Two site visits showcased smooth-running medical laboratories with great staff

DATELINE: CAIRO, EGYPT—on Monday, your Dark Daily editor was privileged to visit two clinical laboratories here in Cairo. Each site visit provided ample proof that, despite differences in the Egyptian healthcare system, there are plenty of similarities in how each clinical pathology department is equipped, organized, and operated, compared to clinical laboratories in other countries.

First stop on the Dark Daily medical laboratory tour was Ain Shams Specialized Hospital in Cairo. This teaching hospital is affiliated with Ain Shams University and has more than 800 beds. It is primarily a surgical hospital. Its laboratory is organized to serve the needs of surgeons. There is also an emergency room and ICU service, which means that Ain Shams Specialized Hospital does admit, and treat, a certain number of inpatients with a variety of diseases and health conditions.

This clinical laboratory performs about 850,000 tests per year. Of this total, about 85% represents inpatient testing and 15% represents outpatient testing generated by clinics associated with Ain Shams Specialized Hospital. The laboratory counts each analyte as one test. Thus, a 12-analyte chemistry panel would be counted as 12 test results.

Clinical Laboratory Performs a Range of Molecular Diagnostics Testing

Daily volume in chemistry is typically about 550 patients. In hematology, the daily test volume is approximately 300 patients. The clinical laboratory has an expanding molecular diagnostics test menu. For example, it regularly runs assays that include PCR, hormone testing, and tumor markers.

In Egypt, clinical chemistry labs are directed by medical doctors who trained in laboratory medicine and clinical pathology. It was explained to Dark Daily that there are no Ph.D. programs in biochemistry in Egypt.

The term “medical technicians” is used to describe the role typically filled by Medical Technologists (MT) and Clinical Laboratory Scientist (CLS) in the United States. Depending on their training program, studies generally include three or fours years of university education, similar to the Bachelor of Science programs in the United States.

At the laboratory of Ain Shams Specialized Hospital in Cairo, Egypt (from L). The lab site visit included: Dr. Hanzada I. Abd El Fattah, Professor of Clinical Pathology and Clinical Chemistry; Robert Michel, Editor, Dark Daily; Dr. Dalia Helmi Faraq, Professor of Clinical Pathology; and Dr. Manal Z. Maran, Professor of Clinical Pathology and Immunology.

At the laboratory of Ain Shams Specialized Hospital in Cairo, Egypt (from L). The lab site visit included: Dr. Hanzada I. Abd El Fattah, Professor of Clinical Pathology and Clinical Chemistry; Robert Michel, Editor, Dark Daily; Dr. Dalia Helmi Faraq, Professor of Clinical Pathology; and Dr. Manal Z. Maran, Professor of Clinical Pathology and Immunology.

The laboratory at Ain Shams Specialized Hospital earned its ISO 9001 Certification about 12 years ago. It is preparing for accreditation to the standards of ISO 15189 and hopes to complete this process by the end of the year.

Cairo Has Independent Commercial Clinical Laboratory Companies

In the second site visit on Monday, your Dark Daily visited Al Borg Laboratories. This is an independent commercial laboratory company that primarily serves office-based physicians. It does have some reference accounts from private hospitals.

Al Borg Laboratories is one of Egypt’s largest commercial medical laboratories. It does business throughout the nation and operates 93 testing sites across Egypt. Annually, the laboratory performs more than 5 million tests, and counts one analyte as one test.

Al Borg Laboratories is one of just a handful of top-tier commercial laboratory companies in Egypt. It was founded in 1987. In 2008, the lab company accepted a cash infusion from Abraaj Capital, a Dubai-based venture capital company. Armed with this capital, Al Borg is actively hunting for more laboratory acquisitions in Egypt and in other countries in the region.

For the owners and managers of private laboratory companies that serve office-based physicians in such countries as Canada, the United States, and Australia, the workflow and organization of activities at Al Borg Laboratories would be familiar. Daily, courier cars fan out to pick up specimens from doctors’ offices and bring them back to the laboratory.

Al Borg’s central laboratory in Cairo starts testing early in the morning and usually finishes the day’s work by around 11:00 p.m. Management shared that, of the specimens it receives each day, it can typically complete testing and report results for 98% of those specimens on the same day.

Al Borg has an integrated informatics capability, and, like independent laboratories in other countries, getting paid is a priority. Some patients have health benefits through their employer, and it is common for the patient to have a co-pay for about 50% of the cost of the laboratory tests.

In the main patient service center at Al Borg Laboratory in Cairo, Egypt (from L): Dr. Waleed Ghoneim, Clinical Pathologist; Robert Michel, Editor, Dark Daily.

In the main patient service center at Al Borg Laboratory in Cairo, Egypt (from L): Dr. Waleed Ghoneim, Clinical Pathologist; Robert Michel, Editor, Dark Daily.

To meet licensing and accreditation requirements of Egypt, Al Borg Laboratories has an ISO 9001 certification, and is accredited to the standards of ISO 15189 for its clinical chemistry department at its main laboratory facility. Dr. Gihan Kamal, Quality Manager at Al Borg and Professor of Clinical Pathology at Ain Shams University noted that Al Borg Labs is working on a four-year timeline to achieve full ISO 15189 accreditation across all its testing activities and different sites in Egypt.

For pathologists and clinical laboratory managers tracking the globalization of laboratory medicine, Al Borg Laboratories provides another interesting insight. Its corporate parent has acquired, and operates, clinical pathology laboratories under the Al Borg name in Egypt, as well as these other countries: Kingdom of Saudi Arabia (KSE), United Arab Emirates (UAE), Qatar, and Sudan.

That means, Al Borg Laboratories is another example of a clinical laboratory consolidator. It operates primarily in the Middle East, which is why medical laboratory professionals in Europe and North America don’t know much about its history and business strategy.

Because both laboratory tours were conducted in a “whirlwind fashion,” and notes of the conversations were scribbled quickly, Dark Daily apologizes in advance if there are any misstatements about the key facts for both Ain Shams Specialized Hospital’s clinical laboratory and Al Borg Laboratories. If any corrections are necessary, the archive copy of this e-briefing on Dark Daily’s website, at www.DarkDaily.com, will be updated.

Finally, Dark Daily would like to recognize how the management teams for both laboratories extended great hospitality to this Editor during the site visits. Each laboratory was in full operation, and the productive staffs at each laboratory were friendly and accommodating.

And one more thing! There is no shortage of trained laboratory professionals in Cairo! Both laboratories report that they are fully staffed, and that a well-trained pool of technical laboratory skills is available to help them increase staffing as their respective laboratories must handle ever-larger numbers of specimens.

Your Dark Daily Editor,

Robert L. Michel

E-mail: rmichel@darkreport.com with your comments.

Related Information:

Abraaj Capital Partners with Al Borg Laboratory to Expand Healthcare Services in Egypt and Across MENASA Region

Al Borg Laboratories Acquire the Leading Cytogenetics Lab in Egypt

The First Accredited Medical Lab in Egypt