The UAE is working with various stakeholders to strengthen its health surveillance system to ensure preparedness against the next pandemic and other communicable diseases, said Dr. Farida Al Hosani, Infectious Disease Expert and Executive Director of Infectious Diseases, Abu Dhabi Public Health Centre, at the Medlab Middle East Congress 2023, held in Dubai between February 6 and 9.

“We are automating and further developing our electronic notification system to be more integrated with the public and private hospitals. We are also expanding our passive and active surveillance for influenza and a wider panel of respiratory diseases that we would like to keep a close eye on. We want to identify any risks that might emerge from, say, MERS, RSV, adenoviruses, and other panels of respiratory diseases. These are part of our routine surveillance. We want to evaluate the priorities of the coverage and distribution of a vaccine. The availability of vaccine and treatment advocacy is important to lower the burden of infectious diseases,” said Dr. Al Hosani while discussing the ‘Current status of COVID-19 and Monkeypox in the region.” 

The pandemic is at an inflection point, as per the World Health Organisation, which means high levels of immunity to the virus SARS-CoV-2 are beginning to limit its impact and reach. As of February 7, 2023, the WHO dashboard reported 75,000 new cases in the previous 24 hours. Over 750 million people have been infected globally and over 6.8 million lives have been lost since the onset of COVID-19 pandemic in late 2019. “Both figures, however, seem to be underreported as the burden of disease was way high.”   

Talking about influenza, Dr. Al Hosani mentioned that the UAE is closely monitoring the changes in the virus. “Globally, there have been reports of Tamiflu-resistant strains, which makes the disease more severe. Having new modes of treatment, and participating in different clinical trials to identify new treatments is, therefore, very important at this stage. The public awareness campaign is part of our overall continuous strategy to engage with the audience. The higher the trust we develop, the more effective our strategy in controlling infectious diseases will be.” 

The UAE health authorities routinely conduct risk assessments of diseases that can pose threats to public health on a periodic basis. It has recently finished risk assessment for this year to gain a wider scope of understanding on where its focus should be this year. 

Visit Medlab Middle East 2023 to attend thought-provoking sessions led by industry experts from across the globe.

 

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The high cost of point-of-care testing (POCT) services is one of the biggest impediments to its greater use and adoption in less fortunate countries, said Prof. Khosrow Adeli, Division Head, Clinical Biochemistry, The Hospital for Sick Children, Canada.

“The cost of POCT is a major concern. POCT tends to be more expensive than tests conducted in laboratories, which poses a challenge to greater adoption in less fortunate countries. But I think many countries are developing their own point-of-care systems. There is growth in the In-Vitro Diagnostics (IVD) industry. Systems become more affordable when they are produced locally,” said Prof. Adeli at the sidelines of his session on ‘POCT in paediatrics: An inherently ideal tool in patient management’ on the second day of Medlab Middle East Congress 2023 in Dubai on February 7. 

Over the past decades, diagnostic testing has steadily moved out of the central laboratory into testing sites closer to patients. The ease of use of POCT for a number of medical conditions has facilitated greater disease diagnosis and allowed better monitoring and management. 

POCT is available for pregnancy testing, blood glucose, HIV, haemoglobin concentrations, complete blood count, cardiac biomarkers, and numerous additional applications. 

Thousands of new POCT devices are introduced each year and the industry has been growing at 7 per cent annually. 

“I think there is a huge potential for growth of this industry in the Middle East. Before the pandemic, the global market for POCT was growing at 7 per cent per year, but in the last couple of years, the market has expanded significantly. The surge in popularity isn’t just for testing COVID-19 but for a host of other medical conditions too. There is a significant need for POCT in acute care hospitals, primary care and rural and remote areas that do not have access to hospitals or laboratories. The sector will continue to register robust growth in the region,” noted Prof. Adeli. 

Households and healthcare workers have increasingly adopted advanced testing technologies and care strategies. This approach provides rapid, highly sensitive and low-cost testing, in addition to improving diagnostic, therapeutic, and monitoring practices, thus, increasing patient satisfaction. 

Talking about the clinical utility of POCT in paediatric healthcare settings, Prof. Adeli added: “Access and use of PCOT can have a significant impact on a child’s health. Take, for instance, diarrhoea. It is a major killer of infants. If parents can do a quick test and see that the electrolyte levels in the child are suddenly dropping, they can give the child fluids, which could prevent the health from getting worse.”

POCT is playing a crucial role in emergency medicine, critical care, and at-home monitoring. According to Global Market Insights, the market size of the POCT industry is more than US$34.6 billion and it is estimated to grow at a CAGR of 7.9 per cent between 2022 and 2030. 

 

Visit Medlab Middle East 2023 to attend thought-provoking sessions led by industry experts from across the globe.

 

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Patients are more comfortable with finger pricks versus a venous draw, which is strengthening the popularity of point-of-care testing across the globe, shared Prof. Rajiv Erasmus, Head of the Department of Chemical Pathology at the University of Stellenbosch in South Africa, at his session, “Connectivity strategies in managing Point of Care services” that took place on Day two of the Medlab Middle East Congress 2023.

Complimenting the phenomenon, multiplex testing is further set to be the next biggest trend in the field, as it provides an accurate diagnosis of multiple underlying infections in one sitting while retaining quality control. “We are now getting point of care instruments that are very precise, accurate, portable and use very small amounts of blood,” Prof. Erasmus added.

Prof. Erasmus was among the speakers sharing the latest insights and developments under the Technological Advances and Vital Clinical Impact track, supported by The International Federation of Clinical Chemistry and Laboratory Medicine.

Point-of-care testing is currently at the forefront of creating value in healthcare. Its features ranging from digital data collection and use of real-world data to the integration of customised patient care are further contributing to the rapid development of a new healthcare landscape. For physicians, this means optimised processes that fulfil the ongoing demand for accuracy and timeliness in clinical decisions.

Prof. Erasmus also highlighted the importance of streamlining the care pathway through the optimisation and improvement of processes. This involves aligning four critical dimensions of efficiency, economics, safety and reputation, which not only reflect the key needs of healthcare providers but also enhances the value of healthcare provisions for stakeholders in the industry.

To secure continuity and growth, there is a need to ensure the automated validation and transfer of patient results to Electronic Medical Systems. Prof. Erasmus said that this could be achieved through the development of open-access data mx systems to enable connectivity to any devices from any manufacturer.

Visit Medlab Middle East 2023 to attend thought-provoking sessions led by industry experts from across the globe.

 

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Data in silos is not very useful, but it becomes extremely valuable when different data points are integrated and refined, said Dr. Abdullah Nasser AlJurayyan, Executive General Director, Laboratory Operations Centre, Health Support Services, Ministry of Health, Kingdom of Saudi Arabia. He was speaking on the first day of Medlab Middle East Congress 2023 in Dubai on February 6. 

“Data has played a crucial role in allowing us to successfully manage the pandemic in Saudi Arabia. Initially, we had a unidirectional, reactive, and manual approach to public health. But COVID-19 provided us with a push towards digitisation, and we have transformed our health sector into adopting a digital-first approach for improving quality of service and access to care.”

He further noted that if in March 2020, various entities in the Kingdom of Saudi Arabia operated in silos and followed non-standard communications and processes, the public health system today is thriving on the back of good use of technology.

“Today we have centralised management, defined governance, and operations. Various entities in the public health space follow standardised and documented processes, communications, and quality leads. The country has also leveraged multiple databases and applications to gain access to required data and has fully integrated services with live sample tracking and end-to-end visibility,” said AlJurayyan. 

Saudi Arabia is now keen to build on the successes achieved in the health sector during the pandemic. The country is building a national database to serve ID public health programmes. It plans to leverage microbiology data to detect the prevalence and pattern of bacterial outbreaks. “We also plan to build laboratory-based surveillance, understand the local bacterial resistance pattern, and use data analysis to ensure hospital readiness and capacity.” 

Saudi Arabia’s Ministry of Health collates data on bacterial antimicrobial resistance stewardship, multi-drug resistance rate, food poisoning, dengue fever, Candida auris, Tuberculosis, meningitis and influenza from laboratories.    

The mining of laboratory data from across the country has helped the Ministry of Health to refine various screening programmes and improve the quality of life of the local population.

“We have been able to introduce new models of care that focus on prevention as part of the Vision 2030 initiatives of the government. We plan to improve the quality of care which can be met by preventive health measures,” said AlJurayyan. 

KSA conducts mandatory newborn screening, prenatal screening, cancer screening, and premarital screening in its public healthcare centres. 

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Leaders in the laboratory need to view total lab automation as a tactic, else they may be putting time and resources at risk, according to Dr. James Donnelly, the technical director at the National Reference Laboratory in the UAE. In this case, he defined ‘tactic’ as specific actions undertaken to achieve a strategy, while ‘strategy’ is the action plan that takes laboratory professionals where they want to go.

Dr. Donnelly was among the top speakers at Medlab Middle East 2023 where he led a session titled, “Making the most of laboratory automation” under the banner of Managing technology and innovation.

Total laboratory automation is being able to move workflow from point A to point B faster without affecting research data and samples. This concept can be applied to virtually any type of lab besides traditional clinical chemistry labs, such as haematology, immunology, microbiology and infectious disease diagnosis. However, total laboratory automation is a costly process.

“Laboratory automation is a very expensive and laborious process, which is why we need to identify the reasons to opt for it, rather than do it because we think it is expected of us great thing to do. Without the tactic, we would simply be wasting time and resources,” Dr. Donnelly said.

Addressing lab directors and those responsible for laboratory operations and administration, he advised selecting one or a combination of approaches to ensure successful automation in the lab. This involves a focus on staff resource drivers, quality, safety and supply chain.

Dr. Donnelly explained that this includes looking at reallocating staff and implementing a standardisation of practices from a staff resource perspective. We also need to look at the multiple labs that are operating under different quality systems and standard operating procedures (SOPs), non-standardised instrumentation and non-harmonised results, as well as reducing the number of vendors and distributors in the supply chain.

Dr. Donnelly further broke total lab automation down into two areas — people and processes— as crucial parts of sustainable implementation.

“We need to look at current skillsets and what future skillsets would look like. Essentially, you would want to have the right mix of people and skills that you could transition or reallocate to other areas where they would benefit,” he said.

In terms of workflow, professionals should focus on pre- and post-analytic steps, informatics, menu as well as existing dependencies and workarounds. He also highlighted that improving turnaround and efficiency can come at a later stage in the system and should not be the primary focus during transition.

Visit Medlab Middle East 2023 to attend thought-provoking sessions led by industry experts from across the globe.

 

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Sustainability is a global responsibility, said industry leaders during a panel discussion on the first day of Medlab Middle East 2023 on Monday.

“Policymakers and governments have to sit together and agree on legislation to make healthcare organisations less polluting to the environment, including the pathology industry. While the pathology industries in Europe, Canada, US, and the Middle East are doing well, the same cannot be said for some developing countries. We need legislation for sustainability, equipped with incentives, taxes, subsidies, green finance, etc. Healthcare systems and organisations should be supported in their green efforts and sustainability practices,” said Dr. Rana Nabulsi, Head of Operations and Quality, Pathology and Genetics, Dubai Academic Health Corporation.

The comments were part of the panel discussion: Holistic approaches to reducing the environmental impact of clinical laboratories. 

Laboratories, in general, are resource-intensive spaces and use up to 10 times the energy and four times the water of a typical commercial office building. The industry also significantly contributes to plastic pollution. 

Green policy initiatives in the healthcare sector, in general, and laboratory space, in particular, could reduce greenhouse gas emissions and have a positive impact on climate change.

“Sustainability is an ecosystem with various stakeholders such as patients, regulatory agencies, legislators, insurance companies and policymakers, C-suite leaders, etc. It needs a big organisation such as the UN that can allow collaboration across stakeholders and countries and ensure the same standards are followed on sustainability everywhere, noted Dr. Nabulsi, adding: “We need to support less fortunate countries. We need a budget, leaders, policies, incentives, taxes, in addition to awareness. We need global stewardship to work towards a net zero carbon footprint.” 

These sentiments were echoed by other panelists too. “We have a number of policies already in some of the Western countries, but we need a more global approach to this. We need to work with developing countries to improve resource management,” said Dr. Bernard Gouget, IFCC, France.

Accreditation is another effective way to nudge the pathology industry towards a more sustainable way of working, opine the industry leaders. “One of the best ways to get more effective in our message is to work with an accreditation and quality management organisation because sustainability should be part of the guidelines. If activation bodies try to enforce proper utilisation of resources in laboratories, in addition to their current focus on quality, it will help the cause,” said Prof Sergio Bernardini, IFCC Division on Emerging Technology, Italy.

Sustainability is an aspect of public health and should be accorded the same importance as other industries. “It is imperative that the government leads the charge on this front, otherwise the industry might not have the urge to commit to the cause. There should be guidance from the Ministry of Health. We need auditing to ensure compliance with standards. It will be great to see incentives or subsidies for SMEs and startups to encourage them to work on this front, concluded Dr. Nabulsi. 

The global pathology laboratories market was valued at US$311.2 billion in 2021 and is expected to expand at a compound annual growth rate (CAGR) of 7.86 per cent from 2022 to 2030, as per Grand View Research. 

The increase in the number of healthcare facilities in developing nations, the growing demand for routine medical check-ups, and the improvement in the reimbursement for diagnostic tests are major factors driving the market. Global regulations for this industry embedding sustainability as a key aspect of organisational operations could reduce the negative impact on the environment.

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