Healthcare workers have borne the mental health brunt of the pandemic, being on the frontlines, discussed speakers on the last day of the three-day Patient Safety Virtual 2021 Conference that started on Thursday.

In an interview session titled “Tackling post-pandemic clinician mental health” with Cynthia Makarutse, Senior Conference Producer, Informa Markets, Dr Marjorie Morrison, psychologist and CEO, Psychub, said, “Healthcare workers bore the brunt of the worst because when everybody else was going home, they were going to work. They were treating people – they are the true heroes of Covid.”

She also said that the mental health spectrum had widened during Covid and since every person, including healthcare workers, already had underlying issues, the pandemic exacerbated it. 

“When everyone was at home, they were going to work and deal with everyone else’s anxiety. I think healthcare providers, clinicians and technicians are going to have the toughest of recoveries because it is only so long that you can work in this chaotic, traumatic environment before you start to see repercussions of that.”

Makarutse said that mental health in clinicians is not a new topic but Covid-19 has affected people in various ways and has brought mental health to the forefront not only for the healthcare workers but for people in general. 

Dr Morrison said, “Mental health has been issue for a very long time but has pretty much been ignored. Now in the US, four out of 10 people are reporting signs of depression and anxiety which is up four times more than it was pre-Covid.

“And we don’t need to be a specialist to understand why this has happened. There is a crisis, a lock-in as well as uncertainty which was a common thread with almost everyone in the world since everybody was undergoing the same experience.”

Dr Morrison said that the world was on the brink of mental health crisis before Covid. “It was brewing but Covid shed light on the entire issues. Before it there was so much shame, either with substance abuse or other mental health issues where people were pretending or trying to hide them.

But in Covid, we are seeing it more and athletes, actors and musicians have been coming out and sharing their mental health issues which I see as positive since we are moving the conversation more to the middle of the spectrum. 

Answering to a question by Makarutse on whether the pandemic has brought mental health issues to light or broadened the spectrum, Dr Morrison said, “All these issues were there before but Covid exacerbated all of them.

The fear of the unknown is the hardest thing for humans because we like to have control as much as we can. So when we don’t know what is going to happen, it creates anxiety no matter what."

Other than financial implications, there was the fear of losing jobs, the impact on the economy and health. “There was a point in time when everyone though that they might die so when you add all this, it blew up.”

Dr Morrison also said that social media contributed to an increase in anxiety. “When you see all these people look so happy on social media and if you are not so happy, it gets to you. All this was already brewing and Covid came, it kicked all this into over drive.

Talking about mental health stigma, Dr Morrison said that we don’t realize what biases we have.

“If you haven’t had difficult times, you can’t really think of good times. It is how we learn to feel about things; like differentiate between good and bad days.”

She also advised people to keep sharing their stories. “Because what happens is that you make it okay for others to share their stories and this affects the whole eco-system including your employers who then are more sympathetic and understand. Also, don’t be afraid to ask to help,” she added.

Accurate clinical documentation and data have a direct impact on patient safety, said a speaker on the last day of the three-day Patient Safety Virtual 2021 conference that started on Thursday.

Talking at the session on “Supporting patient safety through high quality clinical documentation” on November 6, Tammy Combs, Trainer and Director at AHIMA CDI and Clinical Foundations said: “We often think about the direct impact clinical documentation has on patient safety but it is important to understand how it works.

Clinical Documentation Integrity (CDI) teams document in real case scenarios and we have several examples of the impact that documentation integrity has on patient safety itself.”

CDI programmes that healthcare organisations can initiate are a representation of the patient’s clinical status.

“These CDI programmes include what happens during the patient’s stay, how sick the patient was, the diagnosis, what was the treatment plan - all of which is recognised through clinical documentation.”

CDI facilities also make sure that the data is an accurate representation by reviewing the health records and also ensure that it meets CDI standards that they are validating so as to translate that information into appropriate coded data.

Combs said that it was important to review data thoroughly. “We look at data for many different reasons. There are many avenues through which patient data is reviewed as it impacts reimbursement for many organisations. The review also shows the quality of care that is provided, supports research as well among many other utilisations of that coded information through data analysis,” she added.

Combs also said: “It is important to think of CDI being at the core of the patient record because it is telling the patient’s story and we want to make sure that we are telling an accurate story; for that we have to make sure that the documentation is meaningful, timely, accurate and also reflects the scope of services that were provided.”

The same characteristics can be applied to different settings whenever medical records are reviewed which makes it the foundation of integrity that is a key component of documentation. 

“We know that having high quality documentation can have an impact for the organisation, for the patient and for the provider because it is telling the true story of what occurred.”

But how does this documentation impact patient safety? 

Documentation that is complete and consistent, timely and clear, precise and legible and reliable will show the true picture of a patient’s health condition.

“When we look for complete documentation for a patient’s medical records, we are looking for maximum and thorough content and relevant information. Documentation should also be consistent and not contradictory.

For example, there should be no contradictory diagnosis if we are looking at a health record and there are several providers looking after the patient,” added Combs.

Documentation should also be timely and prepared as close as possible to the point of care. It should also be clear and concise with a thorough description of patient’s picture.

“It should also be precise, accurate, exact and strictly defined as well as legible in a language that is easy to decipher and comprehend. It should also be reliable documentation that is trustworthy and safe.”

CDI impacts patient safety as it supports medical decision making, helps identify missing or incomplete information, recognises potential safety concerns in patient care, and also validates that documentation has been added to patient care.

It is important to have CDI teams in place at the healthcare facility to ensure patient safety at your organisation, added Combs.

With the pandemic, the public and stakeholders have to realise that infections are no longer contained within hospital boundaries, said panellists on the second day of the three-day Patient Safety Virtual 2021 conference that started on Thursday.

At the session titled “IPC in outbreaks – lessons learned” and moderated by Dr Maria Fernanda Bonilla, Staff Physician, Medical Subspecialties Institute, Cleveland Clinic Abu Dhabi, the panellists said that only by practicing proper infection control strategies could infections be controlled in the future.

Prof Tawfik A. M. Khoja, Prof of Public Health, Imperial College London; Family and Community said: “Among the lessons learnt from Covid-19, we understand that quality and patient safety roles have become diverse, multi-sectorial and multi-disciplinary and involve a lot of people from within and outside the healthcare industry.”

In 2010, the World Health Organisation (WHO) asked all countries to develop a national programme for infection and control. Studies show that in Europe there are nine million patients with infections acquired during their stay in hospitals while seven to 15 percent patients had infection problems in high and middle income countries, he said. 

Other WHO studies done in the Arab region also show that 12-18 per cent of patients have hospital acquired infections. In babies born in low and middle income countries, the rate of infection is almost 20 times higher than any developed and high income countries. 

“In the pandemic the issue became complicated because several countries in the Arab region have high prevalence rates. Secondly there are many unsafe practices within healthcare institutes. Lastly, the healthcare teams, too are infected. But now it is evident that with low cost interventions we can minimise such infections,” added Prof Khoja.

The cost and economic impact of hospital acquired infections is huge. In the US alone, $30 billion is spent per year while in Australia, 12-16 per cent of the expenditure goes into managing infection control in hospitals.

Prof Souha S. Kanj, Professor of Medicine, Head, Division of Infectious Diseases, Department of Internal Medicine, Chair, Infection Control and Prevention Programme; Co-Director, Antimicrobial Stewardship Programme; American University of Beirut Medical Center, Beirut, Lebanon said: “More than ever we have learnt about infection control practices during the Covid pandemic.

For people who did not think that infection control practices were important, now are totally convinced that these practices are a must. But we cannot talk about practices without stressing on the importance of proper hand hygiene, as well as precautions about transmission processes.”

Education is part of the Infection Prevention and Control (IPC) mandate and it is not only to put policies and procedure in place. “In regions such as Lebanon and Italy where there were shortages of masks and PPEs, we came up with re-sterilization processes for N95 masks and googles. Also, the work of the IPC is to manage outbreaks just as they did in Covid 19.”

Dr Amal Saif Al-Maani, Director, Central Department for Infection Prevention and Control, Ministry of Health, Muscat, Oman said: “The public and decision makers have to realise that infection control is not within the hospital walls only now. We engaged the public during Covid-19 with all the infection and prevention control strategies and the public has been wearing masks to halt the spread of the infection as well as practicing hand hygiene during the pandemic.”

Engaging the public during the pandemic through proper risk communication of what it means to be infected and their compliance can also be done for all other infectious diseases, including the healthcare associated infections. 

“For a long time we have been treating hospital acquired infections as a stigma for the society and as something that is pinpointing a bad practice at the facility, but if you look in reality, many of those are preventable,” said Dr Al-Maani.

Community stake holders including workplace leaders were interested in buying strategies to control infection because of loss of lives, time and money during the pandemic. 

“Why can’t we do this for all respiratory diseases? If we take the pandemic as any other outbreak and as an opportunity to enforce strategies of infection prevention control in the day to day practices of individuals while reminding them of Covid while it is still fresh in their minds, we will be in a better shape to sustain infection control for the future,” she concluded.

The pandemic has changed the outlook on the sterile processing, even for those working in the same healthcare facilities, discussed healthcare professionals at the three-day Patient Safety Virtual 2021 conference that started today.

Panellists at the session on “International Association of Healthcare Central Service Material Management (IAHCSMM) - View from the IAHCSMM Board: A candid conversation on the future of sterile processing” moderated by Damien Berg, Vice President of Strategic Initiatives for IAHCSMM, discussed that over the past five years, regulatory agencies have been paying more attention to the sterile process in healthcare settings. 

Monique Jelks, Sterile Processing Expert; Board Member, IAHCSMM said, “Over the last year, people realised what we do because now everyone wants everything sterilised so that they don’t get Covid.”

She also said: “Over the past year, we have taught people more about sterile processing than we have done for people who were from non-surgery because they wanted Personal Protection Equipment (PPEs) sterilised. We also had the big push for the N95 mask because everyone is trying to figure out how to reuse it.”

“This is our new normal and we are looking at the next phase of our years of being recognised as sterile processing professionals.”

The panellists also discussed that it was not time to create job processing professionals not just technicians but individuals who have chosen this field as a career and as professional healthcare workers.

Casey Czarnowski, Sterile Processing Educator, Stanford Health Care; Board Member, IAHCSMM said, “What gratified me being a sterile processing professional was when people would come and say can you guys handle Covid? and I’d say we’ve been handling Covid for about like 50 years now. We clean and sterilise whatever you need and we know Covid already.”

Jelks added that JCI decided 10 years ago to look into the sterile processing department. 

Marjorie Wall, Director of Sterile Processing, Kaiser Permanente; President-Elect IAHCSMM Board of Directors added: “Global issues related to infections in 2015 was a wakeup call for the industry. For us to be able to continue growing and innovating in our field, we had to get comfortable in two things – one is giving voice to our technicians and building them as professionals and making them feel safe (psychologically), to be able to speak up, give their ideas about how to improve and work safely in our department.”

The second thing, she said, “Is to get comfortable with change and innovation and also work on data and understand it, open up ourselves to Artificial Intelligence, visual recognition and technology which will push our field into the next generation of innovation and people success.”

Czarnowski said that advancement of hydrogen peroxide sterilisation and the leaps and bounds it had taken, not only in technology but also manufacturers understanding it has had a big effect, especially during Covid.

Jelks said that robotic technology had also changed the way instruments used for sterilisation were being reprocessed. 

“Inspection is going to be more critical now since every product has been updated and has an expiry date.”

Brian Reynolds, Assistant Chief of Sterile Processing Service, V.A Medical; Board Member, IAHCSMM said that it was important to listen to staff instead of comparing data all the time.

“The data isn’t the one that is putting out or dealing with patients day in and day out. Having the knowledge and expertise of the staff is key because they are doing it every day. We often get to the point where we say the data says this but we don’t listen to the people who are doing the actual job.”

The panellists said that it was important to keep talking about the profession of sterile processing. “Right now we are operating in a bubble which we need to break out of and talk about how we are keeping patients safe,” added Jelks.

They concluded adding that challenges within the industry were internal conflicts. Focus should be on building strategic relations with hospitals, infection prevention, management as well as administration, they said.

Building safety cultures within healthcare systems, infection control post-Covid, and new risks to patient safety were among the critical issues discussed on the second day of the three-day Patient Safety Virtual 2021 conference that started yesterday. 

Addressing the session “Building a patient safety culture within a large health system post-Covid”, Dr Iahn Gonsenhauser, Chief Quality & Patient Safety Officer, Ohio State University Wexner Medical Center, focused on fundamentals of creating a safe culture and strategies to identify and cope with stressful situations within the workplace.

He said: “In these times, one in five Americans suffer from significant behavioural symptoms including anxiety and depression which are the most common. We have seen during the pandemic that the number has more than doubled to about 40-45 per cent of all Americans who will be considered as clinically diagnosable behavioural health issues.”

He said safety of the workplace and culture also includes psychological safety and speaking up is fundamental to creating patient safety within an organisation. “Without those basic fundamentals, its next to impossible to create a truly communicative, holistic patient safety culture.”

Preventing the next pandemic

In the session titled “Infection Prevention and Control during the Covid-19 era and beyond”, Dr Shafi Mohammed, Director, Infection Control and Occupational Health; Co-Chairman, Infection Control Committee, Cleveland Clinic, Abu Dhabi said that the world has gone through three waves and there could be a potential fourth one if proper acts were not put in place. 

“Since the beginning of the pandemic, several public health measures have been put in place such as travel restrictions, masks and vaccinations but what is the effectiveness of these measures?”

Quoting several studies that have been carried out, Dr Mohammed said that restrictions on travel and lockdowns saw a dramatic drop in Covid cases in China and Thailand. Universal masking, especially wearing medical masks also proved to be effective against infections, according to studies. “The mathematics here is simple; the more the people wear masks, the lesser the ability of the virus to transmit.” 

Studies have also shown that the higher the number of people taking the vaccine, the reduced numbers of deaths, hospital admissions and Intensive Care Unit admissions.

The impact of Covid-19 on infection prevention and control has been huge. “We have seen dramatic changes in processes and outcomes and measures related to infection prevention and control such as the high use of hand soap and alcohol, highest use of PPEs, masks and antibiotics.”

Interestingly, he said, “there has been a slight reduction in multi-drug resistant pathogens despite an increase in the use of antibiotics, which proves that hand hygiene prevents transmission of infections.”

Returning to normal and tackling burnout

The panel discussion “Identifying and addressing new risks to patient safety (post-Covid) – do we need new strategies?” moderated by Dr Afrah Packirsaibo, Senior Conference Producer, Healthcare, Informa Markets highlighted the risks to patient safety.

Rola Hammoud, Chief Medical Executive, Clemenceau Medical Center Dubai said: “The pandemic created very high risks to the patients because the disease was new. Other risks were propagation of the infection itself which was concerning and huge and needed to be mitigated.

At the level of hospitals, we could do this by putting in place a very thorough infection control programme. Outside hospitals, the risk was very huge, and while some countries were good at mitigating, many others were not.”

Dr Ahmed Mohamed Elsheikh, Quality & Patient Safety Director, Security Forces Hospital, KSA said: “I would like to elaborate on health systems’ risks which may continue for a while because of business nature. Most of us were overlooking the burnout factor for healthcare workers during the pandemic. We were tackling two pandemics at the same time - the disease and the pandemic affecting the minds, which is burnout.”

He added: “An identified risk is also the plan to return to normal which will bring challenges of its own.”

Our nervous system cannot differentiate whether we are being chased by a lion or a work deadline. When we are stressed, whether from work, relationships, negative thoughts or poor sleep, the reaction in the body will be the same. And most people do not realize the impact of these daily stressors on the body’s nervous system. The body’s stress response has evolved over thousands of years as a survival mechanism and now as a result our body goes into a fight-or-flight response, also known as the stress response.

The science behind “Stress”

When the stress response kicks in our mind, it sends a signal to the brain to release a cascade of stress hormones in the body. The body then activates and sends energy to certain parts to ensure survival and shuts off energy to other parts that are not necessary at that moment. In the lion or work deadline example, when being chased by a lion, in the short term energy is sent to our limbs, and diverted away from our digestive system or growth hormone, because we do not need those systems to be working while we are being chased by a lion. However, unlike being chased by a lion i.e., short-term stress, our day-to-day work life is medium-term or even constant stress in some cases, which means most of us are living in a mild to moderate state of fight-or-flight all the time, which is causing havoc on our mental and physical wellbeing.

Can this be avoided? The answer is yes, read on…

Related: How wearables can help support mental health and well-being

There are many activities that contribute to a strong and resilient mind and body that could potentially help us push back our daily stressors. While some could be considered as good-to-do on a daily basis while on other hand some are quite mandatory – which means if you aren’t doing these activities, then the stress could pile up and as a result, you are less likely to feel your best.

The top three mandatory activities that I would list are - good sleep, exercise, and mindfulness exercises. Advanced wearables, like Fitbit, these days have built-in sensors that can give us biofeedback about our body’s stress response and what we need to be doing to optimize our overall wellbeing.

Here are some facts around my list of three activities:

Related: Can wearables help improve sleeping patterns?

Sleep: The idea that sleep is just a time when our body ‘rests’ is a bit outdated.

• ​​​​​Sleep is the single most effective thing you can do for your brain and body. If you are not getting 7-8 hours of good quality sleep, you are considered sleep-deprived.
• Not all sleep is created equal—deep restorative sleep is different from REM sleep, and you need both to be able to function at your best.
• And we know for sure that sleep is good for physical health to recuperate, but sleep is also very good for mental health to be regulated. For example, if you do not get sufficient sleep your amygdala (which is your fight-or-flight reactive centre) is 60 per cent more activated. That means no matter how much you know about managing your stress, it won’t matter because you aren’t able to access that information due to a more reactive amygdala.

Exercise: Some say sitting is the “new smoking” and moving is key to a strong and resilient mind and body.

As commonly known, if you are sedentary, you are more likely to have physical and mental health problems compared to if you follow a 150 mins weekly active zone minutes target. For those with a sedentary lifestyle, the popular Dubai Fitness Challenge has just kicked off last weekend and it can help you redefine your routine, motivate you to get 30 mins of exercise daily. The popular Fitbit rebounder area is in place once again, where participants can achieve their daily 30-minute activity goal by joining a fun and socially distanced trampoline class.

• ​​​​​​Exercise has neuroprotective and cognitive benefits, especially pertaining to memory and learning-related processes.
• It has antidepressant effects and counteracts disease, age-related mental impairment, and atrophy, such as Alzheimer's disease or dementia. Contrary to the age-old notion that the number of neurons in the brain remains static after prenatal and neonatal development—new neurons can be generated in the adult brain via a process known as neurogenesis. This phenomenon has been linked to exercise.

Mindfulness exercises:  Last but not the least, mindfulness exercises are a mandatory and non-negotiable practice that I recommend in order to manage and reduce stress.

I have come across some interesting, advanced smartwatches and fitness trackers that go beyond tracking your steps and include tools for measurement of stress, skin temperature and much more than traditional wearables. Devices such as the Fitbit Sense and Charge 5 also come with an EDA – electrodermal activity sensor that measures the perspiration on your hands which go up in times of stress. Basically, it will look at your ‘ fight-or-flight response in the body (also referred to as the sympathetic nervous system activation) and is one of the most sensitive and valid markers of stress, which a regular practice of meditation can help manage.

Some devices also feature tracking of Heart Rate Variability (HRV), which tells you how resilient your body is and how much time you are spending in the fight-or-flight mode.

• Higher HRV variability - which is at times misunderstood, is actually a positive attribute that is associated with reduced morbidity and mortality, and improves psychological well-being and quality of life.
• Low HRV, on the other hand, means that you are in a sympathetically dominant fight state, with high-stress hormone levels even when you are at a resting or dormant stage. This could be very taxing on the body and could result in various mental and physical health problems.

Another new Premium only feature that I have recently come across on Fitbit’s wearable devices is the Daily Readiness Score - which is a composite score that combines your activity, sleep and HRV over time to reveal each day if you are ready to exercise or should prioritise recovery.

Wearables have advanced over the years and are now equipped to demonstrate how small changes in our daily habits could have a big impact on the overall stress in our mind and body.

International Stress Awareness Week was created in 2018 to raise awareness about stress prevention and is being observed from Nov 1 to 5 this year. Let’s start observing our individual activity, sleep and mindfulness habits and ultimately try to redefine our routines to improve our overall physical and mental wellbeing.

Dr. Saliha Afridi

Improvement in quality of service, as well as safety of patients and healthcare workers, are among the main lessons learnt during the pandemic, officials said at the three-day Patient Safety Virtual 2021 conference that started today.

Addressing the opening session, “The changing face of safety: The impact of COVID19 on defining and improving safety in healthcare” Dr Kathy Leonhardt, Principal Consultant for Quality & Patient Safety, Joint Commission International (JCI), Wisconsin, USA said that healthcare organisations need to adopt broader safety strategies, apply quality improvement using tools, and leverage technology in digital tools to bring safety into organisations to achieve the next generation Quality 4.0.

“The pandemic has made us more transparent and we have realised the good and the not so good in our efforts to improve safety across the globe.”

New processes have been created and existing ones have been disrupted. “This includes use of technology which many were not familiar or comfortable with such as doing telemedicine through the computer, e-visits and using different tools for patients to communicate with their families. All these changes impacted the outcomes and risks which also impacted patients,” she said.

Post-pandemic, the most frequently reported findings in JCI surveys identified in 1,500 hospitals in the US that Covid stress on healthcare industry contributed to worsening of existing safety events, and there was a significant increase in patient falls, pressure ulcers, central line and bloodstream infections. Medical care was either delayed or missed, while misdiagnosis of Covid and non-Covid care were also reported. 

“But what we were not prepared for was the impact of Covid on the safety of our healthcare workers,” she added.

Other impacts were deaths as well as psychological and physical attacks on healthcare workers and consequently, an exodus of medical workers has been seen, leaving hospitals understaffed and unable to provide quality care to patients. 

“Our healthcare systems have not been able to respond. However, we learnt and continue to adjust and prepare for the future.”

Recommending three strategies, Dr Leonhardt said that healthcare organisations need to adopt broader safety strategies, apply quality improvement using tools in standardised method to make decisions and adapt, and leverage technology in digital tools to bring safety into organisations.

“When you combine all these strategies, you get Quality 4.0 which is our next generation without replacing previous methods and building upon them.”

JCI is also moving towards, AI and machine learning to provide reliable services to its clients. “To eliminate harm for all, healthcare needs to optimise improvement efforts with the use of technological tools to empower people to build reliable systems,” she added. 

Checklists key to patient care

At the keynote address “Implementing safety solutions/interventions in a health system – the patient safety toolkit post-Covid,” Prof Nick Sevdalis, Implementation Science & Patient Safety; Quality Improvement & Implementation Science CAG, King’s Health Partners; Founding Section Chief Editor, Frontiers in Health Services, King’s College London said that checklists are important for patient care.

“We need to start looking at methodologies and systems to develop what we already know and build upon them.”

He also said that there has been a noticeable shift in the knowledge gap in patient safety that was present years ago to implementation gap. “We need to work on being consistent in implementation.”

Moderate rise in antibiotic prescription and consumption in UAE during pandemic

In another session on "Antimicrobial Resistance (AMR) after COVID-19 – what challenges await?’", moderator Dr Jens Thomsen, Chair, UAE Sub-Committee for AMR Surveillance, and UAE National Focal Point for WHO Global AMR Surveillance (GLASS) Data Manager AMR, Ministry of Health and Prevention, Abu Dhabi, presented a global study done in 2020 showing that there has been a moderate increase in antibiotic prescription and consumption in UAE during the pandemic.

“An increase in antimicrobial resistance was also seen in different strains,” he said.

Dr Luke Moore, Infectious Diseases Physician and Clinical Microbiologist; Honorary Clinical Senior Lecturer, Faculty of Medicine, Department of Infectious Disease, Imperial College London, London, UK, said that the pandemic has changed prescribing habits, and the challenge is to see if this will continue in the future as well.

Dr Stefan Weber, Consultant Microbiologist, Sheikh Khalifa Medical City, Abu Dhabi, UAE said that there was a short disruption in supply of antibiotics during the pandemic, but it was largely overcome. 

“During the pandemic, the doctors did not know where we were headed and let their guards down which led to us losing what we had achieved in infection control earlier. It will be a challenge to start again with a new energy.”

If integrated into health systems properly, Artificial Intelligence (AI) will give healthcare workers more chance to show care and empathy.

Addressing a special session on “The role of artificial intelligence and machine learning in Patient Safety” at the three-day Patient Safety Virtual 2021 conference that started today, Dr Samer Ellahham, Medical Director of Continuous Improvement, Director of Accreditation, Cleveland Clinic Caregiver, Senior Cardiovascular Consultant, Heart and Vascular Institute, Cleveland Clinic Abu Dhabi, UAE said that integrating AI into healthcare can make processes a whole lot more efficient. 

“If AI is integrated into medical records of patients, it will be very helpful for a caregiver,” he said.

AI is not the future but the present and it is defined as building of machines that are capable of thinking like human beings. Allaying common concerns of machines taking over jobs of humans, Dr Ellahham said that AI is not here to replace humans but to provide support by making processes more efficient and precise while dealing with a large number of data to make not only appropriate suggestions, but also predictions. 

“AI is affecting all walks of life especially healthcare and it can be approached as patient-centred, data driven, healthcare enhanced communications and medical diagnostic imaging,” he added.

Machine learning happens through data to solve problems while deep learning is building new networks that automatically discover patterns for future detection, he said. 

Talking about portable AI devices, Dr Ellahham said that continuous electronic monitoring is the focus by using remote notification system with an alarm to notify the care provider. “The application for patients is wearable devices which is the most interesting and also aids in patient rescue. No matter how many caregivers we have; this is a must for any healthcare organisation.”

Non-invasive monitoring is all about AI and portable tools that give an appropriate evaluation of the patient. Such machines are very easy to use and have advanced technology, fewer complications, less costs, portable and very accurate while data can be transmitted even to the smart phone. 

“Technology is improving remarkably and the tools continue getting smaller and more efficient. We should not accept any mediocracy in healthcare,” said Dr Ellahham.

However, human resistance and unwillingness to integrate AI into healthcare facilities is among the challenges facing the industry while technical factors include limitation of data and design. 

“There are limitations to AI currently and it is evolving.”

He also said that precision and population medicine is here to stay. “When knowledge and evidence based medicine increases, we also need to see an increase in intelligence based medicine. In future, the term AI in healthcare will not exist but will be called augmented healthcare or intelligence based medicine.” 

Safety of AI in healthcare is focused on predictions and outcome after systems and applications are used and defined appropriately. Remote surveillance provides meaningful patient alerts in settings and it is important to have these systems that are integrated with IT systems.

With this, we may even be able to have predictions, not only reactive but proactive in healthcare as well as data protection and trust, all done under proper regulations, he concluded.

Breast cancer kills more women than any other cancer. The World Cancer Research Fund reports that it represents 25 per cent of all cancers in women, with 2.3 million being diagnosed in 2020 alone. In the same year, 685,000 women died of the disease. Worryingly, the annual global incidence of breast cancer is increasing because of changing lifestyles in developing regions.

The good news is that breast cancer screening technologies have come on in leaps and bounds in recent years. 3D mammography systems – also known as digital breast tomosynthesis (DBT) - provide clinicians with three-dimensional, high-resolution images of early-stage breast cancer – even in those without symptoms.

Women seeking the most advanced and efficacious mammograms should seek out DBT from their healthcare providers because of their ability to achieve better depth resolution and tissue separation. Companies that pioneer such technologies include Siemens Healthineers, which has developed a ‘MAMMOMAT’ Revelation DBT system with a 50° Wide-Angle Tomosynthesis. This wide-angle system enables doctors to see the deep tissue of the breast in greater detail, detect cancers at an early stage, deliver better and less aggressive treatment options and improve survival rates.

The benefits of gaining mammography images through DBT over traditional 2D projections is so significant that it is quite likely that they will soon become the industry standard.

Integrating software

Once taken, those images can now be analyzed in much greater detail through advanced software platforms, making it possible for radiographers to achieve very detailed Volumetric Breast Density Assessments. The integration of these breakthrough imaging technologies with advanced analytical software programs helps medics to gain an even greater insight into the nature of breast tissue composition, breast density and the likelihood of the presence of cancer cells.

Artificial intelligence

The implications for survival rates are significant. Now, with the acceleration of AI-based machine learning (ML) algorithms, vast quantities of historic data can be processed to create statistical predictions – and research shows that it is highly accurate. One such study reclassified 35 per cent of its standard DNA-based analyses after ML-based algorithms were applied. This represents an exciting new dawn in early-stage diagnosis and in the fight against breast cancer.

These innovations make it possible for clinicians to analyze and report on the results of mammograms in record time. Healthcare innovators have come to market with new software solutions that speed up the entire workflow for breast imaging, with dashboards that make reading and understanding mammography images much faster. In essence, this means that radiographers and oncologists can work at pace and accurately classify patients depending on need, in record time.

These easy-to-use dashboards flag up abnormalities in breast tissue and offer a so-called ‘confidence score’ - the probability of cancerous tissue developing. By implementing evidence-based AI, a significant increase in accuracy and a 35% reduction in workload can be achieved. This allows doctors to deliver much more accurate diagnoses and process more patients, faster – speeding up and improving the breast health journey from discovery to recovery.

A holistic breast health journey

These advanced technologies are, however, most effective when they form part of a holistic, personalized 360° approach along every step of the breast health journey. Bespoke care pathways that are human-centric and complemented by technologies, can help a doctor to walk women through the journey from early-stage discovery to recovery. It is a journey that can now also be made safer through the use of low-dose mammography systems such as those from Siemens Healthineers, which use 30 per cent less radiation than traditional alternatives. 

Underserved communities

As advanced technologies become more commonplace, modern lifestyles in the developing world are becoming more ‘westernized’, creating breast cancer distribution that is becoming closer in profile to that of women in industrialized nations. Therefore, policymakers, community doctors, oncologists and innovators must actively promote self-examination techniques and discuss the intrinsic value of early diagnosis methods and technologies with women in all communities. This requires a shift in mindset from reactive to preventative healthcare provision even in the most medically underserved parts of the world.

October was Breast Cancer Awareness month, which provided an impetus for all stakeholders to push harder to raise awareness of breast cancer prevention and treatments. Across all regions but particularly in the developing countries, the suspicion of breast cancer can fuel uncertainties, fear, and cultural taboos. Wherever they are, women deserve to understand how to self-examine, what to look for and what to ask for from medics. Together, through the provision of holistic breast health journeys and the incredible potential of artificial intelligence, we can help women all around the world to achieve early diagnosis and beat breast cancer.

The Dubai branch of BD (Becton, Dickinson and Company), a leading global medical technology organization, is all set to showcase industry-leading and cutting-edge MedTech innovations at the 17^th edition of the Patient Safety Congress scheduled from 4^th - 6^th November 2021.

BD positions patient safety at the helm of its efforts. The company strives to support the region’s healthcare providers in their aspirations to achieve sustainable practices by delivering advanced medical technology, expertise, and solutions. At the Patient Safety Congress, BD will highlight the importance of medical technologies that prevent healthcare-associated infections, foster safer medical procedures, address the need to detect several life-threatening pathogens, identified and tested for antibiotic susceptibility for enhanced treatment management decisions.

“The situation that we have been through in the last two years has demonstrated that healthcare is at the heart of the region's growth and has highlighted the necessity for advanced MedTech adoption to strengthen the health sector's standing. Avenues like the Patient Safety Congress are critical for raising awareness and enabling conversations about the needs and improvements that are required for the future of patient safety,” said Maher Elhassan, Vice President & General Manager, BD Middle East, North Africa & Turkey. “As part of our mission to advance the world of health, our participation at the Patient Safety Congress 2021 reaffirms the company's commitment to the healthcare sector by showcasing our latest innovations in patient care, safety, diagnostic accuracy, automation, and more."

BD will also be partaking in two webinars at the virtual event, titled Patient Safety, shared responsibility and Connecting & Optimizing a Patient’s Journey to Safety. The first webinar will provide the audience with a better look into BD’s quality-driven background that enables the sustainable culture of patient safety while maintaining quality efficiency. The second session will showcase an immersive virtual experience at the BD Centre for Safety & Clinical Excellence.

It is estimated that 1 in 10 patients is harmed while receiving unsafe care and research shows that 30-70% of medical errors are preventable with the adoption of advanced MedTech solutions. To address these challenges amongst others, BD continues to focus heavily on improving diagnostic accuracy and efficiency to set patients on the right clinical path, delivering an enhanced error-free experience in their journey.