Since the start of the COVID-19 pandemic, U.S. hospitals and health systems have continued to scale up their telemedicine and remote second opinion (RSO) programs for both domestic and international patients. The U.S. Cooperative for International Patient Programs (USCIPP) – a program of the National Center for Healthcare Leadership (NCHL), an American 501(c)(3) nonprofit organization – conducts an annual survey of U.S. hospitals and health systems with international services divisions. The most recent survey collected data from the period between July 2019 to June 2020, and 54 American hospitals and health systems responded to the survey in total.

Some key findings from the July 2019–June 2020 survey follow. (Figure 1 contains USCIPP’s standard definitions for both “telemedicine and “RSO” as well as further subclassifications for both.)

• Seventy-four percent (74%) of the US hospitals surveyed indicated that they provide RSO services to international patients.
• Of those hospitals offering RSO services to international patients, written RSOs were the most common format. The median number of written, international RSO encounters was 35 across the 28 hospitals reporting at least 1 encounter.
• Sixty-three percent (63%) indicated that they provide telemedicine services to international patients.
• Of those hospitals offering telemedicine services to international patients, real-time telemedicine was the most common format. The median number of real-time, international telemedicine encounters was 17.5 across the 22 hospitals reporting at least 1 encounter.

Figure 1. USCIPP standard definitions for telemedicine and remote second opinions

In speaking with U.S. hospitals and health systems that currently offer cross-border digital health services, the broad sentiment in late 2021 is, unquestionably, that the ability to offer international telemedicine and RSO services is an increasingly important component of U.S. providers’ broader relationships with their global partners. These partnerships may include clinical collaborations with public and private healthcare facilities abroad, relationships with international ministries or departments of health, collaborations with international information technology companies, and more.

Providing international telemedicine and RSOs in the GCC

American hospitals and health systems continue to care for significant numbers of international patients who travel to the U.S. from the GCC. Cases referred to American providers from the region are often quite complex; anecdotally, U.S. providers report that this has been particularly true since the start of the COVID-19 pandemic. Increasingly, international telemedicine and RSO services can be used as a tool to help patients and in-country physicians decide if travelling abroad for care would be in a patient’s best interests. Cross-border digital health services can be used both for pre-arrival screening as well as for follow-up care once patients return home from receiving care in the U.S.

Across the Gulf, the laws regulating the cross-border delivery of telemedicine and RSO services continue to evolve. The USCIPP program has worked closely with its member hospitals and international law firm Hogan Lovells to monitor relevant regulatory updates and changes. Some highlights from the current regulatory environments in four Gulf countries – Kuwait, Qatar, Saudi Arabia, and the United Arab Emirates (UAE) – follow below.

Kuwait

• In general, physicians who are not licensed to practice medicine in Kuwait are not permitted to provide remote, virtual care to patients in Kuwait. However, there may be some exceptions to this rule, particularly for follow-up care for patients who were previously treated abroad or those who are preparing to travel abroad to receive care.
• Physicians must be licensed in Kuwait to provide written RSOs directly to patients for the purpose of being used for the treatment of the patient in Kuwait. However, there may be exceptions to this if the purpose of the written RSO is for the treatment of the patient outside Kuwait.
• Physician-to-physician services are generally permitted.

Qatar

• Currently, there are no specific laws relating to telemedicine in Qatar. However, in general, foreign doctors who are not licensed and registered in Qatar may not deliver virtual care directly to Qatari patients. However, foreign doctors may be permitted to provide preliminary assistance or follow-up care from outside the country if they advise the patient to seek care locally afterwards. 
• Foreign physicians who are not licensed or registered in Qatar can continue to provide routine follow-up care to established/existing patients (i.e., patients who previously received in-person care from the non-Qatari physician outside Qatar and now have returned to Qatar).
• Foreign doctors who are not licensed or registered in Qatar may engage in a virtual consultation with Qatari doctors, and Qatari patients may be present during such consultations. At the time of publication, written RSOs directed to Qatari patients are not regulated.

Saudi Arabia

• Virtual, cross-border, direct-to-patient telemedicine services remain prohibited. The exception to this is if both the physician is licensed in Saudi Arabia, and a Telemedicine and Telehealth Centre oversees the activity.
• Physician-to-physician services are now permitted. There is no explicit requirement for non-Saudi physicians to be licensed in Saudi Arabia to provide these services. Foreign physicians also can provide peer-to-peer RSOs to Saudi physicians.

UAE

• As a general requirement, all physicians practising in and from the UAE must be licensed by the regulatory authority in the emirate in which they practice. Where the physician is providing the services in and from the UAE, there are no exceptions to this requirement. Physicians providing services from a location outside of the UAE to individuals based in the UAE are not covered by this and as such would not require licensing/registration by UAE authorities.
• Under the Federal Telehealth Regulations, there are “general controls” for the provision of all remote health services and “specific controls” for certain services, including “remote medical consultation.” The definition of “remote medical consultation” includes both peer-to-peer consultations/RSO and physician-to-patient consultations in which the two individuals are not in the same place (this would cover interactive video consults with patients).
• For “remote medical consultation,” specific controls may be imposed by the emirate-level health authorities. These controls cover matters surrounding the types of medical issues for which “remote medical consultation” could be offered.

Looking forward

U.S. providers that offer digital health services to patients and partner organizations located in the GCC should expect countries’ telemedicine laws to continue to mature as time goes on. Future changes could affect how American providers are able to engage with prospective patients who may need to travel to the U.S. for care and how American providers can collaborate with the governmental bodies responsible for administering the treatment abroad programs for those patients. Additionally, future changes to telemedicine laws may affect how international digital health services fit into the broader framework of U.S. providers’ clinical partnerships with both public- and private-sector hospitals across the GCC.  

This article appears in the latest issue of Omnia Health Magazine. Read the full issue online today.

Modern-day medicine relies on solutions that can shape the future of healthcare. Digital medicine’s ability to influence through innovation is making strides in various healthcare avenues, including disease prediction, prevention, diagnosis, treatment, and post-treatment management. For example, for patients who suffer from thyroid disorders, the impact on their day to day lives is significant. Thyroid disorders, which are treatable and frequently curable, are affecting the quality of life of thousands of UAE residents. According to specialists at GluCare Integrated Diabetes Center, one in every 20 persons in the UAE suffers from thyroid disease, the most prevalent of which is Hashimoto’s thyroiditis.

 According to the Dubai Health Authority, hundreds of individuals seek treatment for thyroid issues each month, with 30 per cent of them unaware of their ailment. Many only seek treatment when they are experiencing acute symptoms. Patients with Hashimoto’s disease have a 30 per cent chance of acquiring thyroid cancer, which is the sixth most frequent malignancy and is reportedly expected to become the third most common cancer in women by 2025.

By harnessing digital technology, specialists can provide patients with a new lease on life that breaks away from convention. Digital therapeutics (DTx) and Remote Continuous Data Monitoring (RCDM) are paving the way for specialists at Glucare Integrated Diabetes Center to offer patients unobtrusive forms of treatment options. Round-the-clock attention can be provided to patients through Artificial Intelligence, along with other forms of treatments that can help avoid unwarranted procedures such as thyroidectomies.

Data-driven personalised medicine and the use of DTx and RCDM methods is taking centre stage, with GluCare utilising wearable AI-assisted bands to remotely monitor patient’s response to thyroid medication as a function of heart rate, sleep patterns, skin temperature and weight changes. The clinical-grade band of the wearables is practical and customised, allowing for remote observation of the process of titrating medication, with GluCare specialists routinely communicating with a patient while receiving online updates. The care team, in conjunction with AI, closely monitor the patient and are on standby to respond to any concerns.

In terms of diagnosing thyroid nodules, GluCare uses a method that combines AI with an endocrinologist for a more sensitive and objective approach towards evaluation instead of an examination or ultrasound. The results produce highly accurate thyroid imaging, reducing the need for painful tissue sample testing.

In a discussion with Omnia Health Magazine, Dr.Ihsan Almarzooqi further comments on the integration of digital medicine and how tech-driven methods are empowering physicians and patients at GluCare.

From a patient perspective, what were the most frustrating setbacks you recognised in the stages of diagnosis? Was there a lack in personalised care, and how is innovation supporting positive patient outcomes?

The most frustrating part of the diagnosis is the ‘one size fits all’ approach. There is very little personalised care when it comes to endocrine disorders such as Hashimoto’s, and physicians usually provide  medications based on a set of given rules (weight, gender, etc.). This therapeutic plan is set without the option for any change until the next appointment and does not engage the patient in any way. When we introduce digital therapeutics (DTx) as part of our care model, we are gathering new patient information that has not been collected before, which allows us to monitor and potentially change therapeutic plans remotely without the need to wait until the next appointment.

For physicians, how crucial has digital transformation been in elevating treatments for thyroid patients?

As the first provider globally to introduce digital therapeutics as part of our standard care model, our physicians have vastly more information streaming back from the patient on a minute-by-minute basis. In tandem with artificial intelligence that processes this information into insights, our care team can take action into real-time treatment plans, as opposed to waiting until the next appointment, which could be one year away. In addition, we can change or tweak therapeutic plans continuously with new pieces of information being collected.

Can you tell us about GluCare’s use of DTx and RCDM? How are these innovations benefiting patients and transforming the way physicians work?

The GluCare model introduces DTx and RCDM and fundamentally changes the way chronic or autoimmune diseases, such as Hashimoto’s, are being managed from an episodical, symptomatic approach, which has been practised for the last few decades, to a continuous real-time model of care. Since we are now able to collect large data sets (from IoT devices) that were previously not available, as a provider of care, our responsibility to manage patients does not end when patients leave our facility. Since our care team is connected to patients all the time, physicians are able to manage patients in real-time, and our clinical outcomes, which are vastly better than any traditional provider, prove that. I believe all providers will practise this model of care in the future.

How vital are tech-driven methods, especially AI integrations, in shaping the future of healthcare? Is data derived from these technologies helping healthcare specialists bridge the digital gap?

It is inevitable that providers who do not collect, interpret, and action patients’ data from new data sources will eventually fail to deliver the best outcomes. Every day, more relevant information from patients is becoming available for interpretation. We believe that we are on the verge of a new domain in medicine, which we term as ‘Datalogy’, that will emerge from these vast data sources. ‘Datologists’ will analyse and interpret data and train AI algorithms to provide primary care teams with predictive insights on every patient. We are practising this now and continue to expand on both the number of data sources and algorithms being trained.

If untreated, Hashimoto’s Thyroiditis can be fatal. How can awareness be raised to avoid serious implications?

Get tested. Unfortunately, thyroid screening is not as common as it should be, considering its prevalence rate.

For thyroid patients, is hybrid care becoming the preferred form of treatment? How are these learnings being implemented?

For most thyroid conditions, titration of medication is a key factor to improve outcomes. The balancing act of patient re-visits and dosing is a long, expensive, and frustrating methodology. Using our model, for example, in managing hyperthyroidism, we titrate medication remotely and analyse sleep and heart rate data to get to the optimal dosage without the need to constantly visit a facility. As a result, patients remain engaged and connected to us. The results of this hyper-personalised, data-driven approach that we practise are being showcased globally via transparent reporting of our clinical outcomes.

This article appears in the latest issue of Omnia Health Magazine. Read the full issue online today.

Egypt’s healthcare sector is changing. It may lag behind its neighbours in the MENA region, but it is starting to catch up fast and that presents opportunities for investors. Based on Colliers research, by 2030, Egypt will require approximately 38,000 new beds (based on Egypt’s ratio 1.3 beds / 1,000 population) with an estimated investment of US$8 to 13 billion and up to 120,000 new beds (based on the MENA ratio of 1.9 beds/1,000 population) with an estimated investment of US$25 to 40 billion, with half of these investments coming from the public sector.

Colliers also calculated the investment required to fill this gap based on the current cost of construction with fitouts for a Grade A hospital, which is in the range of US$ 1,500/sqm to US$ 2,000/sqm (average US$1,750/sqm), while the gross area per bed ranges from 90 sqm to 120 sqm (average 115 sqm) with investment in medical fitouts ranging between US$80,000 to US$100,000 per bed (average US$90,000).

Related: Striving for better breast care in Egypt

Moreover, one of the popular products in Egypt is “Doctor’s Clinics”. Also, based on Colliers research, by 2030, Egypt will require approximately two million sqm of medical clinics space with an estimated cost of US$1 billion, providing opportunities for developers to develop and sell the clinics to doctors/investors.

Introduction

Egypt is one of the most populous Arab countries in the world with over 100 million people living within its borders and another 10 million living abroad. With population growth running at a rate of 2.5 per cent per annum, demand for physical and social infrastructure, including healthcare and education services is growing.

Related: Egypt embraces digital transformation

Egypt’s healthcare sector lags MENA both quantitatively and qualitatively, but that needs to change. Rapid reforms are underway. COVID-19 may have put huge pressure on Egypt’s healthcare system, but the pandemic also provided an opportunity to strengthen it with reforms such as the implementation of a Universal Health Insurance (UHI) plan. Nonetheless, the longer-term success of Egypt’s healthcare sector depends on how quickly the market embraces new technologies and innovations, founded on global research and development (R&D) and adopts a data-driven, patient-centric and results-oriented approach to the industry.

The changing population profile:

Based on Colliers estimate, Egypt’s population is expected to grow from its current 101.6 million level to 130 million by 2030 and 175 million by 2050, with the increase set to fuel demand for healthcare services. Total population numbers will drive up overall levels of demand for healthcare, but it will be its composition that determines the type of services provided. Around 75 million (74 per cent) of the population is under the age of 40 and the cohort is expected to increase to 86 million by 2030 and 115 million by 2050.

Concurrently, only 8 per cent of the population is over the age of 60 (approximately 7.7 million), but this age group is expected to increase to 18 million by 2030 and reach 13.8 per cent of the population (around 24 million) by 2050.

Key demand factors

Mother & childcare: Between 2021-2030, approximately 26 million babies will be born in Egypt, creating a huge demand for mother and childcare facilities and services, such as obstetrics, gynaecology, and paediatrics.

Lifestyle diseases: Globally, Egypt has one of the highest prevalences of lifestyle diseases with approximately 15 per cent of the population over the age of 20 with diabetes, 32 per cent with obesity and over 25 per cent suffering from hypertension.

Geriatric care: Population growth in the over 60s will drive demand for geriatric services such as long-term care, rehabilitation, and home care. Presently there are 5.5 million over the age of 65, but this number is expected to increase to 7.7 million by 2030.

Rejuvenation and anti-ageing: Globally, regionally, and domestically, there is increasing demand for services focused on rejuvenation and anti-ageing services such as stem cell therapy and hyperbaric oxygen therapy (HBOT).

Key causes of death in Egypt

Non-communicable diseases, including cardiovascular disease, diabetes, cancer, and chronic respiratory disease, are currently the leading national cause of death in Egypt.

Non-communicable diseases account for approximately 82 per cent of all deaths and 67 per cent of premature deaths.

Lifestyle Diseases

In recent years, the rate of diabetes-related illness has increased dramatically in the MENA region. International Diabetes Federation (IDF) data shows that of the 463 million people with diabetes globally in 2019, MENA contributed 55 million. Estimates suggest that by 2045 diabetic patients in MENA will rise to 108 million. Egypt’s age-adjusted diabetes prevalence rate, at 17.2 per cent among the 20–79-year-olds totalling over 11.9 million, is one of the highest amongst MENA countries and other developed countries.

Another widespread lifestyle disease is obesity. Egypt’s obesity prevalence rate among adults is 32 per cent, which is higher than some developed countries, as well as other countries in MENA.

These trends indicate that the demand for specialities such as endocrinology, nutrition consulting and bariatric surgeries will be on the rise. Research suggests that the demand for Centre of Excellence facilities providing these specialities has been increasing in the region and this trend will be reflected in Egypt.

Implementation of Universal Health Insurance law

The Universal Health Insurance (UHI) plan was launched in 2018 to reform the fragmented healthcare system in Egypt. The comprehensive healthcare insurance scheme will cover all governorates by 2032, with implementation taking place over six phases, each phase focusing on a different geographic area.

In 2018, around 55.6 million of the population was insured. A historical CAGR of 2.7 per cent, suggests that numbers insured by 2020 should reach 58.6 million, but this target is likely to be exceeded given the introduction of the universal health insurance law in 2018.

The emergence of the insurance market will have a significant impact on private healthcare and may also drive, as seen in many other markets, the need for more cost-effective practices and greater efficiencies.

Market Opportunities

A focus on daycare surgery

Constantly developing technology has resulted in improved diagnostics, advancements in new surgical techniques, anaesthesia administration and enhanced postoperative care. These advances have resulted in a significant increase in daycare surgeries across the globe and particularly in the developed world. In Egypt, their prevalence is likely to grow in line with regional benchmarks, such as 32 per cent in the KSA and around 42 per cent in the UAE, offering tremendous opportunities for expansion. A move towards daycare surgeries not only reduces the need for significant capital outlay due to fewer hospital beds required but will improve cost efficiency. Based on a UK study, average daycare costs were £698, compared to the average elective inpatient cost of £3,375. Ongoing growth in the insurance market will also add impetus to the preference for daycare treatment.

A focus on centres of excellence

As a result of urbanisation, and rising life expectancy and disposable income, there has been an increase in chronic/lifestyle diseases such as diabetes, coronary problems, and other obesity-related illnesses. Six specialties now account for over 80 per cent of all surgery. Colliers expects that, like in many other developed nations, Egypt will experience a realignment of treatment through the establishment of specialised Centres of Excellence (CoE), away from family clinics and general hospitals.

Long Term Care/Rehabilitation

One of the biggest changes in Egypt’s population profile is an increase in life expectancy. This has increased from 46.8 years for males and 49.3 years for females in 1960 to 69.8 years and 72.6 years for males and females respectively in 2020. Life expectancy is predicted to continue rising and could reach 75 years for males and 79.3 years for females by 2050.

Egypt’s over-65s in 1960 totalled just a tad more than 1 million, but by 2020 there were roughly 5 million in that age bracket and by 2050 there could be almost 16 million.

Egypt currently requires around 19,000 dedicated Long-Term Care (LTC) beds to cope with elderly patients. By 2050, it is likely to need almost 62,000.

Primary Care

Owing to Egypt’s large population and high hospital occupancy rates, the country will require more primary care clinics and medical centres to meet the demands of a rising population.

Laboratory and Diagnostic Centres

There is a need for more standalone laboratories and diagnostic centres in Egypt to support the increasing volume of outpatient facilities.

Increasing demand for qualified and specialised Human Resources

Key, yet often ignored, a prerequisite for the provision of quality healthcare services is the availability of human capital. Without qualified, specialised human resources, even the best medical facilities using the most advanced medical equipment are not efficient. By 2030, an additional 88,000 doctors will be required, 73,000 extra nurses and 18,000 pharmacists.

Furthermore, to improve healthcare service provision in Egypt, the country needs to adopt new medical technologies, and that will need advanced medical education for specialised doctors, registered nurses and AHPs in the fields of artificial intelligence, data analytics, robotic medical sciences, and genome sequencing.

Medical Tourism

Egypt has earned a strong regional reputation for having quality doctors and infrastructure at a competitive price. Easier visa access than some of its regional competitors also supports business.

These factors have helped Egypt become a regional medical tourism hub, attracting tourists mainly from North, East, and West Africa & GCC. This traffic helps increase the utilisation rates of existing healthcare facilities.

Beauty & Cosmetic

Higher-income levels and aesthetical awareness have resulted in increased demand for beauty and cosmetic treatments, such as body contouring, anti-ageing, lipoplasty (liposuction), eyelid surgery, breast implants, rhinoplasty, facelifts, botox, medical spas, and hair transplants. In response to demand, a large number of beauty and cosmetic centres have emerged in upscale areas of Cairo and elsewhere.

Health driven wellness resorts/second home developments

One attraction of Egyptian property is as a hedge against inflation. The recent devaluation and currency fluctuations have seen residential prices rise by approximately 20 per cent (in EGP terms) year-on-year; a trend supported by a lack of supply in the residential market.

Alongside primary accommodation, the second tier of property interest has emerged over the last decade with holiday or vacation homes becoming a popular investment and lifestyle choice. Demand in this sector will remain underpinned by the volume of products and choices available to consumers, both in terms of location and price points.

Sustaining high occupancy levels all year round in second homes can be challenging. Colliers has seen these challenges being addressed through the introduction of healthcare and wellness-driven resorts, long-term care, and rehabilitation facilities.

These facilities have a positive impact on occupancy rates by attracting not only vacationers but retired households and those seeking longer holidays within proximity to healthcare facilities.

Seasonality is one factor behind demand levels but ‘pull factors’, such as proximity of hospitals, clinics, long-term rehabilitation centres, wellness retreats, fitness/skill retreats and retirement homes, also contribute to the equation.

Healthcare/medical cities and parks

Regionally, and in Egypt specifically, there is a new trend in developing healthcare/medical-driven mixed-use developments, known as “Healthcare Cities/Parks” or “Medical Cities/Parks”. These are a combination of retail, residential, commercial and hospitality developments working together to form a desirable destination.

Conclusion

Egypt’s healthcare sector, particularly the private healthcare sector, offers several lucrative opportunities for developers, investors and operators. However, it also possesses several challenges, such as high costs of capital and a brain-drain of qualified doctors and paramedical staff, typical to the GCC countries.

One of the key drivers is the increase in population. As a result of the increased population, Egypt will require approximately 38,000 new beds (based on Egypt’s ratio of 1.3 beds / 1,000 population) with an estimated investment of US$8 – 13 billion and up to 120,000 new beds (based on MENA ratio of 1.9 beds / 1,000 population) with an estimated investment of US$25-40 billion dollars, with half of these investments coming from the public sector.

One of the key challenges to establishing and operating additional beds will be qualified staff. Our analysis identified an additional 88,000 doctors, 73,000 nurses and 18,000 pharmacists will be needed to serve the additional demand by 2030, suggesting an increase in demand for medical education institutions.

In addition, Egypt and the African region is expected to follow the footsteps of Dubai and other established healthcare centres to promote and attract medical and wellness tourism by offering high-quality, patient-centred healthcare services at affordable prices. Greater Cairo is expected to establish itself as a medical tourism hub focusing on developing centres of excellence for cardiovascular, cancer, neurology, liver, pancreas, pulmonology, urology, nephrology, gastroenterology, obstetrics and gynaecology, paediatric care, and other complex treatments.

North Coast and other coastal developments can be established as health and wellness hubs by offering beauty and cosmetic, health farms and rehabilitation services.

Egypt is also expected to develop integrated health cities providing a wide range of services relating to healthcare, pharmaceuticals, medical education and research, medical equipment, wellness and allied services, which is expected to contribute to Egypt’s GDP and create jobs.

As many emerging markets face uncertain prospects and economic pressures as a result of the global pandemic, Egypt which requires a large investment in the healthcare sector will have to focus on PPPs and privatisation to raise the funds required to fulfil the demand gap.

PPP and privatisation are expected to bring in much needed new technologies, an improvement in operational efficiencies and international linkages with key healthcare providers from Europe, U.S., and Asia.

Mansoor Ahmed

This article appears in the latest issue of Omnia Health Magazine. Read the full issue online today.

We often hear stories today about how wearables are actually saving lives and can even help diagnose COVID-19. For instance, recently, Apple Watch’s ECG and fall detection features reportedly helped save a 70-year-old man’s life by alerting authorities about his fainting spell. But are these devices really that effective? Let’s find out!

Today, many people around the world are using wearables for several different reasons. Devices like the Apple Watch are connected to our smartphones and record some of our vitals continuously, something which has been a significant missing link in healthcare till now, highlighted Dr Zakiuddin Ahmed. A visionary strategist, healthcare entrepreneur, physician leader, coach & invited speaker who specialises in developing socially beneficial and innovative solutions in healthcare through information technology, Dr Ahmed has been working in the digital health space for over two decades.

In a conversation with Omnia Health Magazine, he said: “A device that provides continuum, which means that people can have access to their heart rate over a period of time, is a beneficial tool for monitoring health.”

For instance, a patient’s blood pressure is recorded only when they visit the doctor, which might be once every two or three months or even longer. Unfortunately, this doesn’t provide enough information for healthcare professionals to make informed decisions.

One of the primary use of wearables today is the ability to track exercise and monitor step count. The Apple Watch on top of this has important and life-saving health features that give patients the ability to monitor certain health metrics from the convenience of their wrist. Patients also have the ability to share those metrics with their physicians giving health specialists a better window into their health’s condition and helping them make more informed decisions.

Dr Ahmed said that chronic disease burdens such as diabetes and heart disease are some of the leading causes of death, and these have doubled in the last few years. So, having an Apple Watch reminding you to walk, stand up every 15 minutes, and regularly move your body is extremely important. “You can’t treasure what you can’t measure. So, measuring something provides the opportunity to treasure the information and then put it to use. Wearables have also helped create a shift and started creating more empowered patients.”

An empowered patient is someone who is informed and has education or information about their own disease condition or wellness. They are involved in the process of decision making and take responsibility for responding to the information. So, any device, which monitors different vitals and provides information to the consumer, is facilitating this shift of creating an empowered patient.

This empowered patient phenomenon has been taken to a whole new level with the Apple Watch series. The device series 4 and onwards comes with an electrocardiogram (ECG) feature. Sensors included in the watch can measure heart rhythm and electrical activity. The device has four LED clusters, which allow ECG and SpO2 measurements. In addition, the digital crown on the right side of the watch doubles up as a sensor for the ECG feature.

The ECG on the watch is not a 12 lead or a six lead one. But the benefit of having such a device on your wrist is that it gives you information about arrhythmias, for instance. “There is great value in having a continuum of the heart rhythm monitored and recorded. Arrhythmias alone kill millions of people in the world. Even with if one or two leads in the device, it gives you enough information to monitor the rhythm of your heart and could potentially save one from atrial fibrillation,” emphasised Dr Ahmed.

The advantage here, he stressed, is that having a device such as an Apple Watch that not only monitors your rhythm but also provides connectivity between the patient and the physician and makes a difference in the treatment involved in keeping that person healthy.

Apple Watch Series 6 or later also comes with a blood oxygen sensor to monitor heart and respiratory health. The results are displayed on the health app on the iPhone. Low blood oxygen levels have been linked to COVID-19 because it affects the ability to get enough oxygen. And if you are wearing a device, which continuously monitors your health, that could potentially help doctors determine the severity of the disease. The health sensor shines infrared lights to calculate the colour of a person’s blood, which indicates blood-oxygen level, in 15 seconds. It also captures periodic background readings and stores them while the person sleeps.

“However, the devices cannot diagnose COVID-19; that’s false. These measurements are not intended for medical use and are designed for general fitness and wellness purposes,” he added.

One of the most interesting features that I found in my experience of using the Apple Watch Series 6 was the hand wash feature, which is so crucial for the time we live in! The microphones and motion sensors of the watch are able to detect handwashing motions automatically. The mode lasts for 20 seconds. If you finish earlier than that, the screen prompts you to keep washing your hands. Another great feature is the sleep tracker that allowed me to establish a regular bedtime routine.

Dr Ahmed concluded by saying that behaviour change is fundamental in healthcare. Physicians also need to change their behaviour, as it is one of the significant barriers to technology adoption. “It is imperative that we educate physicians. There needs to be enough evidence and data, which shows that the patients who wear these devices change their behaviour for the better, and they are becoming more empowered patients. So, there is a need to create this link and show physicians the proof of concepts.” 

This article appears in the latest issue of Omnia Health Magazine. Read the full issue online today.

The last one and a half year, driven by the ongoing COVID-19 pandemic and its implications, has made people realise that they can’t predict health emergencies. The only option left is to become more cautious and aware about securing their lives with an appropriate health cover policy. In the UAE, compulsory health insurance was introduced a few years back. Expats must be aware that in case they have a history of any illness/medical condition, they are advised to combat the disease with a proper and timely check-up without any delay. Not to forget, while buying individual health insurance, expats should tell the truth, give accurate information, and make sure to read the proposal form holding all the terms and conditions of the policy. Make it a thumb rule – when in doubt, do disclose!

A few months ago, a 40-year-old person was advised knee surgery. He applied for a claim against his health cover to his insurer. In addition to the employer-provided health insurance, he also had private health insurance. There were no claims on the cover in the last three years. While assessing the claim, the insurer found a doctor’s note stating that this person had an accident four years ago and had undergone minor surgery. This was not disclosed by the person while purchasing the health cover. The insurance company rejected the claim on the grounds of non-disclosure of pre-existing medical conditions.

Related: Welcoming the digital shift in healthcare insurance

The burden of lifestyle-related disease in the UAE is higher, but the care provided is undoubtedly the best. That’s why health insurance plays a massive role in providing a high level of care and treatment, which is necessary for expats living in Dubai. False information constitutes a breach of trust, as the insurer relies on the individual to provide true information. Expats must reveal and read all details asked in the application form for a smooth claim settlement. The reason behind laying more emphasis on reading the policy document is because the declarations in the proposal form are the basis on which the insurance companies underwrite policies, assess the risk, and calculate the premium to cover that risk.

Here are a few essential things you must know before buying an individual health insurance policy if you suffer from a pre-existing or chronic condition:

Related: COVID-19’s impact on health insurance trends

Complete Disclosure: Health insurance companies consider the full medical history while pricing the policy. All medical conditions, medicines taken, hospital stays, surgeries, test reports, current treatment plans are always relevant to the insurer. Sharing this information safeguards the policy buyers from denial of claims.

We highly recommend members to pay a visit to their treating doctors to get complete medical history with the above-requested information and any future treatment plans, if any, to be covered in the report. We also request members to be forthcoming in sharing every report and medical information and let the insurance company decide the relevance of it than the policy buyer themselves.

Premium Determination: If a policy buyer has a pre-existing disease or chronic condition, then the policy premium would be slightly higher than otherwise. However, one must not hide their illness due to the fear of high premiums, as not disclosing might lead to claim rejection later. Also, this premium keeps on reducing later with time when the policy is renewed continuously over the years, and conditions are controlled.

Thus, it is recommended to always disclose crucial information about pre-existing ailments before taking a health insurance policy. This will ensure complete transparency for the individual and the insurer, reducing the possibilities of claim denials and/or policy cancellations.

Neeraj Gupta

This article appears in the latest issue of Omnia Health Magazine. Read the full issue online today.

According to the World Health Organisation, the global average life expectancy increased by more than six years between 2000 and 2019 while the population grew by more than one billion. This, combined with rising cases of health conditions associated with diabetes and obesity, are putting healthcare systems under pressure to treat an increasing population suffering with sustained illnesses.

Medical professionals must often choose between curing a patient of a condition or simply managing it over time to ensure they can live the best life possible. Many treatment plans are designed to monitor people’s illnesses, not necessarily cure them. This ‘maintenance approach’ means patients require ongoing treatment from their healthcare provider, which is more costly and time-consuming than curing a condition. For medical conditions which are difficult to cure, such as diabetes and chronic wounds, the situation is more complex.

Frequent care leads to higher costs

In the case of chronic wounds such as leg and foot ulcers, the wound will need cleaning and redressing sometimes as often as three times a week to avoid infection. Wounds can take months to close, if they even heal at all, requiring a lot of time and resources from medical staff. Treating the wound over time, however long that is, can, therefore, cost a lot of money.

According to a 2006 report by the Wound Healing Society, chronic wounds – including pressure ulcers, diabetic ulcers, venous ulcers, and arterial insufficiency ulcers – are becoming more frequent as the global population is living longer. Venous leg ulcers (VLU) alone are estimated to affect up to 3 per cent of the global adult population.

As the modern world becomes more populated, and as conditions such as diabetes and obesity are rising, cases of chronic wounds are expected to increase further. Healthcare systems will, therefore, need to dedicate more time and resources towards wound treatment; however, this will increase the costs associated with treating these patients.

Wound treatment already costs global healthcare systems billions each year: treating VLU costs the U.S. approximately US$3 billion while treating leg ulcers in the UK costs the NHS £1.94 billion. These costs are largely attributable to nurse visits and the bandages and dressing needed for treatment.

Until recently, the ‘maintenance approach’ has been widely adopted for treating chronic wounds. However, medical technology (MedTech) is introducing new methods of treatment, which are making healthcare systems more efficient and cost-effective.

Improving costs and patient care

Medical devices are allowing new methods of treatment to be implemented into healthcare systems around the world, particularly in the treatment for chronic illnesses such as leg ulcers and diabetes. MedTech is working alongside, and in some cases instead of, traditional methods of treatment. Such devices are speeding up in patient recovery times, reducing the need for ongoing treatment and, crucially, decreasing costs for patients. This new breed of technology can also provide a permanent treatment to chronic medical conditions, rather than solely maintain a patient’s wellbeing over time.

Integrating new devices within healthcare systems is not an easy process. It can take decades of consistent work and requires a lot of money, clinical data, regulatory approval and backing from clinicians within the system. MedTech devices are also required to meet regulatory approval before they can be implemented into healthcare systems; the U.S. Food and Drug Administration (FDA) and the UK National Institute for Health and Care Excellence (NICE) are two of the world’s leading regulation services and help to set standards for healthcare across the globe.

MedTech devices, such as Sky Medical Technology’s geko device, can be used in the treatment of leg ulcers. Clinical data has found that increasing blood flow to the wound surface, thereby enhancing oxygen and nutrient delivery, ulcers can eventually be cured rather that treated and monitored over time. Sky Medical Technology’s wearable geko device sits behind a patient’s knee and sends short, painless electrical pulses down the leg to promote blood flow equal to 60 per cent of walking. This in turn increases circulation, reduces swelling, and accelerates wound healing allowing the wounds to close in a matter of weeks as opposed to months or not at all.

Now approved and regulated devices are being implemented by forward-thinking clinicians to treat conditions such as leg ulcers, significantly reducing the financial and staffing strains on healthcare systems all while improving patient outcomes.

Implementing devices into evolving healthcare systems

The challenges that drivers of MedTech innovation now face involve finding ways to reward innovation and risk without tearing up what already exists: how can we adopt new and improved solutions into existing treatment plans without causing harm, wasting time, or losing money?

The vast differences in healthcare systems around the world make this particularly complicated, especially in terms of costs. Healthcare payments vary depending on the type of treatment a patient needs, how long treatment can take, whether the patient can access public or private healthcare, and in some cases whether the patient is a native or an expatriate.

Many healthcare systems across the world, including the U.S. and parts of the Middle East, have traditionally operated under a “fee for service” payment scheme. This means each healthcare provider gets paid separately for each service they provided. For instance, if a nurse attended a patient’s home to redress a wound, that is one cost; if a patient needed a specialist assessment, that would be another, separate cost.

Under this model, healthcare providers get paid regardless of whether the service leads to a positive patient outcome, including for treating a leg ulcer over time that does not ever heal. For the growing number of patients suffering with chronic conditions who require long-term care, especially wound care, this can result in extensive bills.

However, many of these healthcare systems are shifting towards a “fee for quality” or episode-based approach. Under these systems, patients will pay for the quality of care they receive irrespective of how long and how often treatment is needed. Healthcare systems can predetermine the best products and approaches for treatment based on medical evidence, enabling patients to access the best quality and most cost-effective care, making it fairer and more effective for both providers and patients.

This should – in theory – help to ease the pressure of treating an increasing number of individuals with chronic illnesses. The sooner patients can be treated and cured, more patient beds will be available, fewer nurse visits will be required and less resources will be needed.

Better healthcare for all

A less expensive, more efficient treatment plan for patients will allow healthcare systems to provide the best care possible – seeking to adopt medical innovation with the aim of curing a patient’s illness as quickly and effectively as possible.

MedTech is uniquely placed to bring about positive change across global healthcare systems. Instead of trying to ensure adoption of new innovations within the confines of the previous system, healthcare systems are changing to actively foster adoption. This shift will not only enable more investment in development of new technologies, but in turn will help lessen the pressure on the entire healthcare operation – creating a brighter, more effective, and affordable system for all.

Andrew Thelwell

This article appears in the latest issue of Omnia Health Magazine. Read the full issue online today.

Cases of renal disease are on the rise, with close to 10 per cent of the world’s population suffering from kidney disease, or over 700 million people worldwide. This is a 30 per cent rise since 1990 and disproportionally affects countries in the Middle East, the Subcontinent and China. India and China alone have more than 100 million people with kidney disease each, which poses a major health challenge for these countries as their population ages.

In addition, renal disease management has become a substantial economic burden even in industrialised countries. For example, in the U.S., there are 750 K Medicare members with end-stage renal disease, i.e., 1 per cent of the Medicare population costs US$42 billion per year representing close to 10 per cent of the Medicare budget. Also, the Advancing American Kidney Health initiative launch in 2020 was partly to control the burgeoning costs of managing renal disease.

Dr Siddiq Anwar, a Consultant Physician in Sheikh Shakhbout Medical City and a Clinical Associate Professor of Medicine at Khalifa University, spearheaded the digitisation of renal care in SEHA, which has the biggest end-stage renal disease programme in the UAE. He is keen on using data-driven decision making in healthcare and process optimisation to improve overall healthcare outcomes. One of his research interests is to prevent Acute Kidney Injury (AKI) using AI solutions.

Dr Siddiq Anwar

He firmly believes there is a pressing need for a paradigm shift in nephrology where “we need to pivot away from dialysis and dedicate our energies on prevention.”

He further adds that Automation, Machine Learning (ML) and Artificial Intelligence (AI) can bridge the existing gap and help free limited trained human resources in nephrology to focus on preventing renal disease. The technology can also bring high-quality renal care to areas with a limited qualified workforce to help manage patients with renal disease.

Dr Anwar is a member of the International Society of Nephrology (ISN) multiple sub-committees including the Middle East Regional Board. The ISN is a global professional association dedicated to advancing kidney health worldwide through education, grants, research, and advocacy. He is part of some of the global initiatives led by ISN to upskill healthcare providers in regions with insufficient specialists to look after the tsunami of renal disease straining their healthcare facilities. Moreover, ISN’s primary focus is to reduce preventable AKI deaths, an effort that requires a lot of trained human resources.

To this end, he is collaborating with Dr Mohammad Yaqub, Assistant Professor at the Mohamed bin Zayed University of Artificial Intelligence (MBZUAI), Dr Mecit Can Emre Simsekler, Assistant Professor in Khalifa University and his research student Himanshu Upadhyay. They have developed a platform called RenAIssance that uses ML and AI to help detect, diagnose, and aid the management of AKI.

Dr Mohammad Yaqub

RenAIssance was selected by Ericsson and the UAE Ministry of Economy at a recent hackathon to help develop solutions that can tackle global problems using the latest technology.

The team aims to disrupt the current model of care, which is very expensive and requires a lot of specialist human and material resources. The project will integrate medical IoT devices and 5G technology innovations with its cloud-based, medical IP-rich AI platform to diagnose and manage AKI. As a result, RenAIssance has the potential to improve patient healthcare outcomes by bringing augmented intelligence to aid medical decision making.

Dr Yaqub adds: “RenAIssance’s mission is to help improve and simplify renal care by harnessing state-of-the-art AI algorithms and best clinical practices”.

Dr Yaqub has extensive AI research and development experience in various healthcare applications, including foetal ultrasound image analysis, echocardiography, and brain MRI assessment. In addition, he brings more than six years of international industry experience in developing AI-driven solutions to medical imaging problems. Some of his projects are licensed to different companies, including GE Healthcare (now in Voluson Swift machine). He is currently the head of the BioMedIA group at MBZUAI and a visiting fellow at the Department of Clinical Neurosciences at the University of Oxford. On top of solving various challenging healthcare problems using AI, his vision is to make healthcare affordable and easily accessible to all.

Dr Simsekler says: “Leveraging systems thinking principles and AI algorithms, RenAIssance offers a patient-centred solution to improve healthcare outcomes, including patient safety, high-quality renal care and patient experience”.

Dr Simsekler’s research spans healthcare analytics and management to improve operational and safety outcomes and accelerate risk-based decision-making. He explores innovative approaches to help healthcare organisations transform their operations strategy, risk management policy and organisational culture. His research has been published in leading medical and engineering management journals, including high-ranked outputs. Beyond scientific contribution, Dr Simsekler’s vision is to make healthcare safer.

Dr Mecit Can Emre Simsekler

Currently, Dr Simsekler is an Assistant Professor at the Industrial and Systems Engineering Department at Khalifa University, Abu Dhabi, UAE’s top-ranked university. He is also part of the Research Center for Digital Supply Chain and Operations Management at the university. Further, he has active visiting affiliations at Boston Children’s Hospital (Harvard Medical School Teaching Hospital) and Cleveland Clinic Abu Dhabi and honorary researcher affiliation at UCL School of Management.

For research student Himanshu Upadhyay, a Machine Learning Engineer from the Indian Institute of Technology – Delhi, “RenAIssance is a model for the future. It dwells on the idea of using data analytics and AI for better and affordable healthcare.”

Himanshu Upadhay

Upadhyay’s work has been primarily focused on leveraging technology to solve business problems. He was involved in the Future of Work research funded by the Research Center for Digital Supply Chain and Operations Management at Khalifa University. He is an alumnus of the Harvard Crossroads Emerging Leaders Programme and has been working simultaneously on multiple healthcare start-ups involving genomic medicine and Electronic Health Records. He is also currently a part of the UAE National Program for Artificial Intelligence in collaboration with Facebook. He also has prior experience working at a US-based banking giant, Citi. His work mainly revolves around the use of futuristic technologies in different business domains. He is a firm believer in the positive impact of these future technologies on our lives.

The RenAIssance team believes academia and industry collaboration is vital to help develop scalable solutions to tackle various healthcare challenges faced by an ageing population and limited trained workforce.

They believe there is an emerging medical R&D cluster in Abu Dhabi and UAE with the establishment of universities such as Khalifa University, MBZUAI and the entrance of Mayo Clinic, a leader in AI for health, into the healthcare scene in Abu Dhabi.

These prudent investments have allowed team members from diverse backgrounds to coalesce around an innovative project in Abu Dhabi. Moreover, the establishment of Sheikh Shakhbout Medical City, one of the UAE’s largest hospitals for serious and complex care and a joint-venture partnership between Mayo Clinic and Abu Dhabi Health Services Company (SEHA), will allow many more such academic projects to foster innovative healthcare solutions not just for UAE residents but other countries in the region as well.

Hackathons such as “Together Apart Hackathon” organised by Ericsson with the support of UAE’s Ministry of Economy helps showcase emerging talent. This demonstrates the country’s leadership vision of transforming the country into a knowledge-based economic powerhouse.

The RenAIssance team is looking forward to showcasing their platform at Expo 2020 Dubai and meeting industry leaders to discuss how they can collaborate to help the millions of people who suffer from kidney disease across the world.

This article appears in the latest issue of Omnia Health Magazine. Read the full issue online today.

Patient safety and quality care have remained top priorities for healthcare experts at Abu Dhabi’s The Corniche Women’s and Newborn Hospital during the pandemic.

Speaking at the “Pandemic’s effect on non-Covid care and treatment, The Corniche Women’s and Newborn Hospital Experience” session on November 6 at the three-day Patient Safety Virtual 2021 conference, an official said that regardless of difficulties the pandemic brought, healthcare staff remained focus on providing quality care.

Jane Kelly, Quality Director; Quality and Patient Safety said: “Patient safety always comes first. As quality experts, we make sure that things are not slipping for our non-Covid patients because we are so focused on Covid patients.” 

On March 3, 2020, Abu Dhabi Health Services (SEHA) issued a Code Delta as the pandemic became very real in Abu Dhabi. On April 8, a Covid-confirmed woman gave birth to a baby at the hospital and on the same day, another Covid positive baby was born.

“Since we have to talk about the pandemic’s effect on non-Covid processes, we need to get into context which was business as usual at the hospital but nothing was usual.” 

The hospital established safe and effective services for all Covid positive patients whilst maintaining a seamless service for non-Covid patients who continued to grow throughout 2020-21. In April and May 2020, the hospital put a temporary pause on gynaecology elective surgeries even as women needed care. 

“It was an emotionally charged journey but business needed to continue. We had High Dependency Unit and Intensive Care Unit admission rates with really sick women.”

In 2020, the hospital saw 5,640 deliveries, 94,238 out-patient visits, 1,058 Neonatal Intensive Care Units (NICU) admissions and 19,651 urgent care visits.

Acuity and demographics of patients changed considerably during the pandemic. In 2020, there were under 1,000 Covid cases but 2021 hit harder. However, by the end of August 2021, cases went down. Some stillbirths and maternal deaths took place in the UAE as numbers increased across the globe during the second wave in 2020. 

Staffing levels and workload was affected as the hospital was designated in Abu Dhabi region for Covid positive pregnant women. The hospital has a huge number of workforce from India who were also impacted when the second wave hit their families back home. 

Though the Covid numbers grew exponentially, processes at the hospital expanded as well. 

“As we progressed into the pandemic, we were better able to manage our Covid positive and non-Covid patients by establishing zones,” said Kelly. Green Zone was set up for non-Covid patients, Amber Zone for those waiting for Covid results and Red Zone for Covid positive or high risk patients.  

Pathways were developed for newborn babies as well as elective OBs/Gyne and emergency cases and were constantly reviewed and updated. An admission screening procedure was introduced for patient safety while a Personal Protective Equipment table ensured that staff was kept safe at all times.

“The psychological impact of the virus was huge and we knew we had to keep our staff mentally well to continue to care for our patients and for this our senior executive team was available to answer their queries.”

Focus was also on setting up quality improvement projects and establishing a Covid assessment centre in February that saw 2,596 encounters until August. Waiting times at the emergency registration were fine-tuned while flexibility and imagination was applied in making space for patients.

“We know that the best way to keep our patients safe is show evidence-based care; for this we keep our policies and guidelines up to date,” concluded Kelly.

Since our Voice of the Healthcare Industry Market Outlook report in December 2019, the COVID-19 pandemic has affected every single member of the healthcare community, both personally and professionally – and at every level of the supply chain, from manufacture to bedside care.

Through this year's survey, we asked healthcare respondents worldwide about the impact of the events of 2020-21, including technological, financial and healthcare delivery. 

Manufacters, agents, dealers and distributors

Among the manufacturer, agents, dealers, and distributors sector, two thirds of respondents reported that they are now looking to expand the range of products they offer within their current market (66%) over entering new markets with the same product range (29%) or other strategies (5%). This is particularly true for companies with an export rate of below 50%.

Of the companies surveyed with a higher export rate (more than 50%), however, almost half see entering new markets as their strategy for growth. In Africa and the GCC, the strategy of expanding product range within current markets is even more prominent, at 75% and 77% respectively. Trade exhibitions were identified by this sector (and particularly manufacturers) as the main focus for driving new leads at 51%, over social marketing, email marketing, content marketing, digital advertising, society events, digital directories or print advertising.

However, the importance of trade exhibitions has reduced slightly from 59% in December 2019. Email marketing in particular has seen a high increase in focus, from 25% in December 2019 to 34% in May 2021.

Content marketing, social media, digital advertising, and digital directories have also seen an increase in focus, while society events and print advertising have dropped in focus slightly for driving new leads.

Trade exhibitions are particularly important for companies with higher export rates. This lead generation activity is especially important to manufacturers, agents, dealers and distributors based in Europe, with 69% of respondents choosing this over other activities.

Interestingly, the GCC region places more importance on digital directories than other regions at 27% – high above social media (15%), digital advertising (15%), society events (12%) and print advertising (19%).

Clinics & medical practices, private hospitals & public hospitals

When asked about the most important factor in ensuring a satisfactory patient experience, opinion came down firmly on understanding the patient’s needs. 45% chose this over other aspects, representing an increase from 39% in 2019.

These healthcare providers were also asked about attracting patients by location. The trend is clearly towards attracting local patients, with three quarters of the respondents stating they were very or extremely interested.

This compares to 54-58% that responded with the same levels of interest in attracting international patients from neighbouring countries or other regions.

Government/healthcare regulators

When asked about the strategies deployed in response to the pandemic, the most prominent activity carried out by governments and healthcare regulators has been a nationwide vaccination programme, followed by quarantine measures, PCR testing, mask wearing and contact tracing technology.

Only 33% placed restrictions on domestic travel, and even fewer made border closures or carried out sterilisation of streets and public spaces.

About the report

The Voice of the Healthcare Industry Market Outlook 2021 survey was designed by Informa Markets to understand the impact that the pandemic has had on four key areas of the industry: manufacturers and agents, dealers and distributors; clinics and medical practices; private hospitals and public hospitals; government and health regulators; and charities, non-profits and NGOs.

Through GRS Research & Strategy Middle East we asked 1,600 respondents worldwide about the financial and operational impact of the events brought by the pandemic.

The survey also looked to assess how the industry has responded to the pandemic, and how key players have evolved their business strategy. We also asked participants to reflect on how the future will look, and what key trends they are now anticipating. 

Download the full report for free

Click here to download the Voice of the Healthcare Industry Market Outlook 2021

There has been an exponential growth in the use of Healthcare Information Technology (HIT) in healthcare systems over the past decade.

Speaking at the session titled “Patient safety impact of Health Information Technology (HIT) on patient safety” on the second day of the three-day Patient Safety Virtual 2021 conference that started on Thursday, Eric Woo, Regional Director, Asia Pacific Regional Office, ECRI Institute said, “A World Health Organisation (WHO) survey found in a study done between 2010–2015 in 96 countries that there was a huge spike in the adoption of health IT in healthcare systems.

“Of this, 50 per cent was from high income nations and 60 per cent from upper middle income countries.”

The idea of getting IT involved in the healthcare delivery system today is primarily driven by clinical and operational efficiency and effectiveness in terms of care especially for patient monitoring. 

The study also showed that the growth was driven by funding, ecosystem, infrastructure, policies, legal framework and people and processes, he said.

The key points on how IT today is contributing to our healthcare systems include improved and effective communication, reduction in medical errors, improvement in safety, quality and efficiency as well as adherence to clinical and operation guidelines.

However, even though IT continues to play a vital role in health communications, there are some apprehensions. “In the works and projects we do in systems in various countries in Asia Pacific, we found that there were some challenges and considerations in the health system itself,” said Dr Woo.

He said that there is a need for a comprehensive team for interoperability as well as adequate resources. “The workflow has to be understood while designing a system. There are challenges trying to match the workflow with the system itself, especially the frontline process where data is all processed.”

Additional challenges include interoperability, usability, availability of system and information as well as the confidentiality and integrity process.

International experiences in HIT showed incident trends such as medication errors, patient identification errors, laboratory related errors, blood transfusion and more which were mainly due to contributing factors including data input, transfer and output mainly due to data quality, system interoperability, as well as people and processes.

Dr Woo said that among the interoperability challenges highlighted by studies include having an integrated system design which limits the effort to improve the workflow and also hinders the model of care as well.

Another international challenge that hinders HIT interoperability is cybersecurity. “During the pandemic, the number of hackers trying to hack the hospital system to get data from the hospital staff and hold the hospital ransom increased,” said Dr Woo.

Presenting recommendations, Dr Woo said that it was important that healthcare facilities have a monitoring programme after the implementation of the system to create a continuous feedback approach. 

“This is meant to identify risks and potential risks associated with system failure and the system itself.”

Medical devices today are managed by undertaking risk assessments as soon as possible. “Today, technology is managed from a technological perspective such as availability of technical parts for better integration. We see a lot of insufficient consideration of risk particularly in different generations of devices that have impacted people and processes.” 

Medical device risks also need to be identified. “We see electronic medical records with lack of customisation and standardisation that are not tested enough, workflow issues, cybersecurity risks, interface design issues, network failures in medical devices,” he added.

HIT has contributed to success in better health outcomes. However, the risks associated persist and adopting new technology can also bring potential new risks. 

It is also important to identify risks associated with integrating medical technologies. A robust plan, a committed resource, comprehensive understanding on current people and processes as well as technological factors is important, he concluded.