Reducing hospital readmissions is a key goal of healthcare policymakers. Those readmissions that result from poor inpatient or outpatient care are specific targets, as eliminating them can not only lower healthcare costs but also drive improvements in care and patient satisfaction.

Although hospital readmissions are frequently considered a key indicator of the quality of care, they also speak volumes about the organisation and administration of hospitals, and of communication between medical providers and patients.

Related: Improving hospital operations and patient experience through digital transformation

 

Securing transitions of the right kind

To reduce hospital readmissions, healthcare providers must master the transition process following patient discharge.

Related: How clinical communication and collaboration platforms can ease information overload – and deliver better patient outcomes

Indeed, one study of transitional care processes in the US found that healthcare providers that made use of more recommended care transition processes had lower readmission rates. It further noted that healthcare institutions with dedicated case managers working on transitions boasted significantly better outcomes.

Many healthcare providers are turning to admission, discharge, and transfer (ADT) data to improve the transition period. These real-time insights help providers understand what is happening to a patient when they are admitted to a hospital, discharged, or transferred from inpatient to outpatient care, giving providers the opportunity to provide interventions when and where they are needed.

 

Identifying risks involved with predictive analytics

Data has several important uses. Using data and predictive analytics can help healthcare providers identify risk factors for readmissions.

By analysing population health trends, hospitals can understand common risk factors for readmission and compare them against patient health records. In doing so, they can quickly identify individuals at risk of readmission and intervene appropriately.

Among these risk factors are specific diagnoses, co-morbidities, emotional and personal issues, mental health, age, medications, history of readmissions, financial issues and deficient living conditions.

 

Communication between hospital and patients is essential

At the heart of this is communication: hospitals should conduct follow-up calls with patients, not just to assess the patient’s condition, but also to ensure they are taking their medication. One study on hospitalisations in the US found that between 33 per cent and 69 per cent of admissions are attributed to medication non-adherence.

Communication between hospital and the patient may not even require a call. Researchers from the University of Pennsylvania studied the use of an automated text message programme, finding a 41 per cent reduction in the odds of readmission within 30 days. The team even discovered that the text messaging programme had a higher rate of patient engagement than a post-discharge follow-up phone call, in addition to saving hospital staff time.

Ultimately, it is important that patients have their post-discharge instructions and responsibilities adequately explained to them. If communication is poor, patients may forget or misunderstand the direction they have been given, raising levels of risk and increasing the chance of readmissions.

<< Back to Management

A new study has found that middle-aged people who experience frequent bad dreams are more likely to be diagnosed with dementia later in life.

The research done at the University of Birmingham and published in The Lancet journal, eClinicalMedicine, suggests nightmares may become prevalent several years or even decades before the characteristic memory and thinking problems of dementia set in.

Neurodegenerative diseases triggered by nightmares

“We have demonstrated for the first time that distressing dreams, or nightmares, can be linked to dementia risk and cognitive decline among healthy adults in the general population,” said Dr. Abidemi Otaiku of the University of Birmingham’s Centre for Human Brain Health.

“This is important because there are very few risk indicators for dementia that can be identified as early as middle age. While more work needs to be done to confirm these links, we believe bad dreams could be a useful way to identify individuals at high risk of developing dementia and put in place strategies to slow down the onset of the disease,” he added.

The study examined data from three community-based cohorts in the US. These included more than 600 adult men and women aged between 35 and 64; and 2,600 adults aged 79 and older. All the participants were dementia-free at the start of the study and followed up for an average of nine years for the younger group and five years for the older participants.

Commenting on the study, Dr. Mustafa Seyam, Consultant Neurologist at Fakeeh University Hospital, Dubai Silicon Oasis said that some studies confirm the definite link between sleep disorders and dementia, particularly Alzheimer’s dementia.

“There is a higher risk to develop neurodegenerative diseases by sleep disorders occurring during REM sleep, but it is unlikely by non-REM since there is no proven correlation between dementia and sleep disorders occurring during non-REM sleep,” he explained.

The research shows that middle-aged people (35 to 64 years old) that experience bad dreams on a weekly basis are four times more likely to experience cognitive decline over the following decade, while older people were twice as likely to be diagnosed with dementia.

Men are at high risk of dementia episodes

Interestingly, the study found that the associations were much stronger for men than for women. For example, older men experiencing nightmares on a weekly basis were five times more likely to develop dementia than older men reporting no bad dreams. In women, however, the increase in risk was only 41 per cent.

Dr. Seyam said that physical and mental activity is considered crucial in slowing the onset of dementia. “The human brain starts developing changes 20 years before the appearance of any clinical symptoms. Early screenings are important to identify patients who may be at high risk of developing dementia in the future to begin treatment early. Aging is a risk factor for dementia, however that doesn’t make dementia a normal aspect of ageing,” he added.

Next steps for the research will include investigating whether nightmares among young people could be associated with future dementia risk and whether other dream characteristics, such as how often we remember dreams and how vivid they are, could also be used to identify dementia risk. Using electroencephalography (EEG) and magnetic resonance imaging (MRI), the researchers also plan to investigate the biological basis of bad dreams in both healthy people and people with dementia.

As Movember, a month dedicated to raising awareness about men’s health, is coming to an end, it is important to shed light on an issue that often gets overlooked – breast cancer. While breast cancer is the single greatest cause of cancer for women globally and reportedly affects almost 2.7 million people, the disease is usually associated with the colour pink, giving the impression that it’s only a female disease.

However, the incidents related to male breast cancer are rising, highlighted Dr Suzanne Robertson-Malt, Associate Professor, Director Health Sciences, School of Humanities, Social Sciences and Health, the University of Wollongong in Dubai (UOWD), in an interview.

According to the Breast Cancer Research Foundation, about one in 833 men will develop breast cancer in their lifetime. While that statistic may not sound as daunting as it is for women, the fact that male breast cancer is so rare makes it uniquely challenging.

The doctor stressed that the breast cancer signs and symptoms are the same for both males and females. “The breast is the same tissue for both genders. Men and women need to get into the regular practice of self-examination, both visually and by touch, to ensure early detection. Young men should get into the habit of assessing if they have any abnormal lumps on the breast or underneath their armpit. They should also seek care as soon as they notice any discolouration of the breast tissue or discharge from the nipple that’s unusual.”

Dr Suzanne Robertson-Malt

Furthermore, Dr Robertson-Malt highlighted that the moment one can actually feel a breast lump is, in many ways, late. While mammography is the gold standard for diagnosing breast cancer, it will only detect a lump that’s of a cherry size. So, it is crucial to be on the lookout for observing symptoms beforehand, such as recognising increasing fatigue, dietary changes or some swelling in the breast. There could also be increased warmth in the breast because one of the classic signs of cancer is that it uses a lot of blood and capillaries to grow.

Eliminating toxic environments

Unfortunately, cancer has become a by-product of our modern era, and one of the primary reasons breast cancer cases are on the rise is because our environments are so polluted. Several reports have highlighted that the increasing amounts of hormones released into the water and overuse of antibiotics in our bodies and the food chain can have a long-term impact on us and our genetic strength.

“Our well-being is the most important thing we have in our in our hands. As a community, we need to be aware of this and work with governments to make sure that our environments are as healthy as they can possibly be,” the doctor added.

Primary prevention through risk modification can help identify the chances of developing breast cancer. For instance, if a family member has had breast, ovarian, or prostate cancer, it can put one at a higher risk. Therefore, in such cases, people can opt for genetic tests and counselling to identify their risks. Furthermore, obesity is another risk factor which can be modified through proper diet and exercise.

Dr Robertson-Malt concluded: “It is crucial to ensure people have the right information at the right time. The information needs to be delivered in a way that doesn’t scare people but empowers them to act. It should encourage people to take control of their well-being and stress that regular self-assessment is incredibly important.

“If detected early, breast cancer can be managed well, and education is key to achieving this. Through events at UOWD, we want to help our students change their perception of breast cancer and understand that both young men and women need to pay attention to breast cancer signs and symptoms.”

Back to Management

The rising burden of various diseases and chronic conditions has amplified the adoption of safe and effective diagnostic tools. In this regard, the diagnostic ultrasound market is expected to record significant expansion in the forthcoming years. The rising number of pregnancies worldwide has increased the demand for several imaging tests that deploy sound waves to view the development of the baby as well as check the female pelvic organs in pregnancy.

The need for ultrasound inspection has also grown as it offers the benefits of ease of use, lower implementation costs, and versatility. In light of these benefits, there have been rising advances in diagnostic ultrasound imaging technology for improved diagnosis and providing immediate clinical information. Subsequently, the higher availability of instant diagnostic data has helped reduce total healthcare costs by replacing expensive diagnostic exams.

Related: Laboratory automations accelerate diagnostic delivery

The diagnostic ultrasound industry will further witness significant developments with increasing clinical application scope, ranging from orthopaedics and cardiology, obstetrics and gynaecology, prostate and breast cancer detection, and emergency medicine. This technology is also favoured mainly over other imaging modalities considering its cost-effectiveness, efficacy, speed, and noninvasive nature.

Mentioned below are a few recent innovative ventures that will infuse a positive scenario for the growth of this business space:

Philips introduces handheld POCUS for ultrasound portfolio expansion

Related: Radiology through the AI looking glass

In February 2022, Philips launched Lumify, its handheld point-of-care ultrasound solution for expanding its ultrasound portfolio to offer an advanced hemodynamic assessment as well as measurement capabilities. The new product allows clinicians to quantify the blood flow in several point-of-care diagnostic applications, comprising cardiology, abdominal, vascular, obstetrics, urology, and gynaecology.

Samsung rolls out V8 ultrasound system for medical professionals

Samsung, in September 2021, introduced the V8 (Versatile 8), its new high-end ultrasound system to offer enhanced usability, image quality, and convenience for all medical professionals while being optimized for use in almost all busy hospitals worldwide. In fact, in radiology, V8 is deployed with S-Shearwave Imaging™ to provide information regarding tissue stiffness caused due to the disease by using ultrasonic transverse elasticity.

Hologic unveils the first-ever cart-based ultrasound system - SuperSonic™ MACH 40

In July 2020, Hologic, Inc., announced the expansion of its ultrasound product line with the launch of the SuperSonic™ MACH 40, its first cart-based system which is designed to alleviate unnecessary biopsies, and lesion correlation time, whilst enhancing overall diagnostic accuracy. Equipped with SonicPad™, a multi-touch trackpad, the system offers enhanced accuracy and efficiency, in addition to delivering high-quality images as well as standard-setting imaging modes.

Fujifilm India launches new ultrasound machines in India

Fujifilm India, in March 2022, introduced a new range of a portfolio of products that offer complete and integrated solutions in diagnostic activities, such as CT, AI, PACS, MRI, X-ray, endoscopy and ultrasound systems. The products are deployed with the Supria series, Scenaria View, The Echelon Smart and the Arietta series.

In essence, the demand for ultrasound equipment is likely to soar to new heights as it is highly economical as some of the most advanced ultrasound systems are found to be more cost-effective than low-end MRI (magnetic resonance imaging) systems. The emergence of core predictive technologies, including vibration analysis and infrared imaging, is another impact-rendering factor for market expansion in the looming years.

A recent study that examined regional and national trends in age-specific volumes and outcomes after ERCP in the paediatric population estimated that between 2005 and 2014, approximately 11,000 endoscopic retrograde cholangiopancreatography (ERCP) procedures were carried out in children in the United States.

The new study suggests a similar relationship in paediatric patients to adults for advanced endoscopy procedures like ERCP and endoscopic ultrasound (EUS), where a strong correlation between volume and outcomes has already been established. It was found that only 5 per cent of paediatric ERCPs were carried out in rural hospitals, while 34 per cent and 60 per cent of paediatric ERCPs, were carried out in urban teaching centres and general urban centres, respectively, with significantly shorter hospitalisation times than those in rural centres.

Paediatric advanced endoscopy (PAE) cases are anticipated to rise in frequency over the next few years, according to experts. Endoscopic treatment is used to treat the increased incidence of pancreatic diseases in children. Additionally, in America, the increased obesity epidemic has increased in association with biliary and gallstone in children.

The North American Society for Hepatology, Pediatric Gastroenterology, and Nutrition (NASPGHAN) established a special interest group focused on ERCP in 2014 as a result of the increase in interest in PAE.

Broad range of training paths

The majority of paediatric advanced endoscopists in practice today completed an adult fellowship programme for their training. The variability in training pathways is highlighted by a recent survey of working paediatric endoscopists within NASPGHAN, which was presented at the 2021 Digestive Disease Week. 38 (92.7 per cent) of the 41 endoscopists who were surveyed responded, and 27 of them were counted in the analysis because they independently practiced ERCP (n=23) or EUS (n=13). Nine endoscopists from adult advanced endoscopy fellowship programmes made up the majority of respondents (n=11), who also received training from other sources. Seven more respondents reported training that included some time with adult developed endoscopy, compared to the five additional respondents who reported training exclusively with an adult advanced endoscopist. The majority of respondents had been trained specifically in a PAE fellowship programme, while the remainder had been trained in some other combination of these pathways.

Most respondents performing ERCP (85.7 per cent) and EUS (100 per cent) reported training with an adult advanced endoscopist, with less than half of respondents (46.4 per cent) training with a paediatric advanced endoscopist. Despite the low volume, the majority of respondents paediatric ERCP (82 per cent) and EUS (80 per cent), reported feeling prepared to practice independently after completing training.

The training available for PAE has become more robust. Unlike general paediatric GI or adult advanced endoscopy, there is no structured training pathway. Few children's hospitals across the nation have signed agreements with adult sister hospitals to train paediatric endoscopists as a fourth-year fellowship coordinated by the paediatric and adult GI groups. 

AI: future of Barrett's Esophagus Surveillance

A systematic review and meta-analysis found that while artificial intelligence-based detection algorithms are not yet common in clinical practice for the surveillance of neoplasia in Barrett's esophagus, they clearly have advantages.

In a data pool that evaluated various AI strategies and methodologies, AI was more than twice as accurate and sensitive as expert endoscopists.

Improved performance

AI-aided diagnosis will be a favourable adjunct to endoscopic surveillance for accurately detecting and treating early Barrett's neoplasia, improving patient outcomes. Additionally, since AI systems learn from experience, their performance will only improve over time.

Many researchers used image enhancement or other technologies, like volumetric laser endomicroscopy, to speed up AI processing. AI has a high degree of sensitivity, accuracy, and specificity for detecting early Barrett's neoplasia.

Future scope

However, AI for early Barrett's neoplasia detection is still in its infant stage, and current systems primarily serve as proofs of concept rather than examples of how AI can be applied in everyday medical practice.

Only three data sets used real-time AI algorithms in their study, and the majority of them were used to process images from endoscopies. Before the technology is ready for widespread use in BE surveillance, classification accuracy and speed of AI systems still need to be improved, along with validation on a variety of data sets.

AI gives the possibility of real-time evaluation. The overall goal of this technology is to assist endoscopists in selecting areas to biopsy and/or treat with high confidence, avoiding the need for random biopsies and repeat treatment procedures.

Although other methods for early Barrett's neoplasia detection may play a role in screening in particular situations, AI is in a great position to become the norm because it enables early Barrett's neoplasia to be found and eliminated in the same procedure. AI technology will be a valuable tool in characterising and resecting neoplastic Barrett's esophagus.

The global endoscopy devices market size in 2021 was US$30.3 billion and will reach US$56.2 billion by 2030 at a 7.1 per cent CAGR during 2021-2030. Endoscopy is accelerated by artificial intelligence (AI), robotic-assisted endoscopy, and reimbursement options. AI and future advancements in three-dimensional and four-dimensional imaging in robotic endoscopy, as well as novel suturing and dissecting devices, will drive significant advances in endoscopic surgery.

Innovation on ERCP and EUS

ERCP procedures were once performed for both diagnostic and interventional reasons. However, since the development of less invasive diagnostic techniques like EUS, ERCP has been used mostly for interventional procedures. A variety of endoscopic tools, such as stents, dilation balloons, guidewires, lithotripters, cannulas, stone removal balloons, sphincterotomes, and baskets, can be used by the doctor during the procedure.

Since the introduction of Boston Scientific's AXIOS lumen-apposing covered-metal stent in 2016, the ERCP device market has grown significantly. One of the most recent developments in the ERCP industry is the lumen-apposing covered-metal stent market, which is indicated for transgastric or transduodenal endoscopic drainage of symptomatic pancreatic pseudocysts and walled-off necrosis under EUS imaging guidance.

The SpyGlass DS Direct Visualization System, another cutting-edge product from Boston Scientific, is a single-use cholangioscope that can be attached to a duodenoscope to provide digital visualization during an ERCP procedure. Infection control is one of the most expensive and dangerous aspects of endoscopy. In this process, scopes are manually cleaned, put through an automated endoscope reprocessor, sterilised, and then kept in a specialized drying cabinet.

Fine needle biopsy (FNB) devices are a relatively recent addition to the EUS needle market and are primarily used to sample solid tissue masses. These cutting-edge devices are now more popular on the market than fine needle aspiration (FNA) devices, which are typically used to collect cyst fluid. The Beacon FNF from Medtronic is a notable FNB device.

Article provided by Strategic Market Research

References

https://www.strategicmarketresearch.com/market-report/endoscopy-devices-market

https://www.gastroendonews.com/Endoscopy-Suite/Article/09-21/Preparing-for-the-Future-Of-Pediatric-Advanced-Endoscopy/64550

https://www.gastroendonews.com/Endoscopy-Suite/Article/08-22/AI-Artificial-Intelligence-BE-Barrett-s-Esophagus-Surveillance/67684

https://singleuseendoscopy.com/here-are-the-flexible-endoscopy-trends-to-watch-in-2022

https://www.meddeviceonline.com/doc/innovation-stimulates-growth-in-the-u-s-gastrointestinal-endoscopic-device-market-0001

Back to Technology

Healthcare companies in the Middle East need to work towards developing a resilient ecosystem to drive change as the region takes centre stage in tackling climate change over the next two years.

This year’s COP27 that took place in Egypt to be followed by COP28 in the UAE in 2023 requires businesses to commit to the environment and sustainability through action, not just words. It might surprise some that the healthcare sector, which encompasses everything from hospitals to pharmaceutical manufacturing, is responsible for approximately four percent of global greenhouse gas emissions.

In a recently published article in regional media, Pelin Incesu, AstraZeneca’s area Vice President for the Middle East and Africa said that if the healthcare sector were a country, it would be the fifth-largest emitter on the planet.

“For the world to achieve the internationally agreed targets to limit global temperature increases, the healthcare sector must recognise its contributions and play a key role in driving down emissions,” she said.

She also said that AstraZeneca is taking bold steps to reduce its carbon footprint through a US$1 billion investment on the Ambition Zero Carbon programme that aims to achieve net-zero greenhouse gases and build resilience across the company’s supply chains. She said that as a biotechnology company, Astra Zeneca has aligned the climate strategy with the latest science.

Dr. Azad Moopen, Founder Chairman and Managing Director of Aster DM Healthcare said, “Climate change is impacting humanity and leading us to a precipice through global warming. The public, especially the younger generation, are becoming more and more aware and active in protecting the environment. However, there is requirement for large corporate players including healthcare providers to get actively involved in this as it is our duty towards the future generations.

“Many major corporates have set net-zero targets and have implemented numerous initiatives. While the implementation of some strategies might be time consuming and won’t have an immediate effect, as responsible organisations we must lead by example to ensure that we enable a sustainable future for planet.

“At Aster, we are raising awareness among internal and external stakeholders to maintain a healthy balance to protect and nurture the world. As a responsible and socially committed healthcare provider with the highest level of ESG rating, our endeavour is to adopt best practices for achieving sustainability. This is achieved through partnerships and collaborations that will reduce our environmental footprint. Moreover, Aster has integrated 11 United Nations Sustainable Development Goals (UN SDGs) into its ESG policies which includes Climate Action.”

Dr. Azad Moopen

Financial hurdles could be the biggest barriers for healthcare companies to adopt a sustainable ecosystem, therefore, the healthcare industry must find ways to better use existing resources to deliver care to more patients. Digital and remote healthcare technology is positively contributing to environmental change by removing the ‘care miles’ of patients travelling to and from healthcare facilities, as well as reducing the need for single-use personal protective equipment that has a high global warming potential.

Asma Ali Zain is an independent journalist and a regular contributor at Omnia Health.

 

Back to Management

Over 300 healthcare professionals from India, the Middle East, and Africa recently joined international experts to share knowledge and best practice about the importance of taking a multidisciplinary approach to managing type 2 diabetes (T2D) at the ‘CRM 360 Meeting’ hosted by Boehringer Ingelheim.

In an interview, one of the moderators at the event, Dr. Jalal Nafach, American Board-Certified Endocrinologist, University of Nebraska Medical Center, US, and Consultant Endocrinologist at Dubai Diabetes Center, Dubai Health Authority, UAE, highlighted some key diabetes statistics in the UAE and shed light on the interconnectivity of T2D with cardiovascular, renal, and metabolic systems.

What are the most prominent statistics on diabetes in the UAE?

First, let’s look at matters from a regional perspective. Nearly 73 million adults live with diabetes in the MENA region. This number reflects the highest proportion of people living with the disease compared to other regions and is based on the International Diabetes Federation’s most recent study published in 2021.

In the UAE, 1 in 8 people aged between 20 and 79 have type 2 diabetes, marking an alarmingly high rate for the population’s overall health as this is a chronic illness that needs to be managed effectively. Additionally, 4,343 deaths are associated with diabetes on an annual basis in the UAE.

However, the total number of people living with type 2 diabetes in the UAE could be a lot higher due to many people being undiagnosed due to showing no symptoms in the early stages of the disease. It is important to be aware of the statistics around type 2 diabetes in the UAE so that more efforts can be placed towards prevention and improved health.

Given the high rates of type 2 diabetes in the UAE, are there certain warning signs that people should be aware of to protect their health?

Protecting your health begins with knowing what can put you at risk of developing type 2 diabetes. As a specialist, my aim is to raise awareness of the factors which may put anyone at risk of developing type 2 diabetes now or in the future. The most common factors include a family history of diabetes, pre-existing conditions such as high blood pressure and carrying extra weight. The risk also increases with age and is amplified with an unhealthy lifestyle, such as smoking or having an overall sedentary lifestyle.

Knowing the risk factors helps people make a change in their lifestyle at an early stage and prevent the onset of type 2 diabetes. Whether you have any other risk factors or not, if you’re over 40, your risk of type 2 diabetes and other conditions is higher. As a healthcare expert, I urge patients to check their blood sugar levels by getting advice from their specialists and committing to regular health checkups, including blood sugar tests.

Why is it important to know about the interconnectivity of T2D with cardiovascular, renal, and metabolic systems, and how are they interconnected?

The body is made of complex systems that work together to create a state of balance. With type 2 diabetes, conditions of the heart, the pancreas and the kidneys are primary examples of this interconnectivity. They have the potential to both positively and negatively impact each other.

Let’s take the renal system as an example. Having type 2 diabetes can damage blood vessels in the kidneys, which makes them not function as well as they normally would. Eventually, this can lead to chronic kidney disease, and should the condition worsen, it could ultimately result in kidney failure. To add to the extent of this interconnectivity, if a patient has high blood pressure, then kidney damage could worsen, and chances of having a heart attack and stroke would increase.

Dr. Jalal Nafach

Is a holistic approach to treating diabetes recommended?

Traditionally, managing type 2 diabetes was delivered through a single specialist setting with a primary focus on controlling blood sugar levels. However, now that the landscape for treating type 2 diabetes has evolved, it’s become vital to seriously consider the possibility of preventing cardiovascular, renal and metabolic (CRM) conditions as well.

CRM conditions affect more than one billion people worldwide and account for up to 20 million deaths annually, making them the leading cause of death globally. In the Middle East and North Africa alone, the prevalence of diabetes is at 55 million adults and is set to double by 2045.

Given the magnitude of the regional reality, it goes to show how seriously the interconnectivity should be taken and the need for a multisystem control to be in place.

Further to that, the market currently offers treatment solutions for multi-organ protection. When combined with a multidisciplinary approach to care, this can boost clinical practice and positively impact patient outcomes on their journey to better health.

What were the most important takeaways from the CRM 360 meeting regarding this issue?

The CRM 360 Meeting emphasized the management of this complex multisystem condition by multiple healthcare providers from both primary care and specialist settings. The meeting reflected just how necessary it is to bring together diverse and regional medical talent to discuss the latest scientific guidelines that can improve treatment outcomes and transform the lives of patients. The overarching takeaway was that a true sense of collaboration between multidisciplinary medical professionals has the power to offer patients optimal care.

Allowing health care professionals to coordinate treatments for patients from a collective standpoint means that managing type 2 diabetes and its related conditions can be more effective.

What advice would you give when it comes to preventing severe health issues as a result of diabetes?

It’s important to take comfort in the notion that life can be lived to the fullest for those diagnosed with T2D and who have associated heart and kidney conditions. With that said, it is vital for patients and their caregivers to, first of all, understand the diseases and how best to manage it through having regular and coherent conversations with their doctors. Following a strict treatment regime by taking prescribed medications and committing to certain lifestyle habits is also a priority, and that is focusing on a healthy diet, staying active and quitting smoking

If the above habits are instilled and consistent, it is possible to reduce the risk of worsening the condition or facing multiorgan failure.

References

IDF Diabetes Atlas 10th edition, Key global findings 2021,

GBD 2015 Mortality and Causes of Death Collaborators. Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: A systematic analysis for the Global Burden of Disease Study 2015. The Lancet. 2016;388(10053):1459–544.

Members, R., Africa, M. and MENA, D., 2021. Diabetes in MENA. [online] Idf.org. Available at: https://www.idf.org/our-network/regions-members/middle-east-and-north-africa/diabetes-in-mena [Accessed 27 September 2022].

A closer look at the top 10 Chinese medtech companies shows a strong compound annual growth rate (CAGR) of 28 per cent between 2019 and 2021— far above their international counterparts.

Medtech is also creating a wave in the Chinese stock market. In 2021, the number of Chinese medtech initial public offerings (IPOs) broke the record. This momentum has continued into 2022— on August 22, 2022, United Imaging, a Shanghai-based medical imaging device vendor only in its 12th year, raised $1.6bn on the day of its stock market debut, ranking top five in global IPOs in August 2022.

The growth of Chinese Medtech is conspicuous.

Factors driving the fast growth of Chinese medtech

There are several factors driving the fast growth of Chinese medical device companies, including strong domestic demand, technology proliferation, and government support, as well as the boost generated by the COVID-19 pandemic.

Strong demand for medical devices in the domestic market

Chinese medical device companies rise against the backdrop of the country’s fast-growing medical device market. Between 2016 and 2020, China’s medical device market, globally the second largest, growing at a CAGR of 13.6 per cent. According to Omdia’s projection, the growth momentum is expected to continue into 2025 at a CAGR of more than 10 per cent. The demand for medical devices is strongly driven by the ageing population and increasing medical expenditure.

Sped-up learning curve via technology proliferation

The Chinese market’s high potential attracts international medtech companies to invest in China, including building production facilities, R&D centers, and sales organizations. The technology has proliferated through the localized practice of international medtech companies. For example, to better access and serve the local market, Philips Healthcare established a joint venture with its Chinese partner, Neusoft, in 2004 to produce and develop medical imaging devices; the 10-year joint venture helped Neusoft grow as a key medical vendor. For over a decade, Neusoft was the top Chinese vendor for CT equipment before it was overtaken by United Imaging in 2018.

The “made-in-China” condition, which is required for participation in government procurements, fosters the localisation strategy of international medtech companies, further propelling the proliferation of technology among local companies through the flow of talent. It is very common to see senior executives in the Chinese medtech industry with previous working backgrounds from international medtech companies.

Support to Chinese medtech from the Chinese government

China’s 14th Five-Year Plan (for the period of 2021–25) set a goal of having at least six Chinese companies in the top 50 global medical device companies. To achieve this, the government has supported Chinese medical device companies in various forms, including leading and funding innovation projects, favourable taxation, streamlined administrative procedures, and subsidies to Chinese companies.

The Chinese government spends a massive amount of money on subsidies to favored companies whose industries or technologies are deemed strategically important. The amount of subsidies is sometimes substantial to a company—for example, Neusoft’s government subsidy accounts for 50 per cent of its profit in 2021. The subsidies reduce the costs of the recipient companies, creating a competitive advantage in both domestic and international markets.

COVID-19 boosted the growth of Chinese medtech companies

Soaring demand from overseas markets for COVID-19-related medical devices—such as ventilators, respiratory care devices, and life monitoring devices—gave a boost to Chinese vendors. For example, Yuwell and Mindray reported 45 per cent and 27 per cent revenue growth, respectively, in 2020. The growth was largely contributed by COVID-19-related demand from overseas markets.

In China, CT scanning is the gold standard for COVID-19 diagnosis. The demand for CT equipment for COVID-19 management focuses on the low-end segment. Hence, Chinese CT vendors benefited more from the soaring demand for the Chinese CT equipment market compared to their international counterparts, whose product portfolios focus on the mid- and high-end segments. The top four Chinese CT vendors experienced strong revenue growth of 107 per cent in 2020 and 29 per cent in 2021.

A new phase of expansion and upgrading

After decades of learning and catching up, Chinese medical device companies are grabbing significant market shares in many medical device industries, particularly in the low- and mid-end segments of the China market. Take diagnostic ultrasound equipment as an example —Chinese vendors’ market share in China grew from around 20 per cent in 2011 to nearly 35 per cent in 2021. The ambition of Chinese companies is growing. They are shifting their focus from the low-end segment to the high-end segment, from the domestic market to the international market, and from standard products to ones with original features.

Investing in R&D is one way to further strengthen the competitiveness of Chinese medtech companies. Producing low-end segments of medical devices is usually where Chinese companies start off. To upgrade their product portfolio, Chinese medtech companies invest heavily in R&D to tackle technological bottlenecks. Take the top two Chinese medtech companies as an example — United Imaging and Mindray grew their R&D spending by 23 per cent and 30 per cent, respectively, in 2021. United Imaging’s and Mindray’s R&D expenses accounted for 14 per cent and 11 per cent of their total revenues, respectively, in 2021—far above the R&D-to-revenue ratio of their international counterparts.

The R&D investments resulted in technology breakthroughs. Unlike its Chinese peers, United Imaging started producing key components, including X-ray tubes and high-voltage generators, instead of fully relying on suppliers. With the enhanced technology, the company steadily penetrates the high-end market.

Some Chinese medtech companies are working on leapfrogging their international competitors in technological development. For example, MicroPort MedBot, a startup founded in 2015, produces a wide range of surgical robots. Toumai, its endoscopic surgical robot, is the first robot from a Chinese company to conduct complex laproscopic surgery and is registered for clinical trials. According to MicroPort MedBot, Toumai has demonstrated non-inferiority to the da Vinci Surgical System, the world’s leader in surgical robots.

Mergers and acquisitions also accelerate the growth of Chinese companies. Mindray, China’s biggest medical device manufacturer by sales revenue, is now the fourth ultrasound vendor in the world. Mindray has grown partly through a series of acquisitions of overseas medical technology companies.

Insights from Omdia

Backed up by the fast-growing Chinese medical device market and the support of the Chinese government, Omdia expects Chinese medtech companies to continue having a high rate of growth in the coming 10 years. But they also have challenges to address.

Low profitability is a common issue among Chinese vendors, compared with their international counterparts. The high purchase costs of key components, low-end product mix, and high distribution costs have squeezed profits. The withdrawal of government subsidies would challenge the vendors’ market viability. The low-profit rate, in turn, can restrain R&D investment, which can negatively affect technological innovation.

Lack of talent restrains technological innovation. China’s zero-COVID policy has a big impact on its stock of talent. The quarantines, lockdowns, and unknown roadmap are anxiety-inducing. In the wake of stringent lockdowns, the outflow of talents from Chinese tech companies to other countries soared.

High revenue growth by expanding in overseas markets is a good approach to address the low-profit rate of Chinese medtech companies. However, they face high entry barriers, including regulatory clearance, brand recognition, and customer loyalty. In the case of the US, the world’s biggest medical device market, the volatile US-China relationship also means unpredictability to market entry. Other geopolitical factors also affect the growth of Chinese medtech companies.

Chinese medtech companies are also running against the rise of Indian competitors. India’s low production costs and huge market potential are attractive to international medtech companies. For example, in April 2022, Wipro GE Healthcare (a joint venture between GE Healthcare and its Indian partner Wipro) launched the “Made in India” CT system to strengthen accessibility in India. In July 2022, GE Healthcare opened a 5G innovation lab in India, aiming to bring cutting-edge technology to rural and suburban regions.

Chinese medtech companies face both growth opportunities and challenges. Therefore, the next 10 years will be crucial for Chinese medtech companies to transform and upgrade to a new phase.

Sally Ye is the Senior Analyst, Healthcare Technology at Omdia

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