COVID-19 exposed how complacent we all were about germs because we seemed to be winning the battle – we had new drugs, treatments. So, when the Coronavirus came around, we didn’t have anything to protect us from it since we didn’t understand it and didn’t know what to do.

One company that early on realised the importance of offering virus killing masks to the general population was Fine Hygienic Holding (FHH). The company operates in the world of hygiene, disinfection and wellness. “The prevention of infection, that’s what we focus on,” shared James Michael Lafferty, CEO, Fine Hygienic Holding, in an interview with Omnia Health Magazine.

Related: Omnia Health Magazine February – March 2021

While Fine is synonymous with tissue products, the company made its foray into the mask market in February 2020 with the Fine Guard Mask, which has become the reusable mask of choice in the market.

“We sterilise our tissues to UV light,” said Lafferty. “It is sterile when it leaves the factory and when the box is opened at home, they’re more sterile than another tissue. But gradually, germs can settle on the tissue and it doesn’t stay sterilised. We had been thinking about ways to address that challenge.”

Related: Navigating effects of COVID-19 on the medical device industry

In this regard, a technology from Switzerland came to FHH’s attention. It was basically a chemical that can be applied to a tissue or textile. It not only kills the germs but keeps killing them for a year. He stressed: “Imagine the tissue in your house; you’re sick with a cold, but, of course, don’t want your family to get sick. You blow your nose, and the tissue kills the virus. So, if someone else touches the tissue, or picks it up off the floor, they don’t get sick. We had been working on this for two years but couldn’t get it to work on paper since its very delicate. But we knew that it worked on textiles.”

Lafferty shared that he has a background in physiology and a keen interest in microbiology. So, when in January 2020 the first news stories about the Coronavirus were coming out, his interest was piqued, and he reached out to a virologist friend and asked him a few questions. His friend told him that this virus “loves the human respiratory tract, so if it has killed 80,000 people, it’s going to kill a lot more and is going to go global, and that it is an airborne virus.

He said: “My friend said that the number one thing you can do is wash your hands. Also, you have to cover your nose and mouth with a mask. That’s when I thought, we know how to make masks and we know how to spray this technology onto textiles. So, we can’t do it on a paper mask, but on a reusable mask and we can be good for the planet!

“Eight days later, we launched the Fine Guard Mask line to market. It’s the fastest record in the history of the fast-moving consumer goods business to launch a product in such a short span of time. In my 35-year career, this is probably my number one most fun and rewarding story because every mask we sold was ultimately saving human lives.”

Prior to this kind of technology, the way people looked at masks was based on filtration and whether it was an N95 or not. N95 refers to 95 per cent filtration of any particle down to a size of point three microns. Point three microns is pretty small, but that would cover dust, pollution, most bacteria, pollen and most spores of moulds and fungi. But it doesn’t cover viruses because those are smaller than point three. For example, the Coronavirus has a measurement of point one to five diameter, which is one third the size of the filtration. Therefore, a virus like a Coronavirus goes right through an N95.

Lafferty explained: “All of the world’s technology to measure masks was based on filtration, so it was a point of concern for the Coronavirus. This whole idea of a textile that kills a germ is brand new and so most governments had never even confronted this. I would get letters on social media with people saying, “you’re lying, how can a fabric kill germs?” There is not a lot of understanding about the technology and how it works. But it certainly does. It was tested and validated in leading laboratories such as the University of Arizona’s department of microbiology.

“I think I’m a fairly healthy person, but I can safely say that once every year I did get sick with a cold. But here we are in the middle of a pandemic and this is the first year of my life that I haven’t been sick! I think part of it is those masks, as they don’t only protect from Coronavirus, but also the common cold.”

Committed to saving lives

When asked about how FHH responded to the COVID-19 crisis internally, Lafferty highlighted: “I’m very proud of how we responded to the pandemic because it’s in times of adversity that you measure the character of a person or an organisation. I think we really showed the character of the company. The first thing was how we responded to our own organisation. We were very clear about not cutting salaries. We not only didn’t cut pay, but we gave raises and bonuses, as people worked extra hours. We provided employees with 24/7 counselling and other programmes to help them cope with the challenges of the pandemic.”

Externally, he said, FHH expanded its profile from being a wellness company in the hygiene sector to being a wellness company in the disinfection sector and made a commitment to saving lives. “We launched masks and gloves and a whole new range of long-lasting disinfecting products, which save lives. We have sold several million masks. But I don’t think about it as selling these many masks, but about potentially saving two or three million lives, thanks to the revolutionary antiviral technology we use in our products,” he added.

Furthermore, he said that countries were able to evaluate and change the regulations and change the importation laws on protective masks, to varying degrees of speed. “It took us quite a while to launch in Egypt because the regulatory requirements vary from country to country, and this is a new technology. The UAE was very quick, as were some of the European markets. But still, governments around the world take time to accept the change of a virus killing mask.”

Recently, FHH also introduced the Fine Guard Pure Hands 24-hour hand sanitiser that only needs to be put on once a day. The company also launched Pure Surfaces, which lasts for 21 days. “So, you can disinfect your table or your doorknobs once every three weeks,” he said. “These products are also completely protected and have been validated in independent research.”

He concluded: “In the coming years, I think more and more people are probably going to be germophobes due to what they have witnessed during the pandemic. This will create a ripple effect on two segments. Segment one will be disinfection and killing germs. Also, hand sanitisers will be a part of the fabric of our society. The second segment is the immune system function, which is what are the foods and supplements that can improve immunity so that if someone does catch a virus, they can ensure that they can beat it.

“These are the two areas that we see in wellness that are going to be big and permanently elevated in terms of market demand. And those are two areas that we as a company are going to be focusing on.”

Lafferty was instrumental in starting Procter & Gamble’s (P&G) business in the Levant region in 1998 when the Greater Arab Free Trade Area (GAFTA) agreement was signed, and markets such as Syria and Jordan opened up to the world.

He shared: “I was the first general manager of P&G in that business and opened up the Jordanian, Palestinian, and Syrian business as well as managed part of the business in Israel and Lebanon. I left in 2000 and moved on to another assignment within P&G in Poland. I loved the Levant region and always wanted to get back. In 2015, I got the opportunity to join FHH. Eventually, the board asked if I would like to step in as CEO and I agreed to that in 2018.”

Due to COVID-19, a number of people had to defer their medical treatment, and this has the potential to impact the healthcare sector greatly. In fact, a recent McKinsey report found that 40 per cent of individuals cancelled upcoming appointments, routine check-ups or treatment for chronic conditions. The pandemic created a heavy toll on healthcare systems around the world, which directly influenced hospital capacities and the ability for patients to seek care for a number of diseases.

Delaying routine or preventative screenings was understandable during the onset of the pandemic, especially with patients resorting to effective telehealth services. It is, however, alarming that the detection, prevention and treatment of diseases have been postponed across the globe; this could have detrimental consequences with significant public health risks.

Related: Omnia Health Magazine February – March 2021

In an interview with Omnia Health Magazine, Marzena Kulis, Managing Director of Johnson & Johnson’s Medical Devices Middle East, discusses how to tackle these impending healthcare challenges and elevate the standard of care in the region. Excerpts:

According to you, what has been COVID-19’s impact on some of the region’s top diseases?

According to the World Health Organization (WHO), during the three-month peak of COVID-19 in 2020, over 28 million elective surgeries across the globe were cancelled, whilst 38 per cent of global cancer surgeries were postponed or cancelled.

Related: Bringing connected health to the forefront

The Middle East has seen a sharper decline in elective surgeries than Europe and the United States, with some procedures affected more than others. Bariatric, some orthopaedics and plastic surgeries have been among the hardest hit, with trauma and some cardiovascular procedures seeing less of an impact.

There are countless stories of missed trauma surgeries, deferred cancer treatments and undetected conditions that if left untreated could evolve into complex problems that impact patients’ quality of life. As hospitals gradually return to normal operations and more people get vaccinated, we expect a backlog of surgeries to be carried out.

Earlier in 2020, we anticipated this global challenge and launched our My Health Can’t Wait initiative, a patient education effort and comprehensive resource hub aimed at inspiring people to prioritise their health and improve understanding of how and when to pursue care. The My Health Can’t Wait website places an emphasis on getting patients to understand the urgency of addressing their health needs and the options available for routine pre- and post-operation care, whilst also helping them to recognise the potentially harmful impacts of delaying care.

We are broadly optimistic about the future and are committed to working with our partners and stakeholders to ensure the seamless improvement of surgery line-up without compromising patient outcomes. Empowering people to make the right health choice is critical to our mission of changing the trajectory of human health, and we will leave no stone unturned to help our patients receive the care they need.

What would you say is the current impact of connectivity on the delivery of healthcare?

Connectivity continues to play a critical role in enhancing the quality of healthcare by improving patient access, enabling remote diagnosis and monitoring, and boosting the efficiency of care delivery.

Furthermore, technological advancements in the connectivity space are transforming the day-to-day tasks in healthcare facilities, like inventory and stock management and the distribution and tracking of medication. This frees up both clinical and non-clinical staff, allowing them to focus their time and efforts on what matters the most, delivering the best care for patients.

Enhanced connectivity also allows patients to have continuous and remote access to healthcare services from the comfort and safety of their homes in the form of telehealth. This is particularly helpful for people who are at high-risk if infected with COVID-19, and also for those who have limited mobility or those who live in remote or isolated communities. Likewise, the use of telehealth can support healthcare institutions by reducing the pressure on patient care facilities in times of high demand, whilst also protecting the safety of front-line healthcare workers by limiting unnecessary exposure.

What are some of the challenges that medical devices companies will face in the coming months?

The impact of the pandemic is still very fluid, but Johnson & Johnson (J&J) was built for times like this and has grown through many global crises. We have robust plans in place across our global supply chain network to prepare for unforeseen events and spikes in demand so that we can meet the needs of the patients, customers and consumers who depend on our products.

One challenge that we are currently seeing is increasing access to healthcare in less developed parts of the MENA region. Since we first entered the Middle East market in the 1980s, we’ve brought our medical devices to many under-served communities in the region. Our Credo (Latin for ‘I believe’) is our set of guiding values and it challenges us to put the needs and well-being of the people we serve first – to be a positive force in the world.

Additionally, medical devices companies across the world are and will continue to face the illicit trade of medical devices. This has been heightened throughout the pandemic as healthcare is at the forefront of the global agenda. Our Global Brand Protection team in the region works 24/7 behind the scenes with the law enforcement authorities, manufacturers, data scientists, customs officials and many others to ensure our patients, consumers and products are safeguarded against all forms of illicit trade, including counterfeit, diversion and tampering.

How, in your opinion, can businesses operate efficiently in the new normal?

The pandemic impacted every area of our lives, which meant that all businesses needed to adjust and respond quickly, especially in the healthcare sector. At J&J Medical Devices, we were agile and responsive to ensure uninterrupted communications amongst healthcare professionals. The organisation was quick to adopt technology to maintain the frequency and depth of interactions with healthcare professionals despite physical distancing measures.

A key component of this is company culture. At J&J, we are driven by a fundamental sense of purpose that originates from our Credo. We were able to connect, engage, and find inspiration from one another because of our united sense of purpose – to change the trajectory of human health. It is this collaborative mindset that has allowed us to operate efficiently in the new normal so that we can focus on serving those who depend on us.

Marzena Kulis

What, according to you, are the major healthcare market segments that are likely to expand this year, and why is this so?

Emerging market economies continue to see the highest growth in healthcare provision across the globe. This growth spans across many different healthcare segments, but we are seeing the largest expansion in areas such as the treatment of obesity, colorectal cancer, strokes and orthopaedics.

These are being driven by a number of trends, including an increasingly ageing population across the region compounded by the global pandemic causing people to adopt more sedentary lifestyles.

Obesity is one of the most prevalent diseases in the region, with 31.7 per cent and 35.4 per cent of the population affected by it in the UAE and Saudi Arabia respectively. And unfortunately, the incidence of obesity in the Middle East is expected to rise by as much as 110 per cent to 82 million patients in 2045. Education and awareness are key and if they are prioritised in the coming years, we could see an increase in the adoption of multi-disciplinary approaches in the treatment of obesity.

Although it is a preventable and curable cancer, colorectal cancer (CRC) is the second most common cancer in the UAE, KSA and Kuwait. It is the leading cause of cancer-related mortality in the region. The coming year will likely see increased awareness and screening to advance early diagnosis and treatment, as this can significantly improve patient outcomes.

Strokes are among the leading causes of death globally and present a great burden on healthcare systems. This is no different in the region, and sadly only 8 per cent of those affected by a stroke receive treatment in the EMEA region (Europe, Middle East, Asia). This year will see greater effort being made to make the general populations more aware of the symptoms and the urgency with which one should seek treatment.

With economic and social activity likely to pick up throughout the year as the world deals with the pandemic, traumatic injuries resulting from incidents such as road traffic accidents or sporting accidents have the potential to rise. This, combined with an ageing population demographic and a high incidence of obesity, could result in more people needing surgeries such as hip and knee replacements. With one of the most comprehensive orthopaedics portfolios in the world, J&J is well placed to deal with this – people have been walking on our hips and knees for decades.

Tech transformation in healthcare is one of the major objectives for companies today. Be it inside the hospital through digitalised platforms or outside through traceability and tracking logistics and supply chain solutions, Honeywell is working towards providing end-to-end solutions. In an interview with Omnia Health Magazine, Miroslav Kafedzhiev, Vice President & General Manager, Honeywell Safety & Productivity Solutions, discusses how hospitals can optimise their resource utilisation. Excerpts:

How has Honeywell responded to the COVID-19 crisis?

For Honeywell, it was a significant realignment of the priorities. We put forward the products and solutions that we already had that would help the first responders, healthcare professionals as well as authorities and individuals. For example, the first thing that we did was we significantly increased our output capacity for safety masks.

Related: Omnia Health Magazine February – March 2021

Secondly, we have historically been a large producer of respiratory products, whether it is single-use masks or multiple-use respirators. The second thing was that we have also been a historical supplier for the various sensors for lung ventilators. Normally, we would be selling these sensors to various manufacturers. But all of a sudden, we ended up supplying, especially in the region I oversee, whether this is in Turkey, Russia, Malaysia, Singapore, or Brazil, tens of thousands of sensors, and every ventilator has anywhere between four to six sensors. We helped in producing thousands of ventilators quickly.

The third one was that the moment when the lockdown started, e-commerce basically exploded upwards. This required a significant increase of the capacity of volume that was passing through the distribution warehouses through the points of dispatch as well as for last-mile deliveries and we stepped in and we provided our products for identification such as mobile terminals, printers, etc. That helped, especially the regional, large retailers, e-commerce companies for food and non-food items as well.

Can you shed light on some of Honeywell’s latest healthcare solutions?

Related: Optimising the COVID-19 vaccine supply chain

Healthcare is an extremely complex undertaking, and you can’t do it by yourself. There needs to be an ecosystem of partners in place. At last year’s GITEX, we demonstrated the outcome of one of these ecosystem partnerships, together with our healthcare partner Influence Healthcare International, where we showed an end-to-end digital healthcare solution that was blockchain-enabled and running on mobile devices. The path forward for the technologies that we’re bringing jointly aimed at several things. One is for safe deployment of end-to-end digital solutions in the hospitals as well as significant optimisation of the resource utilisation, as well as the asset increase utilisation site in the hospital while at the same time providing a better and safer healthcare service from the service providers such as hospitals, pharmacies, clinics and polyclinics.

For example, you would normally go through several steps before you see a doctor – you take an appointment, coordinate with insurance companies etc. What we demonstrated was the ability and capability to actually deploy a solution where from the moment you arrange your appointment through a mobile phone up until you see the doctor, you actually don’t have any interaction with anybody. Basically, you are able to receive contactless access and care all the way to the doctor in a scheduled and sequential manner without the need to spend time in queues or setting up an account again and again. The important factor is to ensure that when the person does get care, there is simultaneous real-time, multiple points of entry, multiple points of management of the information for the patient and the care at scale. These solutions are already deployed in a hospital here in the region and we are in discussions with multiple other hospitals to evaluate this offering.

The one thing that we’re trying to break is a certain misconception that a lot of the healthcare provider staff have about digitalisation. You can digitalise one form and it’s going to give you a small incremental improvement. But the solution we are putting on the table is actually scalable. It’s ultra-safe, and it is subscription-based. In a lot of the cases, there is even an opportunity to talk about performance-based healthcare service, which is based on, for example, working capital optimisation, which includes levels of inventory, the number of patients, waiting times, turnaround time, account clearance etc. The ultimate goal of every healthcare provider is to provide high quality, super safe healthcare service. While at the same time, you’re actually doing it with an optimised inventory. And you’re doing it profitably.

Miroslav Kafedzhiev

What are the major healthcare market segments that are likely to expand in the near future?

At the moment, we are in discussions around more connectivity and offering a care communication platform between the patient and the healthcare provider. We have a solution that we launched in the second part of this year, which has the ability to connect, for example, all the diabetes patients inside a country with the hospital and provide in real-time their daily status and inputs about blood sugar, insulin intake, etc. This offers the ability to provide care and the ability to manage and monitor patients remotely outside of the hospital in the care of their home. That’s where we are actually seeing expansion.

The second area that is coming in is about the true actual digitalisation of the healthcare service. This refers to structural digitalisation including the ability to actually be connected and be mobile. At the moment, healthcare providers still have a lot of paper forms. If you look at the percentage of how much information exchange is done through drop-down menus, versus through text, currently, around 20 per cent is dropdowns. Ideally, there should be a voice-enabled digital exchange or the interface between the care provider and the actual healthcare system. That’s where we are seeing the big opportunities that could drive changes in the healthcare industry.

The other side is tracking and traceability of medicines and vaccines. Honeywell is probably the only company in the world that has an actual tracking and tracing solution, from manufacturing all the way to end-user of medicine, tobacco, meat, etc., but also have the capability to deploy and manage these devices. We are even in the position to deploy vaccine tracking.

For vaccines, the priority right now is more around the ability to procure it and bring it as fast as possible to the people rather than the ability to actually track and trace it 100 per cent. We understand that this is an opportunity for us to talk and to put forward solutions that we have used historically in both pharmacy as well as in tobacco. But we know that this is going to come after some time when there will be much more scrutiny when it comes to healthcare supplies going forward. Based on some of the statistics we have seen, more than 20 per cent of all produced vaccines in the world are actually not used because providers are not able to validate and verify that their safety conditions have been met and the entire traceability and transparency of the procurement have not been done.

The emergence of COVID-19 vaccines has given hope, but healthcare systems around the world are now faced with the complex task of securing and distributing supplies to the population. Several factors need to be kept in mind such as the fact that cold chain technology is essential in vaccine distribution. Moreover, in order to make vaccines accessible worldwide, collaboration is important. For example, if you are a logistics provider without the right technology, being willing to partner with other companies is necessary to deliver, stressed Katherina Olivia Lacey, Quincus Chief Product Officer and Co-founder.

In an interview with Omnia Health Magazine, Lacey highlighted some of the potential challenges that transporting vaccines present. She said: “Vaccines are sensitive to external conditions—their transportation requires a lot of care and monitoring.

Related: Omnia Health Magazine February – March 2021

“A small temperature hike, even for a short time, can reduce the effectiveness of the vaccines. Hence, there needs to be a lot of visibility in terms of transportation conditions.”

She added that additionally, vaccines are time-sensitive and essential to controlling the pandemic. In terms of logistics, this means visibility in terms of location (i.e., tracking).

Related: COVID-19 vaccines: The most precious medications in the world?

“We need to know how many vaccines there are and where they are,” emphasised Lacey. “Especially given the scale and magnitude of vaccine distributions, this can be a challenge as it requires a lot of coordination and communication between many vendors and intermediaries.”

Role of supply chain technology

To understand the role of technology in the vaccine supply chain, it is important to look at how the vaccines need to be administered. Most of them require a second shot after a specific amount of time. This makes them time-sensitive.

This, on top of the temperature sensitivity of the vaccines (once opened, it can only be stored for a certain period of time under cold conditions), put a lot of pressure on the supply chain to meet tight delivery deadlines—vaccines cannot afford to be delayed and have to be transported under controlled conditions.

Lacey explained: “Under this context, technology has a large role to play in creating transparency in the process. Logistics operators need to know where the vaccines are at any point of time. If there are delays, why and under what conditions are the vaccines in? Many solutions offer real-time data and communication to facilitate this.

“Additionally, the logistics for vaccines are already insufficient to meet demands. For this, route optimisation has a large part to play in making sure that resources spent for each delivery are minimised to invest more resource making more deliveries—this is to ensure that vaccines are accessible for more people.”

When asked about what attributes of the supply chain and logistics operations need to be closely monitored to ensure timely delivery of the vaccine, Lacey said it has to be end-to-end visibility.

“The time and temperature sensitivity of the vaccines demand that they are carefully monitored throughout the supply chain and not only in the last part of the journey. From packaging to storage, delivery providers need to know the conditions, locations, and more—all in real-time,” she said.

Moreover, it has become crucial for supply chain managers to focus on end-to-end visibility for seamless integration of temperature sensors into one platform, from start to finish point. Furthermore, this platform needs to have the capabilities to alert or indicate any temperature breaches.

Managers also need to ensure that the locations of the vaccines are clearly communicated to them on this platform—even with many intermediaries and logistics providers at hubs (e.g., ports, and airports). Apart from ensuring that the vaccines are on the right routes, this also ensures accountability amongst operators to prevent possible theft.

Katherina Olivia Lacey

Quincus offers Enterprise SaaS solutions for logistics. The company focuses on empowering the supply chain ecosystem by providing machine learning-driven optimisation as well as cross-modal and multi-mile visibility—all in real-time.

She concluded: “Over the pandemic, Quincus has been helping companies innovate. We have been partnering up with logistics providers in increasing visibility in their processes to make vaccines more accessible to remote areas. We also helped companies remain competitive as they branch out into new fields through route and fleet optimisations.”

In the last edition of Omnia Health Magazine, we discussed oncology medications that are worth more than gold: Is it possible that, right now, there are even more precious medications than these? The answer may very well be yes. Vaccination has rightly been lauded as one of the greatest medical achievements of modern civilisation. Childhood diseases that were commonplace less than a generation ago are now increasingly rare because of vaccines, and one of the greatest examples of the world uniting as one to advance health was the campaign to eradicate smallpox via mass-vaccination. Smallpox is practically forgotten now, despite the fact that the disease blighted humankind for centuries and carried a 30 per cent fatality rate.

The current COVID-19 pandemic, and the race to repeat the achievements of the smallpox campaign in a far shorter timeframe with initially limited supplies of vaccines, requires that we protect, track, utilise absolutely ‘every drop’ of vaccine available to us, and track the recipients. The speed at which these vaccines have come to market also places a responsibility on healthcare providers and vaccination authorities to produce actionable Real World Evidence (RWE), as we deal with virus mutations and variants, heterogenous population responses, and recipients from high-risk patient groups.

Related: Omnia Health Magazine February – March 2021

Medical devices and associated technology are central to the successful roll-out, maintenance, and monitoring of high-quality vaccination programmes. The first thing to say is the simple volume of syringes and needles required is immense and difficult to comprehend- 1 billion injection devices to support COVID-19 vaccinations, placed end-to-end, would circle the Earth twice. Ramping up of production to meet this challenge requires the supplier to have an extensive history of quality management, and robust manufacturing standards that can allow for increasing production without any sacrifice in quality. Quality, despite massive volumes of production, is key.

As soon as a vaccination clinic or health centre receives a supply of vaccine, the issue of security and storage arises. There are already news reports of an emerging black market for particular COVID-19 vaccines and of organised crime ‘mafias’ looking for opportunities to obtain these scarce resources, as well as direct anti-vaccine sabotage attempts from within organisations. If we look at some of the core vaccines available in the market, we can see how vital judicious temperature control and an effective tracking of thawing, refrigeration, removal from refrigeration, time spent at room temperature, and documented delivery to the patient is.

Related: Encephalitis prevention another reason to receive COVID-19 vaccine

Distinct, lockable, compartments and access via code or biometric recognition add security for refrigerated vaccine storage. 

The Center for Disease Control (CDC) has guidelines for temperature monitoring of refrigerated vaccines, and these recommend that temperature sensors be immersed in bio-safe glycol to mimic a vaccine’s thermal characteristics, and that stand-alone refrigerators with no freezer compartment be used, to preclude the risk of accidental freezing of vaccine vials.

Technology can assist in ensuring safety and maximised usage of all supplies as medical grade ‘intelligent’ refrigerated units integrated to Automated Dispensing Cabinets ensure accurate temperature control and create alerts for any deviation and can track a vaccine vial’s location through simple scanning processes and connected inventory systems. Distinct secure compartments within an integrated-intelligent fridge can also add the required security and required access-privileges via codes or biometric recognition will allow tracking of any discrepancies in count.

The Institute for Safe Medication Practices (ISMP) suggests that vaccine centres and pharmacies carefully consider the timeframe for vaccine stability at room temperature and patient scheduling to minimise waste. A date and timestamp for removal of vials from the refrigerator is extremely valuable for both keeping this safe workflow going and for auditing. Verification of the doses needed per day from the vaccination centre to central cold-chain suppliers on a frequent basis – particularly in the case of those requiring ultra-cold temperatures – is also advocated by ISMP to prevent waste. Medical grade, intelligent and inventory integrated, refrigeration units can also assist in this, as well in the allotment of doses based on footfall trends through the centre.

Fringes integrated into Automated Dispensing Cabinets allow for the production of labels for prefilled syringes before vaccines are dispensed to clinicians. 

As the currently available vaccines all require a second dose, this is particularly important for Group Purchasing Organizations (GPO) that service many vaccine distribution centres and need to know regional or national stock levels and have to forecast ‘booster’ vaccinations.

This vaccine usage data, when integrated into Electronic Medical Records (EMR), also has the potential to be a real asset for rapid review of appropriate and prudent usage. The societal value of reducing medication wastage has never been so well represented as it has been by the current crisis. Equally this data, as it can tie vaccine type, lot, vaccination date, and location to patient demographics from the EMR, assists in the gathering of RWE by specialised effectiveness and tracking technology that has already shown an impact on the tracking of Antibiotic Microbial Resistance. This technology and know-how are now being applied to help track and share COVID-19 insights with hospitals and public health agencies across the United States.

ISMP advice on the dispensing of these vaccines is that if pre-filled labelled syringes are being dispensed to clinicians, a check that the needle cap is secure should be made before any batch is dispensed. ISMP also recommends an independent double-check of any dilution process.

We have seen how governments around the world have competed for access to COVID-19 vaccines. Given how potentially fragile an adequate global supply chain of both first and second doses is the highest standards of medication management, utilisation and protection are required in order to ensure these very valuable vaccine resources are shared as effectively and equably as possible. High rates of vaccine waste could potentially lead to extending the pandemic unnecessarily and make our societies vulnerable to continuing waves of infection.

Recently, EY launched a report titled: ‘Embracing digital: Is COVID-19 the catalyst for lasting change?’ The report investigates how providers were using digital solutions to respond to the crisis; what benefits have flowed from these new ways of working; and how digital is likely to alter service delivery in the future. In an interview with Omnia Health Magazine, Mohammad Sear, MENA Digital Government and Public Sector Consulting, EY, discusses key findings as well as what barriers are there to implementing digital technology and what needs to be done to execute these successfully. Excerpts:

What has been the uptake of digital technologies by healthcare providers during the pandemic. How has it increased in the UAE and the wider region?

The adoption of digital technologies and data solutions has nearly doubled during the pandemic. Before the outbreak of COVID-19, just 18 per cent of Health and Human Services (HHS) organisations had managed to embed digital tools in the way they work. Multiple factors supported this change with safety of frontline health workers and social distancing norms being the most important ones. In many places, hospitals and health centres were overwhelmed by the increase in COVID-19 cases, which stretched their capacity in both infrastructure and availability of necessary workforce – contributing to the case of increase in adoption of digital technologies.

Related: Omnia Health Magazine February – March 2021

According to the EY report, phone and video consultations have seen the greatest uptake by service users and patients, with phone consultations being offered by 81 per cent of HHS organisations (up from 39 per cent before the pandemic) and video consultations available from 71 per cent of organisations (up from 22 per cent before the pandemic). User support tools — from online self-assessment to disease management tools and patient portals — have also increased dramatically. Other tools, including mobile sensors or wearables, have also seen rapid increases, but are still not commonplace among HHS providers.

For staff, the shift to home working necessitated by social distancing was supported by an increase in the deployment of desktop or laptop computers (from 58 per cent to 80 per cent) and the use of mobile solutions for remote access to organisational networks (37 per cent to 67 per cent). The most dramatic change, however, was in the adoption of video conferencing platforms, which soared from 27 per cent to 73 per cent.

Related: A race to innovate

Almost two-thirds of respondents to the EY survey reported an increase in the use of these tools. This shows a promising resilience, with the industry adapting to new ways of working under pressure.

In the UAE, 41 per cent of respondents indicated they increased the use of digital technologies and data solutions, while 36 per cent said that it was unchanged for them. The analysis suggests that a higher percentage of organisations were already using digital solutions prior to the pandemic in the country, which may have further helped to establish a number of fit-for-purpose options that could be adapted to other organisations. 

Patient service or user portals are offered by 83 per cent respondents, if we look at the resources being made available to patients by HHS organisations in the UAE. This is highest among the six countries studied in the EY report. Chronic disease management tools, mobile sensors and wearables, apps for reporting problems are offered by 79 per cent responding HHS organisations. 78 per cent respondents also provide online self-assessment and patient engagement tools, while 69 per cent organisations also had an AI powered diagnostic tool available for patients to use.

How have these technologies led to increased productivity in healthcare?

The EY report indicates that despite the rapid speed of digital technology adoption and significant disruption to pre-pandemic ways of working, most respondents state that the use of these solutions has had a number of positive effects, including increase in productivity.

This increase in productivity can be attributed to variety of factors such as enablement of a better collaborative working, improvement in operating models through better and digitised process, staff productivity and their ability to quickly adopt digital solutions.

A majority of respondents in all countries reported that digital technologies and data solutions have increased the productivity of staff, ranging from 54 per cent in the UK to 86 per cent in the UAE. On an average, 63 per cent of respondents across the six countries surveyed agreed that staff productivity has improved because of digital tools and solutions.

Furthermore, a majority of respondents, from five of the six countries surveyed (all but the UK), reported that these solutions were effective in improving the quality of experience, access to care, and outcomes for patients and service users.

Encouragingly, a further 66 per cent of global respondents (82 per cent in the UAE) agreed that their staff quickly adapted to using new digital tools since the onset of COVID-19. Around 61 per cent of respondents agreed that their organisations are using these digital solutions more effectively than before the pandemic began and 58 per cent (73 per cent in the UAE) reported that digital solutions have made operating models more efficient.

What are some of the barriers to implementing digital technology in healthcare, and why?

Prior to the pandemic, practitioner concerns — including the potential for increased administrative duties, loss of interactions with service users and reliance on data insights over professional judgment — were most prevalent among our respondents, with 40 per cent citing this as a barrier to implementation.

Countries like the UAE and India also highlighted ethics and privacy/data protection (using technology in making decisions about individuals and ability to protect an individual’s identity and personal information) as a major barrier which can also impact the future adoption. Nearly 40 per cent of respondents from both countries listed ethics and privacy concerns as a prevalent barrier to its implementation. However, responses from the U.S. (20 per cent) and the UK (11 per cent) indicate that data privacy is not a major barrier for HHS in these countries. Although the reason behind this variation needs further exploration, it is likely to be combination of cultural factors, citizen attitudes, and information governance policies and infrastructure.

Other major challenges include IT interoperability and adaptability, lack of funding or reimbursement for digital services, lack of skills and expertise, and lack of overall digital strategies by HHS organisations.

One of the primary reasons behind these challenges is that digital technologies have found it difficult to be part of long-term strategies by HHS organisations. Adoption of technology has been more of quick fix solutions rather than a strategically planned integration into operating models and the value chain of the healthcare industry – which we are now seeing change.

Mohammad Sear

What needs to be done to ensure digital technologies are implemented successfully and the momentum is maintained?

The extraordinary circumstances amid the pandemic have helped HHS organisations overcome some of these barriers to rapidly implement digital and data solutions. Many countries temporarily relaxed regulatory constraints and approved payment for remote or digital services that may not have been reimbursed prior to the pandemic.

However, to deliver long term value beyond the COVID-19 pandemic, we must focus on five actions to maintain the momentum of change:

Prioritise user needs

Service users have become much more comfortable with using digital technologies and analytical solutions during the pandemic, meaning they are likely to be more amenable to these once the crisis ends. People are likely to opt for technologies which are easy to use and decrease wait times. But there is still a lot to learn about the impact of these technologies on patients, service users, and practitioners. Governments and regulatory bodies should therefore evaluate where and when remote care is appropriate, rather than taking a one-size-fits-all stance. Additionally, there must be an inclusive approach to digital health services – making it accessible by all.

Support provider adoption and buy-ins

The EY report found that the need to train practitioners to adapt to new ways of working was the top priority for organisations planning for the future. Accordingly, solutions should be user-friendly and incorporate seamlessly into existing workflows, rather than creating an additional administrative burden. At the Hong Kong Hospital Authority, for instance, new digital tools are designed to be intuitive – requiring no training for staff.

In addition, trainings for effective collaboration and communication through digital tools and channels will support adoption of services such as virtual consultations.

Focus on incentives

Many HHS providers received emergency funding for new digital or analytical solutions throughout the pandemic, but in future they will have to compete with other government priorities. Organisations should leverage the impact created by digital solutions during the pandemic to build strong business cases.

Moreover, governments need to identify cost-effective services and provide incentives for their use. Germany’s new Digital Healthcare Act, which entitles all individuals covered by statutory health insurance to reimbursement for certain digital health applications, could provide interesting lessons for other countries.

Embrace interoperability and data sharing

There is still much to do to enable better data sharing across the wider ecosystem – not just among health and social service providers but other government agencies (such as police, justice, and education) and third parties (such as care homes, non-profits, and community organisations). Data is often locked away in siloed legacy systems that are difficult to integrate.

A decentralised and networked infrastructure, built on common data standards and structures, could unify disparate information from multiple sources and make integration seamless. Estonia, for example, has a digital innovation platform that integrates all health and social care across the country, thereby eliminating interoperability issues.

Rethink attitudes to risk

Breakthrough innovations require a culture of risk taking. However, this doesn’t mean lack of protocols in place to ensure risk management and service-user safety – especially exploring technologies such as AI.

The actions of regulators, payers, service providers, vendors, and service users over the coming months will further affect the use of digital technology and analytical tools within HHS organisations across the world. It is imperative that these parties work together to address the challenges and maximise the potential benefits of these solutions to deliver improved services to all citizens.

What are the major healthcare market segments that are likely to expand this year, and why is this so?

We can expect recovery and expansion in all major segments including healthcare services, medical devices and hospital supplies, medical insurance, as well as pharma and diagnostic services. Most of the recoveries are expected in the second half of 2021.

Although the pandemic is far from over, large scale vaccination programmes and fall in mass infections are likely to encourage people to go for costly medical interventions that were delayed and postponed in 2020. Similarly, hospitals and healthcare facilities are expected to re-align their resources as the number of COVID-19 patients drop.

Capital expenditures may remain flat on the back of strained revenue and additional capacity creation during 2020 – with exception to investment in digital tools and services which are likely to continue over the next three years. However, reinforced focus on public health by governments following the pandemic will provide an impetus to demand across all key segments. For instance, India announced an increase of 135 per cent on healthcare in its FY2021/2022 budget.

If we look at pharmaceuticals, they continued to perform relatively well unlike hospitals and healthcare service providers, and this is unlikely to change in 2021. Increased use of telemedicine and availability of online providers of prescription medicines are expected to provide cushion to any shocks resulting from further lockdowns.

Last year on International Women’s Day, we highlighted the achievements of seven (or ‘Magnificent Seven’) female leaders in healthcare.

This year we’ve gone one further, casting a spotlight on eight of our own female talents.

The video below reveals some of the inspirational women who make our world-class healthcare events and publications happen. See what they say about their achievements in recent months.