From the moment we are born, breathing is an instinctive, natural part of our lives. The inability to breathe is a powerful sensation that can impact one’s life dramatically. End-stage lung disease patients carry this burden with them every day. While early-stage lung disease can be managed medically, lung transplantation is the only effective therapy for advanced lung disease and lung failure.

In the UAE and Gulf region, the common causes of end-stage lung disease and lung failure include pulmonary fibrosis, interstitial lung disease, cystic fibrosis, pulmonary hypertension and, in recent years, COVID-19-related lung fibrosis and failure. In advanced disease, medical therapy may not be able to provide adequate care and lung transplantation remains the only feasible option to improve the quality of care and provide longevity.

Dr. Usman Ahmad, Department Chair of Thoracic Surgery and Lung Transplantation at Cleveland Clinic Abu Dhabi, explains that unlike abdominal organ transplants (kidney, liver), access to lung transplants is limited.

He says, “While there are fewer lung transplant centres in the world, there continues to be a critical shortage of transplantable donor lungs. As a result, there are thousands of patients waiting and sometimes, unfortunately, dying from the progression of their lung disease while waiting for a transplant.”

He adds, “Cleveland Clinic Abu Dhabi’s lung transplant programme is uniquely positioned to serve UAE residents and patients from surrounding countries as well as Asian and European markets. The landscape of organ donation in the UAE has dramatically evolved over the last few years.

“With governmental support, increasing education and awareness and the institution of appropriate laws, we have become an international hub for evaluation and treatment of patients with end-stage lung disease.”

Dr. Usman Ahmad

Just in the last six months, Cleveland Clinic Abu Dhabi, a Mubadala Health partner, has evaluated lung transplant patients from various geographies. Patients were evaluated based on the severity of their illness, and when appropriate, lung transplantation was offered. With six double lung transplants performed in the second half of 2022 and two double lung transplant surgeries already conducted in January 2023, the programme is growing rapidly and has become a regional and international referral centre.

Partnerships with the National Programme for Organ Transplantation and the Department of Health — Abu Dhabi (DoH) have been critical in establishing lung transplant services in the UAE. The programme has provided invaluable expertise and resources in enhancing societal awareness regarding donation and transplantation and plays a critical role in ensuring appropriate donor management, logistics support and, most importantly, a transparent and ethically sound process of donation and allocation.

Thanks to its state-of-the-art amenities that deliver world-class service standards and a multidisciplinary approach to care, patients can receive cutting-edge transplant facilities right here, ‘at home’. This forward-thinking approach aligns closely with the Department of Health – Abu Dhabi’s vision to develop a healthcare hub in the region as a sought-after destination locally and internationally for patients seeking easily accessible premium healthcare and services.

Some unique aspects of the lung transplant program at Cleveland Clinic Abu Dhabi include regional partnerships with other countries to enhance access to recipients as well as donors. The multidisciplinary surgical, medical, critical care, pulmonary, pharmacy, immunology and physical rehabilitation teams have worked together to support and transplant some very ill Emirati as well as international patients who had been deemed high risk for a transplant in other countries.

“In dealing with lung failure, sometimes we have to support the patients with extracorporeal membrane oxygenation (ECMO). We have a state-of-the-art respiratory ECMO programme led by Dr. Vivek Kakar, where our physicians can evaluate and place patients on lifesaving therapy at local and regional hospitals if required. If appropriate, these patients can then undergo lung transplant at Cleveland Clinic Abu Dhabi,” says Dr. Ahmad.

Back to Clinical

AI is poised to revolutionise the healthcare industry, providing numerous opportunities to streamline processes, improve patient outcomes, and enhance efficiency in healthcare delivery. The technology provides a vast and complex network of algorithms, machine learning, and deep learning algorithms that can analyse vast amounts of medical data and provide actionable insights, improve decision-making and reduce the burden on healthcare providers.

“Artificial Intelligence (AI) is taking us into a new medical era. We are not replacing radiologists. However, radiologists are facing a lot of problems with findings in medical images. Thus, the future of healthcare is in AI because the amount of data is immense, and with all the technologies of modalities, there will be a huge amount of data and a human being cannot interpret all this,” said Charbel Makhoul, AI Solution and Healthcare IT Director — Russia, Turkey, Middle East and Africa at Canon Medical, who showcased some of their advanced medical solutions that integrate artificial intelligence and deep learning at Arab Health.

The summation of all this data as it grows whether it is created, captured, or replicated – has been termed the Global Datasphere, and it is growing at an unprecedented rate. experiencing tremendous growth. IDC predicts that the Global Datasphere will grow from 33 Zettabytes (ZB) in 2018 to 175 ZB by 2025. This translates to approximately 175 billion terabytes. Healthcare data alone is set to grow at a CAGR (Compound Annual Growth Rate) of 36 per cent during this period, outpacing other industries such as manufacturing, financial services and media.

In recent years, the healthcare industry has witnessed major advances in AI, with numerous applications and use cases that are helping healthcare providers improve patient outcomes, reduce costs, and enhance operational efficiency. From virtual assistants, chatbots, and predictive analytics to machine learning-powered diagnostic tools, it is increasingly becoming a vital tool for the industry worldwide.

One of the key areas being transformed in healthcare is disease diagnosis. AI algorithms can analyse millions of medical documents including imaging scans, lab results, and patient histories, and provide doctors with more accurate and faster diagnoses. In fact, a study by Stanford University found that an AI algorithm was better than human radiologists at detecting breast cancer in mammograms, with a diagnostic accuracy rate of 89 per cent compared to 86 per cent for human radiologists.

Personalised medicine is also being transformed due to AI, as algorithms can parse vast stores of insight and information, including genomic data, patient histories, and lifestyle factors to provide highly customised treatment plans and recommendations. This not only helps improve patient outcomes but also reduces costs, as the technology can help identify and avoid ineffective treatments. A recent study by the Harvard Medical School found that AI algorithms were able to recommend personalised treatment plans for patients with depression with an accuracy rate of 77 per cent. This personalisation also translates into other areas of healthcare provision, as the machine learning elements of AI have given rise to new ways of interacting with patients. Virtual assistants, chatbots, and other AI-powered tools are providing patients with access to healthcare services 24/7, reducing wait times, and improving overall patient satisfaction.

Another aspect of healthcare being transformed by AI is the optimisation of clinical workflows. Algorithms can help healthcare providers manage patient queues, reduce wait times, and optimise staffing levels, providing a more efficient and effective healthcare experience for both patients and providers. A study by McKinsey found that AI algorithms can help healthcare providers reduce patient wait times by up to 35 per cent.

The much-needed transformation of healthcare delivery, improved patient outcomes and reduced costs, clearly make AI a critical tool that cannot be ignored by healthcare sectors worldwide.

 

This article appears in the Daily Dose 2023. Read the full issue online today.

Back to Technology

The pace of change witnessed across all sectors in recent years, combined with the need for innovation and next-generation problem-solving to address some of the planet's greatest challenges, makes it crucial to drive representation across every aspect (or part) of the supply chain.

When it comes to the healthcare sector, women account for 70 per cent of the industry’s workforce globally and 59 per cent of all graduates in the medical, biomedical, and health sciences fields. Although these are very positive signs, only 25 per cent of senior leadership roles globally are held by women - which represents a significant missed opportunity. If we do not represent everyone, we cannot innovate for everyone. This is especially important in healthcare, where women constitute the majority of the workforce but are vastly underrepresented in leadership roles.

The lack of gender diversity in leadership is not only a gender issue but also presents business and societal challenges. In an interview, Tracy Goodridge, Head: Novartis Middle East & Africa Aspiring Markets, stressed that it is crucial to take action to address this systemic problem. As the world celebrated International Women's Day earlier this month, the theme of Embrace Equity served as a timely reminder of the urgent need to bridge the gender gap and ensure equal representation in all sectors, including healthcare. Excerpts:

In your opinion, what does it mean to "embrace equity", and why is it important for organisations and industries to have female representation in leadership positions?

When we talk about embracing equity, it needs to be more than a hashtag or a catchphrase we leverage for a day. It should mean understanding that the leadership team of any organisation or industry should reflect the market itself – including the perspectives and experiences of women.

It should not just be about diversity for diversity's sake; research shows that diverse teams are more innovative, productive, and successful. In fact, a McKinsey report found that companies in the top quartile for gender diversity were 25 per cent more likely to have above-average profitability than companies in the bottom quartile.

Female representation in leadership positions can also play a key role in prioritising women’s health issues, leading to more data being generated in women’s health that has to date been missing and created a gap in care. 

Inclusive research starts with inclusive leadership, and it’s up to both men and women across all ethnicities and abilities to ensure this equity is embraced.

Tracy Goodridge

How can we create a culture where women can thrive and succeed and where their contributions are recognised and valued on International Women's Day and beyond?

To create a culture where women can thrive and succeed and where their contributions are recognised and valued, leaders should commit to embracing equity, challenging the status quo, and standing up for women's rights. This involves taking risks, placing a bet on diverse leaders who bring innovative ideas and fresh perspectives, and breaking the glass ceiling to unlock the full potential of female leadership.

Organisations must create a culture that values and recognises women's contributions, whether it's through acknowledging their achievements, providing equal pay and benefits, or ensuring their voices are heard in decision-making processes. Creating a culture where women can thrive also requires a long-term commitment to gender equity and a willingness to take action to address systemic inequalities.

By supporting women's career growth, providing equal opportunities for leadership, mentorship, and career development, and creating a more inclusive and diverse workplace, organisations can promote gender equity and help all employees reach their full potential.

What specific initiatives has Novartis undertaken to increase female representation and empower women leaders?

I am so proud that Novartis not only talks about increasing female representation and empowering women leaders in healthcare and beyond but actively puts in the steps to achieve it. We understand that diversity and inclusion are not just buzzwords but essential ingredients for success.

In 2018, we joined the United Nation’s Equal Pay International Coalition (EPIC) and pledged to conduct regular gender pay equity analyses and remediate annually as appropriate to help prevent pay differences. We also pledged to eliminate the use of historical salary data when making internal and external officers, and we committed to pay transparency by sharing with our associates their pay as compared to internal and external benchmarks.

So far, we are live with pay transparency in 32 countries globally, and we have achieved global balance in management, with men representing 53 per cent of our managers and women at 47 per cent. 100 per cent of our associates globally have access to parental leave, and 84 per cent of our recruitment efforts no longer ask for historical salary.

A further 47 per cent of associates now have pay transparency to external benchmarks and 85 per cent of associates are covered by a regular pay equity study. To date, we are still the only pharma company to have signed the EPIC Pledge.

Back to Management

Are   we   ready   for   telemedicine   in anesthesia?  Dr.  med  Andrea  Vincenzo Braga, CEO, Bragamed, Baar, Switzerland, says  ‘yes’.  He  highlighted  that  the  medical industry has always been ready for the concept of remote consultation, considering the significant evolution in communication channels to accommodate it. “Telemedicine existed since the 1800s when a telegraph-based teleconsultation took place in Barrow Creek, an Australian outback, in 1874. As I looked into various research publications, I found that even certain instructions for anaesthesiology, or even surgery, were shared by telegraphy. The recent pandemic simply brought telemedia in anaesthesiology back into the minds of medical professionals and end-users,” he said.

Looking ahead the future of telemedicine itself is bright. According to Statistica, the ehealth market is poised to grow by Euro 78.1 billion by 2025, further driven by significant mobile smartphone ownership notably among users aged between 18 and 49 years. Dr. Braga also highlighted that the latest advances in technology have made video teleconferencing seamless. However, media training is a scope that is not often addressed to improve the remote interaction between practitioner and patient.

“One thing that is very important for those involved in various disciplines that use telemedicine — from the anaesthesiologist and GPs, to paediatricians and psychiatrists — is that we need to understand how to maximise the use of technical devices,” he said.

This includes retraining doctors to be more confident on camera and teaching them how to present themselves during live video consultations to build a level of trust among patients. Telemedicine in anaesthesia remains largely unexplored, but healthcare leaders such as Dr. Braga is paving the way for the design and installation of state-of-the-art telemedical consultation centres to enhance the delivery of care in different phases. 

In his keynote, Dr. Braga highlighted that telemedicine in anaethesia involves pre-medication consultation, management of anaesthesia and observation during patient recovery. It can further offer university-level support for rural hospitals, and establish pre-operative settings for standard operations on healthy patients.

“I would really like to highlight that one case published in the British Journal of Medicine last year, around 2,800 or so patients were doing the pre-interventional visits with anaesthesiology, and this showed a very high success rate,” he said.

While the need for medical care in remote areas has traditionally driven telemedicine and its adoption, there are newer trends taking it to newer heights. Among these is the need for more GPs and specialists across the world. Dr. Braga states that Europe, in particular, is faced with an imminent shortage of general practitioners as 70 per cent of the existing doctors are above the age of 55 years. This is because the new generation is less motivated to march down the general practitioner route or work long hours. This is further coupled with the desire to work part-time as a work-life balance has become a priority. As a solution, telemedicine helps professionals be geographically independent, reduces commute times, creates opportunities to interact on an evolving work model, and allows flexibility in practice.

“Rising healthcare costs are challenging financing systems,” he added. “We also need to consider the behavioural change in how and when medical advice is sought,” he said. To stay abreast of trends, medical practitioners need to rethink existing processes and adopt novel ways to integrate technology into the field.

“We have to rethink how we perform medicine, which may involve letting go of old habits and accepting change. Telemedicine and other forms of technology are here to stay. It is also important to be able to use our resources in an intelligent way that involves both the physician and patient,” he concluded.

This article appears in the Daily Dose 2023. Read the full issue online today.

Back to Technology

Innovation in radiology and imaging has been an area of increased focus in the medical industry  over  the  past  decade, with new technologies  and  visualisation advancements emerging at a rapid pace.  Artificial Intelligence (AI) implementation and advancement in imaging technologies have been crucial to developing more accurate results, thereby improving diagnoses and patient treatment options.

“The ultimate basis of acceptance and use of imaging is strong clinical evidence supporting the value. It is value based. You might have the best tool in the world, but if it doesn’t change the patient outcome then it doesn’t matter beyond simply being pretty pictures,” said Dr. Evis Sala of the University of Cambridge, UK who was part of discussions at the Total Radiology conference in Dubai, as she focused on state-of-the-art integrated diagnostics and the benefits of developing and validating functional imaging biomarkers for certain cancers.

Innovations in medical imaging are clearly a game changer but the direct impact on patient and economic outcomes is quite often understated, contends Dr. Arash Tehranzadeh of Cedars-Sinai-Kerlan Jobe Institute in the US. Such innovations coupled with artificial intelligence have improved the quality of careers for some of the world’s most well-known and highly paid athletes. “Some athletes with contracts in excess of US$55 million come into our clinics to get treated for career-threatening injuries, and these innovations in radio imagery have recently allowed for better treatment, potentially saving their lucrative careers as well as the performances of their teams.”

Now AI algorithms are being used to analyse millions of medical images in real time, enabling the detection of early-stage diseases and conditions. For example, it is being used to improve accuracies of mammograms, a crucial tool for detecting breast cancer, as well as advanced analyses of MRIs to help detect and treat prostate cancers. These algorithms analyse images faster and more accurately than human radiologists, reducing the sole reliance on manual image interpretation and minimising risks of missed diagnoses.

Advanced MRI Techniques have been in regular development, making the procedure faster, safer, and more efficient. New techniques such as “compressed sensing” MRI allow for faster scans, with fewer scans required to produce the same level of detail. This can be especially beneficial for patients with mobility issues or children who struggle to remain still during scans. Whole Body Magnetic Resonance Imaging (WBMRI) for example, is the most sensitive imaging test, allowing for earlier detection and treatment of multiple myeloma, directly contributing to improved long-term health and economic benefits.

Additionally, Computed Tomography (CT) scans, widely used to produce detailed images of internal organs and tissues, can be associated with significant radiation exposure. New and improved technologies include dual-energy CT scans which reduce radiation doses while providing high-quality images. These scans use two different types of radiation to produce images, enabling radiologists to differentiate between healthy and diseased tissues more accurately.

The introduction of Teleradiology has become a focus of digital transformation in healthcare systems which are continuously facing challenges in meeting the demands for medical imaging services, particularly in rural and remote areas. Teleradiology is helping to bridge the gap between patients and radiologists, providing improved access to imaging services and reducing wait times, resulting in much faster diagnoses and reduced burden on practitioners.

3D printing has also entered the medical fray where models of internal organs and bones can be used to help plan surgical procedures and visualise complex anatomy. The vast amounts of data being collected, analysed and stored by the above key innovative technologies require immense storage but with the additional caveat of allowing instant access when needed. Cloud-based management solutions enable healthcare providers to store and access images from anywhere they need, at any time. These systems provide a secure and efficient way to store, manage, and share images, reducing the risk of data loss or breaches.

 

This article appears in the Daily Dose 2023. Read the full issue online today.

Back to Technology

With the rise of chronic diseases and long-term pain, the embrace of alternative medicine has grown more than ever.

There are several reasons why today, an increasing number of patients are opting for more natural treatments. These include concerns about the side effects of medication, or perhaps it presents a solution for those battling persistent pain.

Dr. Riyaz Badami, Homeopathic Practitioner and Medical Director, Good Living Medical Center, Dubai, explained: "We have to understand that a human being is different from a car or any other machine. Everything in a human being is interconnected. Therefore, it is important that we go to the root cause of a problem and don't only look at the symptoms or the condition from which that person is suffering. All aspects, right from when the problem started to how it started and the situation around it, must be considered. So, it's important that a holistic approach, including lifestyle changes, is advised. Homoeopathy works very well in holistically healing a patient when incorporated with a lifestyle change, if and where required."

Dr. Riyaz Badami

Alternative medicine is an effective treatment plan for those suffering from mental health disorders, which have increased exponentially due to the pandemic. Dr. Badami stressed that conditions such as anxiety, fear, and depression, can be treated effectively with homoeopathy. "The treatment delves deep into the root cause of why this fear or anxiety started, why palpitation occurs and what is the reason for the panic attack. Unless you understand the core, you will never be able to overcome it. Hence, understanding the patient's history is essential to help them cope with their condition well."

Furthermore, homoeopathy also works well for those suffering from allergies, migraines, dysmenorrhea, fibroids or polycystic ovaries. It is also a milder alternative for children experiencing recurrent tonsillitis or chronic sinusitis.

According to Dr. Badami, the UAE has been a pioneer in making alternative medicine mainstream. He said: "We must give credit to the leaders of UAE for having an open mind and accepting alternative medicine as a part of mainstream healthcare, giving licences for homoeopathy, acupuncture and various alternative medicine approaches, right from the early 2000s. I have been practising in Dubai since 2003 and have witnessed the evolution in patients' mindsets and an ever-increasing demand for homoeopathy, acupuncture and ayurvedic treatments. In fact, several medical centres today work closely with alternative medicine specialists."

When asked about how he sees the scope of alternative medicine evolving, he said that the future of medicine is integration. "Allopathic doctors and homoeopathic and ayurvedic doctors and acupuncturists must all work together to leverage each other's strengths. I think the future of healthcare is integration where all hospitals will have departments of alternative medicine and patients can be referred to the different departments to ensure holistic healing," he concluded.

This article appears in the Daily Dose 2023. Read the full issue online today.

Back to Management

With 200 new colorectal cancer cases reported annually in the UAE, a lack of health literacy and cultural barriers are driving the frequent incidence of the disease. Colorectal cancer is the second most common cancer for men in the country and the third most common cancer affecting women. It mainly affects people over 40, and prevention through regular screening is cited as the most effective way to safeguard against it.

Colorectal cancer can grow in the body without any apparent symptoms. By the time the symptoms become obvious, cancer has usually progressed to quite a degree and may require a combination of surgical intervention and/ or chemotherapy. A Sheikh Shakhbout Medical City (SSMC) - commissioned survey found that 63 per cent of respondents cited the absence of any troubling symptoms as the number one reason they felt regular colorectal cancer screening was not needed, signalling a lack of health literacy in the region. For Emiratis, deterrents included the fear of pain, fear of finding a severe disease, and shame.

Dr. Aref Chehal, Consultant Oncologist at Sheikh Shakhbout Medical City, in partnership with Mayo Clinic, says a change in bowel habits, blood in the stool, abdominal pain or discomfort, ongoing fatigue, and unexplained weight loss may all signal the presence of colorectal cancer. “The typical starting point for colorectal cancer is the formation of small, benign polyps on the colon's lining. However, over time some of these polyps may develop into cancerous growths. To prevent this, a colonoscopy can be performed to identify and remove any polyps before they can become cancerous.”

In the UAE, colorectal cancer is one of the leading causes of cancer-related deaths. But it is also one of the easiest cancers to prevent when detected early, with cure rates as high as 95 per cent. Various screening methods can help detect this type of cancer, including colonoscopy and Fecal Immunochemical Test (FIT). “Colonoscopy is highly recommended for women and men every 10 years from age 40 as this is the age group where around 80 per cent of all colorectal cancers are found. A FIT test, which looks at stool samples, can be taken annually and is especially important for those with a family history of this type of cancer,” says Dr. Chehal.

The UAE-approved Artificial Intelligence-powered technology, GI Genius, is setting a new standard for early colorectal cancer detection. “The system has been shown to significantly improve visualisation during colonoscopies, which increases the accuracy of detecting pre-cancerous polyps in the colon. This leads to a 50 per cent reduction in the risk of death from colorectal cancer,” explains Dr. Chehal. Since April 2022, SSMC has used the GI Genius module to screen over 300 patients successfully.

The treatment options for colorectal cancer vary depending on factors such as the stage and location of the cancer and include various approaches such as surgery, chemotherapy, immunotherapy, targeted drug therapy, and interventional procedures. From the full range of laparoscopic and robot-assisted colorectal procedures, which reduce pain, blood loss, and recovery time while helping patients preserve normal function and avoid colostomy bags to Ostomy Polypectomy Laparoscopic surgery, a partial colectomy, lymph node removal surgery, endoscopic mucosal resection, resection of metastasis, HIPEC (heated intra-peritoneal chemotherapy), adjuvant and palliative care, and many others, patients have many options at their disposal.

“However, prevention is better than cure. And the best way to safeguard yourself is to undergo regular check-ups and screenings if you are 40 or above. It is the only way to increase chances of early detection and the most effective way to increase survival rates,” he adds.

 

The growing climate emergency is undoubtedly real and affecting our present. Though there is a divided consensus with many denying its existence, the climate crisis is looming large adversely impacting human health and in the upcoming times, the threat is only likely to multiply. The medical journal Lancet has called it the ‘biggest global health threat of the 21st century.’

According to the World Health Organisation (WHO), ‘climate change has the capacity to produce severe consequences for human health. The health sector can play a pivotal role in helping nations across the globe adapt to these serious consequences. It can play a leadership role in mitigating climate change – that is reducing its magnitude and consequences,’

Role of stakeholders in climate change

It is the primary responsibility of the stakeholders of the healthcare sector to contribute their bit in breaking the vicious cycle of healthcare’s carbon footprint and climate change. People are falling ill or dying due to a significant shift in climate, which has led to increased dependability and use of medical care facilities for treatment. It is imperative to note that the greater the use of technology and medical equipment and resources, the more the emission of GHGs, which increases the sector’s carbon footprint and further aggravates the climate crisis.

This, in turn, would lead to an increased influx of people in need of healthcare to battle the adverse effects of climate emergency, causing the cycle to continue. According to a 2019 groundbreaking report by “Health Care without Harm”, healthcare’s climate footprint is equivalent to 4.4 per cent of global net emissions. The research report further highlights that the global healthcare climate footprint is equivalent to the annual greenhouse gas emissions from 514 coal-fired power plants. In terms of countries, the report reveals that the top three emitters, the US, China, and collectively the countries of the European Union, comprise more than half the world’s total healthcare climate footprint (56 per cent) and finds that while vastly different in scale, each nation’s health sector releases greenhouse gases— directly and indirectly — while delivering care and procuring products, services and technologies from a carbon-intensive supply chain.

Conscious carbon footprint reduction

Manufacturing of medical products, use, and disposal along with the consumption of massive amounts of energy for running healthcare devices, equipment, etc. as well as transport are some of the main sources that emit greenhouse gases. The only duty of healthcare is to not only treat the sick and dying from the climate emergency but also become aware of its role, understand its contribution to the Sustainable Development Goal of Climate Action, and take adequate steps/ measures to prevent and consciously work towards significantly reducing its own carbon footprint.

Though there is growing discourse around why the healthcare sector should work toward preventing and reducing its emissions, it is also crucial to understand and look at the challenges faced by the sector while en route to opting for the environment-friendly way. Financial challenges is on the top of the list since realigning existing approaches would come at an increased cost. This is likely to make it difficult for smaller clients to opt for the cash-intensive route. Hence there is a need for a strong global focus on charting out a clear roadmap — actionable timelines, framework, etc. to reduce healthcare’s net emissions and factor in large-scale investments in climate finance to enable offering subsidies so that the sector’s clientele, be it big or small can meaningfully contribute in healthcare’s climate change mitigation plans.

Digitalising healthcare to reduce emissions

While the global healthcare industry is on the brink of reducing its carbon footprint and greenhouse gas (GHG) emissions, the sector should also be mindful of the efforts taken to combat climate change not just because of the urgent need but also of its impact on the future.

A significant step towards reducing emissions is digitalising healthcare. The COVID-19 era has already taught us to opt for digital healthcare, and unless it is an emergency, the sector could leverage and bank on this opportunity to continue providing medical care and services digitally wherever possible. This would lead to a decrease in footfall of patients in medical facilities, use of resources, and thereby reducing emissions.

One of the most crucial climate actions that the healthcare industry need is its collective alignment and commitment to the Paris Agreement (the international treaty on climate change) whose goal is ‘to limit global warming to well below 2, preferably to 1.5 degrees Celsius, compared to pre-industrial levels. To achieve this long-term temperature goal, countries aim to reach global peaking of greenhouse gas emissions as soon as possible to achieve a climate-neutral world by mid-century.’ 

After all, adherence to the agreement would need the various stakeholders including suppliers and manufacturers to come together and work on a single mission of reducing net emissions to zero by or before 2050. However, climate action by healthcare or ‘green healthcare’ can become a reality only when various agencies and contributors of the sector understand and accept the significance of climate emergency on human health. There is a pressing need for more discussion, discourse and research to create more awareness among the stakeholders on the role of healthcare and its strong interlinkage with climate change so that they can take responsibility and work towards mitigating the greatest threat to human health in the immediate future.

This article appears in the Daily Dose 2023. Read the full issue online today.

Back to Management

The scale at which the pandemic changed things in healthcare and other industries across the world has never been witnessed before. The fast-evolving global economic scenario and the regional business environment will have an impact on how healthcare shapes up this year.

As some of the short-lived changes wear off, a clear picture of what will stay back is emerging:

Accessibility to healthcare services

One notable change that will continue to evolve further is the accessibility to services and products. Consumers of healthcare have a significantly lower resistance to ordering healthcare online and consuming it without leaving their homes. This is a major reason why many pharmacy players have taken to e-commerce in the last couple of years, and the value and volume of online pharmacy orders will certainly grow this year. According to an estimate, the online pharmacy delivery market in the UAE alone has reached US$250 million in 2022. This number will continue to grow at a fast pace in 2023 too.

In addition to traditional healthcare providers who are now adding online delivery to their models, we will also witness leading brands from other industries trying their hand at healthcare digital delivery and e-commerce.

Vivek Shukla, Senior Advisor to Healthcare Boards and CEOs

Care delivery at homes will also flourish further. With numerous companies that sprung up, mostly to provide PCR at-home services, the segment has many new players that are now looking to innovate and stay in the game. We have already seen the erstwhile ‘nurse at home’ companies adding more services to their portfolios. It is currently at a place where even dialysis at home or remote ICU setup at home is being offered.

The biggest opportunity in this is that the leadership position is up for grabs across various markets in the GCC.

Cost efficiency

As more and more economists talk about the global recession, we can see healthcare bracing itself in 2023. Further, as employers look to downgrade the insurance networks, access to premium facilities gets reduced as well. This can result in a lop-sided demand surge for mid- and lower-end facilities for consuming healthcare, and for generic medicines instead of branded ones. This is something that has happened in some of the markets in the last few years and is expected in 2023 as well. Hence, business efficiency in terms of cost drivers will be an important factor for healthcare companies.

Cost optimising is a function of two major areas — manpower and inventory. Healthcare providers are already experimenting with innovative ways to engage physicians and other manpower to keep costs in check. More players will start managing their inventory levels and cash flows aggressively this year. A tighter grip on receivables can be expected too, thus putting additional pressure on the insurance companies and payors. The year 2023 can easily be a year of efficiency when it comes to hospitals.

In the UAE, the introduction of Corporate Tax in 2023 will result in an added focus on cost efficiencies.

Insurance penetration

It is a given that significantly more people will have health insurance in 2023 than in 2022. KSA and Oman are already on the way to having mandatory insurance for everyone and so are the Northern Emirates in the UAE. Saudi Arabia has 9.8 million people with insurance coverage, and it is estimated that this number will continue to grow, owing to the Vision 2030 reforms.

Higher insured population means pressure on providers to keep working capital flowing as credit billing increases, whereas on one hand, we have increased access to healthcare results in higher patient volumes for the facilities, and on the other, per-patient revenue takes a dip as insurance penetration increases.

Higher patient volumes will create a marginal demand for employing more manpower. This, in turn, will continue to create demand for health education and training in the region.More mature insurance markets like Abu Dhabi and Dubai in UAE that have a DRG system of reimbursement will continue to underpin the necessity for cost efficiencies, as described earlier.

Medical tourism

As the governments in the region work more towards building non-oil economies, medical tourism will see support from them. There has been some success in the UAE already over the past few years.

According to an estimate, 630,000 medical tourists visited the UAE in 2021 and this trend will continue to grow. We will also see initial attempts in the KSA for medical tourism in 2023, given the rapid changes taking place in the overall business environment of the country.

As tertiary care facilities increase in each region, governments and regulators will empower citizens to get treated within the country as much as possible.

Digital innovation

The pandemic has been a tremendous accelerator for digital innovation in healthcare. The year 2023 will see its fruits and progress. As we know, AI and ML are fast becoming a part of diagnostic radiology and other modalities in healthcare. This will continue to sustain and grow this year. More and more healthcare providers are trying newer digital ways to acquire and retain patients. Patient-friendly apps, digital CRM, use of third-party aggregators, and more such interventions can be expected in 2023.

In addition, cybersecurity in healthcare will see a renewed focus. There has been a surge in cyber-attacks on more vulnerable players, thus crippling their operations and earnings for a short period. This has compelled more and more players to upgrade and innovate the existing security protocols.

Buzzwords of sustainability

Every year, there are some buzzwords that do the rounds in an industry. Not all buzzwords graduate into a sustainable trend though. However, it is worthwhile to keep an eye on what new trends may be on the horizon that may have the capacity to shape the industry.

Metaverse is one such word. The initial entry of this word into healthcare has been welcomed by many. It remains to be seen if and how quickly this gets accepted and infused into the ecosystem.

Environmental, Social, and Governance (ESG) is another initial movement that is in its infancy. There will certainly be more awareness among healthcare providers about the environmental impact they make. The extent of these efforts may although depend on numerous factors, including the regulatory framework for monitoring carbon emissions.

Consolidation and growth

Different geographies in the GCC are at different levels when it comes to the lifecycle of the industry. The more mature markets where the sector has already grown and is heading towards maturity will see consolidation and acquisitions. We saw a decent amount of activity in 2022 in the UAE and there is likely to be more consolidation in 2023 too.

In the markets where the industry is still on the growth curve, we will see new healthcare facilities emerging. The Kingdom of Saudi Arabia, for example, will see several new hospitals coming up in various cities. Healthcare groups from other countries have already been planning and setting up facilities in cities like Jeddah.

Overall, the healthcare industry is on the threshold of an exciting post-pandemic journey. With a new mindset and lower resistance to change, we can all look forward to a promising future in 2023 and beyond.

 

This article appears in the Daily Dose 2023. Read the full issue online today.

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