1. What are the major challenges that the growing demand for care brings about in Dubai, and how is the DHA working to address these challenges?
The healthcare sector in Dubai remains robust driven chiefly by continued growth in population and supported by economic growth and Dubai’s position as a financial, trading and aviation hub for the Middle East region. Rise in prevalence of chronic diseases such as diabetes, cardiovascular diseases, cancer etc. also contribute to a rise in health spending as it necessitates investment in specialised services and chronic disease management.

Higher life expectancy and consequent rise in ageing population in the next decade will lead to a rise in demand particularly for long-term care, rehabilitation and home-based health services.
Innovations in clinical services, the adoption of new technology in care pathways, and mobile health solutions are changing the way health services are delivered across the world, and we can expect to see new and innovative models of care and the use of technology in early diagnosis (e.g. genome sequencing), and treatment of diseases (through precision medicine, use of 3D printing, advanced robotic surgeries, use of VR and AI in disease management and treatment pathways).

Increased access to health services owing to mandatory health insurance in the emirate will also push up demand for services.

The key challenges confronting DHA are to control the rise in health spending, curb unnecessary utilisation of health services and improve the availability of high calibre clinical talent to support the needs of the health sector. Hence, we focus on preventive care to reduce the burden of non-communicable diseases (NCDs). DHA also works on regulations, projects and initiatives with the Dubai and federal government stakeholders as well as the private sector to address these challenges, and improve the health eco-system.

2. What are the current trends in Dubai’s healthcare industry? What is your outlook for the health sector in the medium to long term?
Dubai provides encouragement and support for private sector investment and participation in the health sector, and this has resulted in significant growth in utilisation of health services in the private sector. The private sector accounted for over 75% of outpatient services and 70% of inpatient services in 2016. We expect to see continued rise in investments in innovative primary care models (especially ambulatory care and urgent care clinics) to address the demands of the under-served segments and for new residential communities in South Dubai.
Large investments are expected in specialised centres and centres of excellence for specialised services to provide access to high quality health services to UAE nationals, residents and visitors. Dubai is currently developing a Clinical Services Capacity Plan that looks into the demand, supply and gaps for health services and manpower over the next 30 years, which will be completed in early 2018. This will provide us with quantifiable information on investment priorities, and accordingly, efforts will be made to drive, support and encourage investments from the private sector, as well as foster partnerships to deliver health services that address the needs and gaps in the health sector.

3. As the Dubai Health Strategy 2021 completes almost two years of implementation, how would you evaluate its success in improving healthcare services in the emirate? What has been its impact on patients, healthcare professionals, facilities and the overall health sector in Dubai?
DHA’s Dubai Health Strategy 2016-2021 has three key goals: drive innovation and ensure governance, protect and improve population health and ensure patient happiness by providing world-class health services. These goals aim to fulfill DHA’s vision of progressing towards a healthier and happier community. Our focus is on working across a continuum of care, starting from early prevention and detection of diseases all the way to rehabilitation.

In the last two years, we have accomplished several key tasks aligned to the top three goals of the Dubai Health Strategy, which we had divided into immediate, medium and long-term goals.  Several of the immediate initiatives were accomplished and these include:

Achievements in innovation and ensuring governance

1. Implementing easier medical regulation processes in line with international best practices. Total number of health professional license increased by 15 per cent and number of licensed facilities increased by about 27 per cent.

2. DHA is working on revamping its health governance structure, which will result in increased accountability of hospitals and further improve patient safety and experience.

3. Adoption of new health technologies such as telemedicine, RoboDoc and 3D printing with the aim of fostering innovation across the continuum of care in addition to smart applications.

4. Completion of electronic medical records implementation across all DHA facilities. Recently, Rashid and Dubai Hospitals and 12 DHA PHC’s were felicitated with an award for achieving EMRAM stage 6 of patient data maturity.

Achievements in protecting and improving population health

1. Currently, 92 per cent of hospitals in Dubai have completed their international accreditation, which is a significant jump from 86 per cent in 2015.

2. Number of physicians per 10,000 of the population has reached 33 exceeding the national level (27) and approaching the level achieved by Sweden (39).

Achievements in realising patient happiness and providing world-class healthcare services

1. The mandatory insurance coverage has been a direct source of patient happiness and today, 98 per cent of Dubai residents are covered under the scheme.

2. Life expectancy of Dubai residents has reached almost 80 years exceeding that of the USA and approaching that of UK and Japan.

4. How has the mandatory health insurance scheme benefitted the sector in Dubai and how will it drive the sector’s maturity in the years to come?

In line with our vision that healthcare is a universal right and not a luxury, Dubai’s mandatory health insurance scheme has provided a basic blanket cover for its residents in a financially sustainable manner, irrespective of their income or strata.

Apart from access to care, it offers access to better quality of care and Dubai has standardised care by implementing clinical guidelines so that health facilities that provide better quality of care will be rewarded through the payment model. In addition, screening – especially for NCDs – is becoming a bigger part of the mandatory cover and is an important step towards our mission to provide preventive care and early detection of diseases.

In terms of driving the sector’s maturity, healthcare has evolved into a data-rich sector as we continue to capture vast amounts of healthcare information.  Such gold-standard evidence-based healthcare data will help us devise policies based on measured outcomes. In 2016, the number of healthcare transactions through health insurance was 63 million, which is valued at AED 9.6 billion, and which accounts for more than 70 per cent of the total health spending in the emirate.

Going further, innovation is now becoming key with programmes such as hospital at home for the elderly, which helps with early discharge of patients. Once home, patients are monitored through telemedicine and provided with customised homecare services. This service is provided for elderly UAE nationals under the Saada Health Insurance programme.
                                                      

5. What steps are being taken by Dubai to transition from being a hub for the best available medical care to being a source of innovation in medical science?

DHA is currently establishing its innovation centre and partnering with world leaders in healthcare and pharmaceutical industries to work on addressing the region’s healthcare challenges and utilising the best research minds while leveraging the best practices worldwide.

DHA’s close association with the Dubai Future Foundation Accelerator programme has led to collaborations with several upcoming firms for implementing innovations in healthcare delivery.

In its day-to-day healthcare delivery, DHA currently utilises a number of advanced technologies such as 3D printing for prosthetics, dentures, and cosmetology. In addition, Telemedicine is widely used, and DHA has piloted and is now implementing RoboDoc, which enables specialists to provide expert opinion to cases in remote areas, or for patients who are less mobile.

6. What are the long-term care services being planned to meet the specialised needs of the growing elderly population?

DHA has a robust homecare programme for elderly patients and we intend to expand this. Currently, we have a full-fledged nursing home and will soon be setting up another facility.
Rashid Hospital is equipped with an acute care unit for addressing the needs of elderly in-patients while DHA’s 15 PHCs provide frontline care with screening services for early detection of diseases so that patients can be referred to the geriatric clinics early on.

The DHA’s geriatric section is also working with the private sector to roll out joint initiatives and services.

The Internet of Things (IoT) has truly revolutionised businesses across various sectors, including the healthcare industry that gave rise to the emergence of the Internet of Medical Things (IoMT). The benefits of interconnecting medical devices are easy to grasp; instead of test requisitions and reports sitting at the nurses’ station, physicians today conduct this entire transaction digitally, ensuring that patients receive a far better standard of care and are prioritized based on need rather than chronology. 

According to a report published by Deloitte , wider adoption of Technology Enabled Care (TEC) – where healthcare practitioners can undertake e-visits, write e-prescriptions, diagnose, and deliver treatment via remote digital monitoring – can result in direct cost savings and enhanced patient care. Hospitals have already started to increase use of connected devices, and operators feel that wider adoption in the healthcare sector can greatly reduce time spent on treatment and improve the doctor-patient relationship significantly.

The time spent collecting patient data at regular intervals costs hospitals a significant amount of time and resources. Automating these processes by using technology such as wearable devices that can track a patient’s vital statistics results in not only cost savings for the medical services, but also benefits patients by offering a more efficient method of data collection and enabling doctors to make a well-informed diagnosis. This is just a small example of how connected devices can revolutionise medicine in ways that were unimaginable before.

Wearables - revolutionizing healthcare

The National Health Service (NHS) in the UK has discussed how harnessing data through wearable devices, electronic patient records, and assistive technology can greatly benefit the healthcare sector.  According to Medicom Health, which develops evidence-based health and wellness software applications, the wearables can collect an array of critical information including activity levels, sleep, and heart rate. This is valuable information for providers dealing with patients with congestive heart failure, diabetes, and other chronic conditions. It is expected that wearables will also be able to collect additional biometric data like blood glucose levels and blood pressure through non-invasive sensors in real time which can be used to predict an increased risk of a potentially fatal health event, and alert healthcare providers in case an intervention is needed

While all connected devices from pacemakers and insulin pumps and x-ray machines have significant benefits, they also run a significant risk of being attacked. The Food and Drug Administration (FDA) confirmed earlier, following the death of a patient, that St. Jude Medical's implantable cardiac devices were in fact vulnerable and could be easily accessed via vulnerabilities they had disclosed the previous year .  The FDA announced that device manufacturers are at a significant risk of being hacked and issued a set of recommendations to secure medical devices that could jeopardise the safety and privacy of their users. This includes medical device manufacturers and health care facilities taking the right steps to ensure appropriate safeguards. The recommendations also state that device manufacturers should undertake appropriate measures to ensure proper device performance. Hospitals and health care facilities should also evaluate their network security and protect their hospital systems.

Protecting patient records

The Dubai Health Authority (DHA) has recently announced that 1.4 million patient records are now electronically available and a unified electronic medical system is live across a designated number of hospitals in Dubai under the ‘Salma’ initiative. Similarly, the government announced that it would launch the NABIDH program to digitise patient records.  Both of these initiatives are linked to the UAE’s wider vision of fostering innovative and integrated care models across the healthcare sector and using big data to develop evidence-based public health policies.

This is a bold move, and the DHA recognizes that technological advancements also bring with them risk: the risk of patient records and other sensitive data making its way into the wrong hands is a very real threat that hospital and healthcare operators run. According to the U.S. Department of Health and Human Services’ Office for Civil Rights, one in two Americans were affected over this last year by a data breach in healthcare. Furthermore, cyber liability insurers raised their premiums threefold for healthcare providers as this has been the most attacked industry two years running, surpassing the financial sector.

Last year, UK’s National Health Service’s Lincolnshire and Goole hospital cancelled all of its planned operations and diverted major trauma cases to neighbouring facilities following a targeted attack. Although the hospital didn’t divulge the kind of virus that infected its systems, it is likely an infestation of ransomware — a malware scourge whose purveyors have taken to targeting hospitals and healthcare facilities. Here in the UAE, a well-known private medical centre also faced a similar attack in 2016.

If hackers manage to lock and/or encrypt the health record of a patient needing immediate healthcare attention, the patient’s life will be in danger. Securing the network and medical devices therefore has become top priority for the healthcare industry, and now more than ever the healthcare sector must ensure that they put patient data confidentiality on par with patient care.

Operators therefore need to acknowledge that the data is as important as their patients. Given the reliance on connected healthcare devices and the data they provide, protecting this data and the devices that monitor and treat are in-line with protecting patient lives, hence the healthcare sector and medical device manufacturers need to understand that securing the Enterprise of Things is vital. The Enterprise of Things is a network of intelligent connections and end points within the enterprise – including a collection of devices that enable smart product development. For device manufacturers, the focus is still almost entirely on the function of the device rather than its capacity to be secured.

Securing medical devices and the network

There are some tools that can be employed to secure medical devices. Hospitals must teach staff how to identify and avoid phishing scams, ransomware attacks, and other email-based threats. They should also ensure that all staff use secure communications tools when texting, making or taking phone calls, or collaborating with staff or patients and even insist on multi-factor authentication on all their devices.

As far as securing their technology goes, healthcare providers should also put email solutions, collaboration tools, and other critical apps in containers to protect sensitive content. Laptops and desktop PCs, tablets and smartphones, wearables, and IoT devices can be protected with unified endpoint management solutions (such as BlackBerry UEM). Giving systems a security check-up to identify potential threats is also a good idea.

Implementing healthcare technology security standards like DTSec that promotes security from the ground up is also a good idea. Launched in May 2016, BlackBerry’s medical device cybersecurity standard DTSec is the most comprehensive security standard for medical devices. The standard is a holistic representation of best-practice medical device security, developed with input from a variety of industry experts, including university researchers and cyber security firms to nurses and medical manufacturers.

The healthcare sector must also use secure file-sharing solutions that allow them complete control over their information and the capacity to secure information safely within their borders. The healthcare industry, like other enterprises, should safeguard critical information the same way it safeguards a patient’s wellbeing.

Some organizations are especially vulnerable to ransomware attacks because they often have fewer IT resources than big companies. They may not be strictly following best practices or doing regular data backups of all critical servers. They may also have a harder time controlling their environment and ensuring employees follow their anti-phishing and other training to prevent such malware from taking root.

Healthcare systems must therefore secure their networks so they aren’t vulnerable to hackers. They must also write cybersecurity requirements into their procurement policies to force device, IT hardware, and software makers to build security into everything they sell. Finally, they need to ensure that any applications they install are user-friendly; otherwise staff will turn to less-secure shadow IT workarounds (like personal messaging, cloud storage, and other apps).

Healthcare workers must understand how mobile device policies secure Protected Health Information (PHI) and how using the healthcare organisation’s approved apps (that have been security tested) supports data security.

Device makers meanwhile must strengthen device security, including regularly patching operating systems and apps against vulnerabilities.

BlackBerry UEM software provides comprehensive, policy-based management of all the endpoint devices a healthcare organization can own. Through BlackBerry Workspaces, files such as medical records are encrypted and watermarked so that hackers cannot access them even if stolen. This allows hospitals and patients to avoid paying ransomware to attackers, and also more easily track down the hackers.

In conclusion, it can be said that enterprise technology gives healthcare providers a way to efficiently deliver the best quality medical services, but they need to develop a strong security framework to ensure the smooth functioning of their business without compromising on patient care.

“MEDLAB is a wonderful opportunity to connect with hospital laboratory colleagues from throughout the MENA region.”
- Fred Schutte,Regional Director,Mayo Clinic Laboratories, United States

“MEDLAB is a unique opportunity for us at Siemens Healthineers to share with our customers, to display our latest innovations, and let them see how we can help them take healthcare to the next level.”
- Romain Fournials, Vice President, Laboratory Diagnostics, Siemens Healthineers, UAE

Come February 5, 2018, and the 18th edition of the MEDLAB Exhibition and Congress will move into its 2nd year as a stand-alone show, looking to welcome more than 25,000 attendees from over 140 countries at what is clearly the largest attended laboratory expo worldwide. Occupying 7 exhibition halls of the Dubai World Trade Centre, the 2018 edition of this annual laboratory meeting celebrates its vigorous growth by presenting a platform to over 600 exhibitors from more than 40 countries, including 13 national pavilions and one unique regional pavilion featuring the city of Berlin.
In addition, the MEDLAB Congress 2018 will also introduce new clinical tracks designed to enhance collaboration between laboratory professionals and clinicians as they come together to discover innovations in medical laboratory testing.

MEDLAB is the flagship exhibition and congress of the MEDLAB Series portfolio, a collection of leading laboratory management and diagnostics exhibitions and conferences worldwide, spanning across the Middle East, Asia, East/West Africa, Europe and the USA.

Showcasing the latest laboratory advancements from all corners of the globe, the year-on-year growth and success of MEDLAB stems from more than 15 years of growth alongside the MENA region’s largest healthcare gathering, Arab Health.

The core specialities of the MEDLAB 2018 exhibitors include: Allergy, Anatomic Pathology, Cardiovascular Disease, Coagulation, Dermatology, Endocrinology, Gastroenterology, Genetics,
Haematology, Infectious Diseases, Medical Drug Monitoring, Microbiology, Obstetrics/Gynaecology, and Oncology.

Highlights of MEDLAB 2018
Dealers and Distributors Zone: This dedicated meeting area onsite allows medical dealers and distributors to promote the products they are looking to source from exhibitors, as well as provide their contact information. This encourages business relationships between the participating companies and their core audience.

Workshops: Hosted by leading laboratory management and diagnostics companies, the workshops occur onsite on the exhibition floor and offer a more hands-on approach to learning and are tailored to each specific company’s latest findings, technology and best practice.

Scientific Posters: Displaying the latest research from laboratorians worldwide, the scientific poster zone promotes knowledge sharing and networking amongst MEDLAB’s delegates, to congregate and discuss the latest research and developments within the industry to encourage future partnerships.

Country Pavilions: The 2018 edition of MEDLAB will host 13 country pavilions further enhancing the range of hospital equipment, medical equipment, medical devices and medical technology on display at the exhibition. New country pavilions this year include those of Finland and Japan. The other dedicated pavilions are from China, USA, Germany, Austria, Brazil, Poland, United Kingdom, Taiwan, Spain, France and Egypt. MEDLAB 2018 also introduces the concept of a unique regional pavilion with Berlin marking its debut in this category. In addition, the 2018 event will witness increased country attendance from Korea, India and Turkey.

Introducing the Obs-Gyne Zone

MEDLAB, the all-encompassing event for every speciality within the laboratory management and diagnostics spectrum, features the Obs-Gyne Zone this year—the region’s leading expo and congress for obstetricians and gynaecologists. Apart from meeting with more than 80+ international exhibitors at the Obs-Gyne Zone, visitors can also gain knowledge of recent developments in women’s health in the Middle East and build important relationships with key industry stakeholders.

Obs-Gyne also features new and leading obstetrics and gynaecology devices, equipment and solutions. Exhibitors include imaging companies looking to showcase the latest technologies in ultrasound and mammography. Other product areas range from endoscopic, laparoscopic and hysteroscopy equipment to more conventional surgical equipment, cervical cancer screening products to gynae chairs and stretchers. Another area of focus at the exhibition is hospitals, clinics and IVF centres including the numerous cord blood bank and stem cell technology based organisations.

More than 50 speakers from the Middle East, UK and US will also bring international perspectives on medical and health issues prevalent worldwide at the 10th Obs-Gyne Congress. This premier annual scientific women’s health meeting for the Middle East audience, scheduled from 5th to 8th February, features four dedicated educational tracks and is held under the theme, ‘Optimising best practice & research in obstetrics & gynaecology’.

MEDLAB 2018 Congress Overview

In conjunction with the MEDLAB expo is a multi-disciplinary Congress set to attract over 6,500+ local and international delegates. Accredited by Cleveland Clinic Ohio, USA, this year’s congress introduces 17 conference tracks, with the overall theme of unifying clinicians with laboratorians to better improve patient care in the region. Through these multi-disciplinary CME-accredited conferences, the Congress provides education, best practice and the chance to learn, meet and network with leading laboratorians from across the globe, as delivered by over 128 thought-leaders.

MEDLAB Congress 2018 will be introducing 7 new clinical tracks and serves as the ideal platform to come together and discover innovations in medical laboratory testing.
This will aid in accurate interpretation, quick reporting and diagnosis, therefore strengthening each laboratory’s ability to provide clinical decisions and improve the overall quality of service and care.

LABORATORY TRACKS

Laboratory Management 5 February 2018
This conference is designed to provide its audience with a unique opportunity to understand the collaboration of administrative and medical leadership and exchange knowledge about the dynamics of quality management and safety improvement in a medical laboratory of any size, scope, or speciality.

Molecular Diagnostics 5 February 2018
This conference will bring together a balance of industry and academics, so that delegates have the unique opportunity to network with colleagues from different sectors and gain fresh perspectives on the various researches and studies on molecular and non-molecular rapid diagnostic techniques and Next Generation Sequencing.

Haematology 6 February 2018
Focusing on the lab testing and interpretation of treatment of blood-related diseases, this conference provides an opportunity to the delegates to discuss the emerging therapeutic options and recognise the factors that affect the diagnosis, staging, and prognosis of patients’ treatments.

Laboratory Informatics 6 February 2018
As clinicians are likely to become increasingly dependent on direct access to pathology data, the challenge for laboratory scientists is to ensure the timely and effective introduction of IT systems that can meet the needs of modern laboratory medicine. This conference will discuss better solutions on optimal use of pathology services to encourage appropriate test requesting.

POCT - Point-of-Care Testing 6 February 2018
As the only point-of-care event in the Middle East, international and regional speakers will provide a global consensus on the key challenges and best practices for all POCT users while also discussing regulatory aspects, validation and clinical applications to develop skills needed for successful application of POC in a variety of settings.

Clinical Microbiology 7 February 2018
This conference provides a unique platform for the clinical scientists, young researchers, and consultants and will focus on the latest developments in microbiology and immunology and the role of medical laboratory in both the management of infectious diseases and epidemiology of infections.

Clinical Chemistry 8 February 2018
To further develop a thorough understanding of laboratory operations, instrumentation and test availability, this conference will provide laboratory professionals latest solutions for better quality and turnaround time and technology usage.

Blood Transfusion Medicine 8 February 2018
From the management and organisation to the clinical and lab aspects of transfusion, this conference will discuss the global challenges in transfusion transmitted infections and effective tools for improving these practices in the hospital setting.

Histopathology 8 February 2018
This conference seeks to provide participants a comprehensive review of the latest histopathological, cytological and related technical advances, and features a discussion to exchange views regarding the latest research on cell biology using molecular tools and genomic data.

CLINICAL TRACKS

Oncology 5 February 2018
Focusing on topics including non-medical oncology methods, radiation oncology, tumor testing, screening and surgical oncology, this programme serves as being essential to all specialties involved in the care, treatment and management of patients with cancer.

Obs-Gyne 5-8 February 2018
Obs-Gyne this year features a conference programme with four dedicated educational tracks on general women's health, gynae-oncology, foetal medicine and infertility.

Diabetes Testing and Management 5 February 2018
To establish a successful functioning of the patient‐physician-laboratory triangle in interpreting lab tests, this conference will focus on clinical‐laboratory correlations and communication of diagnostic processes.

Endocrinology 6-7 February 2018
A must-attend for everyone involved in the diagnoses and development of endocrine disorders, this conference aims to promote greater collaboration and a stronger working link between the clinician, laboratory, and imaging department to improve the quality of diagnoses and efficiency of working practices.

Cardiology 7 February 2018
As global and regional field leaders present a comprehensive review of new guidelines and share contemporary and novel clinical techniques and strategies, cardiovascular specialists can accrue information enabling the enhancement of their expertise.

Tumour Markers 7 February 2018
This conference deals with advances in biomarkers used in oncology to help detect the presence of cancer and is designed to gather oncologists and lab professionals to better understand application of research findings related to cancer.

Cardiac Markers 8 February 2018
This is the only focused cardiac marker interpretation conference in the region led by clinicians and laboratory professionals which will discuss developments in current and new markers for acute coronary syndrome, atherosclerosis, chronic heart failure and non-cardiac conditions.

Antibiotic Use and Misuse 8 February 2018
Apart from addressing the challenges concerning antibiotic use within the region, and globally, this conference will also discuss the latest developments, innovations, and the corrections necessary to meet the critical need of tackling antibiotic misuse.

In addition to hosting more than 40 dedicated national pavilions, the 43rd edition of the event showcasing the global healthcare industry in the Middle East, gives a truly international representation of hospital equipment, medical devices and medical technology on display at the exhibition. Occupying the entire exhibition space of the Dubai International Convention and Exhibition Centre, Arab Health 2018 will enable companies to showcase progress and achievements in the sector, and help facilitate the exploration of new business opportunities in the global healthcare field. The exhibition also provides an important platform for the MENA healthcare industry to build relationships with international stakeholders.

From its inception 42 years ago in Dubai, UAE, as a small trade show under a tented canvas to its emergence and transformation as the MENA region’s foremost global healthcare industry platform and education hub, the Arab Health Exhibition and Congress enjoys the continuous patronage of healthcare professionals in the region and beyond.
Accompanying the exhibition will be 19 business, leadership and Continuing Medical Education (CME) conferences providing the very latest updates and insights into cutting-edge procedures, techniques and skills. Arab Health Congress 2018 is one of the largest multi-track medical conferences accredited to CME worldwide and will see the participation of more than 8,000 delegates and 500 speakers from the region and around the world as it aims to bridge the gap in medical knowledge. 

WHAT’S NEW FOR 2018

PERSONAL HEALTHCARE TECHNOLOGY ZONE

This is the new platform at Arab Health 2018 that will enable personal healthcare device manufacturers and service providers to showcase new technology, products and services to thousands of decision makers both regionally and internationally. Exhibitors will display the latest in “smart” healthcare technology that connects patients to physicians and hospitals/clinics.

Wearable technology is becoming an essential part of our daily lifestyle. With diseases such as diabetes and obesity becoming increasingly prevalent, smart personal healthcare devices have the potential to help patients and clinicians to monitor these conditions, as well as keep track of fitness, blood pressure, and even sleep quality, amongst others.

This Zone also includes Connected Health as an overall theme with Big Data, Telehealth, Healthcare Software, 3D Medical Printing, Patient Monitoring, Homecare Devices and many others.

Your Guide to Arab Health 2018
Here is a quick overview of things to look out for at Arab Health 2018.

THE WORLD’S MEDICAL PRODUCTS
With even more companies participating this year, explore thousands of products on display from more than 4,200 companies coming in from over 70 countries. The exhibition gives a truly international representation of hospital equipment, medical devices and medical technology.

3D MEDICAL PRINTING ZONE
Get updates on the latest 3D technology healthcare applications at this immersive feature area. Alongside the Zone, a 3D Medical Printing conference will also expand on the latest educational components around 3D printing.

EDUCATION
With 19 conferences, Arab Health Congress is one of the largest CME accredited multi-track medical conference in the world. More than 8,000 delegates and 500 international and regional speakers will be welcomed over the four days of the Congress.

HANDS-ON-TRAINING (HoT)
An innovative concept introduced in 2017, these Hands-on-Training modules are delivered on the exhibition floor with a number of unique programmes. The trainings allow high-level participants to train on advanced techniques with the latest state-of-the-art equipment across different modalities.

PLAN YOUR VISIT WITH OMNIA
Omnia The Global Medical Directory is a supplier, manufacturer and product database providing you with information of all Informa Life Sciences exhibitions, 365 days of the year. This digital platform allows you to connect with the people and products in one simple click.

PROMOTE YOURSELF
The Dealer and Distributor Wall takes information you provide and displays it at the exhibition. This will allow exhibitors to identify which distributors/dealers are looking for their products and set up a meeting directly onsite, fast-tracking business opportunities between you and Arab Health attendees.

Despite our various attempts to improve medical outcome through exceptional advancement in medical science, technology, pharmaceutical products and more importantly healthcare providers’ skills, knowledge and subspecialty fields, the outcomes remain unsatisfactory. It seems medicine will remain an uncertain field as it has ever been. This should not be a surprise because we simply are in the field where a minute error could result in a catastrophe.

Medicine is not like other industries where the product could be anything from a car to a hamburger to an investment. The products in the latter case are well defined with distinct specifications that are easily monitored and assessed. Consequently, the outcome of such products are usually within the organisation’s expectation, and for some reason or another if the plan didn’t go as expected, the organisation can redesign or restructure the plan and hope to succeed, or in the worst-case scenario it could have some financial implication, but there would be no loss of life or incur a major disability.

Unfortunately, the number of medical errors has increased at an unprecedented number from around 100,000 in 1998 to 440,000 in 2016 and has become the third leading cause of death in the United States. Moreover, according to three studies conducted in 1998, the researchers found a disturbing outcome; about 40 per cent of autopsies had not improved since 1938.

Consequently, I always believed that we should be extremely careful when comparing the outcome of other industries with those of a patient care and quality measure, as success in non-health-based industries is not at par with success in the healthcare industry. On the contrary, some of these measures could have an adverse impact on patient care such as allocating a specific amount of physician time for every patient walking in an outpatient set up, or ascribing the same treatment for all patients with the same medical treatment irrespective of biological diversity among humans.

Nonetheless, there is no doubt that programmes such as quality improvement, clinical auditing and implementing a set of standards and protocols have improved the overall outcome in the medical field. And, learning measures of quality improvement and preventing human error from high-reliability organisation (HRO) such as nuclear plant, aviation or automotive industries’ safety measures, contributed in the medical outcome. Yet, attempting to fully integrate such programmes in medical practice could add more harm than good.

For instance, in the automotive industry, the implementation of lean sigma by Toyota Company has led to an unprecedented level of quality outcome in the history of the industry. However, it would be totally irrational to expect the same outcome in the medical field because it’s simply about having a patient’s life on the line and not a car on a production line.

References available on request.

A complaint is an expression of dissatisfaction when there is a gap between expectation and delivery of a product or service. Complaints about healthcare rise year on year. Healthcare complaints are grievances that may be indicative of some system failures or individual failings or a combination of both. Individual failings may be symptomatic of typical behaviours or atypical e.g a response to an unknown mitigating factor such as workload or resources. Thus, complaints are representative of problems concerning individuals and, or their organisation.

Complaints and complainers

More recently, it has been suggested that complaints are partly indicative of the general public’s supposedly unrealistic expectations of healthcare expressed as a general lack of patient-centeredness if not ‘clinical heartlessness’ (Newdick and Danbury 2015: 956). Nevertheless, complaints are not considered patient safety red flags per se, but they do point to a broader conceptualisation of ‘harm’ (McCreaddie et al 2018). Moreover, patients’ legitimate concerns tend to extend beyond the initial complaint (or complaints) to the process and subsequent outcome (of the complaint).

Complaints are diverse, relatively unstructured, complex and emotive (Reader et al 2014). Many complaints evidence serial failings that subsequently breach a given threshold (McCreaddie et al 2018). In short, patients or relatives who complain are unlikely to simply complain about one issue. Understandably, once a transgression has occurred and there is no immediate successful attempt to resolve the grievance, then the healthcare relationship has been breached. Accordingly, this is likely to set off a cascade of additional serial complaints culminating in a formal ‘written’ complaint. In turn, complainants report psychological distress throughout the whole process; care to complaint – as well as with the subsequent outcome. Table 1 outlines complaint behaviour.

So, what can we do to help?

Service recovery is a term more akin to consumer industries and is a strategic approach to returning aggrieved customers to a state of satisfaction following a breach of expectations (Zemke and Bell 1990). Service recovery follows service failures and is aimed at maintaining the relationship and promoting positive word of mouth through prompt, efficient and successful complaint resolution. Successful complaint resolution is but one aspect of service recovery and enhances the consumer-provider relationship through a resultant perception of quality and value. Conversely, service recovery in healthcare is arguably wholly reliant upon complaint handling as opposed to complaint resolution, with the former reportedly lacking impartiality (Francis 2013), taking too much time and effort making relatives fearful of the implications for future healthcare and, perhaps unsurprisingly in the current context, unlikely to lead to a successful outcome (Wessel 2012).

The Middle East perspective

The Middle East and the UAE, in particular, is home to rapidly developing healthcare facilities who treat patients from across the region and beyond. It is also a cauldron of diverse nationalities and cultures that may have varying sensitivities and cultures – which in of itself, has the potential for gripes and grievances. Many healthcare facilities currently have patient relations officers and are likely to expend considerable time in addressing grievances. Yet, the Middle East is arguably a non-complaining culture but with a population with increasing expectations of healthcare and service. Complaints may, therefore, be made informally (via a third party) and may even focus on material aspects such as the type of room or furnishings – in addition to non-health/clinical issues.

The large non-Arabic speaking expatriate healthcare workforce who may not be viewed as positively as indigenous or western staff – more akin to maids as opposed to a respected professional grouping – may also be a contributing factor in a perception of disaffection. Moreover, the possibility of litigation and the concept of ‘blood money’ may potentially create additional pressures for staff who are dependent upon employment to support themselves and their families abroad.

Within the UAE the ‘complaints’ agenda has largely been addressed through Patient Satisfaction Surveys with the Government requiring the use of a variety of tools. In Dubai, all hospitals must be accredited by an external audit such as Joint Commission International or the Australian Council on Healthcare Standards. A critical standard within these external reviews includes assessment of patient satisfaction and the management of complaints.

The current tools used to assess patient satisfaction and review complaints in the UAE include:

• "Happy faces" – machines located throughout health facilities that allow patients to press a button that reflects their opinion of their experience and
• Formal satisfaction surveys sent to patients on discharge such as Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) and Press Ganey.

Quantitative tools used to assess patient satisfaction and manage complaints should be internationally recognised, be reliable and have both construct and predictive validity. Moreover, if patients and, or, their relatives take the time to either write a complaint, press “a face button” or complete a survey, then organisations must be prepared to reflect, and if appropriate, act. However, Table 2 perhaps gives some insight into these narrow but limited approaches. Healthcare is a complex, dynamic entity that cannot be distilled into a ‘Happy’ or ‘Sad’ face.

Conclusion

A review of 60 written complaints in the UK concluded that healthcare staff may benefit from understanding how complaints are formulated to be able to more appropriately address patients’ grievances from the outset and therefore, reduce the considerable associated harm for all concerned: patients, relatives and healthcare staff (McCreaddie et al 2018). The aforementioned ‘tools’ are laudable, but they arguably lack context, quality and importantly, fail to take account of the diverse cultural context in which healthcare in the Middle East is practiced and consumed. For the UAE to truly become a world leader in healthcare it needs to better understand not just what people complain about but why people complain, how they complain (or not) and their expectations with regard to resolution.

References available on request.

Atopic dermatitis (AD), also known as atopic eczema, is a chronic relapsing inflammatory skin condition. Incidence of AD has increased 2- to 3-fold in industrialised nations, impacting approximately 15 to 20 per cent of children and 1 to 3 per cent of adults worldwide. Arab Health Magazine spoke to Dr. Anwar Al Hammadi, who is a consultant dermatologist and Head of the Emirates Dermatology Society in the UAE, about the methods and challenges of treating AD, as well as its impact on the society.

What is Atopic Dermatitis and what causes it?

Atopic Dermatitis, which is the most common form of eczema, is a chronic inflammatory skin disease resulting in itchy, red, swollen and cracked skin. While the condition may occur at any age, the rashes tend to flare, go away and come back. Doctors don’t know exactly what causes AD, and it can look like several other skin conditions as eczema affects people differently – making diagnosis and treatment difficult.

How does Atopic Dermatitis affect people with the condition?

Having the condition or living with a loved one who suffers from it has the potential to affect many aspects of everyday life. Apart from physical discomfort from the intense itchiness, the disease can trigger emotional distress; for instance, showing up to work every day with big red scaly spots on your face is a challenge that people with severe AD face at some point in their lives.

Can you tell us about some of the methods and challenges to treating Atopic Dermatitis?

Current treatments include emollients, topical creams and steroids, though the latter is associated with unpleasant side effects. However, being an AD patient in the UAE means that you have access to the latest and most innovative medications and therapies in the world.

In terms of challenges, proper treatment and clinical care for AD tend to get complicated by social media and ‘diagnosis by Google’. Patients ask me all sorts of questions, especially through my Instagram and Snapchat accounts, about certain ointments and remedies that they’ve read about online. It would be ideal if they would consult with their doctor before trying any new products on their skin. Seeking treatment plans from good medical experts is crucial to help reduce the physical and emotional impact of AD on your quality of life.

Moreover, while our approach to individuals is important, I strongly believe that supporting people with AD requires moving beyond just prescribing treatment – we need adaptable solutions that span the whole community.

Can you elaborate on some of these solutions?

We need to target the complex network that encompasses individuals and their families, the social networks and relationships in their lives, the organisations and institutions that provide services and support to the patients and the communities in which they work and live.

The kind of health advice that people receive close to home, in their own environment, is among the most influential in determining their health behaviors. Therefore, families need to be well equipped with the knowledge of how to deal with the worst side effects of Atopic Dermatitis that their loved one may be encountering, such as anxiety and depression. There are a few coping strategies families can use to help their children manage the emotional challenges of eczema. Preventive counseling is also a good option for parents to consider. We often don’t think about counseling until there is a big problem, but often it’s more effective if it’s in the early stages of change.

What are some examples of successful community initiatives that can inspire the same for Atopic Dermatitis?

A great way to educate the community and get it to take action is through awareness campaigns. You’ve probably heard of the ALS Ice Bucket Challenge which has raised more than US$115 million for ALS charities since 2014. This is a very good example on how to make noise for a cause and how far the results can go.
Another way to target the community is through education. Explaining what AD is and isn’t is crucial to create a better understanding of it, which will ultimately lead to better disease management. AD is chronic, non-contagious and non-curable, and when the general public understands that, it will be better equipped to support family, colleagues and loved ones who are dealing with it. It may lead employers to become more flexible and peers to be less judgmental and more supportive.

AD is chronic, non-contagious and non-curable, and when the general public understands that, it will be better equipped to support.

Are there any current initiatives that address Atopic Dermatitis?

Yes. We have created a nationwide initiative called #LivingWithEczema, in collaboration with Sanofi, to highlight the struggles of patients with AD, and raise awareness of the fundamentals of the disease and on its treatments available in the country. We are a network of thought leaders whose mission is to own the conversation and drive more awareness of AD in the UAE in order to help them achieve the best of their health and wellbeing. We hope that through our community-based approach we are able to reach as many families as possible and bring as much comfort to patients as we can

In a recent survey commissioned by Landmark Group, family/social support emerged as vital in successfully managing diabetes – in addition to a thorough understanding of the initial signs and symptoms of the condition to prevent it.

According to the International Diabetes Foundation, by 2020, an estimated 32 per cent of the adult population (between ages 20-79) in the UAE, including both UAE nationals and expatriates, may have diabetes or prediabetes over the next decade, if current trends continue.

Results from the recent survey conducted in the UAE indicated that family and community support, awareness of diabetes symptoms, regular blood testing and improved awareness on the condition as such play the most important role in diabetes prevention and management.

Below is an in-depth look at the results:

* Close to 60 per cent of people between the age of 25-34 years agree that they would struggle to recognise if they were suffering from hyperglycemia (high blood sugar) or hypoglycemia (low blood sugar). Ages between 16-24 are the least aware of the symptoms of diabetes.

* 77 per cent of respondents emphasised on the need for improved awareness on the condition to ensure effective diagnosis and prevention of any complications.

* 46 per cent of people agree that they lead a sedentary lifestyle and have a poor diet.

* 57 per cent of the survey respondents that have a family member affected by diabetes, think that feeling tired is the main symptom of diabetes. Identifying the early signs and symptoms of diabetes is important to reduce the impact of the disease and maintain good health. Some of the most common signs of type 2 diabetes include constant tiredness, blurred vision, frequent urination, slow healing wounds and weight loss.

* Close to 30 per cent of people with diabetes who participated in the survey strongly agree that they lead a sedentary lifestyle and have a poor diet. As per the International Diabetes Federation, these are the two major risk factors contributing to the high prevalence of diabetes in the UAE and wider region. This calls for a change in the lifestyle – one that addresses the lack of exercise and unhealthy diet. Addressing this, 82 per cent of the total respondents agreed that that they believe they can prevent diabetes by leading an active lifestyle and eating healthy.


* Results from the survey also suggested that 55 per cent of adults encourage their family to be healthy by making home-cooked meals. In addition to this, taking part in recreational activities together, going for regular walks, and discussing about the importance of being healthy topped the list of preferred ways to stay healthy. To successfully manage diabetes, family/social support is imperative in addition to a thorough understanding of the initial signs and symptoms.

Identifying the early signs and symptoms of diabetes is important to reduce the impact of the disease and maintain good health.

A leader is one who knows the way, goes the way, and shows the way.” A good leader has a futuristic vision and knows how to turn ideas into reality.

The Central Sterile Services Department (CSSD) is considered as the heart of the hospital, as the heart takes impure blood, purifies the same and supplies it to all the organs of the body to function well. CSSD too takes all used material of the patients, sterilises the same, and supply it back to use on another patient. Hence, CSSD is of utmost importance in the hospital set up in controlling Hospital-Acquired Infection (HAI).

The staff working in CSS needs to have a science background that will allow them to understand the principles of killing mechanisms of microbes, the relation between time and temperate that helps sterilise the goods, importance of humidity and many other basic criteria of sterilisation techniques. Only when a staff understands these sciences and its implications then only can they be performing their job well. A job well done can lead to success that is indicative of no or minimum rates of HAI’s. Therefore, to achieve the best results, CSSD must be led by an efficient leader.

A leader can be efficient only when they possess thorough technical knowledge. As the education qualification of the staff ideally has to be with a science background, it is important that the person leading the department should too possess a degree in science. The leader should have at least 10 to 15 years of experience in the field, as experience is the best teacher.

Manpower challenge

There are many challenges in the field of sterilisation that have to be handled by the leader. The first and foremost challenge is to handle the manpower. Manpower is the biggest source that needs to be handled appropriately, as if not handled well it could cause a lot of problems. No one person can do the job well, it is a team that has to work not just the individual. Therefore, the leader has to keep the team spirit high at all times. This will be done by developing trust amongst teammates. Never compromise your team’s trust in you by assigning a job that is well beyond their capability level. If the job is not done well then you will lose trust with the staff and with customers too, which is very difficult to gain.

Communication is another important aspect of leadership, as one can’t expect the team to understand and execute a task without clear communication. To have clear communication, the leader must have a clear vision or goal. That is why it is stated that before you initiate any action you should plan and re-plan. For example, with a surgeon, it is important as a leader to train and educate the staff well to address the request with due dignity to the position.

A leader should constantly upgrade their skills but also train and retrain the staff working in their units. If the employee is deemed to be incompetent, then the manager must work with the employee until they can complete the proper steps.

The leader should ensure the staff’s cross-functional training that will help them gain the necessary knowledge on operating procedures with importance on having the right instrument for right procedures. Such training not only improves knowledge but also boosts the confidence of the CSS staff to enhance productivity.

It is equally important to provide sufficient resources to cope with the workload. In case of insufficient resources, there could be challenges in providing the right set of instruments at the right time and that could lead to the use of improper/additional instruments, ending up increasing the workload of the department.

The general tendency of the staff working in CSS is that they feel that they are packers. However, the leader should enforce the importance of cleaning, packing, and labelling, as that involves a lot of quality control measures and this is the job of the CSS personnel.

Another important criterion is that the staff should be given freedom of speech, as only then the manager gets to understand the ground-level situation that further helps to improve the protocols.

Leaders need to generate loyal employees and promote trust throughout with open communication with the team. Leaders should not view themselves as better than or above the rest of the team. Employees appreciate if their opinion is valued and respected by the leader. The same helps in achieving employee satisfaction that aids efficiency and enhances productivity.

Medical optics and instruments company Olympus has announced the regional launch of its surgical orbital camera system, ORBEYE – for microsurgical procedures. The newly introduced tool is expected to enhance microsurgical procedures for neurosurgeons who at present rely on traditional microscopes for their precision surgeries.

The launch of the ORBEYE Camera System into the regional market from Olympus’s UAE MEA headquarters aims to ease operational processes for surgeons and to provide them with clearer viewing capabilities, with the incorporation of the new instrument into surgery aimed at ultimately improving patient outcomes. The adoption of the ORBEYE Camera System provides a host of advantages to neurosurgeons, which will in turn translate into better patient outcomes not only in the MEA region but also across the world.

ORBEYE is the first optical technology system to utilise a 4K and 3D camera, with the advanced features serving to augment surgical visibility in the field of neurosurgery through immersive imaging. By using this innovative instrument, neurosurgeons are presented with a more ergonomic solution to surgeries stemming from the removal of ocular lenses, with other consulting surgeons also able to join the procedure and enable multi-expert procedures. This also gives rise to the suitability of the ORBEYE for training and education, as all procedures are clearly visible on the large screen. Enhancing these advantages, ORBEYE is also functionally beneficial, being both simple to set up and manoeuvre, within the operating room, while occupying far less space than its predecessor.  

Latest tech

“Today, we are launching into the UAE a revolutionary surgical orbital camera system that changes the way neurosurgeons perform their surgeries,” said Maurice Faber, Regional Managing Director at Olympus MEA. “With precision surgery being at the forefront of surgical operations, we have created a camera system that incorporates the latest advances of 4k and 3D video technologies. This will not only improve surgical accuracy as it provides high resolution stereoscopic images of the fine structure of tissue and blood vessels, but it will also create better outcomes for patients of the UAE and the wider region in need of neurosurgery.”

The camera system incorporates the latest advances of 4k and 3D video technologies.