Overview

Coeliac disease is an autoimmune condition that requires lifelong adherence to a gluten-free diet. A recently published position paper from ESPGHAN (European Society for Paediatric Gastroenterology Hepatology and Nutrition) recommends antibody testing for long-term monitoring of children and adolescents diagnosed with coeliac disease. Autoantibodies of immunoglobulin class A (IgA) against tissue transglutaminase (tTG) play the most important role in diagnostics and monitoring, while coeliac-specific IgG antibodies should be analysed in patients with an IgA deficiency.

Gluten intolerance

Gluten is a component of many grains such as wheat, rye and spelt. It is made up predominantly of gliadin, which is only partly digested in the intestine. Oligopeptides are formed which can pass through naturally occurring gaps in the intestinal epithelium, reaching the underlying connective tissue. Here they are bound by the enzyme tissue transglutaminase (tTG) and modified (deamidated). In people with a certain genetic predisposition, the resulting complexes of tTG and gliadin oligopeptides can trigger an immune reaction leading to the formation of specific antibodies. The immunological overreaction causes inflammation of the small intestinal wall and corresponding symptoms. With progressive damage, the small intestinal epithelium cannot absorb enough nutrients, leading to deficiencies of important minerals and vitamins. Gluten intolerance, known as coeliac disease, is a chronic autoimmune disease. It cannot be cured, but when a strict gluten-free diet is followed, the immune reaction abates and in most cases the level of antibodies drops

Clinical chameleon

Coeliac disease has a very diverse clinical picture. The classical form often manifests at a very early age. When infants consume their first gluten-containing food, typical symptoms such as chronic diarrhoea, vomiting, abdominal pain and cramps occur. The resulting malabsorption leads to weight loss, anaemia, growth disorders and delayed puberty. Coeliac disease can also manifest in adulthood. In these cases, untypical symptoms such as constipation, osteoporosis, joint disorders, depression, miscarriages or the chronic skin condition dermatitis herpetiformis (Duhring’s disease) can also occur.

Coeliac disease should therefore not be diagnostically excluded just because typical symptoms such as diarrhoea or weight loss are not present. Notably, overweight and obese persons can also suffer from coeliac disease. The diverse symptomology has led to coeliac disease being called the chameleon of gastroenterology. Moreover, it is not a rare disease, with a prevalence estimated at 1%. A large number of undiagnosed cases is also suspected, as patients and clinicians often do not think of gluten intolerance as a cause of some complaints. According to recommendations from ESPGHAN, coeliac disease should be considered as a possible cause even in cases of unspecific or non-gastrointestinal symptoms.

Diagnostics

Damage to the intestinal mucosa can be identified by intestinal biopsy, but this method is now relegated to a more minor role behind serology for differential diagnostics of coeliac disease. The

investigation of antibodies is recommended in patients with symptoms suggestive of coeliac disease, both children and adults, as well as in asymptomatic persons at high risk of developing the disease. At-risk groups include first-degree relatives of coeliac disease patients as well as persons with certain diseases, for example Down’s syndrome or type I diabetes mellitus.

Figure 1. Detection of EmA on the tissue substrates liver and oesophagus 

The first-line test is the detection of anti-tTG antibodies of the immunoglobulin class A (IgA). These autoantibodies are specific for coeliac disease and do not occur in healthy individuals or persons with other diseases. Total IgA is determined in parallel to exclude IgA deficiency, which occurs with above average frequency in patients with coeliac disease. If a high value for anti-tTG-IgA is obtained, defined as a titer of at least tenfold the upper limit of normal (≥10x ULN), a second blood sample is taken for a confirmatory indirect immunofluorescence test (IIFT). In IIFT the anti-tTG antibodies are known as anti-endomysium antibodies (EmA) since they react with the connective tissue layer endomysium. If the EmA-IgA detection is also positive, a diagnosis of coeliac disease can be made without biopsy. With negative or low titers of anti-tTG or low total IgA, a biopsy remains necessary for diagnosis, but should be supplemented by further tests such as IgG antibodies against deamidated gliadin peptides (DGP), tTG or EmA.

Antibody detection methods

Coeliac disease-specific antibodies can be determined using different methods such as ELISA, chemiluminescence immunoassay, immunoblot and IIFT. Anti-Tissue Transglutaminase ELISAs (IgA, IgG) from EUROIMMUN provide high sensitivity and specificity and are ideal for fully automated high-throughput processing of many analyses. The IIFT for detection of EmA-IgA is especially suitable for confirmation of a positive anti-tTG-IgA result due to its outstanding specificity and sensitivity. Liver or oesophagus is generally used as the detection substrate (Figure 1), whereby the two substrates provide equivalent sensitivity and specificity.

An additional important antibody test in coeliac disease diagnostics is the determination of antibodies against deamidated gliadin peptides (DGP). The development of a specially designed antigen containing only the diagnostically relevant epitopes of gliadin (gliadin-analogous fusion peptide in trimeric form, GAF-3X, Figure 2) has greatly increased the sensitivity and specificity of this test. The detection of IgG antibodies against DGP by ELISA plays an important role in patients with IgA deficiency. A test combination of anti-tTG-IgA and anti-DGP-IgG significantly increases the serological detection rate for coeliac disease.

The immunoblot EUROLINE Coeliac Disease Profile enables multiparameter detection of anti-tTG and anti-DGP antibodies. The IgA blot additionally includes an IgA band to support simultaneous exclusion of an IgA deficiency. The EUROLINE Autoimmune Gastrointestinal Diseases Profile provides these and further markers to aid serological differentiation of coeliac disease from Crohn’s disease, autoimmune gastritis and pernicious anaemia.

Genetic analysis

The determination of the genetic parameters HLA-DQ2/HLA-DQ8 is useful, for example, in patients with unclear results or in symptomatic patients who have already started a gluten-free diet and whose antibodies are therefore no longer detectable. Since around a third of the healthy population possesses the HLA-DQ2/HLA-DQ8 alleles, their detection alone is not evidence of coeliac disease. The parameters serve rather for exclusion diagnostics, since without these alleles coeliac disease is very unlikely. The microarray test system EUROArray HLA-DQ2/DQ8-h Direct provides easy determination of all clinically relevant alleles and does not require any previous knowledge of molecular biology. The evaluation, interpretation and documentation of results is fully automated.

Figure 2. Schematic representation of GAF-3X antigen for detection of anti-DGP antibodies 

Monitoring of gluten-free diet

Once coeliac disease is diagnosed, adherence to a strict gluten-free diet is the only reliable possibility to curb the immune reactions and prevent continued damage to the intestinal epithelium. With a gluten-free diet regeneration of the mucosa can in some cases take several years, although the concentration of the antibodies usually falls within a few months (Figure 3).

A recently published position paper from ESPGHAN provides recommendations for follow-up of children and adolescents with coeliac disease and monitoring of the gluten-free diet. The first follow-up examination should be performed after 3 to 6 months, with measurement of anti-tTG-IgA antibodies by ELISA or other enzyme immunoassays. In patients with IgA deficiency, IgG assays for anti-DGP, anti-tTG or EmA are recommended. With adherence to the diet the antibody titer usually normalises over time (

It is important to use the same test systems for diagnosis and follow-up in order to circumvent discrepancies between different assays and allow meaningful comparison of antibody levels.

The follow-up of children and adolescents after diagnosis helps to assess growth and development, resolution of symptoms, possible complications, as well as compliance with the gluten-free diet. If no reduction in the tTG-IgA titer is observed after 6 to 12 months or if slightly elevated levels persist over a long time, this usually indicates non-compliance with the gluten-free diet. More frequent follow-ups may be required if the patient has difficulties following the diet or if symptoms persist or worsen despite dietary compliance. Malnutrition or laboratory abnormalities may also indicate the need to assess the patient more regularly. Further aspects of the new position paper cover education of children, parents and caregivers about the disease and improving communication to ensure full adherence to the gluten-free diet.

Figure 3. Antibody titer course in patients on a gluten-free diet

 

References

Husby et al. J Ped Gastroenterol Nutr 70(1):141-156 (2020)

Mearin et al. J Ped Gastroenterol Nutr 1;75(3):369-386 (2022)

 

This article appears in the latest issue of Omnia Health Magazine. Read the full issue online today.

 

Back to laboratory

Artificial intelligence, and deep learning in particular, has been used extensively for image classification and segmentation, including on medical images for diagnosis and prognosis prediction. However, the use of deep learning in radiotherapy prognostic modelling is still limited.

Deep learning is a subset of machine learning and artificial intelligence that has a deep neural network with a structure like the human neural system and has been trained using big data. Deep learning narrows the gap between data acquisition and meaningful interpretation without explicit programming. It has so far outperformed most classification and regression methods and can automatically learn data representations for specific tasks.

The application areas of deep learning in radiation oncology include image segmentation and detection, image phenotyping and radiomic signature discovery, clinical outcome prediction, image dose quantification, dose-response modeling, radiation adaption, and image generation.

An article published in Clinical Oncology analyses 10 studies on the subject noting that researchers suffer from the same issues that plagued early normal tissue complication probability modelling, including small, single-institutional patient cohorts, lack of external validation, poor data and model reporting, use of late toxicity data without taking time-to-event into account, and nearly exclusive focus on clinician-reported complications.

It adds that the studies, however, demonstrate how radiation dose, imaging and clinical data may be technically integrated in convolutional neural networks-based models; and some studies explore how deep learning may help better understand spatial variation in radiosensitivity. In general, there are several issues specific to the intersection of radiotherapy outcome modelling and deep learning, for example, the translation of model developments into treatment plan optimisation that will require an additional combined effort from the radiation oncology and artificial intelligence communities.

Hence, the use of machine learning and other sophisticated models to aid in prediction and decision-making has become widely popular across a breadth of disciplines. Within the greater diagnostic radiology, radiation oncology, and medical physics communities promising work is being performed in tissue classification and cancer staging, outcome prediction, automated segmentation, treatment planning, and quality assurance as well as other areas.

Envisioning the future of radiology

Dr. Ali Vahedi, Consultant Radiologist at Mubadala Healthcare, explains that AI has an important role to play in the current and future of radiology. At present, this is primarily in the form of helping clinicians improve efficiency and diagnostic capacity which is essential with the exponential increase of diagnostic tests conducted year-on-year. He adds that AI has the potential to rapidly evaluate a vast quantity of imaging data, helping to prioritise worklists and diagnoses, which will aid in reducing reporting time, improve the accuracy of reports as well as limit discrepancies. In addition, it will give radiologists more time for direct patient care and vital research.

Dr. Ali Vahedi

A study published in the Progress in Medical Physics Journal highlights that high-quality simulated three-dimensional (3D) CT images are essential when creating radiation treatment plans because the electron density and anatomical information of tumours and OARs are required to calculate and optimise dose distributions.

Radiotherapy plays an increasingly dominant role in the comprehensive multidisciplinary management of cancer. As radiation therapy machines and treatment techniques become more advanced, the role of medical physicists that ensure patients’ safety becomes more prominent. With the advancement of deep learning, its powerful optimisation capability has shown remarkable applicability in various fields. Its utility in radiation oncology and other medical physics areas has been discussed and verified in several research papers. These research fields range from radiation therapy processes to QA, super-resolution medical image, material decomposition, and 2D dose distribution deconvolution.

According to Dr. Vahedi, the global imaging market size is expected to grow, driven by numerous factors such as growth in the number of hospitals and clinics and rising demand for minimally invasive surgeries.

He adds that rapid advancements in medical therapy also necessitate the need for regular multimodality imaging. In addition, technological advancements in medical imaging equipment are also contributing to the growth, with manufacturers introducing new products that are more compact, more cost-effective, and produce less ionising radiation than their predecessors. This improved affordability will invariably improve patient access to imaging. it can be concluded that over the past few years there has been a significant increase in both the interest in as well as the performance of deep learning techniques in this field.

Promising results have been obtained that demonstrate how deep learning-based systems can aid clinicians in their daily work, be it by reducing the time required, or the variability in segmentation, or by helping to predict treatment outcomes and toxicities. It remains to be seen when these techniques will be employed in routine clinical practice, but it seems warranted to assume that we will see AI contribute to improving radiotherapy soon. In conclusion, the application of deep learning has great potential in radiation oncology.

This article appears in the latest issue of Omnia Health Magazine. Read the full issue online today.

Back to Clinical

The rising burden of multiple diseases and the growing rate of mortality in recent times has amplified the increase in healthcare spending to cater to the surging requirement for early diagnosis. According to the Centers for Medicare & Medicaid Services (CMS) in 2021, healthcare spending in the US grew 9.7 per cent in 2020, reaching US$12,530 per person.

In view of the growing disease penetration worldwide, the demand for several new technologies and equipment for effective treatment has grown widely in a variety of medical settings as well as at all major levels of healthcare. To that end, the growth of the medical imaging industry is anticipated to remain positive in the coming years considering its soaring popularity for supporting diagnosis, monitoring, and treating different medical conditions. This diagnostic service is recording a significant preference for its rising essentiality in confirming, assessing as well as documenting the course of multiple diseases and response to treatment.

Medical imaging mainly encompasses different technologies deployed for viewing the human body and delivering information about several parts to aid the physician in understanding the complications and enabling them to take better decisions. The procedures are increasingly favoured as they are non-invasive, completely painless, and most times do not require any special preparation.

The widening stream of technological enhancements along with the rising integration of artificial intelligence (AI) and digital solutions in imaging equipment by market players are playing a key role in the expansion of the medical imaging industry for enhancing patient care and transforming clinical outcomes. Stating an example, GE Healthcare joined forces with Intel for advancing the use of AI in medical imaging by developing an algorithm to assist the medical staff in triaging potentially life-threatening cases faster.

Breakthroughs in X-ray technology to augment the medical imaging market share

In recent times, the interest in medical X-ray imaging has significantly evolved considering their rising popularity as valuable medical tools in a wide variety of procedures and examinations for noninvasively helping in diagnosing diseases and monitoring therapy. These products have an upper hand over other imaging technologies as they not only support medical and surgical treatment planning, but also guide medical personnel in inserting catheters, and stents inside the body.

X-ray devices hold paramount importance in the field of radiology given their assistance in diagnosing tumours and removing blood clots or other blockages. To reduce the stress and strain on the radiology staff, the need for designing advanced mobile X-Ray technology is depicting a rise for improved workflow and usability, further influencing the medical imaging market growth. To illustrate, in July 2022, Siemens Healthineers launched its newest mobile X-ray system, Mobilett Impact. The new system is affordable and comes with full digital integration, combining the benefits of mobile X-ray imaging at a patient’s bedside.

Several groundbreaking technologies have also been introduced by top contenders in the medical imaging business sphere to meet the rising need for X-ray imaging outcomes for effective medical diagnosis. For instance, in May 2021, Carestream Health released groundbreaking AI-driven technology, Smart Noise Cancellation (SNC) for improving image quality and producing images that are relatively clearer than with standard processing. Of late, the increasing number of research activities on spectroscopic X-ray imaging has been instrumental in amplifying their deployment from labs to clinics.

Demand for medical imaging depicts a significant rise in hospitals

There is an increasing number of investments aimed at deploying cutting-edge technologies for producing faster and enhanced image quality, leading to quicker diagnoses as well as treatment for patients will support the medical imaging industry demand in hospitals. In October 2019, NYC Health + Hospitals announced to invest US$224 million over 10 years to upgrade the medical imaging technology system-wide.

The regular requirement for performing rapid imaging exams in various complex situations at the patient’s bedside has steered the adoption of medical imaging solutions in hospitals. To illustrate, Canon Medical Systems USA Inc., in August 2020, rolled out Soltus 500, its all-new Mobile Digital X-ray technology to offer these healthcare settings access to systems with enhancements. It also helped them to streamline bedside exams for improved workflow and productivity.

The rising shift to digitisation in hospital settings has also prompted the increasing deployment of cloud-based imaging solutions mainly in the post-pandemic era for the transition from traditional care delivery to a more decentralised model in hospital settings. For instance, in August 2022, GE Healthcare teamed up with AWS for the first Europe-based cloud deployment of well-known diagnostic imaging solution developed for radiologists, Edison True PACS at the Royal Orthopaedic Hospital NHS Foundation Trust. 

The road ahead

In the years to follow, the increasing burden of heart diseases is expected to drive innovations in cardiac medical imaging for promoting early detection and intervention measures. In October 2022, Google Cloud announced a Medical Imaging Suite, its new initiative within the realm of healthcare, for creating an efficient, universally friendly, and value-providing platform, with interoperability and accessibility. This growing technological intervention along with the rising regulatory support, mainly from the U.S. FDA (Food and Drug Administration) for new product approvals will also influence the industry dynamics.

Shreya Bhute

This article appears in the latest issue of Omnia Health Magazine. Read the full issue online today.

Back to Technology

The emergence of antibiotic-resistant super bugs and the increasing incidence of infections in healthcare facilities have thrown into sharp relief the often sub-standard and unhygienic practices prevalent in many hospitals, clinics and other institutions. Add to that the quadruple burden of disease across Africa and the well-known shortage of healthcare workers, and you have the perfect storm for compromised healthcare. 

Although well established in Europe and the USA, the formal accreditation of healthcare facilities is, however, beginning to make a real difference in the quality of healthcare being practised in developing countries. 

Accreditation is an internationally recognised evaluation process used to assess and improve the quality, efficiency, and effectiveness of healthcare organisations. Simply put, accreditation is based on the premise that adherence to evidence-based standards will produce higher quality healthcare services in an increasingly safe environment. It is also a way to publically recognise that a healthcare organisation has met national quality standards (Pomey, 2005)i. 

It is only in the past decade or so that serious research on the value and benefits of accreditation has begun to systematically appear in peer review literature. 

In a ground-breaking literature review conducted by A. Alkhenizan and C. Shaw in 2011, 26 studies evaluating the impact of accreditation were identified.ii 

“The majority of the studies showed general accreditation for acute myocardial infarction (AMI), trauma, ambulatory surgical care, infection control and pain management; and subspeciality accreditation programmes to significantly improve the process of care provided by healthcare services by improving the structure and organisation of healthcare facilities. Several studies showed that general accreditation programmes significantly improve clinical outcomes and the quality of care of these clinical conditions and showed a significant positive impact of subspecialty accreditation programmes in improving clinical outcomes in different subspecialties, including sleep medicine, chest pain management and trauma management. 

The authors concluded: “There is consistent evidence that shows that accreditation programmes improve the process of care provided by healthcare services. There is considerable evidence to show that accreditation programmes improve clinical outcomes of a wide spectrum of clinical conditions. Accreditation programmes should be supported as a tool to improve the quality of healthcare services.”  

In the current era of heightened fiscal responsibility, transparency, accountability, and escalating healthcare complexity and risks from the impact of global warming and climate change, accreditation contributes to ensuring that care meets the highest standards of healthcare decision-making and provision. Accreditation can serve as a risk mitigation strategy, and it can also measure performance; it provides key stakeholders with an unbiased, objective, and third-party review. It can constitute a management tool for diagnosing strengths and areas for improvement (Pomey, 2010). 

Organisations that participate in accreditation confirm their commitment to quality improvement, risk mitigation, patient safety, improved efficiency, and accountability; it sends a powerful message to key decision-makers and the public. This performance measure contributes to the sustainability of the healthcare system. (Nicol, 2015)iii 

The gathering evidence 

An increasing number of academic studies are showing clear benefits of accreditation and it is both a logical and safe assumption that when medical interventions are performed by competent individuals, using appropriate, regularly serviced equipment in standard procedures regulated by written policies, risks are reduced, and outcomes will be better. 

Academic papers, particularly in the past decade, increasingly point to the indisputable benefits of accreditation. 

Although couched in the language of continuous quality improvement, the accreditation process is, at its core, a risk reduction activity. It begins with the setting of contemporary standards that address important organisational functions – for example, patient assessment, and medication usage – and then encourages organisations, through the awarding of accreditation, to comply with these standards. The operating thesis is that if organisations are doing “right things right” as reflected in the standards, then errors and adverse outcomes are less likely to happen than if there were no such standards. Notwithstanding the continued high frequency of errors, this thesis is almost certainly correct.iv 

The El-Jardali et al study on the impact of accreditation on primary healthcarev, concluded, “This study demonstrated the positive impact of accreditation on PHC centres in several areas of quality and performance. Accreditation was associated with improved delivery of healthcare and quality…. Improvements in quality were reflected by the increase in customer satisfaction and several patients visiting PHC centres from various regions and social strata.” 

One of the constant narratives that accreditation organisations hear from their accredited clients is the following: the initial objection to quality improvement and accreditation interventions is the cost factor. However, the systems that are put in place ensure that wastage is reduced, stocks are accounted for, and duplication is minimised results in saving – not least from a reduced number of malpractice suits – that most definitely outweigh the initial investment.  

Web-based information system 

COHSASA uses a web-based information system – CoQIS (the COHSASA Quality Information System) to identify and keep track of improvements in all sections of a hospital or health facility. CoQIS can be used by hospital managers as a management tool to monitor the quality of their operations. It provides easy, user-friendly, continuous access to current hospital standards compliance, which enables management to make informed decisions as to when and where to introduce quality improvement programmes and prepare for accreditation. 

Designated staff in facilities (and in corporate headquarters) access their own data via a secure password online and track improvements and obstacles to improvement in situ. They are able to examine all the areas of service provision and support in their hospitals or clinics and capture progress in compliance levels from the deepest level – criteria level – to the highest and broadest level – performance indicators in a single hospital, across several hospitals in a region, or in one country. 

Senior management can use CoQIS to monitor each hospital performance routinely, while it prepares for accreditation, and monitor the quality of operations in all hospitals, singly or in groups, to ensure that the hospitals achieve and maintain quality standards in all services beyond accreditation. It is a tool for the ongoing monitoring of performance indicators. 

CoQIS provides clear and unambiguous guidance to hospital managers and health policy strategists on what is wrong with hospitals, how deficiencies can be fixed and what is most important to fix first so that patients are safe and legal requirements are met. This means that endemic weaknesses in hospital service delivery can be picked up, monitored and improved. 

For hospital insurance schemes, the knowledge that a facility has been accredited means that safer and better outcomes of patient care can be expected.  

The value of entering a quality improvement programme – culminating in accreditation – is that information on deficiencies and common trends empower management to implement macro strategies to optimise the use of finance and resources. 

Uniform performance evaluation 

There is value in a uniform performance evaluation because it informs budgeting and planning and identifies appropriate and cost-effective interventions. The addition of the internet based CoQIS to the COHSASA portfolio means timesaving and reduced costs of transport and accommodation to gather information.  

Healthcare facilities that carry a COHSASA Accreditation Certificate and have successfully completed the demanding requirements of the programme can offer patients peace of mind that they are receiving treatment in a facility that is safe, clean and meets definite safety and legal requirements. Patients can rely on the fact that there are clearly defined methods of interaction in the hospital that ensure their well-being, that there are systems to detect weaknesses and monitor improvements as well as sufficient, properly trained staff to look after them. 

There are some values attached to accreditation that cannot be quantified but only guessed at. Medical error, as the South African public sector – particularly – has been finding of late, carry a high financial cost. The proper systems required for compliance with standards of safety in both administrative and clinical operations in a healthcare facility means that accreditation may indirectly contribute towards preventing error. On that basis, the value of accreditation is incalculable. 

COHSASA offers an adverse event reporting and monitoring system – PatSIS – which, combined with quality improvement and accreditation may prove to be a powerful set of tools to ensure that safe and better care is provided to patients. The reduction in costs associated with malpractice suits is therefore a given. 

Marilyn Keegan represents The Council for Health Service Accreditation of Southern Africa NPC. 

This article appears in the latest issue of Omnia Health Magazine. Read the full issue online today.

 

Back to Management

Multiple countries across the globe have built Health Information Exchanges (HIEs) to centralise and mobilise patient records and drive better quality of care and improved patient outcomes. Enshrined by World Health Organisation’s eHealth Resolution “to foster exchange of data and information for the promotion of health, health systems and training of healthcare workers,” countries see HIEs as an important tool to strengthen patient services and experiences to improve care and evolve in line with the strong healthcare trends towards preventive and value-based care.

In the Middle East, The Department of Health - Abu Dhabi (DOH) is leading the charge, having commissioned the Abu Dhabi Health Information Exchange Platform, Malaffi, in 2018 and empowering Healthcare Professionals (HCPs) to make well-informed decisions using available patient data from all previous appointments, regardless of the facility.

The challenges of sharing radiology images outside of one organisation

As diagnostics play a critical role in patients’ journeys, radiology images become essential to holistic electronic medical records (EMR). The burden of retrieving radiology and diagnostic images from disparate systems for patients and healthcare providers is significant. Not having easy access to images from previous appointments with different providers may lead to duplication and over utilisation or diagnostic services, delays in treatment, poor treatment outcomes, and a poor experience for clinicians and patients.

Nevertheless, sharing radiology images across different healthcare organisations is challenging due to the large file size and interoperability issues. Only select HIEs globally have implemented an image exchange solution within the providers’ portal.

Malaffi introduces an Image Exchange Solution

Malaffi’s recent launch of the Image Exchange Solution now allows healthcare providers across the Emirate of Abu Dhabi using Malaffi to have access to radiology studies. This latest Malaffi enhancement again positions Abu Dhabi at the forefront of using innovative digital health technologies to drive better patient outcomes.

Malaffi’s user survey revealed that 90 per cent of clinicians felt it very important to have access to the historical radiology images for their patients. It is anticipated that those who will benefit the most from such a solution are surgeons, gynaecologists and obstetricians, internal medicine specialists and cancer care teams, and multidisciplinary teams.

Delays in waiting to receive images – such as X-Rays, CT scans, MRIs and ultrasound images, for example - from disparate systems can be frustrating for the care teams and add to stressful situations for patients. Ultimately, in Abu Dhabi, the burden of patients needing to take hard copy scans or CDs of scans to appointments will be eliminated once 60 facilities are connected to Image Exchange, removing the reliance on the patient and for the HCPs to have more timely access to additional clinical information.

The availability of radiology images in patient records ensures that time-poor healthcare providers now gain a holistic view of patients’ records and can review and compare images from different visits and timeframes. Image access reduces the need to duplicate expensive and invasive radiology investigations, which also safeguards patients from unnecessary radiation and reduces time and cost. A recent study found that the duplication of diagnostic images in clinical settings after implementing an image exchange decreased by more than 20 per cent.

Another study found that nearly two-thirds (61 per cent) of radiologists suffer from burnout, up from 36 per cent in 2013 to 49 per cent in 2017. Reducing the duplication of multiple and sometimes unnecessary scans can help to alleviate this issue.

Likewise, there are many use cases for sharing images across organisations. Consider, for example, a scenario where a patient undergoes a CT scan at a hospital trauma centre and is then transferred to a tertiary hospital. Studies have found considerable duplication of CTs in these cases, in addition to the fact that valuable time is lost when the patient needs to be treated urgently.

Abu Dhabi at the forefront of digital health technology

As healthcare professionals become increasingly time-poor, technology can solve many of the issues they face. According to Persistence Market Research, medical image exchange systems are expected to be adopted globally at a significant pace over the coming years due to the growing adoption of advanced technologies in the healthcare industry.

For Malaffi, delivering an image exchange solution was the natural next step to continue adding value for the clinical users, especially given the fragmented healthcare landscape in the emirate and the need to deliver a single, seamless and secure source of important clinical information. Ultimately, following a phased approach, two million radiology images from over 60 healthcare sites across Abu Dhabi will be available through the exchange. The first facilities to join include NMC Healthcare, Reem Hospital, Burjeel Holdings and HealthPoint.

As part of the global HIE community, Malaffi has been recognised for its achievements as one the fastest-implemented platforms globally. Alongside the image exchange, in 2022, Malaffi released several functionalities such as patients’ appointments, risk profile and a Health Portal, cementing its position among the most advanced HIEs. The organisation continues its journey with a commitment to seek new solutions to improve the quality of healthcare and enhance HCPs’ ability to deliver this in Abu Dhabi.

And now, as the world embraces the emerging healthcare trends moving from sick care to preventive care and the ultimate target of practicing value-based care, HIE innovations in sharing health data will be a crucial component for enabling the future of healthcare. Being able to combine diagnostic images with other clinical data and biomarkers for patients, creates a platform and foundation for AI-enabled tools (which combine clinical and imaging data) to be implemented to drive more targeted and personalised care.

References available on request

Dr Sanji de Sylva is VP Clinical Engagement and Informatics at Malaffi.

This article appears in the latest issue of Omnia Health Magazine. Read the full issue online today.

Back to Clinical

EHRs have finally gained widespread adoption. According to 2021 data, 96% of non-federal acute hospitals in the U.S. deployed an EHR system. Nevertheless, the EHR market faces numerous challenges. In fact, about a quarter of EHR system installations fail.  

That often happens due to a poor understanding of potential implementation risks and missing risk management. So, what are the top EHR implementation risks, and how to manage them? We look into the matter. 

Top EHR implementation risks 

The risks connected with EHR implementation fall into three large groups: 

Cost  

Estimating the EHR project budget is a tricky matter. According to the 2022 EHR Software Report by Software Path, the average EHR budget is $1,2K per user annually. However, the actual cost can vary due to several factors – the available funds, the size of your practice, the features you need, and the implementation method. 

As for the latter, on-premises EHR solutions require system hosting on hospital servers, which may require buying additional computers and other hardware. On the other hand, in this case, you own your data with no concerns about vendor ownership of the system, as happens with cloud solutions. 

At the same time, a cloud EHR solution does not require hefty upfront investments. That is about affordable monthly subscriptions. However, there is still a point to keep in mind. The cost of a cloud-based EHR may significantly grow. With such a system, scaling up is easy but could become less affordable.  

People 

This risk refers to your employees dealing with the EHR system daily. For medical personnel, a new digital tool brings a lot of stress – they need to work and learn the key functions of the new solution simultaneously. That builds up the workload on clinicians and nurses.  

An increased workload and the lack of experience with the new tool increase resistance to change. People knew how to work with the previous solution and got used to the hurdles it offered, and now with the new tool, they are back to adjusting to new processes, training, and overwork.  

EHR Technology 

Though today EHRs are ubiquitous, hospitals concentrate on one aspect of the system – digital data storage. However, another important function is medical data exchange among providers, patients, and their doctors. When insured properly, health data exchange prevents health data losses and helps to ensure care continuity across different locations. 

EHRs work as a cornerstone of any hospital. Doctors from any hospital department should have seamless access to the system from any location. Besides, the ability to connect from anywhere appeals to patients. These two features require integrations with all hospital systems and patient-centric solutions: mHealth apps, patient portals, and tools for remote patient monitoring. 

Additionally, to improve care delivery and patient experience, electronic health records should support clinical workflows. It may require mapping and subsequent redesign. 

Effective risk management strategy 

How to overcome all the risks while implementing an effective EHR solution? Below we provide an EHR risk management strategy that helps run the project smoothly. 

Smart preparation 

Remember that EHR implementation is a long-term investment, not a one-time effort. First of all, you need to draft your total EHR cost. To do so, you need to identify the core features the team needs in the system. You can also assign priorities to those features to see which functions are critical and which can wait for the optimization round.  

Сonsider different add-ons your practice already has (a patient portal, lab software, etc.) These efforts will help you visualize the scale of the project, its cost, and the required integrations. 

Then ensure productive communication with your stakeholders – clinicians, administrative staff, board members, and the marketing department. Prepare the ground by openly discussing the current EHR solution and its deficiencies for all stakeholders. A new EHR project should not be unexpected to them.   

Productive dialogue 

At this point, the new EHR benefits should come under the spotlight. Your hospital leader needs to discuss the problems with the current system and promote the need for a new solution citing its benefits for each group of stakeholders. This approach helps mitigate the resistance to change, as the change comes as the solution to the key pain points. As a result, employees will welcome a new EHR more willingly. 

Besides, it helps pave the way for another important effort – attracting doctors to electronic records implementation. 

Multi-faceted team 

Hospitals differ in size, scale, and the range of services they provide. Logically, software engineers, however qualified, often have no idea how a hospital works. Hence, the team needs to use the clinicians’ expertise to ensure the project's success.  

And here comes another question: which clinicians are a better fit for participating in the project? It makes sense to test your doctors’ computer skills, select those with mid to high levels of computer literacy, and assign them to the development process as consultants.  

Working as project consultants, doctors can: 

• Map the selected workflows so that they fully reflect clinical processes. 
• Foster the integration of existing digital solutions. Clinicians can outline the necessary integrations in advance and submit them to developers to plan the needed services. 
• Test the solution’s usability and detect potentially detrimental issues to patients, like incorrect dosage or units of measurement. 
• Become supervisors during the training. Tech-savvy doctors can help beginners master the top workflows and features relevant to their position. 

The doctors’ participation in the project can drive a better understanding of the system and its place in your practice and make the implementation smoother and swifter. 

Closing thoughts 

Even though electronic health records have become commonplace, EHR implementation projects still face risks that can make them challenging to implement. Those risks include: 

• Swelling project costs; 
• Staff resistance slowing down the implementation; 
• Lack of understanding of the system and its role in a hospital. 

Fortunately, with a well-designed risk management strategy, those risks are manageable. That strategy comprises three measures: 

• The preparation stage. This stage helps take the project cost under control and address staff resistance to the new system. 
• Effective communication. This stage helps bring all project participants on the same page and prove the new system is required. 
• Doctors in the team. This stage helps create EHR systems with your practice specifics in mind and without lengthy rework. 

That strategy helps address EHR implementation risks and prevent the hurdles they may cause. 

Inga Shugalo is a US-based Healthcare Industry Analyst at Itransition: Software Development Company. 

 

This article appears in the latest issue of Omnia Health Magazine. Read the full issue online today.

 

Back to Technology

Radiography is a relatively young profession that started with W.C. Röntgen’s discovery of X-rays in 1895. The profession has greatly evolved over a short span of years, with knowledge about x-rays contributing to the use of different radiographic techniques, design and development of new technologies, image interpretation, and patient care, amongst others. 

For the radiography profession to move forward, and maintain high radiographic standards, it must contribute to its body of knowledge by engaging in research. The future of the radiography profession is based on research and evidence-based practice. Research is the systematic investigation or inquiry for the acquisition of knowledge, where the ultimate goal of the research is to develop and expand this body of knowledge.

Radiographers are increasing their role in actively performing research to keep abreast with the changes occurring at a fast pace in medical imaging and radiotherapy, such as developments in digital imaging, patient administration systems, the introduction of hybrid imaging, and the use of artificial intelligence. Radiographers are the link between technology and the patient.

Radiographers cannot just shadow technical developments but must be proactive and conduct their own research in healthcare and technology and include the perspective of the patient. This implies a role transition from a clinical radiographer to one being a researcher.

The aim of this article is to provide an overview of the research processes. The research process outlines the steps required from generating the initial idea to disseminating the final outcome or findings of the research.

The research process

The way research is conducted depends on the methodology to be used in answering the research question. The type of research will then follow a particular model or paradigm. The main models are referred to as the Naturalistic (qualitative) or Positive (quantitative) models, or a mixed model (including both qualitative and quantitative) approach.

Focusing more on a quantitative approach to research, this follows a tight process before commencing of data collection. The steps involved in a quantitative research design include the following:

Conceptual phase

The first step of the research process is to think (or conceptualise) the area of study. Reviewing existing literature on the subject area helps in identifying gaps in the knowledge that lead to the development of the research question. The review of the literature together with undertaking clinical fieldwork assist in the definition of conceptual definitions and formulation of hypothesis for the research to be undertaken.

The design and planning phase

Once the research question or hypothesis is formulated, the next step is the selection of the appropriate research design to address and achieve the research aims. The target and accessible population are identified from which a sample is selected. For this purpose, a sampling plan is designed to select a sample that is representative of the population for which the findings of the study are to be generalised.

Data collection protocols are developed, which will be followed for data collection. These include specific methods used to measure the variables being studied. In the case of human participants, ethical issues are to be considered. Once the method of data collection is agreed upon, it is put on trial during a pilot study. The pilot study tests the feasibility of the method and provides an opportunity to highlight any issues that are addressed prior to the main data collection process.

The empirical phase

For the empirical phase or data collection, the data collection tools are developed and tested for validity and reliability. Validity refers to the accuracy of a measure, and whether the tools really collect the data that they are supposed to collect. While reliability refers to the consistency of the data collected, and whether the results obtained from the data can be reproduced under the same conditions.

The analytical phase

The data is prepared and organised for data analysis. Appropriate statistical tests are selected based on the type of data, in the case of quantitative data or thematic analysis in the case of qualitative data.

It is important that the results of the data analysis are correctly interpreted, and comparisons made to findings from similar research.

The dissemination phase

The research is not complete unless the results of the research are communicated with others so that the findings can be implemented as recommended. Research is useless if findings are not shared and implemented.

Conclusion

Research findings, to be effective, require dissemination to be used in practice. Translating research findings and other evidence-based practices into routine practice is essential to improve the quality and effectiveness of radiographic services.

References available on request

Francis Zarb is the Associate Professor at the Department of Radiography, Faculty of Health Sciences, University of Malta.

This article appears in the latest issue of Omnia Health Magazine. Read the full issue online today.

Back to Clinical

It would be difficult to miss the trend toward remote healthcare, which ranges from telephone GP appointments to remote patient monitoring technologies. The Covid-19 pandemic has accelerated a trend over the past two years that might have otherwise emerged much more gradually. This change also impacts diagnostics, especially for patients with chronic conditions who require ongoing testing. For instance, repeated complete blood count (CBC) tests may be required for cancer patients to monitor the progression of their disease and the effectiveness of their treatment. 

Hospital systems have been so overworked during the pandemic that they were on the verge of collapsing, and Covid-19 has brought attention to the need for decentralised healthcare services. Delivering diagnostic results to doctors so they can quickly make informed clinical decisions represents one significant obstacle. Rapid point-of-care diagnostics are altering how blood tests are managed and performed. 

According to the Market Research form Strategic Market Research, the Global Point of Care Diagnostics Market was worth US$33.12 billion in 2021, and it will be worth US$90.25 billion by 2030. It should be noted that during the period (2019 to 2021), the demand for PoC diagnostics solutions grew by over 15 per cent. The market can be understood in two categories which are infectious disease PoC diagnostics and non-infectious disease PoC diagnostics. While the market for infectious disease testing is relatively bigger, holding over 60 per cent of the demand, non-infectious diseases such as HIV, cardiovascular problems and others are also gradually adopting PoC testing.   

In terms of demand, the US is the largest global market, accounting for 32 per cent of the revenue share. Emerging economies of the world are also adopting technology at a fast pace. The Middle East region is one such market where rapid growth is expected in the next ten years. The healthcare sector in the Middle East region is progressing very fast and a lot of investments are coming in from the global market players.  
 
PoC testing kit providers are Abbott laboratories and others are already active in countries like Saudi Arabia and UAE through online and offline channels. By 2030, the PoC diagnostics market in the Middle East region is expected to exceed US$1 billion.    

Application of POC instruments  

Disease-related: Point-of-care testing gives patients and healthcare professionals quicker, more affordable access to precise, actionable results at the earliest possible time when treatment can be most efficient. Fast, greater POC liquid handling instruments may encourage faster and more precise diagnosis and treatment when possibly life clinical decisions depend on laboratory testing.  

Rapid diagnosis is essential for the best chance of success in situations like emergency care, public health outbreaks, fast screening of infectious diseases, cardiovascular events, and adverse drug reactions. Other testing requirements, like blood monitoring, fertility testing, ongoing disease management, or routine wellness panels, do not require speed but need repeatable, accurate, and reliable data. Flexible POC liquid handling technologies that can accommodate a variety of test modalities can greatly enhance patient care.   

Technology-related: The diagnosis of both biochemical and molecular diseases is undergoing a remarkable transformation thanks to developments in device miniaturisation, higher sensitivity optics and chemistries, sample multiplexing, disposable technology, greater information processing, sensors, component reliability, and cloud-based data storage and analysis. Designs for point-of-care liquid handling instruments that take advantage of these developments will be best positioned to dominate the POC market. 

The POC testing market is expanding due to higher R&D funding for advanced technology that will shorten the time required for clinical diagnostic testing. Remarkably, the COVID-19 pandemic has increased regulatory agencies' willingness to expedite the approval of diagnostic products. The US National Institutes of Health (NIH) Point-of-Care Technologies Research Network (POCTRN) introduced the Rapid Acceleration of Diagnostics (RADxSM) initiative in April 2020. 

The initiative aims to expedite the creation, approval, and commercialization of novel point-of-care and home-based tests and advancements in clinical laboratory tests that can accurately identify SARS-CoV-2. 

With the development of novel applications in fields like non-invasive prenatal and oncology, the market for point-of-care diagnostic testing through next sequencing (NGS) and other genetic technologies is predicted to expand steadily.

Innovations in POC diagnostics boosting the market growth 

The point-of-care diagnostics market is expanding as big, and small businesses are creating new technologies to help medical professionals diagnose patients quickly from anywhere. Receiving test results sooner can help save time, money, and lives in serious situations because diagnostics are a crucial part of the clinical decision-making process. 

POC diagnostics are also lowering the costs associated with the time-consuming and expensive practice of sending samples to a laboratory. And, as the need to contain healthcare costs has grown, they have proven to be an effective way to meet financial targets without jeopardizing clinical outcomes. 

Factors contributing to the rapid growth of POC diagnostics 

• Point-of-care diagnostics have rapidly increased in popularity due to a number of factors. The most significant are as follows: 
• Technological advancements: Diagnostics have become more accurate with the advancement in technology. This enables providers and patients to obtain results faster than traditional diagnostics.   
• Indications for use are being expanded: The appeal of the technology is expanded to a larger pool of potential customers when a growing number of patients can benefit from it. 
• The increasing rate of chronic and infectious diseases: The demand for point-of-care diagnostics is rising quickly as chronic disease rates are rising and account for a significant portion of US healthcare spending 
• Patient convenience: Patient-friendly point-of-care diagnostic devices, such as glucose monitoring devices, enable patients to manage their chronic conditions better. 

 

This article appears in the latest issue of Omnia Health Magazine. Read the full issue online today.

 

Back to laboratory

 

---- 

References available on request 

The UAE continues to draw patients from local and international markets as its reputation for trans-forming the region into a healthcare hub through research and innovation reaches worldwide acclaim. The emirate of Abu Dhabi has specifically created a healthcare ecosystem that caters to and ad-dresses the evolving needs of the massive local and expatriate population that has made it home, ensuring only the best healthcare is easily accessible through the finest facilities. A major driver of this ecosystem is the cutting-edge research and innovation that is aimed at addressing the evolving healthcare needs of the community and wider region.

Cleveland Clinic Abu Dhabi, a Mubadala Health partner, is part of that ecosystem, solidifying its posi-tion as a world-class facility for complex, leading-edge healthcare and an incubator for research and innovation, pioneering technologies, treatments and surgeries.

With numerous awards to its belt, including UAE's top hospital in Newsweek's World's Best Hospitals 2022, and recently ranked No.1 smart hospital in the UAE and GCC by Newsweek – ranked among three hundred hospitals from 28 different countries – Cleveland Clinic Abu Dhabi’s record of excel-lence is unmatched for innovation and customer and patient-centric care. It also offers more than 50 medical and surgical specialties, allowing it to perform complex procedures across a wide range of disciplines, delivering the world’s best healthcare.

Dr. Jorge Guzman, Chief Executive Officer, Cleveland Clinic Abu Dhabi says, “In order to enhance healthcare in the UAE, we collaborate on several government programmes, direct significant research projects, and deliver state-of-the-art clinical solutions to the region. The Cleveland Clinic Abu Dhabi Research Institute excels by setting itself apart through a team-based research methodology. In or-der to offer our patients the highest calibre of care and expertise, we partner with a network of pro-viders, and source specialists, top surgeons, physicians, and caregivers from around the world who pioneer treatments and surgeries, and serve as examples of our forward-thinking approach.”

Precision and personalised medicine

Cleveland Clinic Abu Dhabi’s Precision Prevention Programme seeks to make sure that the most suc-cessful interventions are directed at the appropriate individuals at the most apt times. The pro-gramme’s goal is to change the way healthcare is traditionally provided by focusing on disease pre-vention rather than disease treatment. Advanced precision diagnostics, which includes proteomics, genetic screening, and advanced lipid testing, and lifestyle management principles, make up the pre-cision prevention program's two complex components.

With its considerable knowledge and experience in genetic counselling and testing, Cleveland Clinic Abu Dhabi has collaborated with the Department of Health Abu Dhabi's (DoH) Personalised Precision Medicine Program for oncology. The programme’s initial phase focuses solely on breast cancer, which is the most prevalent kind of cancer in the UAE, and offers high-risk patients personalised cancer prevention strategies as well as therapy options for some breast cancer patients. This partnership enables Cleveland Clinic Abu Dhabi to create and introduce clinical testing standards that assist pre-sent and future breast cancer patients through individualized genetic profiling, by utilising cutting-edge technology and data obtained from the Abu Dhabi Genome Programme.

Dr. Jorge Guzman, Chief Executive Officer, Cleveland Clinic Abu Dhabi

Dr. Guzman adds, “Information about one’s risk is empowering, and it allows the physician to help patients to reduce their chances of getting breast cancer. At Cleveland Clinic Abu Dhabi, we have an excellent genetic counseling program, and we recently finished a successful pilot of germline testing for cancer patients. The Emirati Genome Project, which uses germline testing to enhance screening of Emirati females in order to prevent and diagnose those at risk of hereditary breast and ovarian cancers.”

The Cancer Center

A few years back, as the highest out-migration for treatment was cancer, the Abu Dhabi government decided to partner with Cleveland Clinic Abu Dhabi to build a Cancer Center.

Dr. Guzman says, “Innovation is Cleveland Clinic Abu Dhabi’s DNA. Showcasing this is the new Can-cer Center which opened in November and is equipped with state-of-the-art equipment to deliver only the best treatment to cancer patients.”

The hi-tech equipment includes Ethos Adaptive Radiation Therapy, the first in the UAE. This uses Artificial Intelligence to allow the physician to change the plans of where the radiation will go each day, so as to provide the most accurate radiation, and to reduce unnecessary exposure by radiation to healthy tissue.

Clinical trials

Cleveland Clinic Abu Dhabi's research division, together with its multidisciplinary team, collaborates with universities and other strategic partners, fostering collaborative models through established local and international partnerships, including its global campuses to advance healthcare in the communi-ty. It continues to invest in the next generation of clinical caregivers and healthcare professionals through wider education and research efforts, and creates innovative therapeutic strategies, cutting-edge diagnostics, and preventative care alternatives that will benefit the people of the UAE for years to come.

Three studies that address obesity, breast cancer, and liver health are currently underway. Our phy-sician scientists are also working on the first in the world, novel endothelial cell base research trial to discover and validate genes which can lead to an efficient and economical way of drug discovery to address these chronic diseases.

The Emirati population is at the center of all three studies, which employ a genome-based methodol-ogy that focuses on genome or DNA data. This method allows for the comparison and validation of results, accelerating the creation of unique therapeutic strategies and individualized healthcare solu-tions for various medical disorders.

New technologies and other firsts

Machine learning is a new branch of artificial intelligence that has the potential to predict and improve clinical outcomes. In order to include predictive modeling into the treatment provided to our patients and to deliver a more focused approach to diagnoses, therapies, and preventative care, our physi-cian scientists are developing algorithms linked to stroke, cardiovascular diseases, and infectious dis-eases.

Cleveland Clinic Abu Dhabi has achieved numerous firsts including a recent agreement with wearable technology manufacturers to monitor patients’ vital signs from the comfort of their homes. The Heart, Vascular & Thoracic Institute recently performed the first valve-in-valve transcatheter mitral valve re-placement surgery on an elderly patient who had previously been warned by other hospitals that the procedure was too hazardous.

Physicians at Cleveland Clinic Abu Dhabi have consistently sought to improve the lives of their pa-tients through innovative technologies and unmatched expertise. They performed the UAE’s first im-plant of a synchronized leadless miniature pacemaker. The device is 93 percent smaller than a tradi-tional pacemaker and smaller than a dirham coin and it eliminates potential complications associated with traditional pacemakers. In addition, the hospital performed the UAE’s first kidney-pancreas transplant and the first simultaneous liver-kidney transplant in the UAE. The institute has since gone on to perform more than 200 organ transplants.

Dr. Guzman concludes, “With the launch of the Cancer Center, we are entering a new era of research and innovation. Cleveland Clinic Abu Dhabi continues to be forward-thinking and anticipates eagerly the part it will play in the development of new technologies and innovations as we continue to strive toward delivering ever enhanced patient care, to the UAE and the wider region.”   

Back to Management

A strong legacy in healthcare is evident when driven by the right balance of leadership, foresight, and passion. When Dr. Fouziyah Mohammed Al-Jarallah took over the reins of Hayat National Hospitals group from her father Mohammed Bin Naser Al Jarallah, she transformed the company into a stronger, reputed healthcare leader with diversified hospital operations across the Kingdom of Saudi Arabia.  

A peek into Dr. Al-Jarallah’s extensive background reveals that she holds a bachelor’s degree in Medicine and Surgery from Saudi-based King Saud University and The American Board of Pediatrics from Canada-based McMaster University. She is also armed with a Doctor of Medicine in Allergy and Immunology from the latter university, as well as a Master of Business Administration in Healthcare Administration from the Dublin Royal College of Surgeons in the UAE, in addition to other international certificates in business development.  

Related: eBook: Navigating the healthcare market: Saudi Arabia edition

With CEO Dr. Al-Jarallah at its helm, Hayat National Hospitals now stands as a notable private hospital group with prominent affiliated businesses that work closely with all the major stakeholders of the Saudi healthcare sector, such as the Ministry of Health, military hospitals (including National Guard Hospitals), medical insurance companies, other healthcare providers, as well as the Council of Cooperative Health Insurance (CCHI).  

The company further secured high-profile board memberships at national organisations that focus on improving and developing the Saudi healthcare sector. Prestigious titles include Consultant in the National and Gulf Centre for Evidence-Based Health Practice, Vice President of the National Committee for Private Hospitals in the Council of Saudi Chambers, and Member of the National Health Committee. 

“We developed successful partnerships with the most reputable global companies in the medical field, including GE, Philips, and Siemens, upgrading the hospitals’ technology to improve service quality. As a CEO, I work hard to increase efficiency and deliver an overall better patient experience,” she added. 

Dr. Al-Jarallah also executed an impressive strategy to enable the expansion of Hayat National Hospitals group and increase investments in the medical field. This led to the addition of new hospitals to its portfolio, which would bring the total to nine major hospitals operational by the end of 2026.  

“This progress helps fulfil the company’s vision, which is to become the most pioneering and successful healthcare company in the Kingdom, delivering quality medical services at the highest international standards,” she said. 

Impact of tech on hospital operations  

Hayat National Hospitals is no stranger to digital transformation in Saudi Arabia’s healthcare sector. With an aim to enhance the level and quality of medical services, the company continues to update its systems across many departments with the latest technologies and promotes the adoption of tech to improve the outcome and facilitate access to its medical services.  

“This year we were proudly recognised with an award of excellence by CCHI as we are properly using the ‘NPHIES’ digital platform in all medical insurance transactions all over the kingdom,” said Dr. Al-Jarallah. 

Hayat National Hospitals also succeeded in the development of variant mobile applications, which will be launched soon to enhance public health through selective new services such as online booking and registration, telemedicine, online medication delivery, and home care.  

“These services will allow our patients to save time and effort and receive elegant medical services,” she added. 

Hayat National Hospitals’ role in sustainability 

Hospitals can achieve their objectives by proactively considering sustainability and making energy-efficient investments. This means diverting attention towards an enhanced patient experience, reducing operational expenses, and optimising facility operations to promote community health.  

“The transformation of healthcare sustainability from a public relations opportunity to a stakeholder expectation is one of the most important themes of this period. Patients, employees, and the communities will directly be impacted by the management's choices about environmental measures that affect their facilities,” she said. 

According to the CEO, these measures require careful and efficient planning to be successful.  

“I take pride in reaching many patients in areas where no other healthcare provider was willing to invest and provide them with high-quality medical care. I also take delight in meeting my company's standards and objectives,” she added. 

Thoughts on the current state of health institutions 

Since the launch of Saudi Arabia’s Vision 2030, there have been many achievements that support the country’s transformation, according to Dr. Al-Jarallah. This enabled the Kingdom to grow its economy, empower its citizens and deliver a future full of opportunities.  

“We are witnessing the upgrade of the efficiency, capacity, and coverage of healthcare, which have also been enhanced with the use of digital transformation,” she said. 

Future plans and Arab Health 

Hayat National Hospitals Group is committed to providing superior medical services that add value to patients, their families, stakeholders, and the overall community. According to the highest standards of quality and to maintain the safety of patients, employees and visitors use the latest diagnostic and therapeutic protocols.  

“We also seek to be the first destination for integrated and optimal healthcare professionals to ensure providing superior patient care, emphasising the patient’s privacy, and being committed to covering the health care for both citizens and residents of the Kingdom,” said Dr. Al-Jarallah. 

To ensure this, Hayat National Hospitals focuses on continuous cooperation in the development of knowledge and uses the latest technologies to achieve comprehensive medical care. It also adopts the best employment policies to recruit and attract the best qualified medical staff and work on developing their skills, thus contributing to raising production rates. 

“At Arab Health, we are eager to connect with our current partners and consider forming new ones. We also look forward to meeting influential global leaders and stakeholders who are advancing the healthcare sector to work together and transform the sector into one with a more sustainable and good impact. We will continue to move forward with sustainable and creative solutions that will challenge current paradigms and transform healthcare for future generations,” she concluded. 

This article appears in the latest issue of Omnia Health Magazine. Read the full issue online today.

Back to Management