title: Re-engineering pre-employment check-up systems: a model for improving health services.
abstract: OBJECTIVE
  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).
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
  
  
  CONCLUSIONS
  This model is highly recommended for improving service effectiveness and efficiency.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Cairo University, Cairo, Egypt.
authors.forename: Said Abdel Hakim
authors.initials: SA
authors.lastname: Rateb
authors.forename: Azza Abdel Razek
authors.initials: AA
authors.lastname: El Nouman
authors.forename: Moshira Abdel Hakim
authors.initials: MA
authors.lastname: Rateb
authors.forename: Mohamed Naguib
authors.initials: MN
authors.lastname: Asar
authors.forename: Ayman Mohammed
authors.initials: AM
authors.lastname: El Amin
authors.forename: Saad abdel Aziz
authors.initials: Sa
authors.lastname: Gad
authors.forename: Mohamed Salah Eldin
authors.initials: MS
authors.lastname: Mohamed
mesh_terms: D001071:Appointments and Schedules; D017598:Efficiency, Organizational; D006298:Health Services Administration; D006301:Health Services Needs and Demand / Q000458:organization & administration; D006801:Humans; D007857:Leadership; D016347:Medical Records Systems, Computerized / Q000458:organization & administration; D017060:Patient Satisfaction; D010808:Physical Examination / Q000592:standards; D058996:Quality Improvement / Q000458:organization & administration*; D013192:Staff Development / Q000458:organization & administration