PM&R physicians from around the world shared their experiences of the COVID-19 pandemic during a Physical Medicine & Rehabilitation Conference panel session at Arab Health 2021. Common trends, irrespective of location, included mental wellbeing and telerehabilitation.

Anxiety

Margeux Blignaut, Director of Rehabilitation, Amana Healthcare, described how the psychological wellbeing of staff and patients in the UAE, “significantly affected” at the beginning of the pandemic, continues to be an issue. Patients were furthermore cancelling rehabilitation services at the beginning of the pandemic because of “heightened anxiety” over healthcare professionals entering their home.

Staff were re-deployed to assist in an in-patient setting meanwhile, resulting in anxiety among those with minimal experience of in-patient settings.

In KSA, many patients were anxious, said Shreemathie Somduth, Rehabilitation Nursing Director, Rehabilitation Hospital KFMC, but they benefited from clear explanations from the rehabilitation team on a daily basis, and online counselling was additionally available.

According to Fahin Anwar - Consultant in Rehabilitation Medicine, Cambridge University Hospitals, the biggest effect seen by rehabilitation services in the UK among patients was “low mood” and lack of engagement due to lockdown and restricted family visits.

In India, an “initial fear and helplessness” in the mind of patients and therapy givers slowly gave way to acceptance of the situation, commented neurologist Nirmal Suryar, President, Indian Federation of Neurorehabilitation (IFNR).

Telerehabilitation

Past respiratory diseases showed that technology could be used to manage patients in rehabilitation, said Anwar. Specific areas of its use prior to the pandemic in the UK included speech-language therapy, patient follow-up and monitoring, telepsychology consultations and tele-exercise group training.

To minimise the risk of viral transmission, most rehabilitation services changed all out-patient clinic appointments to telephone appointments, unless an examination was absolutely necessary.

In KSA, continuity of care was ensured by the rehabilitation team through virtual clinics or telemedicine, revealed Somduth. Telemedicine “played a really important role” in the pandemic.

Suryar highlighted how teleneurorehabilitation was “unknown” in India before 20 March 2020. Low-cost cellular data services present an opportunity to make teleneurorehabilitation an integral part of follow-up services, while there exists a need to infiltrate it into an existing government programme.

At a Total Radiology session during Arab Health 2021 on “Digital Prognosis: COVID-19, data and the future of the industry”, GE Healthcare’s Catherine Estrampes, President and CEO EMEA, and Prof Dr Mathias Goyen, Chief Medical Officer EMEA, combined to consider new radiology opportunities in the pandemic.
 
Recognising that 2020 was “extremely challenging”, Estrampes nonetheless highlighted four key trends emerging in the pandemic, with digital at the centre of each:

1. A growing acceptance of virtual or remote interactions (such as the Arab Health conference itself);
2. Greater acceptance of AI tools and AI-powered solutions. An example during COVID-19 was its critical care suite, deployed around the world to help with identification and quick triage of COVID patients;
3. Rapid innovation in order to ensure that in infectious situations infected patients are separated from non-infected quickly. GE Healthcare’s CT in Box was deployed quickly around the world for this purpose, keeping healthcare staff safe; and
4. Rethinking of delivery care models. Hospitals are focused on taking care of the sickest, while there is a more integrated delivery care model deployed with the acceleration of home monitoring and outpatient centres.

Looking ahead, at a post-Covid future she saw three challenges.
 
First, precision health - how can data be turned into insights with the help of AI tools for more personalised, individualised and targeted care? GE Healthcare aims to be a “primary partner” to providers and governments around precision diagnostics and monitoring
 
Second, there is a need for a more contemporary digital structure or architecture based on outcomes. GE Healthcare’s virtual ICU solution was deployed around the world, including the Middle East, allowing clinicians to remotely and simultaneously monitor highly critical patients in the ICU.  220 ‘Command Centers’ were additionally deployed worldwide, to better manage the operations of a hospital using AI and digital technologies.
 
The third challenge is how to foster collaboration around aggregated data, between hospitals and departments. Estrampes shared the example of accelerated collaboration during the pandemic between GE Healthcare and the University of Oxford around predictive applications.

"AI helps the radiologist structure enormous amounts of data," acknowledged Prof Dr Mathias Goyen, adding that the University of Oxford collaboration will help predict the course of disease in a patient. 

As for the role of the radiologist, he said, this will change, helped by AI - an "invisible friend" in the background. AI will empower the radiologist to talk to the patient, through freeing up their time and relieving them of routine tasks. 

One of the most important factors to successfully navigate through uncertainty is to be prepared, said Dr Patrick Godbey, founder and laboratory director at Southeastern Pathology Associates. Speaking remotely from Brunswick, Georgia, Dr Godbey explained how benchmarking best practices helps keep labs in check, even at times of uncertainty.  

“Pandemic preparedness comes from having the knowledge and support from worldwide experts. Accredited labs receive clear guidance on the verification and validation of their practices. The most significant changes you’ll see is in quality management and infection control,” he said.

Dr Godbey is also president of the College of American Pathology (CAP), which explains his advocacy for accreditation and standardisation, particularly for Covid-19 testing. “The foundation of good healthcare is a high quality laboratory. A quality lab that can provide diagnostic confidence comes from preparedness and proficiency testing and external quality assessment (EQA),” he explained. “And not just any accreditation, one built with the expertise of practicing pathologists using a model of guidance of what to do and how to do it,” he added. 

EQA or proficiency testing provides benchmarking opportunities based on volume of testing, supply and more. It is important to be able to monitor and compare results and standards across multiple instruments or locations.

For in-person event panellist, Dr Ismail Bakhsh, Consultant Clinical Scientist at National Medical Care Co in Riyadh, a main challenge for laboratories today is that “change sometimes needs to be forced”. 

“Laboratories may resist changes to standardisation, consolidation and centralisation, which are all required to maintain excellence,” he explained. “The challenge is also cultural. Having support from the leadership is the key component here. Leadership teams need to advocate for the clients, which are the patients, while also providing a smooth experience for physicians. The lab staff only comes into this cycle towards the end. Change needs to start from the top.”

Ultimately, laboratories are like many other businesses and have been affected by the pandemic to varying degrees depending on their location, patient care levels and most importantly, their own work culture. “As with many other organisations, labs of all sizes and specialisations have been impacted by the current coronavirus pandemic,” said another panellist Shirley Luciap, Laboratory and Quality Manager at King's College Hospital London in Dubai.

Many teams face communication blocks which makes acknowledging errors and maintaining excellence near impossible. “Being in the lab field for the last 20 years, I can connect with the experiences and responses of laboratory staff, and communication is a key area that needs to be improved.”

Other topics covered in Medlab on Monday included Changes and advances in the field of pathology, and Current and future Point-of-Care Tests for emerging viruses and future perspectives.

One of the most important factors to successfully navigate through uncertainty is to be prepared, said Dr Patrick Godbey, founder and laboratory director at Southeastern Pathology Associates. Speaking remotely from Brunswick, Georgia, Dr Godbey explained how benchmarking best practices helps keep labs in check, even at times of uncertainty.  

“Pandemic preparedness comes from having the knowledge and support from worldwide experts. Accredited labs receive clear guidance on the verification and validation of their practices. The most significant changes you’ll see is in quality management and infection control,” he said.

Dr Godbey is also president of the College of American Pathology (CAP), which explains his advocacy for accreditation and standardisation, particularly for Covid-19 testing. “The foundation of good healthcare is a high quality laboratory. A quality lab that can provide diagnostic confidence comes from preparedness and proficiency testing and external quality assessment (EQA),” he explained. “And not just any accreditation, one built with the expertise of practicing pathologists using a model of guidance of what to do and how to do it,” he added. 

EQA or proficiency testing provides benchmarking opportunities based on volume of testing, supply and more. It is important to be able to monitor and compare results and standards across multiple instruments or locations.

For in-person event panellist Dr Ismail Bakhsh, Consultant Clinical Scientist at National Medical Care Co in Riyadh, a main challenge for laboratories today is that “change sometimes needs to be forced”. 

“Laboratories may resist changes to standardisation, consolidation and centralisation, which are all required to maintain excellence,” he explained. “The challenge is also cultural. Having support from the leadership is the key component here. Leadership teams need to advocate for the clients, which are the patients, while also providing a smooth experience for physicians. The lab staff only comes into this cycle towards the end. Change needs to start from the top.”

Ultimately, laboratories are like many other businesses and have been affected by the pandemic to varying degrees depending on their location, patient care levels and most importantly, their own work culture. “As with many other organisations, labs of all sizes and specialisations have been impacted by the current coronavirus pandemic,” said another panellist Shirley Luciap, Laboratory and Quality Manager at King's College Hospital London in Dubai. Many teams face communication blocks which makes acknowledging errors and maintaining excellence near impossible. “Being in the lab field for the last 20 years, I can connect with the experiences and responses of laboratory staff, and communication is a key area that needs to be improved.”

Other topics covered in MedLab on Monday included Changes and advances in the field of pathology, and Current and future Point-of-Care Tests for emerging viruses and future perspectives.

In February 2020, Tom Lawry, Microsoft's National Director for AI, Health & Life Sciences, shared insights on AI in health in an engaging talk on 'How the future isn't what it used to be'. Much has happened in AI and healthcare in the months since, driven by the COVID-19 pandemic. 

Omnia Health Insights caught up with Lawry ahead of Arab Health 2021 to obtain an update on AI in healthcare (full video below) 1.5 years after the onset of the global crisis.

Related: The future is not what it used to be: How AI can be a force for good in healthcare

He highlighted two key lessons that have emerged in the pandemic, and offered an example of how Microsoft helped respond using its tools and technologies. 

"The first is, the pandemic basically showed all of us that when faced with the challenge, healthcare and clinical and business leaders are capable of Agile transformation. So you look at everything that happened, the heroic efforts of clinicians and doctors, nurses and others, to really rethink how to provide health care. And so we saw things like the rapid adoption and growth of telemedicine and virtual visits. And these things show that healthcare is capable of Agile transformation when needed.

The second thing is, the pandemic also demonstrated that AI when done right can produce rapid time-to-value. There are a number of cases that I can think about where, because of AI, we were able to respond much more quickly and effectively than had AI not been used.

So a quick example is here at Microsoft, we have an industrial grade health bot, when the pandemic started kicking in, you know, from the spring of last year, we basically took that bot and spun it into a COVID specific bot, put it out there for hospitals around the world - the Centers for Disease Control adopted it here in the United States - to allow anyone to address questions they had on on their symptoms.

And basically, this bot was used to triage tens of millions of inquiries of people from around the world to help understand what they might have or not have and how to triage for next best steps for actions. So you can only imagine tens of millions of worried consumers and citizens if they were calling in to a phone bank for humans to answer those questions."

AI training

While everyone is still early in the journey of using AI at scale in health and medicine, Lawry continued, there will be barriers that include people not understanding what AI is, or the value that’s driven when properly curated in a healthcare setting.

The “technical side” of AI doesn’t matter, he added - value needs to be understood as automating or augmenting tasks performed by healthcare workers. Rather than replace clinicians and finance specialists, AI will improve the way they work and begin solving problems act were previously not thought of as solvable.

Training is therefore critical, but not necessarily teaching a healthcare worker how to code - rather it relates more to developing an understanding of what AI is, and particularly in the context of what a healthcare worker does.

Pre-COVID, Lawry conducted clinical and executive leadership training on AI, helping professionals to understand how it is applied in a health and medical situation. Clinicians defining where they can get better at is key, allowing teams specialising in machine learning and algorithms to arrive at the right AI solutions. 

Nuance conversational AI

In recent days, Microsoft won US antitrust approval for its deal to buy Nuance Communication, an AI and speech technology company. Nuance is the worldwide leader in the use of conversational AI in health and medicine, Lawry explained.

Its program of conversational AI is powered by Microsoft componentry, allowing a doctor to speak to a patient while an ambient intelligence is recording in the background. The doctor is therefore empowered to look the patient in the eye, have a conversation and demonstrate empathy, while an AI automates the rest. 

Post-pandemic ubiquity 

Lawry anticipates a post-COVID future when AI becomes ubiquitous - an everyday aspect of health and medicine. The majority of systems today - eletronic medical records, diagnostic imaging., and patient administration systems will all become much more intelligent.

Second, AI will empower everyone to look at different models of care, whether in the hospital, at home or in transit with portable medical devices. It will futhermore be much more "prescriptive", allowing the patient to stay healthy or the patient with a chronic illness such as diabetes or OCPD to manage their disease better.

Tom Lawry will be delivering the keynote at the Artificial Intelligence in Healthcare Conference at Arab Health 2021 on Wednesday 23 June 2021 (9.45am - 10.15am).

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UpToDate, the clinical decision support tool from Wolters Kluwer, Health has been approved by the Federation of the Royal Colleges of Physicians of the United Kingdom as a continuing professional development (CPD) activity.

The organization is a collaboration between the Royal College of Physicians of London, Royal College of Physicians of Edinburgh, and Royal College of Physicians and Surgeons of Glasgow. The colleges have more than 50,000 members among them worldwide. The approval of UpToDate comes following new guidelines introduced by the Federation that recognize the use of online resources with current medical content (e-libraries) as CPD.

Earning CPD while caring for patients

Members will now be able to earn and track credits eligible for continuing professional development while using UpToDate to research clinical questions at the point of care. CPD credits are earned from UpToDate by consulting information relevant to a specific clinical question, thus broadening clinical knowledge.

UpToDate will provide physicians and surgeons with quick and easy access to evidence-based clinical topics and recommendations. CPD credits can be earned through UpToDate anytime, anywhere, on desktop or mobile devices. According to research of UpToDate use in 2020, 1 in 4 clinicians (26%) in the UK and Ireland changed their course of action to a more appropriate treatment or diagnosis after consulting UpToDate.

Adrian Jennings, MD, Associate Medical Director for CPD at the Federation of the Royal Colleges of Physicians of the United Kingdom, said, “Physicians within the Federation CPD scheme can now conveniently earn external (category 1) CPD credits when they are caring for a patient and need to research a clinical questions in UpToDate.’’ 

“UpToDate will help our members and fellows keep their knowledge and skills current.” Dr. Jennings added.

Alaa Darwish, country manager – Middle East, Turkey and Africa, Clinical Effectiveness, Wolters Kluwer, Health, said: “With many UK-trained clinicians delivering healthcare services in the Middle East, UpToDate provides an invaluable resource for supporting evidence-based learning and meeting CPD requirements of the Federation of the Royal Colleges of Physicians of the United Kingdom as they care for patients.”

An expert solution for clinical decisions and CPD

UpToDate from Wolters Kluwer contains over 12,000 clinical topics and more than 9,500 graded recommendations to support better clinical decisions at the point of care. A rigorous editorial process is implemented by 50 physician editors on staff who work with over 7,300 expert authors, editors, and peer-reviewers from 50 countries around the world to continuously publish evidence-based clinical information and recommendations.

Learn more about earning CPD credit with UpToDate.

It’s been a rollercoaster 1.5 years since Arab Health 2020 and Medlab Middle East 2020, to say the least. We are therefore thrilled to see the return of both – at the same time - albeit at a very warm time of year in Dubai, and with enhanced hygiene and safety measures applied.

As before, we will be bringing you exclusive stories from the week here on Omnia Health Insights, and we will also be publishing towards the end of each day the 'Daily Dose', your favourite news companion from Arab Health.

For live updates during the week, please follow us on the following social media channels:

• @omnia_health (Twitter)
• @omnia__health (Instagram)

You can also find our latest video content from the week on our Omnia Health YouTube channel, including daily video highlights.We ourselves will be among speakers during the week. Talks to look out for include:

• Lab Trends under the Microscope, 12.45pm, Monday 21 June
• Artificial Intelligence in Healthcare Conference [Welcome Remarks], 9.30am, Wednesday 23 June

For those of you at the event, have fun, and don’t forget to say hello to us.

You can also direct any questions or comments to us on social media - at least one of us will get back to you!

A state-of-the-art hospital offering specialised care for spinal, neurosurgical, neurological, orthopaedic and radiosurgery treatments with an advanced cancer centre and neuro-rehabilitation space has opened its doors in Dubai Science Park, strengthening the UAE’s drive for a robust, resilient and world-class healthcare industry.

The AED 700 million Neuro Spinal Hospital and Radiosurgery Centre has 114 beds – four times the capacity of its former premises in Jumeirah. The hospital also features unique treatment options otherwise only available abroad, including the UAE’s first robotic Cyberknife & radiosurgery centre and the first brain surgical suite, giving patients access to advanced care in a local and welcoming environment.

With advanced diagnosis and robotics, it will provide care across neuroscience, spine, orthopaedics and oncology. Patients in the UAE and abroad will also be able to receive acute and post-acute rehabilitation in Dubai Science Park, a science and healthcare-focused business district that is home to more than 400 companies and 4,000 professionals.

Alongside state-of-the-art equipment and technology required by physicians, the well-designed hospital features open green spaces and gardens to improve the wellbeing of patients, an advanced academic training space, smart patient rooms, a community centre and more. Marwan Abdulaziz Janahi, Managing Director of Dubai Science Park, said: “Building an advanced healthcare industry is one of UAE’s key strategic objectives and we are proud to work closely with our business partners to contribute to this vision.”

He added: “The Neuro Spinal Hospital and Radiosurgery Centre reflects our ongoing efforts to enhance Dubai’s medical sector by providing the right business environment and state-of-the-art infrastructure for companies. This hospital will contribute to the growth of the healthcare industry in the UAE and the region and provide residents with access to world-class care, promote medical tourism and enhance the UAE’s position as one of the most advanced countries in the world.”

Prof. Abdul Karim Msaddi, Chairman and Medical Director of Neuro Spinal Hospital, added: “We are proud to bring world-class healthcare services to Dubai and believe our next-generation hospital will be a game-changer for the emirate’s and the region’s medical industry. It will not only significantly increase the availability of specialist neuroscience and radiosurgery treatments and provide better patient care but help attract and develop local and international talent. Investing in the new centre represents our continued faith in the resilience of the region’s economy, as well as a testament to our ongoing drive towards healthcare innovation in the UAE.”

Founded more than a decade ago, Dubai Science Park is at the heart of the science and healthcare industries with more than 4,000 people working across the community that includes commercial spaces, a central headquarters, a state-of-the-art laboratory complex and warehouses.