Our world is getting inevitably older. Comparatively speaking, planet Earth is estimated to be around 4.5 billion years old, however, human life has only called the third rock from the sun home for close to six million of those years.

Despite this, the global population has flourished to a point that we now face demographic uncertainty as to just how many people will inhabit Earth by the end of the 21st century. According to the United Nations Population Division’s latest insights, the proportion of the world's population aged over 60 years will nearly double from 12 per cent to 22 per cent (2.1 billion people to be precise) between 2015 and 2050. Factor this demographic explosion in alongside the evolving climate crisis, with a global pandemic for good measure, and it quickly becomes evident that the way in which we care for both people and place is the need of the century.

Related: Is digital medicine affecting costs in healthcare?

In the context of the healthcare sector, themes of ‘digital’ and ‘sustainable’ are omnipresent as we navigate challenges and innovate solutions to prolong life of our natural environment and of our people. As we envision the built environment’s role in all of this, I believe we will face a paradigm shift into how care is delivered, how patients will want to consume healthcare services, and how hospitals will need to be organised around a patient-first model.

We are looking at a world where healthcare systems will need to manage rising challenges, be it caring for an aging population, dealing with chronic diseases, or enabling healthcare facilities to operate in a carbon positive reality. This comes at a time where healthcare systems are already facing cost management challenges and scarcity of specialised resources to bring health equality to the masses.

Related: Integrate disruptive digital tech to sustain healthcare operations

So, what will tomorrow’s hospitals look like in the future? Here are eight emerging trends that could shape the sector and redefine the patient experience:

Supporting ‘Healthcare Everywhere’

A shift towards ‘always-on’, ‘healthcare everywhere’ models of care delivery has accelerated following the COVID-19 pandemic. This exponential growth has resulted in the uptake of platforms and applications that provide contactless solutions for patient needs, such as ‘home as the hospital’ and the adoption of telehealth virtual care solutions.

Moving forward, hospitals will need to build infrastructure, support systems and operating models for new ways of treating patients. Wearables and Medical Internet of Things (IoT) will provide digital biomarkers to allow better patient monitoring from the home. Digital channels and community and primary care centres will be crucial to making healthcare more affordable and available to mass population.

In the Middle East & North Africa (MENA) context, where smartphone penetration is 97 per cent and 60 million 5G mobile connections are expected by 2025, the formation of similar solutions could be transformational for the sector. We are seeing already the rise of digital first hospitals globally. Mayo Clinic and Medically Home are partnering to launch a new healthcare delivery model that will deliver ‘advanced care’ typically available inside hospitals into patient homes via wearable biometric monitoring devices.

Remy Levastre, Advisory Director – Healthcare at WSP Middle East

Purposefully designed for the patient experience

To quote my colleague Kevin Cassidy, Healthcare Global Lead at WSP: “We can provide all this great technology, but the patient will always be a human. A human connection is part of the healing process.”

In the future, hospitals will be more patient-centric, where experience is everything. Smart spaces and digitally enabled hospitality will be a necessity, given consumer demands. Hospital buildings will resemble hotels and offer hotel-like amenities such as better food, streaming services, better-positioned outlets for cell phone charging, online entertainment, and making health records more accessible to patients. Patient-centric design, well-being environment and conveniency for the caregivers will also contribute to the patient healing process including the landscape features around a hospital. 

On the inpatient care front, patient vitals could be monitored constantly by wearables and patient flow will be monitored and enhanced using predictive analytics and machine learning through operational and clinical Command Centres and Data Rooms – all with a view towards creating seamless patient interactions and best-in-class care.

Value Based Healthcare at the core

As digitally savvy consumers, patients are going to be active participants in their healthcare journeys, thus demanding transparency, convenience, and personalised healthcare products and services.

They will have awareness of the availability of acute care, precision diagnostics and personalised treatment options, but with flexibility to take control over their data, using more technology to share data to providers to get value-based healthcare.

Powered by tech innovations

Caregivers will be supported by high tech innovations as AI will bring more impact as the healthcare world collects more data globally, especially in under-represented regions such as the Middle East. Hospitals will act more like technology hubs to deal with large amounts of data. Robotics will assume more importance to support the caregivers on simple tasks, to avoid risks in contamination exposure, reducing risk and time into surgical acts. Specialists will be better connected to the outside world with wellbeing Tele-Health rooms for remote diagnostics. 5G will allow doctors to pull up massive amounts of personalised data on a wireless screen in seconds to leverage data, advanced analytics, digital platforms and technology from other partners like payment vendors, providers and other stakeholders.

With wider rollout of high-speed wireless networks, and more people wearing devices tracking data, we will be better positioned to leverage AI and rich data sets to further promote health and wellness.

Modular, flexible, sustainable designs & structures

Hospitals will be much more modular in their designs and structures, adaptable and flexible with a huge focus on sustainability and environment. Lessons learned from the pandemic tell us that medical rooms need to be flexible by design in the event they need to be turned into an ICU-capable room and to provide optimum resilience against the unknown. In the case of Penn Medicine's new health pavilion in Philadelphia the initiative to proactively build ICU-capable rooms added 7 per cent in costs to the project but made sense considering the ICU demands of the pandemic, according to Penn Medicine CEO Kevin Mahoney. This is also exemplified in the redevelopment of Kwong Wah Hospital in Kowloon, Hong Kong, where intelligent engineering services will make it possible to manage infections on either a small scale or in the case of a pandemic, 100 patient rooms can individually be switched from “normal” to “isolation” mode. 

As governments around the world push for more sustainable development, engineers and consultants are at the forefront of solutions to eliminate the carbon emissions of buildings to help mitigate the impact of climate change. Again, this requires foresight and effective front—end strategic advisory to advocate the merit of symbiosis between the natural and built environment for long-term betterment of society. In the future, many providers will not just meet regulatory requirements but will also realise that through implementation of environmentally sustainable operations, they will be able to reduce their energy costs, improve their ESG impact, and monitor and visualise benefits through Hospital Digital Twins. In the Middle East, Zulekha Hospital Sharjah became the first hospital certified at LEED Platinum level with the vision that “sustainability is about creating shared value for our patients, physicians, employees and community we serve” said CEO ‎Zanubia Shams‎‏.

Hospitals as hotbeds for medical innovation

As Medical and Technology hubs, hospitals can offer collaborative spaces for researchers and innovators to nurture incubation of new ideas and inventions which can be adopted and scaled faster with the ultimate objective of propagating a self-sustaining health ecosystem. A prime example of this is the American Hospital Dubai launching its landmark initiative with the region’s first AI-led research lab. This facility, in alignment with the UAE Strategy for Artificial Intelligence, illustrates new possibilities for data analytics, AI algorithms, and technology vendors to empower enriched healthcare diagnostics and predictability of illness patterns.

Be agile on the journey to digital adoption

“We are on a journey to digital everything” – these were the words of GSMA Chief Executive Officer, John Hoffman at the opening of Mobile World Congress in Barcelona earlier this week.

With the digital ecosystem continuously evolving and greener initiatives, backed by technology, paving the road to clean, green healthcare solutions, we are at a defining moment in healthcare history as new concepts take flight. Now with concepts like the metaverse coming to reality, we could see potential use cases being applied within the healthcare industry in education and training, or perhaps use cases in B2C consumables that elevate industry dynamics to new heights.

The future of how we heal people and place is exciting – so, what are your views about how the metaverse and other emerging trends could impact the healthcare system and hospitals?

Digital health is being touted as a progressive solution for some of healthcare's most intractable issues. Although at its infancy in healthcare, advocates claim that the digital future will bring more precise interventions, higher health outcomes, more efficiency, and eventually lower healthcare costs. 

But how realistic is the promise of lower expenditures and enhanced health? We asked experts to share perspectives from a clinical, technological, and financial point of view. 

Dr Steve Ommen is the Medical Director of Consumer Product and Platform Strategy at Mayo Clinic Center for Digital Health. When asked if digital medicine is facilitating efficiency through innovation and its impact on healthcare for physicians, here is what he had to say: “Digital healthcare solutions are improving efficiency in many health care systems. From a patient's perspective, the ability to get care without having to travel to a facility is much more efficient for their daily life. Provider teams are also finding that many of the video visits actually take less time than in-person visits and asynchronous activities such as secure messaging or online algorithmic care options improve efficiencies for those teams. Remote patient monitoring, the use of devices that the patient wears or has in their home to monitor physiologic parameters such as heart rate and blood pressure, allows a small team of nurses to monitor a large number of patients and look for deviations from the expected physiologic data that might indicate a patient is getting sicker. This allows an earlier less costly intervention in many cases. While tools like video visits have become commonplace and are quite familiar to most physicians, the newer solutions such as artificial intelligence or in-home remote monitoring do require teams to get more familiar and adopt some of their care pathways to fully take advantage of these solutions.” 

Related: MedTech devices are facilitating cost-effective care

While Majid Kaddoumi, President of Central & Eastern Europe, Middle East & Africa at Medtronic, shared its viewpoint as a leading global healthcare technology company. 

“We believe that through developments in artificial intelligence (AI) and data analytics, medical devices are advancing disease management by empowering clinicians to personalise medicine like never before. These technologies provide revelatory insights into individual patients, in real time. 

Related: Data integration will drive down costs and improve the patient experience

AI is becoming an integral part of healthcare because of advances in computing and sensing technologies, the expansion of available data, and the creation of better algorithms. As we continue to unlock the continuous data our devices and therapies generate, AI and machine learning are increasingly important tools at Medtronic. That's why we're actively adding innovative AI technologies to our research and design capabilities. Already, AI plays a pivotal role in the company's robotic-assisted surgery platforms, colonoscopy and endoscopy systems, and insulin pumps.  

Recently, we launched the only FDA cleared “smart” insulin pen that integrates glucose sensor data, putting the power of AI to work for patients with Type 1 diabetes who rely on multiple daily injections. The future of healthcare has arrived.” 

Dr Steve Ommen, Medical Director of Consumer Product and Platform Strategy at Mayo Clinic Center for Digital Health

 

Furthermore, is there a possibility of innovation prompting cost reductions in the healthcare industry or will it increased costs?  

Dr Steve reminds us that in the short term there are always start-up costs. However, when looked across a longer timeframe, these new digital solutions can add value, improve this efficiency and save money. “We have shown that the use of video telemedicine solutions to provide specialty services -- like stroke neurologists or neonatal intensive care specialists to rural hospital settings -- results in improved outcomes for the patients in health care expenditure savings. We have also seen with remote patient monitoring that hospital admissions or readmissions can be dramatically reduced. During the COVID public health emergency, sicker patients who were monitored had dramatically lower need for hospitalisation, dramatically lower intensive-care unit stays, and dramatically lower death rates because they were being monitored in their homes by skilled professionals. We have also shown that patients who were offered remote care options express high levels of satisfaction with these services and that we save patients money by offering these services to them. We have also shown in community care practices that allowing providers to have time on their calendar to address remote care in communications that the overall utilisation of the community care services and the cost per patient can be reduced,” he explained.  

Majid added, “We can call it technology or innovation that delivers value: Better patient outcomes result in better economic value. Advances in technology can deliver profound benefits for global health systems. We see firsthand how medical technology is helping patients live healthier lives, creating value across the entire healthcare continuum. And when patients who have chronic, costly conditions like diabetes or hypertension successfully manage their illness, it can help reduce hospital stays and readmissions, allowing health systems to operate more efficiently. Medical devices with the power to analyse continuous streams of healthcare data — such as insulin pumps and certain cardiac devices — can help clinicians devise better treatment plans while helping patients live a healthier life. 

Global healthcare costs are skyrocketing. Fragmented health systems focused on volume are buckling under the financial pressure of treating widespread chronic diseases such as diabetes, hypertension, and cancer. Patients don't always receive the care they need when they need it. And these issues have only been exacerbated by the COVID-19 pandemic's impact on people, health systems, and communities around the globe. 

It's time for a new model of healthcare, one that uses the power of technology and data insights to deliver better outcomes. 

We know the move to a value-based model of healthcare isn't easy. But through technology and innovation, we can address outcomes, costs, and access. There is no better time than now,” he emphasised. 

Majid Kaddoumi, President of Central & Eastern Europe, Middle East & Africa at Medtronic

 

So, what are the factors which cause constraints on resources to be integrated?

According to Dr Steve, there are several constraints on the adoption and implementation of digital health care solutions. “In the United States, health care providers are licensed individually in a state, and some of the states do not allow cross-state delivery of care using these tools. Reimbursement for digital health care solutions cross states, while facilitated during the public health emergency, is uncertain once the public health emergency is declared to be completed. These issues will, conceptually, apply globally, vary in the impact or complexity in each country. From a technology standpoint, many of these options are integrated into electronic health records. When this is the case, it can be part of the care team's standard workflows. However, some of these solutions are not integrated within the EHR and therefore creates some logistical or workflow inefficiencies as new teams are trying to integrate these solutions,” he said. 

Majid highlighted that emerging markets face unique obstacles in their quest to stand up and establish sustainable, high-quality, and cost-effective health systems. “Access is typically impacted by location and proximity to quality health institutions, a few quality trained specialists and healthcare practitioners, and insufficient infrastructure or facilities. These restraints are specific to emerging markets. Developed markets have a set of different restraints that are more related to system connectivity and integration.” 

Technology has facilitated integration of big data, telemedicine and blockchain. However, is the adaption challenging and are we still in a transition period, where training, and purchase of products have significant costs? 

“We are still in a transition. Not only are the big data engines, and artificial intelligence machines just now starting to be trained on health care issues, but the health care teams are just beginning to get comfortable at utilizing these tools as part of the management of their patients. There are also some potential socio-economic disparities if these tools are not thoughtfully made available ubiquitously. As the question itself suggests, these new approaches do come with startup costs which may be difficult in some systems or geographies,” said Dr Steve. 

“The technological and cultural revolutions are allowing technology and people to be better connected to one another, a network of connected, smart devices and objects that can communicate with each other and automate key tasks. Most patient interactions with the healthcare system involve the use of medical equipment and devices. The integration of technology and data brings together the digital and physical worlds to improve the speed and accuracy of diagnosis and treatments, and monitor and modify patient behavior and health status in real time. It also improves health care organisation's operational productivity and effectiveness by streamlining clinical processes, information and education, operations and workflows. During adaptation phase we expect better efficiencies and will provide better value for the technology and services provided,” mentioned Majid. 

And what do insurance providers say?  

Jerome Droesch, CEO of Cigna MEA and SEA

 

"The pandemic has driven the conversation around utilising technology and affordability in a promising direction. We are already seeing innovative solutions and integration of reducing costs in the healthcare sector. It is also making overall procedures efficient and empowering people to manage their effectively. One such example is Cigna’s innovative solution, SmartCare, we developed this solution to make healthcare services more accessible to employees and alleviate the pressure on employers. The service offers access to a tiered network strategy encouraging access to lower cost facilities and driving affordability. 

In fact, Digital Doctor’s, a study by Cigna Insurance Middle East, revealed that majority of doctors (85 per cent) agree that connected health devices and tools will provide patients with real-time data and knowledge about their health that will enable them to pro-actively manage their well-being and prevent diseases. Whether you're a relatively healthy individual who wants to track your fitness goals, an older adult who wants to maintain independence, or someone living with a chronic health condition, you can benefit from using connected health devices,” concludes Jerome Droesch, CEO of Cigna MEA and SEA. 

Researchers from from Cleveland Clinic’s Lerner Research Institute have launched first-of-its kind preventive breast cancer vaccine study aimed at eventually preventing triple-negative breast cancer, the most aggressive and lethal form of the disease.

There is a great need for improved treatments for triple-negative breast cancer, which does not have biological characteristics that typically respond to hormonal or targeted therapies.

Related: New treatment to boost survival rate in metastatic breast cancer patients

The investigational vaccine targets a breast-specific lactation protein, α-lactalbumin, which is no longer found post-lactation in normal, aging tissues but is present in the majority of triple-negative breast cancers. Activating the immune system against this “retired” protein provides pre-emptive immune protection against emerging breast tumors that express α-lactalbumin. The vaccine also contains an adjuvant that activates an innate immune response that allows the immune system to mount a response against emerging tumors to prevent them from growing.

This phase I trial is designed to determine the maximum tolerated dose of the vaccine in patients with early-stage triple-negative breast cancer and to characterise and optimise the body’s immune response. The U.S. Food and Drug Administration recently approved an investigational new drug application for the vaccine, which permits Cleveland Clinic and partner Anixa Biosciences, Inc. (ANIX:NASDAQ) to start the study.

Related: Advanced technologies and AI can help beat breast cancer

The study is based on pre-clinical research published in Nature Medicine and led by Dr Vincent Tuohy, the primary inventor of the vaccine and staff immunologist at Cleveland Clinic’s Lerner Research Institute, that showed that activating the immune system against the α-lactalbumin protein was safe and effective in preventing breast tumours in mice.

“This vaccine strategy has the potential to be applied to other tumour types,” added Dr Tuohy. “Our translational research program focuses on developing vaccines that prevent diseases we confront with age, like breast, ovarian and endometrial cancers. If successful, these vaccines have the potential to transform the way we control adult-onset cancers and enhance life expectancy in a manner similar to the impact that the childhood vaccination program has had.”

According to Dr. Sangita Reddy, Joint Managing Director of Apollo Hospitals Group and Former President of Federation of Indian Chambers of Commerce & Industry (FICCI), the future of healthcare revolves around three Ps – proactive, predictive, and preventive. A global healthcare influencer, she is passionately committed to transforming the healthcare system through technological advancements and is accelerating positive transformation for effective healthcare service delivery.

Dr. Reddy was in Dubai recently and visited the India Pavilion at Expo 2020 Dubai, where she highlighted the collaboration between the UAE and India. In an interview with Omnia Health Magazine, she discussed game-changing technologies and strategies to make the industry more patient-centric. She said: “The future of healthcare is being proactive and using predictive risk profiling to prevent a disease from happening.” Excerpts:

Do you think digital health has had an impact on improving patient outcomes? Are there any specific technologies that have helped in the fight against COVID-19?

There is no doubt that technology has assisted in the fight against COVID-19. For example, at Apollo, within 15 days of the pandemic coming into force, we had over 4,500 doctors on a telemedicine platform. We have had the platform for 20 years, but COVID-19 accelerated the use and adoption of this platform in a tremendous manner. I think it has been an eye-opener for doctors who understood that they could care for patients, even when they are at home; they don’t have to be physically in front of you. I believe that many of these models will continue to play out as the healthcare system transforms itself.

Furthermore, Artificial Intelligence (AI) has made interesting inroads, such as in risk prediction during COVID-19. Assisted software is another area that is set to explode in the healthcare arena and will bring efficiency into repetitive work. AI will be used to manage large pools of data and obtain information on relevant medical conditions and care protocols.

All this will enable doctors to stay current and use the cumulative knowledge of the entire community validated scientifically and presented appropriately so that the patient who is right in front of them gets the best possible care pathway. While the use of AI in the business end of things across various sectors is very well known, I am most excited about the use of AI on the clinical side of things.

What can be done to prepare doctors for this AI-empowered future?

Making doctors a part of the transformation is the most powerful way to prepare them. We are having extensive conversations with doctors and asking them to share their care pathways. Ultimately, AI is only a culmination of the intelligence you put in, then you study the outcome. If more data is available with doctors, it would improve the result for the patient. Therefore, assisted intelligence assists the doctor to treat better.

What can be done to make the healthcare system more patient-centric?

There are several ways this can be achieved. For example, drones can deliver medicines at home; healthcare apps can be enhanced; wearables can be linked to the healthcare system, etc.

While patients are what a hospital focuses on, they should also concentrate on populations and communities. They should be looking at individuals and proactively planning and directing their efforts towards preventative care. The concept of proactive study awareness and treatment prevention should happen for all ages. For example, Apollo Hospital’s cardiovascular risk score profiles the community for modifiable and non-modifiable factors, which cause heart disease. So, instead of having to chase 100 patients, 15 patients are selected and informed that they are high-risk. The hospital can then work with them to reduce their cholesterol and keep their blood pressure under control, thereby decreasing the heart attack rate.

At Apollo Hospitals, we are clear that we belong to the health “care” sector and not the “sick care” sector. Currently, we carry out around 10 per cent of the country’s high-end cardiac surgeries and have patients coming to us from over 120 countries. Yet, at the same time, our chairman is committed that it is essential for us to keep populations healthy. Therefore, we are looking forward to a partnership model to introduce a proactive and preventive health initiative in Dubai. The partnership will see us work with the individual patients, but it will be based on a personalised testing protocol that we create. We will then use this technology to connect the patients with our specialists whenever they need it. We are looking forward to doing more in the region.

Is India on the path to becoming a medical tourism hub?

The market size for medical value travel in India, which was about 2 billion pre-pandemic, will grow this year by about 15 to 17 per cent. I think India has been ranked about 10th on the medical tourism index, but by improving a few aspects, we should be able to move up to the top five globally.

What is your vision for the next five years?

We will look at aspirations at multiple strategic levels. Number one is that we should double the number of patients we treat in the advanced care category, both from India and abroad. We are also aiming to grow the number of patients we serve by five times, from remote care clinics to the outpatient partnership model. Our goal is that everyone we serve should receive the best and the most personalised care. Also, technology and digitally assisted experiences should match up to customer expectations. We are also looking to partner with technology and scientific companies and use the data that we collect and the knowledge of our doctors to make new breakthrough cures. The last aspiration is on the education front. There is a global shortage, and we must continue to train staff digitally and in contact programmes and are open to sharing some of our technologies.

Apollo will continue to stay ahead because of the vision of our chairman and leader. It’s important for us to continue to innovate. For example, Apollo has its own unique healthcare ID and personal health record. We also launched our 3D printing initiative in our hospital in Hyderabad because we believe there is a significant future in that. Moreover, we are committed to robotic surgery. In fact, in Bangalore last month, we celebrated over 100 robotic heart surgeries. This is why Indian healthcare is renowned and patients seek out Indian surgeons to gain the expertise of their skill and capability.

The National Rehabilitation Center (NRC) announced the launch of a project to develop forensic psychiatry services in Abu Dhabi, in collaboration with several ministries, departments and government entities in the UAE and abroad, including South London and Maudsley NHS Foundation Trust, a leading psychiatry treatment and research centre in the United Kingdom.

Forensic psychiatry services are provided to misdemeanants with mental disorders that require treatment in psychiatric facilities, individuals suffering from mental illnesses, and those accused of violence and sexual crimes. The services are also available to individuals acquitted due to their inability to appear before the court due to mental illness, prisoners who have a mental illness, mentally ill patients with a history of criminal behaviour, and mentally ill high-risk serious offenders who have either been released from penal and correctional facilities or are patients admitted to mental hospitals.

The project was discussed at a workshop at the NRC headquarters in Abu Dhabi, which introduced relevant entities to the project, outlined its progress, and the action plan for implementing the next phases and engaging various entities dealing with the cases of psychological disorders as part of their daily work, or organisations offering criminal justice and related medical services. In addition, the session highlighted the role of various stakeholders in granting data access for the project team to ensure that the action plan fulfils Abu Dhabi’s specific requirements.

"In line with NRC’s priority to improve the mental health of the community, this meeting is an initial step towards providing forensic psychiatric services in Abu Dhabi. It will help our partners set out a clear and feasible plan to offer forensic services to those in urgent need, in compliance with international standards,” says His Excellency Dr Hamad Al Ghafri, Director General of NRC.

“It is our collective responsibility to come up with solutions that make a real difference in our society, he added.

Upon completion, the project will allow relevant organisations to benefit from the expertise of psychiatry specialists and provide best-in-class forensic psychiatric services in Abu Dhabi.

According to several scientific studies, acute mental disorders may cause the person to commit crimes. Studies involving patients who have schizophrenia, bipolar disorders, and other major mental disorders have revealed an increase in their criminal behaviour, which often arises from mental illness disorders.

The project involves three phases, beginning with data collection to analyse the need for forensic psychiatry services in Abu Dhabi. The service delivery plan, the care model, and the required specifications will be determined based on the data collected. In phase three, a strategic study including a strategic framework for psychiatric services in Abu Dhabi will be developed. 

Chronic kidney disease (CKD) is one of the leading causes of death worldwide and is projected to be among the top five causes of death by 2040. 

Sadly, few people are even aware of this silent disease, where patients can lose up to 90% of kidney function before experiencing any symptoms. When diagnosed late or left untreated, CKD can progress to kidney failure, leading to highly invasive dialysis or kidney transplants are needed with an enormous impact on patients’ quality of life.

Related: Transforming kidney care with Artificial Intelligence

Despite the huge global burden of chronic kidney disease on patients and health systems, the disease is unfortunately rarely prioritised by decision-makers and few countries have a national strategy for improving CKD care – including fewer than 20% of countries in the Middle East. 

In the Middle East, the burden of CKD and related kidney failure remains high and is growing, currently affecting 5% to 10% of the population. AstraZeneca has chosen World Kidney Day to help drive global action against the rising burden of CKD by hosting the Chronic Kidney Disease Summit at Expo 2020 in Dubai.

Related: Study finds pioneering dual surgery a safe option for patients with polycystic kidney disease

As a company invested in saving lives from renal diseases and in researching the chronic kidney disease treatments of the future, it felt right to put this silent disease high up the agenda on this unique global stage. At the same time, the Summit serves as a convening point on CKD strategy in the Middle East, with delegates from the Gulf Cooperation Council countries, Egypt, Lebanon, Jordan and Iraq coming together to explore regional solutions.

As we host discussions, we believe there are three critical actions that we can take as a global community to address the burden of chronic kidney disease and achieve real change for patients.

First, and perhaps most importantly given the silent nature of the disease, we need to find patients affected. This means improving data collection and surveillance and putting in place appropriate screening to detect the disease sooner. The UAE happens to host one of the oldest kidney registries in the world, established in 1980.  But among Arab countries, only Oman has a registry dedicated to chronic kidney disease. This leaves a gap in high-quality, regionalised data that demonstrates the true socio-economic and environmental impact of the disease. 

Secondly, when we find patients with chronic kidney disease, we need to ensure early and equitable access to treatment. We know that when patients are treated earlier, their quality of life improves significantly and costs associated with end-stage kidney failure, including dialysis, can be avoided. Such actions can also help decrease death rates associated with CKD, which are highest in Jordan, Saudi Arabia and Bahrain within the Middle East region. 

And finally, we need to turn dialogue and exchange of insight on chronic kidney disease into tangible partnerships among stakeholders across the CKD pathway.

Examples of our global partnerships include a diagnostic platform we are developing with Renalytix AI, which uses artificial intelligence to improve kidney disease prognosis, clinical care management, provider and patient education, and patient stratification for clinical trials. 

Additionally, our global campaign “The Pressure is On” is helping physicians test for kidney function during routine check-ups and has seen 10 million patients screened for CKD globally in 2021. Between cutting-edge scientific research and these innovative partnerships, there’s so much already happening to help transform the standard of care for patients with chronic kidney disease but to truly address this silent crisis, finding patients is key. 
 

Pelin Incesu is the Area Vice President, Middle East and Africa at AstraZeneca.

Diabetes is now considered a pandemic, with 1 in 10 adults living with this chronic severe condition — almost 1 million adults in the United Arab Emirates (UAE) have diabetes. This number is expected to increase to nearly 1.2 million over the next nine years. Moreover, statistics released from health authorities show that people currently living with diabetes are not getting better. Most diabetics (75 per cent) in the UAE have poorly controlled diabetes, and diabetes-related deaths have tripled over the last decade. Although diabetes screening is a mandated benefit by law, the UAE experiences one of the highest rates of undiagnosed diabetes at 64 per cent. These impressive numbers tell us that existing health care approaches, both in terms of screening and managing, are insufficient for the detection and treatment of diabetes. The long-term care necessary for diabetes patients costs the UAE almost 7.3 billion AED annually, with a minimum expected cost of 20.2 billion AED once the undiagnosed numbers start requiring treatment for complications. Expenditure on diabetes in the last ten years has increased by nearly 20 per cent and will only continue to rise (International Diabetes Federation).

 A Sobering Outlook for the Future

In addition to affecting the current population, diabetes impacts future generations in the UAE. One out of four live births is affected by hyperglycemia due to gestational diabetes. “Despite advances in medications, treatment therapy, technology, etc., the UAE's population is now more diabetic and poorly controlled more than at any other time since statistics were recorded,” noted Ali Hashemi, Co-founder, and Chairman of GluCare. Glucare is a hybrid digital therapeutics platform that is currently solving the diabetes pandemic using a novel model of care. The UAE is experiencing unprecedented health impacts and costs related to diabetes, and the vast percentage of undiagnosed cases will have a catastrophic effect on healthcare costs. Overall, the diabetes pandemic is expected to impact the socio-economic well-being of the UAE negatively. Available healthcare providers have fallen short in their efforts to treat and prevent diabetes. “It is easy to blame patients and their lifestyle choices; however, we believe this pandemic has been escalated by how current diabetes providers behave and their failure to innovate in new models of care,” Hashemi explained. “Current healthcare facilities do not transparently record their outcomes and are not incentivised to improve outcomes in a fee-for-service model. New ways to innovate diabetes care are required. Otherwise, nothing will change, and we will continue to see rising numbers of patients, complications, and costs. 

Revolutionising Diabetes Care: Humans and Machines Working Together

Image supplied, GluCare app in use

 

The dramatically increasing diabetes numbers without patient improvement demonstrate that the current practice in the UAE is insufficient to impact the trajectory of the disease. Experts believe that diabetes is poorly controlled in the UAE due to misaligning patient needs and provider compensation. Providers are reimbursed for sicker patients, so providers have no monetary incentives to change the behavior of their patients. Moreover, patient support through education on lifestyle changes, such as from a nutritionist, is not reimbursed by the insurance company, so providers have no incentive to provide these services. Additionally, critical medical devices such as continuous glucose monitors are expensive, and insurance companies are resistant to pay for them. GluCare combines constant monitoring of patient symptoms and lifestyle with a personalised care team to manage type 1 or type 2 diabetes accurately. “GluCare has re-invented a new model of care that shifts diabetes care from episodic to continuous through digital therapeutics. This has resulted in an average reduction in HbA1c of 2.14 per cent in just 90 days.

In comparison, the average reduction of a large diabetes center based in Abu Dhabi (self-reported data) resulted in just 0.9 per cent over ten years, and the average patients are still classified as poorly controlled,” said Hashemi. The key to GluCare’s success? “Both humans and machines are involved in the GluCare model of care,” Hashemi explained.  

Under this care model, patients receive in-person care during appointments and remote monitoring to ensure they are not alone in their journey to manage their lifestyle and their diabetes. “The GluCare model utilises remote continuous data monitoring as a standard model of care,” Hashemi explained. “The new data sources allow us to continuously engage patients, leading to sustained behavioral change and vastly improved outcomes.” Continuous monitoring empowers patients to take control of their diabetes and make life-saving choices on a day-to-day basis. “The UAE has been an important launch market for us since the problem is so prevalent here. This care model has proven so successful and significantly better than the traditional options that we are now looking at expanding GluCare Health internationally,” Hashemi added.

Three months into 2022, we have witnessed major leaps for women in healthcare from a patient and professional point of view. Nabta Health, the Middle East's only hybrid healthcare platform committed towards elective, preventative women's healthcare, has secured $1.5 million in a new round of angel funding.

An incredible feat, it went on to announce its partnership with Fakeeh University Hospital to offer women the flexibility to complete a comprehensive range of diagnostic tests at home. These at home tests, designed to support and empower women are the first of their kind to be introduced in the healthcare market in the UAE and across the GCC.

Related: Magnificent Seven: Female leaders in healthcare you need to know today

Furthermore, they partnered with Glucare, a hybrid digital therapeutics diabetes platform, to help UAE-based women screen for gestational diabetes and be safe in the knowledge that they can find immediate care through the Nabta Health network, empowering them to identify and manage gestational diabetes with privacy, autonomy, and convenience.

Adding to the narrative of powering female leadership in health, Jacqui Robertson was recently appointed as Chief of Diversity and Inclusion at Cleveland Clinic. Robertson will drive global diversity and inclusion strategies and efforts across the health system while overseeing the Office of Diversity and Inclusion.

Related: Women in medicine: Insight for future female physicians

Meanwhile the UAE’s very own, Dr. Farida AlHosani was the first Emirati woman to be appointed to the World Health Organisation's Pandemic Influenza Preparedness Framework Advisory Group for the years 2022-2024. Dr. Hosani is the UAE's official health spokesperson, an infectious disease expert, and the executive director of infectious diseases at the Abu Dhabi Public Health Centre (APHC), the region's first dedicated Centre dedicated to protecting Abu Dhabi residents' physical, mental, and social well-being through public and preventative healthcare awareness.

Triumphs in female driven solutions

As part of its latest addition to its 3D platform, Complete Anatomy, Elsevier, a global leader in academic publishing and information analytics, recently announced the unveiling of the most sophisticated 3D whole female model ever available. This is the first time a female model has been produced with this level of detail throughout to represent the female — rather than only substituting female traits in select sections of the male anatomy. For the first time, educators may see, modify, and teach anatomy totally from the perspective of a woman, all in exceptionally realistic 3D detail. Complete Anatomy is the No. 1 top-selling medical category app on iPad in the United States, with over 20 million downloads worldwide, courtesy of 3D4 Medical by Elsevier's groundbreaking cloud-based medical education platform.

With many progressions setting the pace for female driven solutions and leadership opportunities in healthcare, however, there still is a large area where the bias remains.

“For the last 200 years women have been living in a healthcare system built by men for men. The drugs, devices, technology, and products that we use every day for our health and wellness needs have usually been tested on men with very little representation of women in these clinical trials. Most drugs are prescribed to women and men at the same dose. We use apps for tracking our menstrual health or fertility cycles that are designed by men from the male point of view.

Breaking the bias for me means building a woman centered healthcare system, women only trials increasing female representation among researchers, inventors, investors, venture capitalists and founders who in turn can create a much more women centered product and solution base that recognise and target women's specific healthcare needs and eventually achieve a society that is healthy and a community that is safe,” explains Reenita Das, Partner, Senior Vice President, Healthcare and Life Sciences at Frost and Sullivan.

Leadership in nursing is also an area which requires more support moving forward, “Through the years, and especially since the pandemic, doctors have learned to respect nurses, and their abilities more, making a better care team. However, there are key issues which need to be addressed, which are nurse burnout, PTSD from the pandemic and nurses leaving the profession in droves. Nurse leadership needs to constantly reassess our priorities and provide purposeful and meaningful direction to the staff.

We should be prepared for another emergency like the pandemic in the future, and if we work together, we can create a world that is diverse, equitable and inclusive, a world where difference is valued and celebrated and respected.  I think collectively, we can break the bias,” says Caren Busen, Director of International Clinical Support, OBIX Middle East.

Speaking on women’s equality, Dr. Maliha Hashmi, Doctor of Law, Jurisprudence, Health Systems Designs and Health Regulations- Harvard Law School,  expressed, “In terms of equality, and in terms of equal opportunity for females, my vision for our society is one which thrives in harmony. Every person from any race, ethnicity, culture, religion, background, and gender is able to have equal opportunities and productively co exist amongst one another. This will help cultivate mixed teams, where females are equally represented in every step of the way, and given equal opportunities to grow and to succeed.  For a future world where innovation and creativity is fostered, this is essential.”

Adding to the discussion Samar Nassar, Director, Healthcare - KPMG in Saudi Arabia spoke about the importance of passion and self-confidence fuelling female leadership in healthcare “You have to believe in yourself. More than 15 years ago, I saw an ad on bayt.com, LinkedIn didn't exist at that time, and it speficially outlined that the organisation was seeking a male medical representative. When I looked at the job description, I felt I was the right fit and I applied for it and got the job. This was my entry into the industry. Of course you need to have what it takes to perform to your highest and best ability, and excel at the job, focusing on the scope that has been assigned to you to succeed.”

Reflecting on the future health summit in January during Arab health, Dr. Alaa Murabit, Medical Doctor, Global Security Strategist, Women’s Rights Advocate and United Nations High-Level Commissioner on Health commented during the panel discussion on the importance of creating roles and opportunities for female leadership roles. “The population of women that are in the healthcare workforce are actually quite critical, because the primary population that is served by primary health care systems are losing children. When we talk about women in positions of leadership, it does come down to power. That is what leadership is, and leadership is inherently power, a dynamic of power. For women to own more power, the importance of women’s leadership will warrant a very active negotiation,” said Dr. Alaa.

BD (Becton, Dickinson and Company) is spearheading efforts to enhance patient safety in the region and further developing solutions that will help reduce infections from antibiotic-resistant bacteria in its quest to support a safer environment in the future. In an interview with Fiona Garin—Vice President of Strategic Marketing, BD EMEA, we discussed the need for the adoption of medical technology to enhance the patient safety stance in the region and how it will lead to a reduction of medical errors.

Can you tell us about the MedTech solutions BD was showcasing during Arab Health & Medlab? How important were they in enhancing the patient safety stance in the region?

Events such as Arab Health give us a platform to help drive awareness on the burden of disease, cost associated with patient safety and to connect our innovation to support healthcare practitioners solve their daily challenges in this area. It allows us to continue to learn from our customers and to use those learnings to feed our innovation strategy with the purpose of improving patient outcomes and experience through the reduction of adverse events and errors.

This year we kept patients at the heart of the experience. Our Medical and Interventional team of experts presented insightful sessions at Arab Health, highlighting imperative medical technology trends and best practices through Patient Safety Talks, as well as demonstrating a range of solutions through ghost screen technology. In parallel and at the Medlab show, our Lifesciences team similarly showcased our innovations that help expand laboratory outcomes; from reducing preanalytical errors, automating processes to improving efficiency and standardising workflows, with the aim to deliver reliable results to enhance patient safety.

Fiona Garin—Vice President of Strategic Marketing, BD EMEA

The need for patient safety has gained importance in the last two years, can you elaborate on this and discuss the role medical technology and innovations play in reducing medical errors. 

We know that the initial impact of the pandemic was a devastating blow across industries, with healthcare being the one hardest hit. Frontline workers were incredibly overwhelmed having to manage both existing patients as well as new admissions due to the pandemic. Additionally, organisations have had to quickly adapt their strategies and approaches to address changes in the environment including an accelerated digital transformation. Lastly, healthcare systems experienced remarkable supply shortages posing safety risks for patients and healthcare workers.

Patient safety is now more important than ever. The pandemic has brought to the surface things that were working well in institutions and areas that needed to be improved and many surveys highlight that increased number of staff shortages and staff burnout have contributed to an increase in adverse events. These staffing shortages, combined with a surge in hospitalisation due to the pandemic, has led to increased nurse-patient ratios at many facilities, impacting morbidity and mortality.

Improvement in quality of service, as well as safety of patients and healthcare workers, are among the main lessons learnt during the pandemic. What our customers have shared with us is those who had driven concerted efforts and implemented interventions to protect patients from errors, or adverse events seem to have been more prepared when the pandemic hit, including medication errors. This included investing in innovative medication management solutions which helped them embed safety and quality in their daily work at all levels of the organisation. It helped them automate tasks, facilitate information sharing, reduce variation in practice, intercept potential errors and address staff shortages and turnover and show a commitment to their workforce, by enabling them to spend more quality time with their patients.  

At BD, we consider this to be our prime responsibility to equip healthcare providers with the latest medical technology so that we can together enhance the healthcare posture of the region and continue to impact lives.

We will continue to drive innovation, introducing novel solutions, and train medical professionals so that healthcare providers are always prepared to maintain the quality of safety through a similar crisis, be it at a steady pace or accelerated by unfortunate events.

In an ideal world, no patients are harmed during healthcare. Yet, it is estimated that 1 in 10 patients are harmed during hospital admission, can you comment on healthcare-acquired infections and the consequence they carry?

Healthcare-associated infections are one of the most common complications affecting patients in hospital. As well as causing unnecessary pain and suffering for patients and their families, they typically prolong hospital stay, potentially cause long-term disability, increase the likelihood of resistance of microorganisms to antimicrobials, incur a massive additional financial burden for health systems, results in high financial and quality of life-related costs for patients and their families and leads to excess deaths. Additional to the burden of disease and additional costs, healthcare-associated infections (HAI) can affect institutional reputation and increase litigation costs.

To address HAIs, institutions and HCPs can drive increased compliance with best practice clinical guidelines and procedures implementation to reduce associated morbidity and mortality impacting clinician performance and efficiency, drive increased diagnostic accuracy and timeliness including faster diagnosis leading to better clinical decision-making and optimise and standardise workflows, processes, and procedures across the patient journey.

 

Post-operative surgical site infections and medication errors carry deliberating consequences as well, can you speak about this and comment on solutions?

Surgical site infections (SSIs) happen to be the most common type of healthcare associated infections among surgical patients and are commonly caused by the patient’s collective bacteria and other microorganisms.

At BD, we aim to get to the source of the infection. For example, we understand that effective skin antisepsis is vital in preventing the spread of pathogens. For these specific incidents, we have developed a skin antisepsis preparation that offers improved efficacy and overall cost savings.

Furthermore, in compliance with recommendations, BD surgical clippers protect against micro-abrasions helping to lower SSIs rates. And to keep flash sterilisation of surgical instruments to a minimum, our Instrument Tracking System increases the productivity of a medical facility’s Sterile Process Department.

As far as medication errors, standardisation processes, full traceability, automation, and closed-loop medication management are crucial to reducing reported incidents of errors. We remain committed to breaking the harmful cycle of medication errors by simplifying medication management that results in better patient safety and practices in measurable ways.

With our proven technologies, such as automated medication storage, medication dispensing and point of care verification, HCPs can lower costs, improve patient safety, and better enable clinicians to deliver the right care to their patients at the right time.

Presently it is estimated that 63·5 per cent of cases of infections with antibiotic-resistant bacteria are associated with healthcare, can you elaborate on this?

Resistant infections can lead to higher mortality and are often more expensive to treat than susceptible infections. Additionally, the same infections are found to increase the excess length of stay in a medical facility by a significant number of days.

Apart from the medical and financial burdens on hospitals, antimicrobial resistance leads to an organisational burden within the hospital, such as patient isolation.

Care providers must overcome the challenges in patient screening and the implementation of evidence-based practice interventions to battle against bacterial infections through safer antibiotic therapy. Furthermore, an integrated stewardship model with a holistic approach based on antimicrobial, infection prevention and diagnostics can significantly improve the medical environment by effectively fighting off antimicrobial resistance.

We would like to partner with healthcare systems, institutions, and clinicians to build a culture of safety and drive accountability where safety is flowing through every person and every system leveraging improved technologies, services, and capabilities. By being present at multiple stages of the patient journey our intent is to support an overarching shift from reactive piecemeal intervention to a total systems approach by developing and supporting the implementation of safe, innovative, and optimised technology that improves patient safety.