We are now well into the second half of the year, and it’s fair to say that the pandemic is delivering a powerful education unlike anything seen previously in our lifetimes. While the number of daily cases continues to rise, and the outbreak shows no sign of slowing down, there is already much speculation of how a post-Covid world might look.

Related: Dr Maliha Hashmi, MENA healthcare leader, shares NEOM's vision of healthcare model of the future

While this remains anyone’s guess, there are clear trends emerging that are unlikely to go away, from the rise of flexible work to virtual schooling, telemedicine, and more.

Winston Churchill once said “Never waste a good crisis.” As an executive who has now shepherded many in a good way through a historic crisis, I experienced many learnings and witnessed many trends that further validated the strategy I have been working on with my team in creating a holistic integrated health wellbeing biotech ecosystem. 

Related: On healing the system: A new design for a new normal

From my perspective, one of the more pertinent and intriguing trends is the breaking down of traditional silos. The pandemic is succeeding in breaking down walls in healthcare, which might have otherwise taken years to happen. We are witnessing transformation at warp speed! 

Consider the first wall. Health(care) has always been perceived as a system existing within hospitals and clinics. Up until now, it has been very difficult to communicate the point that health(care) begins at home. With the advent of the pandemic, however, telemedicine was embraced by more individuals out of necessity, forcing governments, payers and regulators to act speedily.

With more persons undertaking virtual consultations, perceptions of where health(care) can and should take place have changed. Now there is an understanding that health(care) needn’t start and end in hospital - it can begin from the comfort of home.

This is precisely the system we are building at NEOM. We are seeking to merge silos, removing the perceived wall between home and hospital, believing that healthcare is holistic and that it should be provided from cradle to grave. Accordingly, this validates the strategy we are working on that removes this barrier. 

Second, the pandemic is rapidly eroding mental and physical health silos. Mental health has for too long been in the shadows, and most of the time not taken seriously enough. Many people experiencing lockdown fatigue and other Covid-related stress - including the healthcare professionals themselves - are reaching out for mental and emotional support services, again from the comfort of home. This is now emerging as a strong component of the healthcare system.

Third, there is a rise in people reaching out to life coaches and caregivers for advice. What is interesting is that through virtual collaboration platforms like Zoom and Microsoft Teams people have been able to connect to multiple audiences at the same time and obtain different perspectives all at once, rather than on separate occasions. Counsel has become multi-dimensional.

Fourth, due to the need of ongoing need to take precautionary measures to avoid another outbreak of this pandemic, various siloed pillars have merged such as public health, primary prevention with healthcare, another element solidifying our strategy of creating an integrated health (caring) system at NEOM.

Finally, we are seeing a change in leadership perceptions. There exists an unconscious bias that women leaders do not perform as effectively as their counterparts who, it is believed, exhibit traits that include straightforwardness and assertiveness. The pandemic is changing all that: the female leaders worldwide who have prioritised health over economy and demonstrated empathy have produced better outcomes. 

Do you agree with my observations that the pandemic is challenging traditional barriers and perceptions? Please share your thoughts by posting a comment, and I will publish a selection of these in an upcoming post with my personal thoughts. 
 

Dr. Maliha Hashmi is the Executive Director and the Deputy Sector Head Health and Wellbeing and Biotech at NEOM, where she also served as the Executive Director for all Strategic Partnerships. Dr Maliha Hashmi also serves as the Deputy Chair of the NEOM Covid-19 Leadership Taskforce. Dr. Hashmi also serves as a Leading Expert & Council on Health & Healthcare at the World Economic Forum. 

Recently, Dr. Maliha Hashmi, was selected and recognized as one of the top seven most talented emerging Female Health Leaders of the MENA region. Dr. Maliha has held Executive roles in various sectors and globally renowned organizations and is a well-known name in the region for health & wellbeing. 

Dr. Maliha Hashmi received her Doctorate and master’s degrees from Harvard and MIT. Dr. Maliha Hashmi is listed as one of the top 20 women in the Nation in the United States of America for her achievements making it into the Who’s Who in America List.

The following article is available in full, including figures and data, on Cleveland Clinic Journal of Medicine August 2020 as part of its COVID-19 Curbside Consults.

Several agents intended to supplement dietary intake or endogenous molecules may have a theoretical role in preventing or treating COVID-19. Because of their potential to influence immune response, ascorbic acid (vitamin C), zinc, vitamin D, and N-acetylcysteine have been hypothesized to be useful for prevention or treatment of COVID-19.

Related: Thoracic imaging in COVID-19

The authors outline the biologic plausibility, applicable clinical data, and potential role of each of these agents.

Introduction

As of yet, there is no high-quality evidence to support medication therapy for the prevention or treatment of patients with coronavirus disease 2019 (COVID-19). However, several agents intended to supplement dietary intake or endogenous molecules may have a theoretical role in preventing or treating the disease.

Related: Coagulopathy in COVID-19: Manifestations and management

COVID-19 infection leads to upregulation of systemic inflammation as evidenced by elevated concentrations of pro-inflammatory cytokines interleukin 1 (IL-1), IL-6, and tumor necrosis factor (TNF) alpha, as well as higher concentrations of the anti-inflammatory cytokine IL-10.

Additionally, patients with COVID-19 likely have evidence of oxidative stress, which is characterized by production of reactive oxygen species and reactive nitrogen species, and a concomitant deficiency of antioxidants. Reactive oxygen species and reactive nitrogen species are known to damage cellular biochemical pathways by causing DNA strand breaks, lipid peroxidation, and antioxidant and antiprotease degradation.

There are multiple defense mechanisms against reactive oxygen species and nitrogen species, including enzymatic scavengers (superoxide dismutase, catalase, and glutathione peroxidase) and nonenzymatic molecules (glutathione and vitamins A, C, and E).

It is the imbalance between production of reactive oxygen and nitrogen species and the antioxidant pool in the body that perpetuates further damage and, with a hyperinflammatory response, may contribute to severe manifestations of COVID-19.

Because of their potential to influence immune response and reactive oxygen and nitrogen species, and because of their availability as over-the-counter medications, ascorbic acid (vitamin C), zinc, vitamin D, and N-acetylcysteine have been hypothesized to be useful for prevention or treatment of COVID-19. The biologic plausibility, applicable clinical data, and potential role of each of these agents are outlined below.

Ascorbic acid

Ascorbic acid is known to function as an antioxidant by savaging ROS, and a number of studies have suggested that vitamin C supplementation can impact the immune system.

Moreover, in vitro and in vivo studies in avians have shown that vitamin C could be protective against avian coronavirus infection, and human trials have found that vitamin C may decrease susceptibility to viral respiratory infections and pneumonia. High doses of ascorbic acid reduce the severity and duration of symptoms from the common cold, which is caused by rhinovirus.

Studies of vitamin C for the treatment of hospitalized and critically ill patients have shown mixed results on mortality, length of stay in the intensive care unit, and duration of mechanical ventilation. However, high doses of intravenous vitamin C were generally safe. The impact of vitamin C for the treatment of patients with COVID-19 is unclear, and new clinical trials are under way in China and the United States.

Zinc

Zinc is known to be important for immune function and has a role in antibody and white blood cell production. Deficiency of zinc increases pro-inflammatory cytokine (IL-1, IL-6, and TNF alpha) concentrations and decreases the production of antibodies, while zinc supplementation has been shown to increase the ability of polymorphonuclear cells to fight infection.

Zinc has also been implicated in coronavirus biology, with increasing intracellular concentrations of zinc demonstrated to inhibit virus RNA polymerase activity and viral replication in an in vitro and cell culture model of severe acute respiratory syndrome coronavirus 1 (SARS-CoV-1). In a meta-analysis evaluating studies comparing zinc supplementation and placebo, high-dose zinc reduced the duration but not the severity of symptoms of the common cold.

Overall adverse effects and specifically nausea were significantly more frequent with zinc (which may have been dose-dependent), and the effect of prophylactic zinc supplementation was inconclusive.

Whether zinc supplementation can benefit patients with lower respiratory tract infections such as COVID-19 is unclear. Because of its role in immune function and potential to decrease coronavirus replication, zinc is currently being investigated for prophylaxis and treatment of patients with COVID-19.

Read the full article.

The following article is available in full, including figures and data, on Cleveland Clinic Journal of Medicine August 2020 as part of its COVID-19 Curbside Consults.

Bronchoscopy is an aerosol-generating procedure that creates unique challenges for healthcare providers to reduce the potential spread of the COVID-19 respiratory pathogen. As part of the initial response, Cleveland Clinic postponed elective surgeries including bronchoscopy. We established a 5-tier system for prioritizing the urgency of bronchoscopy procedures.

Related: Coagulopathy in COVID-19: Manifestations and management

When elective bronchoscopies were resumed, we established protocols to reduce aerosolization and potential virus transmission risks such as using an airborne infection-isolation room and changing to total intravenous anesthesia. Also, we established guidelines for periprocedural care and use of personal protective equipment including requirements for wearing N95 masks for all bronchoscopy procedures.

Introduction

Bronchoscopy is a challenging medical procedure in the context of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) because it is an aerosol-generating procedure. Infection control is intrinsic to the daily practice of bronchoscopy teams as they routinely manage respiratory pathogens including those requiring standard or contact precautions typical in hospital patients.

Related: Thoracic imaging in COVID-19

For example, droplet isolation is commonly used during seasonal viral infections, and respiratory isolation is needed for pathogens such as tuberculosis. Existing guidelines about personal protective equipment (PPE), room and space considerations, and various levels of isolation are core competencies. Bronchoscopy is used to diagnose and treat many thoracic diseases including emergent procedures, so it is important to have procedures in place to manage patients with or suspicious for COVID-19, as well as those without COVID-19.

Since the COVID-19 pandemic has emerged, many published guidelines specific to bronchoscopy have been published. While there are similarities and differences in each, the core principles are all based on relatively limited knowledge of COVID-19, requiring authors to use data from historical insights with other infections and extrapolate them into known constructs. As with any guidelines, they represent the best intentions and summaries of the collective knowledge of the expert authors and the various methodologies they used.

The most notable major change was for the use, reuse, and conservation of PPE. Before wide-spread shortages occurred related to COVID-19, most PPEs were used once, and accreditation and infection control policies were strict on this measure. Also, the processes of donning and doffing PPE amidst increased protective measures have changed accordingly.

Prioritising bronchoscopy procedures

Early on in the COVID-19 pandemic, following guidance from the Ohio Department of Health, the Cleveland Clinic postponed elective (or nonessential) surgeries. Exceptions existed for surgeries that were life-saving, prevented permanent dysfunction, decreased the risk of metastasis, or decreased severe symptoms.

As bronchoscopy has a wide range of indications, we created a tier system that prioritizes the importance of bronchoscopy and related pleural procedures, based on exceptions outlined by state health officials. Each procedure is evaluated to determine its priority tier. If it meets the criteria to be performed, we only proceed with all safety measures in place to protect patients and healthcare providers. A similar tier system was published by the Society of Advanced Bronchoscopy that stratified patients based on urgency.

The American Association of Bronchology and Interventional Pulmonology (AABIP) declared that bronchoscopy is “contraindicated” as a first-line diagnostic procedure for patients with potential COVID-19.⁷ Instead, they recommend obtaining samples from the upper airway via swab techniques for the diagnosis of COVID-19. However, bronchoscopy may still have a limited role in confirming the diagnosis of COVID-19 if the first-line testing is inconclusive and to rule out other pathologies. These considerations are relative to the prevalence of disease and available hospital resources.

At the time of this writing, local and state authorities have authorized the resumption of elective procedures, under the assurance that hospital capacity is available to accommodate patients if a surge is observed and that there are enough PPEs available. This is an evolving local assessment and is not uniform across the United States. Thus, many of the procedures that were postponed are now being performed.

Read the full article.

Healthcare has been on a modernisation path for many years. At Zebra Technologies, we’ve worked with hospitals, clinics and ambulatory surgery centres globally for decades to help them digitalise workflows by providing tracking, tracing and collaboration solutions. While some facilities move faster than others, most have made significant progress in achieving their technology utilisation goals. Our company’s 2019 “Intelligent Enterprise Index” indicated 17 per cent of organisations self-identify as fully “intelligent enterprises,” and another 61 per cent claim they’re well on the path to becoming intelligent through the use of advanced technologies.

But despite the definitive steps taken to digitalise workflows, the impacts of COVID-19 have many healthcare practitioners questioning whether enough has been done to improve the quality, efficiency and safety of patient care.

Related: Healthcare technology trends accelerated by COVID-19

Most healthcare systems have spent the last few months scrutinising policies, procedures, processes and systems to see if they facilitate or hinder real-time data capture, analysis and distribution. Many are starting to accelerate planned technology implementations or working to scale already-deployed solutions to support additional use cases. However, the speed at which change is needed continues to exceed the speed at which change is actually occurring.

Technology can be deployed to make an immediate impact

Care teams were mobilised and clinical workflows automated in record time to address some of the systemic issues exasperated by the pandemic. In several instances my company played a role in, mobile technologies were deployed in days to help increase the efficiency and accuracy of patient admissions and diagnostic actions, mitigate supplies shortages and inform treatment decisions.

From these experiences, we’ve learned ways in which the healthcare community can use technology to improve the management of its people, patients, assets and facilities:

Staff management

Any type of event that impacts a large per cent of the population could impact hospital capacity and strain resources: natural disasters, workplace accidents, seasonal flu and even a growing population.

Giving care team members clinical mobile computers that allow for real-time communication and collaboration with geographically dispersed colleagues via text, voice or other data-sharing tools helps “expand” staffing without requiring a larger physical presence in each facility. These devices also help increase clinician efficiency by providing access to patient records at the point of care so they can be updated in real-time without requiring a trip to a nurses’ station.

Patient management

Giving patients a barcoded wristband upon admission ensures positive identification during medication and treatment administration. It can also help with patient locating. The wristband can be scanned using a handheld mobile computer to automatically retrieve and update records with patients’ current locations every time they’re moved.

Alternatively, radio-frequency identification (RFID) tags could be affixed to the wristband for visibility by larger-scale RFID or real-time location systems (RTLS) to verify patients’ locations. Other types of remote monitoring technologies, such as internet-of-things (IoT) devices that monitor vital signs, can be implemented to alert staff about urgent status changes and minimise direct contact with patients for routine checks. Artificial intelligence (AI) tools can help with remote triage to better direct patient care actions before they step into a facility.

Lab management

Accountability starts at the point of specimen collection. Barcoded or RFID labels can be affixed to every specimen to increase accuracy with positive patient ID, tracking and the input of testing results into patient records. Mobile printers synced with clinical mobile computers can make this easy after a quick scan of a patient’s wristband to retrieve and populate label data.

A simple scan of the label at every subsequent touchpoint can confirm who handled what and when. Once the lab technician scans the barcode to retrieve a patient’s record and input testing results, notifications can be sent to the care team for further action. These capabilities are especially important when there’s a surge in specimen volume for the same types of tests and diagnostic panels all at once, like during a global pandemic.

Equipment management

Beds, wheelchairs, IV poles, infusion pumps, ventilators and heart monitors are always in high demand. Affixing RTLS tags to each piece of equipment can make it easy to identify the location of available assets.

Inventory management

Inventory management has long been an issue that becomes easier to solve with the right labels, par location management processes and barcode scanning devices. If staff scan the packaging every time an item is used — whether a mask, blood vial, medical device or medicine — and input the quantity used, then inventory management system accuracy would automatically improve the utilisation of (and access to) consumables within a ward, hospital or entire health system.

These same technologies can be used to comply with government reporting requirements, such as the European Union’s Falsified Medicines Directive, or to report items nearing expiration.

Supply chain management

Having staff scan items every time they’re used enables synced back-end inventory reconciliation systems to alert procurement teams when supplies are running low or even prompt an automatic re-order. This information can also help identify overstocks and minimise unnecessary purchases.

At the same time, implementing RTLS, barcode or other track-and-trace tools throughout the supply chain will help confirm an order status in real-time and alert care team members if and when they may need to be more judicious in their use of supplies due to supply chain shortages or production/delivery delays. They also increase accountability to mitigate fraud and theft.

If your healthcare system already uses clinical mobile computers, printers, barcode scanners, RFID technologies or RTLS solutions, you may simply need to scale your solutions to expand their applicability to additional workflows. For those transitioning to mobility solutions, be sure to update your policies and procedures to incorporate these technology tools and then conduct the proper training. Provide your staff with clear direction on how to thoroughly disinfect all devices (shared or not), how to secure the devices to protect patient privacy and how to maximize all communication, collaboration and workflow applications.

The following article is available in full, including figures and data, on Cleveland Clinic Journal of Medicine August 2020 as part of its COVID-19 Curbside Consults.

Severe COVID-19 illness is associated with intense inflammation, leading to high rates of thrombotic complications that increase morbidity and mortality. Markedly elevated levels of D-dimer with normal fibrinogen levels are the hallmark laboratory findings of severe COVID-19– associated coagulopathy.

Related: Thoracic imaging in COVID-19

Prophylaxis against venous thromboembolism is paramount for all hospitalized patients, with more aggressive prophylaxis and screening recommended for patients with D-dimer levels above 3.0 μg/mL. Point-of-care ultrasonography is the imaging method of choice for patients at high risk, as it entails minimal risk of exposing providers to the virus.

Covid-19–associated coagulopathy (CAC) and disseminated intravascular coagulation are common in COVID-19 and are associated with severe illness and death. Critically ill patients without other risk factors for thrombosis can experience various thrombotic events, including microvascular thrombosis, venous and pulmonary thromboembolism, and acute arterial thrombosis.

Related: Irritable bowel syndrome with diarrhea: Treatment is a work in progress

This article discusses clinical manifestations of CAC, associated laboratory and histologic findings, recent evidence elucidating pathophysiologic mechanisms, and the way we manage it at Cleveland Clinic.

Key points

• We recommend measuring D-dimer, fibrinogen, prothrombin time, international normalized ratio, and activated partial thromboplastin time every 48 hours in hospitalized patients with COVID-19.
• Prophylaxis against venous thromboembolism is recommended for all COVID-19 patients on admission, using low-molecular-weight heparin, unfractionated heparin for those in renal failure, or fondaparinux for those with heparin-induced thrombocytopenia, even in the setting of thrombocytopenia as long as the platelet count is above 25 × 10⁹/L.
• Patients with D-dimer levels 3.0 μg/mL or higher should undergo screening with point-of-care ultrasonography and receive more intensive prophylaxis.

A highly thrombotic state

The clinical presentation of CAC is that of a highly thrombotic state. Shared anecdotal experience from a variety of sources indicates that catheter-associated thrombosis and clotting of vascular access catheters are especially common problems. The need for catheter replacement and dialysis circuits that involve frequent interruption of continuous renal replacement therapy are other high-risk settings.

Two recent studies support the clinical impression that COVID-19 is highly thrombotic. Cui et al reported a 25% incidence of deep vein thrombosis in patients with severe coronavirus pneumonia. Klok et al found a 31% combined incidence of deep vein thrombosis, pulmonary embolism, and arterial thrombosis in critically ill patients with coronavirus. Of these events, 81% were pulmonary thromboembolic.

In Cleveland Clinic intensive care units, we are finding that point-of-care ultrasonography (POCUS) detects deep vein thrombosis at a rate of 25% to 30%, similar to rates in these studies. Another frequent finding is “slow venous flow.” This pattern, described as amorphous echogenicity in major veins, has been associated with a higher subsequent risk of deep vein thrombosis.

Read the full article.

The following article is available in full, including figures and data, on Cleveland Clinic Journal of Medicine August 2020 as part of its COVID-19 Curbside Consults.

Irritable bowel syndrome (IBS) is a heterogeneous functional disease with a high prevalence and significant impact on quality of life. Traditionally understood as a pure disorder of brain-gut interaction, it is increasingly clear that IBS encompasses diverse pathologies, some of which involve objective alterations of intestinal structure, function, and the microbiome.

IBS is subclassified as diarrhea, constipation, or mixed type based on the most prominent stool form. We review the diagnosis and management of the diarrheal type through a pathophysiologic lens, with attention to recent developments that can inform a mechanistically based targeted approach to treatment.

Irritable bowel syndrome (IBS) remains a clinical diagnosis, and its treatment is still mostly empiric and focused on relieving symptoms. That said, our understanding of its mechanisms is progressing, and treatments are increasingly targeted to the etiology in the individual patient.

Key points

• IBS is classified as IBS-diarrhea when at least 25% of bowel movements on symptomatic days are type 6 or 7 on the Bristol Stool Scale.
• New research suggests that IBS has diverse pathologies that include intestinal inflammation, postinfectious sequelae that increase intestinal permeability, food sensitivities, microbiome alterations, and bile acid malabsorption.
• Therapies are increasingly being targeted at one or more of these pathologies, leading to the availability of new treatments such as probiotics, bile acid sequestrants, and the low-FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) diet.
• First-line therapies still include antidiarrheals, regular exercise, psychological therapy, and the traditional IBS diet.

Functional disease

IBS is a functional disease characterized by chronic intermittent abdominal pain and altered bowel habits. Patients may also experience postprandial or stress-related abdominal bloating and sensation of incomplete emptying. Comorbid dyspepsia, mood disorder, chronic migraines, interstitial cystitis, and fibromyalgia are common.

The estimated national prevalence is 10% to 12%, although some estimates are as high as 21%. There is a well-documented 3:1 female predominance. This disorder accounts for 25% to 50% of all gastroenterology referrals nationwide, and its healthcare burden exceeds $20 billion annually.

Irritable bowel syndrome has 3 subtypes:

• IBS-diarrhea (IBS-D) is diagnosed when at least 25% of bowel movements on symptomatic days are type 6 (mushy consistency without clear edges) or type 7 (completely liquid without solid substance) on the Bristol Stool Scale
• IBS-constipation (IBS-C) is diagnosed when 25% of bowel movements are type 1 (hard and lumpy) or type 2 (sausage-like and lumpy).
• IBS-mixed (IBS-M) is diagnosed when both criteria are fulfilled.

About one-third of patients fall into each subtype. This review focuses on the diagnosis and management of IBS-D.

Read the full article.

UAE-based Amana Healthcare, part of Mubadala’s network of healthcare providers, has launched a first-of-its-kind therapy programme to rehabilitate patients who have been left with serious health issues and impairments after recovering from COVID-19.

Utilising the provider’s expertise working with long-term care patients and offering specialised rehabilitation for conditions such as strokes and traumatic brain injuries, spinal cord injuries, Amana’s post-acute rehabilitation (PAR) service is led by an in-house team of multidisciplinary (MDT) specialists which include physical medicine and rehabilitation physicians, physiotherapists, occupational therapists, respiratory therapists, dietitians, rehab nurses and social workers.

Four-step rehabilitation

Dr. Jason Gray, Senior Director for Clinical Operations at Amana Healthcare, explains that now that Mubadala’s patient-facing facilities are COVID-19-free, the focus is moving towards helping patients who have recovered from the disease, but who still have rehabilitation needs, such as being weaned off ventilators.

“Backed by our years of expertise in specialised rehabilitation and working with long-term care patients, we have developed a comprehensive four-stage programme that helps to restore physical and cognitive functions that are often diminished in the wake of the disease, particularly if there have been long periods of care in an ICU,” he says.

Currently, inpatient referrals to Amana facilities come through those acute hospitals treating COVID-19 in the UAE. In contrast, outpatient tele/video rehabilitation and home rehabilitation can also be accessed directly by patients who have been discharged to their homes, or who have self-managed at home to date, but whose rehabilitation needs are yet to be addressed. This growing emphasis on telemedicine and homecare indicates a developing trend in the endeavour of overcoming the virus.

Deborah Pierce, Director of Rehabilitation at Amana Healthcare and a New Zealand-trained physiotherapist, emphasises that the four stages of the programme coalesce with the input of different professional disciplines.

“The four rehabilitation stages cover ICU step-down rehabilitation and ventilator weaning; specialised inpatient rehabilitation; home or tele/video rehabilitation; and specialised outpatient rehabilitation,” she explains. “An assessment is made as to whether all four stages of the programme are necessary. From here, we can deliver the correct therapy to assist in returning the patient to pre-illness levels of function, activities and life roles.”

Situations of outbreak highlight the importance and urgency of having connected healthcare now more than ever before. Giving doctors and healthcare providers instant access to patient data is crucial to making a well-informed decision, and it can save lives, especially in an emergency.

However, regardless of the scenario, outbreak or emergency, connecting healthcare professionals and facilities is essential in building a holistic view of a patient’s health history and, ultimately, improving their outcomes.

In October 2019, Danat Al Emarat connected to Abu Dhabi’s universal Health Information Exchange (HIE) platform Malaffi, which has since enabled the hospital to safely and securely exchange patients’ health information in real-time through Malaffi’s centralised database of unified patient records.

Malaffi is seamlessly integrated into Danat Al Emarat’s Electronic Medical Record (EMR) system, collating all important patient data, such as medications, allergies, and laboratory and radiology results, along with any medical interactions a patient has, from consultation to emergency treatment, in one place, which is accessible through our facility’s EMR system.

Malaffi allows me to access a patient’s medical history, which is safely and securely stored and instantly accessible when needed.

The true benefits of Malaffi for Danat Al Emarat, as a hospital for women and children, are the enhanced quality of healthcare and improved clinical outcomes for patients and their families. Being better connected is key to aiding us as doctors in achieving improved coordination of care and making better informed decisions at the point of care, whether the young patient is in for urgent care or here for a routine check-up.

As we utilise Malaffi, we are also empowered to avoid prescribing any duplicate or unnecessary tests and services, and ultimately improve the safety and experience of our patients.

A good example of how information exchange can save time and prevent unnecessary hospital visits is a case of a family who came to see me to find out the blood group of their child. The child’s birth had been registered at another provider Abu Dhabi, so to find out the child’s blood group, the family had tried unsuccessfully to get the information from that facility over the phone.

In the absence of Malaffi, the family would have had to visit the hospital in person to get that information. However, through Malaffi, I was able to immediately gain access to that information by clicking on the child’s laboratory results.

Through Malaffi, doctors are also able to build the whole picture of their patient’s medical history, especially in paediatric patients, whose parents might not remember medical details. Another example of this is the case of a young patient who had anaemia and previously had investigations conducted at another facility in Abu Dhabi. By accessing the patient’s Malaffi file, I was able to see the patient’s blood test results in less than 20 seconds.

Not only did this allow the staff at the hospital to proceed with treating the patient’s condition right away, but it also spared the child and his family the trauma of undergoing another blood test. This is particularly important and beneficial for patients between 1 and 4 years old as it may be challenging to find their veins as they are always on the go, making the experience very traumatic for them.

In other cases, this helps spare young patients from unnecessary X-rays and radiation, which limits their exposure to radiation as well as limits unnecessary cost.

Unified patient records are also extremely beneficial for young patients with chronic conditions, such as asthma or epilepsy. I recently consulted on a young patient with asthma and Malaffi enabled me to see the patient’s entire medical journey and understand that the patient had had several episodes through a chronology of different hospital visits.

This is key in helping doctors understand the severity of illnesses, how much medical support a patient needs, and how the condition needs to be managed and followed up. Malaffi will be life-saving in situations where a patient is in the midst of an asthma attack or having a severe allergic reaction, or if a patient with epilepsy is having a fit in the waiting area.

Access to vital patient information in these situations would impact the immediate line of treatment and management of the condition.

Ultimately, our responsibility here at Danat Al Emarat is to look after some of the most vulnerable members of our society. Children are in a dynamic state of growth with their organs developing at a rapid rate, and more sensitive than those of adults.

Malaffi can have a tremendously positive impact on the delivery of healthcare for these young patients as it reduces the amount of time that our doctors and care teams spend on administrative tasks to source important patient information from other healthcare providers, empowering and allowing them to focus on their goal of treating and healing their patients.