5 5.1

Cardio-vascular 3.4 2.2

Urinary tract 2.2 2.7

Ear-Nose-Throat (ENT) 3.3 5.5

Eye 1.8 5.0

Accident 2.1 0.2

Satisfaction with health services Urban % Rural %

Satisfied 63.2 52.8

Dissatisfied 36.8 47.3

Reasons for dissatisfaction

Maltreatment by providers 60.5 35.0

Distance 14.5 26.1

Long waiting times 22.9 47.8

Over crowding 33.3 47.8

Disorganized work 26.0 26.1

Unsuitable working hours 7.3 21.7

High cost 11.5 13.0

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PUBLIC HEALTHCARE SECTOR

The MOHP is currently the major provider of primary, preventive, and curative care in Egypt, with
around 5,000 health facilities and more than 80,000 beds spread nationwide. There are no formal
referral systems in the MOHP delivery system. The MOHP service delivery units are organized
along a number of different dimensions. These include geographic (rural and urban), structural
(health units, health centers, and hospitals), functional (maternal child health centers), or
programmatic (immunization, and diarrheal disease control).

Specifically, with respect to inpatient services, the MOHP is the largest institutional provider of
inpatient health care services in Egypt. It has about 1,048 inpatient facilities, accounting for more
than 80,000beds. Hospital services are provided through the following types of facilities.

OVERVIEW OF THE HEALTH SYSTEM IN EGYPT

15 Integrated hospitals are small, 20- to 60-bed hospitals providing primary health care and
specialized medical services in the rural areas. Integrated hospitals contain well-equipped surgical
theatres, X-ray equipment, and laboratories and are responsible for serving a catchment population
of between 10,000and 25,000 people. District hospitals are 100- to 200-bed hospitals that provide
more specialized medical services and are available in every district. District hospitals are
responsible for serving a catchment population of between 50,000 to 100,000 people in the urban
district area. General hospitals contain more than 200 beds and contain all medical specialties.
General hospitals are available in every capital of a governorate. Integrated, district, and general
hospitals were included in the ESPA and were categorized as general service hospitals for this
report. Specialty hospitals are located in urban areas and include specialties such as eye,
psychiatric, chest (34), fever (88), heart ophthalmology (31), tumors, and gynecology and
obstetrics. Specialty hospitals are available in all governorates. Fever hospitals were the only type
of specialty hospital included in the ESPA. The private sector has 2,024 inpatient facilities, with a
total of about 22,647 beds. This accounts for approximately 16 percent of the total inpatient bed
capacity in Egypt.

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HEALTHCARE PROBLEMS

Healthcare in Egypt

• The Egyptian healthcare system consists of two sectors: public and private.
• In general, the public healthcare system is of a low standard due to a lack of funding and
poor staffing levels.
• Government investment in the public healthcare system is low, at just 1.5 percent of the
country’s GDP.
• There are significant differences between the availability of health services in the basic
institutions in rural areas and those found in a big city like Cairo.
• Most specialist procedures are carried out in the capital.

Public healthcare sector:

Although public healthcare has been subject to the government’s attempts at reform, the system is
of a poor quality and certainly not on par with anything that a Western expat would be accustomed
too. Even though it is provided free of charge to locals and potentially to expats, many Egyptians
avoid public hospitals due to factors such as outdated equipment, long queues for treatment,
inadequate staff training and poor sanitation levels.

Problem:

1. Inefficiencies and Errors in Data Sharing

- In an age where medical science has made noteworthy advancements, inefficiencies, and
healthcare errors are still persistent because of low-key technology that the healthcare
industry adopts for management.
- This is not just a hurdle in the way of medical science; it causes regression because of the
waste it generates. Not only do patients pay the price in the form of inconvenience and
health, but we also see a rise in administrative expenses and litigation owing to these
inefficiencies and errors.
- One specific area of concern is the exchange of patient data in case of patient transfer from
one department or one hospital to another. Patient record sharing, when done the traditional
way, is not only time-consuming and inefficient but also exposes the patient information
to the risk of a breach.
- An incomplete or inefficient exchange of this data can prove to be dangerous in the case of
patients in need of urgent or complicated treatment.

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Solution:

BlockChain-Based Database

- To be able to deliver a holistic and satisfactory patient experience, different parties

involved in healthcare – doctors, healthcare scheme providers, insurance providers,
doctors, and patients – should be able to exchange information among themselves securely.
- Using cloud-based data management systems can be one stable solution to solving the
inefficiencies caused by the traditional pen-and-paper way of managing data.
- The most up-and-coming solution to this healthcare management problem is the use of a
block chain-based database to store and share patient records. This healthcare technology
trend can not only permit the quick and complete transfer of data but also eliminate
insecurity, thus maintaining the privacy and integrity of patient information.

2. Managing the Massive Volumes of Patient-Related Data

- Vast amounts of data are generated from health care providers, public and private payers,
ancillary service providers such as labs and pharmacies, and healthcare consumers alike.
The challenge is not just in storage and access, but also in making this data usable.
- Patient-related data is one of the most overwhelming aspects of healthcare. With each new
addition to the patient database, the existing pool of data becomes still bigger.
- Consequently, it becomes even tougher to manage this data. As much as we may expect
the existing traditional infrastructure to manage and secure the data, it is only an unrealistic
expectation.
- The storage and the retrieval of this patient data, when needed, is a challenge that the
hospitals need to address. Data overload and mismanagement often lead to wrong
diagnoses, compromise in data security, improper treatment, lapsed appointments, and
failure to keep up with the changes in progress or regression of the patient’s condition, etc.
The implications can be catastrophic for both doctors as well as patients.

3. Absence of Supply Management System

- As patients, we never think of the logistics that lie behind healthcare services. But they
form the backbone of the industry. Efficient logistics practices ensure uninterrupted
healthcare services. Managing these logistics is, still, a tricky task.
- While it may sound more like a supply chain mismanagement problem, it creates troubles
like mismanaged medical inventory and equipment or drug shortage at the backend. On the
frontend doctor’s end, it causes inefficiencies; on the patients’ end, frustration and, of
course, danger to their health.
- Traditional supply chain management is often wasteful and inefficient. It leads to money
wasted on lost and damaged inventory, improper delivery of equipment or medication, and

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 the damage caused to patients due to all that amount to massive financial losses for
healthcare services.
- Supply shortages, misplaced inventory, and less than stellar preventative measures
regarding shrinkage, all play into the reality that hospitals are epicenters for wasteful
operations without a proper supply management system in place.

RECOMMENDATIONS
• Migration from Paper Based System to Computer Based System and Data Increase in
Health Systems: The paper based system in which transactions are executed and stored is
abandoned.
Transactions are now carried out via computers and data is stored in an electronic
environment.

• Transition from Part-Based Health Information System to Organization Based, Regional

and Global Based Health Information System: The first applications of health information
systems have been realized in certain departments such as laboratory, radiology systems.
After the 1990s, hospital-based systems were transferred to regional and even global
systems by integrating data from different health institutions.

• Health Information System Users can be Health Personnel and Administrators as well as
Patients and Patient Relatives: Computer aided informatics applications primarily aim to
support physicians. Later on, nurses and other health personnel also entered the system.
Today, the practices are widespread for citizens and patients in general.

• Expansion of Use of Health Information System Data: Health information system data was
used for patient care and administrative purposes in the 1980s. Today, these data are also
used in clinical and epidemiological studies.

• Transition from Technical Knowledge Management to Strategic Knowledge

Management: Until the 1990s, technical problems experienced in computer-aided
information systems were considered. However, with the use of these systems, problems
related to organizational changes, social issues, change management and strategic
knowledge management in the long run have come to the fore.

• Incorporation of New Data Types: By the 1990s it became possible to store images such
as film, MR as well as alphanumerical data. Today, it is also possible to store data at the
molecular level (DNA, Protein Data).

• Emergence of New Technologies: The functionality of computer-aided information

systems has increased steadily. Thanks to the latest technologies, it is possible to collect
data continuously from the patients.

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Invest in the Medicare and Medicaid EHR System
- Healthcare reform has been one of the most disruptive political issues right now. Electronic
Health Record (EHR) systems are one of those healthcare technology trends that the
industry is ready to embrace to simplify health record-keeping and Medicare and Medicaid
filing.
- EHRs offer an apolitical tool to control health care expenditure, which is expected to grow
at 5.8% until 2022.
- EHR systems facilitate appropriate electronic forms for Medicaid and Medicare
reimbursement from the government. It is easy for healthcare professionals to keep the
patients’ health records and fill out the forms for reimbursement when the service has been
provided.
- These systems also help improve the transaction of information from the doctors to the
government and vice versa. They also standardize the format of information as needed by
the government to disburse claims, apart from speeding up the submission of patient files
and requesting payments for the services rendered.
- Also, tracking the medical history of a patient online eases the headache of maintaining
paper files. This way, doctors can focus more on their core functionalities and offer
effective coordinate care with other doctors to plan cohesive, personalized treatment plans.

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IHI SYSTEM WITH BLOCKCHAIN

 Blockchain is a very promising technology that enables a secure, private and distributed
environment among peers without any trusted third-party using consensus.
 It is based on a shared, distributed and immutable ledger, Each transaction in the blockchain
network is processed and validated by the majority of the network participants that eliminates
the need of a trusted third-party.
 The validated transactions after verification are packed in blocks. Each block is linked to the
preceding block by hashing the block’s data along with the previous block’s hash, providing
immutability. The blocks in the network are considered valid when more than 50% of the
participants reach an agreement using a consensus algorithm.
 The immutable and replicated blockchain ledger is capable of solving the issues of scattered
data, delayed sharing, lack of audit trail, privacy and security that prevail in the client/server
model. In addition, blockchain has an important characteristic of enforcing smart contracts—
pieces of codes that are executed automatically once certain conditions are met.
 Blockchain-based EHRs have a tremendous potential in healthcare to enable allied health
professionals to manage and share, not only clinical data, but also important patient-reported
social and contextual data. Moreover, implementing artificial intelligence approaches on the
ledger data that includes patients’ health data from all the hospital in the network can aid
allied health professionals in better prognosis and diagnosis support.
 While many researchers investigated the development blockchain-based system for
healthcare data management, most of the works focus on the comparison of different
blockchain development platforms.
 As far as we know, this is the first work to evaluate and compare the blockchain technology
with the current client/server model.

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IHI SYSTEM

Individual Healthcare Identifiers:

 Is health care system based on block chain technology and IOT.

A number that identifies you for health care purposes.
 An Individual Healthcare Identifier (IHI) is a unique number used to identify an individual for
health care purposes.
 It helps ensure health professionals are confident that the right information is associated with
the right individual at the point of care.

Enhancing not replacing:

 My Health Record is not meant to replace direct communication between healthcare providers.
It is another source of health information that you may not have otherwise been able to access.

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VALUE PROPOSITION CANVAS

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BUSINESS MODEL CANVAS

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USERS AND CLINICAL ACTORS

IOT

What is the IOT?

 The Internet of Things, or IOT, refers to the billions of physical devices around the world that
are now connected to the internet, all collecting and sharing data. Thanks to the arrival of super-
cheap computer chips and the ubiquity of wireless networks, it's possible to turn anything, from
something as small as a pill to something as big as an aero plane, into a part of the IOT.
Connecting up all these different objects and adding sensors to them adds a level of digital
intelligence to devices that would be otherwise dumb, enabling them to communicate real-time
data without involving a human being. The Internet of Things is making the fabric of the world
around us smarter and more responsive, merging the digital and physical universes.
 Internet of Things (IOT) technology has attracted much attention in recent years for its
potential to alleviate the strain on healthcare systems caused by an aging population and a rise
in chronic illness.

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What can IOT do for healthcare?

 Before Internet of Things, patients’ interactions with doctors were limited to visits, and tele
and text communications. There was no way doctors or hospitals could monitor patients’
health continuously and make recommendations accordingly.
 Internet of Things (IOT)-enabled devices have made remote monitoring in the healthcare
sector possible, unleashing the potential to keep patients safe and healthy, and empowering
physicians to deliver superlative care. It has also increased patient engagement and
satisfaction as interactions with doctors have become easier and more efficient. Furthermore,
remote monitoring of patient’s health helps in reducing the length of hospital stay and
prevents re-admissions. IOT also has a major impact on reducing healthcare costs
significantly and improving treatment outcomes.
 IOT is undoubtedly transforming the healthcare industry by redefining the space of devices
and people interaction in delivering healthcare solutions. IOT has applications in healthcare
that benefit patients, families, physicians, hospitals and insurance companies.

IOT for Patients

- Devices in the form of wearables like fitness bands and other wirelessly connected
devices like blood pressure and heart rate monitoring cuffs, glucometer etc. give patients
access to personalized attention. These devices can be tuned to remind calorie count,
exercise check, appointments, blood pressure variations and much more.
- IOT has changed people’s lives, especially elderly patients, by enabling constant tracking
of health conditions. This has a major impact on people living alone and their families.
On any disturbance or changes in the routine activities of a person, alert mechanism
sends signals to family members and concerned health providers.

IOT for Physicians

- By using wearables and other home monitoring equipment embedded with IOT,
physicians can keep track of patients’ health more effectively.
- They can track patients’ adherence to treatment plans or any need for immediate medical
attention. IOT enables healthcare professionals to be more watchful and connect with the
patients proactively.
- Data collected from IOT devices can help physicians identify the best treatment process
for patients and reach the expected outcomes.

IOT for Hospitals

- Apart from monitoring patients’ health, there are many other areas where IOT devices are
very useful in hospitals. IOT devices tagged with sensors are used for tracking real time
location of medical equipment like wheelchairs, defibrillators, nebulizers, oxygen pumps
and other monitoring equipment. Deployment of medical staff at different locations can
also be analyzed real time.
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 - The spread of infections is a major concern for patients in hospitals. IOT -enabled
hygiene monitoring devices help in preventing patients from getting infected. IOT
devices also help in asset management like pharmacy inventory control, and
environmental monitoring, for instance, checking refrigerator temperature, and humidity
and temperature control.
IOT for Health Insurance Companies
- There are numerous opportunities for health insurers with IOT-connected intelligent
devices. Insurance companies can leverage data captured through health monitoring
devices for their underwriting and claims operations. This data will enable them to detect
fraud claims and identify prospects for underwriting. IOT devices bring transparency
between insurers and customers in the underwriting, pricing, claims handling, and risk
assessment processes. In the light of IOT-captured data-driven decisions in all operation
processes, customers will have adequate visibility into underlying thought behind every
decision made and process outcomes.
- Insurers may offer incentives to their customers for using and sharing health data generated
by IOT devices. They can reward customers for using IOT devices to keep track of their
routine activities and adherence to treatment plans and precautionary health measures. This
will help insurers to reduce claims significantly. IOT devices can also enable insurance
companies to validate claims through the data captured by these devices.

The major advantages of IOT in healthcare include:

 Cost Reduction: IOT enables patient monitoring in real time, thus significantly cutting
down unnecessary visits to doctors, hospital stays and re-admissions
 Improved Treatment: It enables physicians to make evidence-based informed decisions
and brings absolute transparency
 Faster Disease Diagnosis: Continuous patient monitoring and real time data helps in
diagnosing diseases at an early stage or even before the disease develops based on symptoms
 Proactive Treatment: Continuous health monitoring opens the doors for providing
proactive medical treatment
 Drugs and Equipment Management: Management of drugs and medical equipment is
a major challenge in a healthcare industry. Through connected devices, these are managed
and utilized efficiently with reduced costs
 Error Reduction: Data generated through IOT devices not only help in effective decision
making but also ensure smooth healthcare operations with reduced errors, waste and system
costs.

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USER STORIES

Patients:
• As a patient, I want to request a new medical service from healthcare service providers
list on the IHI system, so I can get this service remotely.

• As a patient, I want to make a new appointment from health care provider, so I can to go
to it on time.

• As a patient, I want to follow up my medications and diagnostic reports, so I need to

accesses it for any another medical diagnosis any time.

• As a patient, I want to communicate though live calling, so I need doctor to follow up my

vital signs.

Hospital staff:
• As a hospital staff, I want to Receive patient’s requests, so I can assign these requests to
the specific department.

• As a hospital staff, I want to make appointment for any patient, so the patient can come
on the time of appointment to take the service.

• As a hospital staff, I want to open new clinic encounter for the patients, so the patent can
check in to the service.

• As a hospital staff, I want to make lab or radiology request, so the patient can make
sampling or radiology.

Doctor:

• As a doctor, I want to Access the patient data, so I can have more information about the
patient’s history.

• As a doctor, I want to request a new medical services such as lab or radiology, so I can
get this results through the system.

• As a doctor, I want to upload and update patient’s documents and diagnostic reports, so
the patient can access this information latterly.

• As a doctor, I want to request medication for patient, so the patient can get this from
pharmacy or to be delivered to him.

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Pharmacist:

• As a pharmacist, I want to show all medical requests of patients, so I can prepare these
medications.

• As a pharmacist, I want validate the medication through the drug-drug interaction

module, so I need to be sure that there is no conflicts between the medications.

Lab Doctor:

• As a lab doctor, I want to Receive lab requests from hospitals and clinics, so the patient
can take these services on time.

• As a lab doctor, I want to create a new lab order, so the I can prepare the tools and
equipment for the order.

• As a lab doctor, I want to upload lab results, so the patients and doctors can show this
results through the system.

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REFERENCES

USAID. [Online]
Available at: https://www.usaid.gov/egypt/global-health

[Accessed 2021].

UNICEF. [Online]
Available at: https://www.unicef.org/egypt/reports/egypt-health-issues-survey

[Accessed 2021].

EAU. [Online]
Available at: https://uroweb.org/a-view-on-the-challenges-in-egypts-public-healthcare-amid-political-turmoil/

[Accessed 2021].

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