KHUH has recently hit the headlines after it adapted to Amazon Web Services (AWS) and developed a long-term storage solution without making changes to its existing Picture Archiving and Communication System (PACS).

The 600-bed hospital faced limitations on the data maintenance front as their on-premise storage of medical images kept on getting bigger with every passing year. The AWS solution has helped the healthcare facility to reduce its data storage costs by 40%.

KHUH’s journey as the tech pioneer in Bahrain’s healthcare sector is sure to be a textbook reference for hospitals in other parts of the world wanting to make it big in the industry.

KHUH’s cloud-based solutions

By January 2022, the hospital had accumulated around one million image studies in some 476 million files. While the total data volume is around 44 TB (terabytes), to date, the hospital has been adding around 1 TB of new data monthly. Out of those one million image studies, only 94,000 from the timeline of 2011-19 were retrieved in 2021, and these nine-year data alone formed a 3TB volume. To simplify the equation, only 7% of PACS data was retrieved annually.

While these storage upgrade works kept KHUH’s IT staff busy until 2021, a state-of-the-art archival solution became a necessity. The innovation required to be an adaptive one towards future technological breakthroughs, while making minimal changes to the PACS system. That’s where Amazon Web Services stepped in with its S3 File Gateway and S3 Glacier. Now, the new on-premise data storage architecture keeps only medical images generated in the last four years, whereas AWS archives the remaining data. The hospital is now having the best information and communication technologies in Bahrain.

KHUH’s data infrastructure

While the Amazon S3 File Gateway provides a file interface into Amazon Simple Storage Service (S3), these two together create a service and virtual software compliance, through which the hospital can store and retrieve objects in S3 file sharing, using the file protocol Server Message Block (SMB). The software gateway is deployed in the KHUH on-premises environment as a virtual machine (VM), which is running on VMware ESXi. The gateway then allows the medical image-related data to be accessed in S3 as files or file share mount points.

While KHUH used the solution to transfer the image data to the cloud without much modification to the existing PACS system, the latter uses the SMB protocol to store data on a Windows file server. If the data volume rises, the hospital adds IBM SAN (Storage Area Network) Volume Controllers (block storage virtualisation appliances from the IBM System Storage product family) to the Windows file server and creates new file shares.

These new file shares are then added to the PACS storage manager. The S3 file share added as another file share, helps the PACS system to store medical images on the S3 File Gateway.

While the initial solution architecture was developed with AWS, the Amazon S3 Glacier Flexible Retrieval storage class got roped in as well, as the healthcare facility onboarded more and more solutions. S3’s induction was done to store those archived data which may not be required immediately but can be easily retrieved as per the hospital staffers’ demand. The feature has flexible retrieval options, balancing cost with access times. KHUH’s goal was to avoid manual interventions in the data retrieval process, which is why the healthcare facility automated the whole operation. If the PACS system attempts to access a file from the Glacier Flexible Retrieval storage class, an error message will be sent to the Amazon CloudWatch logs, resulting in an AWS Lambda function, aimed at retrieving image files via S3 batch operation.

“We have achieved our digital transformation by focusing on three vectors. Robotic process automation, AWS storage technology, and most importantly, empowering our in-house engineers,” said Hamad Saeed Abdulrahman, Director of ICT at King Hamad University Hospital.

But then, there was a catch as the KHUH didn’t have access to the image data in any of the S3 File Gateway cache or S3 bucket in the AWS Cloud, which prolonged the recovery process. To remove the obstacle, the medical facility deployed another S3 File Gateway virtual machine in their data centre. These gateways are addressed through a single domain name system with failover alias records.

Following the AWS Storage Gateway user guide, KHUH didn’t write multiple file shares to one S3 bucket and configured two Identity and Access Management (IAM ) roles to put the bucket in the failover architecture. The hospital’s on-premise application monitoring system checks the S3 File Gateways. If one of the gateways becomes unavailable, KHUH’s IT team gets a notification about the glitch.

While the hospital reduced the storage cost by some 40%, it achieved benefits such as higher durability for medical images, a reduction in administrative efforts like expanding the on-premise storage facilities yearly, and long planning cycles for infrastructure development. The KHUH can even carry out quicker changes in the archiving department.

KHUH Healthcare information system recognised by oracle

“After trying many other systems, we realised we had to build our own. Today, we are very proud to have developed HOPE. It has shown that it is a robust, user-friendly system with proven excellence over the years,” said Major General Dr. Shaikh Salman Bin Ateyatallah Al Khalifa, Commander, King Hamad University Hospital, in a recent Oracle report.

KHUH has been using HOPE since 2017. From scheduling, admissions, electronic medical records, lab testing, speciality care, pharmacy, catering, revenue management, or any other healthcare service, HOPE is the answer.

While the facility offers over 40 specialised treatments, it was finding it difficult to come up with a responsive hospital management information system. Eventually, they found a capable solution in the form of Oracle Application Express (APEX). This cost-effective framework provides application development at a faster rate compared to Java and Net programs. KHUH’s development of the HOPE portal relied heavily on APEX.

The hospital now has one application, which carries a suite of over 40 modules. Under it, the application development speed not only got increased by five times, but it also resulted in the creation of a paperless modern healthcare information portal, while saving 80% of the operational costs of the KHUH during its 10-year budget period savings exceeding the $40 million mark.

The healthcare facility has now diverted the saved money towards fulfilling the goal of becoming the first and only healthcare facility to connect to Bahrain’s National Electronic Medical Records (NEMR), National Healthcare Insurance Information System (NHIIS), and Drug Utilization Review (DUR).

KHUH has taken innovation to the next level with the development of its fully automated robotic pharmacy and chemotherapy preparations. During the COVID pandemic, apart from having robust virus testing and vaccination services, its telemedicine mechanism proved to be a game-changer as well.

Bahrain Oncology Center (BOC), under KHUH, currently possesses a fully integrated chemotherapy protocol workflow. Under it, some 300 protocols have already been integrated, with 30 more to go, to meet the goal of a cost-saving, safe medication management programme. Services, especially on the chemotherapy front, improved by leaps and bounds, as few errors and incidents got reported.

Currently, the hospital app has 5,000 users, including its physicians and staff. It registers some 4 to 5 million hits daily, apart from arranging 8,000 to 10,000 sessions in the same timeframe.

While access to real-time data and reporting has brought transparency in hospital finance and accounting, the institute now has an efficient budget control mechanism under its wings. All these are helping the hospital to prioritise patients and reduce waiting periods.

Robotic Process Automation: KHUH’s answer to COVID

King Hamad University Hospital has been no stranger to the entity called automation. Since the start of COVID, KHUH has worked to have robotic process automation that empowered it to make drastic changes to its operations to cope with the pandemic fallouts.

Beginning with the declaration of COVID symptoms, an RPA (Robotic Process Automation) mechanism was developed to integrate and operate multiple silo systems. The rota system sent an actionable email to all healthcare staff members to see if they had COVID symptoms. Following the identification of the infected personnel, an infection control mechanism will be activated, in which the healthcare facility will schedule testing appointments, initiate a quarantine action in the HR system, and notify managers/team leaders of the isolated employees. The system was operational from the start of the pandemic until mid-2022. Furthermore, this system enabled KHUH management to monitor trends and spikes, giving the hospital agile and proactive quarantine measures, which ensured healthcare provisioning and continuation of services.

The RPA took one week to create and another week to test. This quick rollout utilising current in-house technology had a significant impact on the hospital. A positive case would cause the action of having symptoms to be triggered by clicking on a staffer’s email prior to the start of the designated shifts. All of the preceding actions would be activated, and they would be assigned time slots to be tested in the quarantined COVID testing tent. The HR attendance system would be locked for the duration of the testing results, and their managers/team leaders would be notified so that any necessary shift changes could be made.

The rapid and agile deployment of the RPA inspired multiple applications and systems that coped with pandemic challenges, such as the lack of human resources and the extended duration of material deliveries. This will be discussed in depth in the next part of the article.

Migrating the hospital in Zero Operations Downtime

In early 2020, KHUH faced the complex challenge of core network replacement. Even though the cycle refresh was due, the medical facility wanted to ensure that not a single second of hospital operations would be disrupted. Putting matters into perspective, all KHUH systems that supported operations were on-premises. The hospital leadership came up with a three-tier plan.

Firstly, through Microsoft M365 SaaS (software as a service), KHUH was able to shift communication from on-premises to a cloud solution. That enabled two main success factors, more versatility in the user experience and connectivity, and independence for the current infrastructure.

The second plan was to virtualise all systems in place. Going from physical to virtual was a challenging task as all the systems were live and had to be accessible during working hours. KHUH utilised VMware virtualisation technology, with ICT engineers creating virtual copies of current running systems as they were running, and then utilised the time between hospital shift changes to replace the live physical system with the virtual copy.

KHUH was left with the access server hardware after virtualising all of the systems. Therefore, it enabled the hospital to have multiple server clusters, meaning that those servers could be moved seamlessly from one data centre to another. This was the main success factor behind KHUH’s core network migration.

The last tier was to segregate the network into different zones. In simple words, this operation was all about splitting a complex setup into many small segments, which are easier to manage. Furthermore, it meant that the engineers could migrate systems from affected segments.

Because all of the tiers were in place, the hospital’s migration went smoothly and was completed by mid-2022. Furthermore, the performances of all systems have been exponentially great. Faster response, increase in storage space and having an agile infrastructure are some of the added features achieved in this endeavour.

Going beyond standard Oracle Enterprise Business Suite

Another aspiring endeavour was the vast implementation of proactive systems that were developed and deployed in record time. The KHUH IT team has worked extensively to boost its current ERP (Enterprise Resource Planning) with agile and proactive features to face the challenges imposed by the post-COVID period.

With its HR portal, mass hiring of health care professionals was already in place. However, maintaining the vast quantity of documents and licenses for each employee was a great challenge, especially during the pandemic times. Therefore, KHUH ICT developed an employee profile management system, in which staffers’ medical licenses with dates were maintained, managed, and scheduled. This system ensured zero congestion with renewals and regulation compliance-related issues.

The hospital’s ICT team also streamlined the maintenance of the healthcare facility’s bio-medical systems, through the creation of its custom bio-medical assets management system. Under this, all assets’ locations are tracked. It also listed the history of the maintenance works done on the assets. It also sets the planned periodic maintenance of each asset. The solution expanded the life of the medical equipment in KHUH, apart from enabling the pre-ordering of consumable parts per item, prior to shortages and supply chain stagnation.

Lastly, KHUH ICT managed, maintained, and automated the hospital’s sub-store inventory. This system empowers these sub-store managers for accurate item consumption history throughout days, months, and years. This also enabled department managers to easily transfer items between sub-stores and have the deliverables tracked and confirmed. Finally, an in-depth investigation on the maximum and minimum requirement of each item in each store has been digitised to enable auto reordering of those products, thereby stopping item shortages hospital-wide.

As for what is next in KHUH ICT plans, they have finished the initial testing of a supplier portal and moved it to a selective release in November 2022. This system completely transforms the procurement operations in the healthcare facility, as it enables its suppliers to update and upload their proposals and bids for any open purchase order, check the status of the awarded bid, and track the delivery dates through two-way communication and a delivery calendar.

Conclusion

King Hamad University Hospital’s case study is not any other success story of a healthcare facility. It shows the game-changing effects of disruptive technologies in the medical field. Embracing the technology has not only cut down the hospital’s daily mundane paperwork and operational costs, but it also ensured an improved patient care mechanism. Days are not far away when the KHUH model will not only be replicated across the Middle East but will emerge as a viable solution across the world as well.

The post Armed with RPA, KHUH revolutionises healthcare industry appeared first on International Finance.

Practicing medicine requires a combination of diagnostic and surgical skills that only highly trained doctors and nurses can reliably offer. Robots have increasingly entered medical settings over the past four decades. Medical robots assist in surgery, streamline hospital logistics, and enable providers to pay direct attention to patients.

Robots exist everywhere, from sci-fi to the automation industry, and are at the stage of revolutionary participation in healthcare. The notion that robots perform tireless tasks, freeing medical staff from routine tasks, is best suited for medical assistance. In addition, the involvement of robots makes medical procedures safer and less expensive for patients.

A medical robot is a robotic system used in medical science. For example, an accurate computer-assisted surgery uses technology with telemanipulators. It is a robotic arm with an endoscope, while the other two manipulator arms have interchangeable tools, such as scissors and grippers. Such surgeries are also called master-slave telemanipulator systems, where surgeons operate programmable machines using computer-aided technology.

Types of Robots in Healthcare
The healthcare industry uses the following types of robots in low-risk activities. The da Vinci System, a commonly used generic surgical robot that focuses on a wide range of surgical procedures in urological, bariatric, and gynecological, is the most widely used robot in healthcare. In addition, Stryker’s MAKO system specialises in orthopedic surgery, especially knee replacement.

Surgical robots either allow surgeries to be performed with better accuracy than unsubsidized human surgeons or allow remote surgeries where human surgeons are not possible with the patient. Robotic surgery is a type of surgery performed using a computerised system.

Pharmaceutical robotic systems help in dispensing drugs in retail pharmacies and help read the information sent by the hospital information systems. They also update the status of the prescribed medications in the system. In addition to scanning and using bar codes to verify medicines, these robots can package, store, and distribute prescription packages.

Rehabilitation robots facilitate and support the lives of people with disabilities, the elderly, or those with impaired organ function. They are also helpful for rehabilitation and related procedures, such as training and therapy.

Telepresence robots allow off-site medical professionals to move from remote locations, look around, communicate, and engage. Ava Robotics, an iRobot spinoff, are intelligent telepresence robots deployed at the hospital. They enable isolated doctors at home to be present in emergency rooms and allow nurses to see patients.

Disinfection robots can sterilise entire room using vibrating ultraviolet light. They are used to fight the Ebola virus and help kill microorganisms using special UV disinfection techniques.

In addition, with future advanced technology working on nanobots, small robots are on track to help treat complex diseases such as cancer, type 1 diabetes, or infection.

How do Robots Help in Healthcare?
The SwabBot robot, developed to conduct COVID-19 swab tests, has recently taken a step forward in the healthcare domain to facilitate medical procedures.

Until recently, robotics has begun to share regular work in medicine. For example, some robots go hand in hand with specialist doctors for surgery and help in the operation theatre. These collaborative robots, called cobots, are for direct human-robot interaction in the shared space.

Cobot, for example, can cut a patient’s bones more accurately and safely using a laser beam. Here, the robot is trained to minimise bone and soft tissue damage, which helps in faster recovery.

The robotic hair transplants promoted in the health market are credited with accuracy and speed. However, they rely on cobots for proper surgery in small places and transporting dangerous substances.

Robotic medical assistants monitor critical patient statistics and alert nurses when a human presence is required in the room. These robotic assistants automatically enter information into the patient’s electronic health records.

You can now see robotic vehicles carrying supplies through the corridors of the hospital. Robots are also helping with surgery, allowing doctors to perform surgery with smaller incisions instead of inch-long incisions. Robotics is also having a significant impact in other areas of medicine.

Mechanical robots first came into practical use in surgical settings in the 1980s. However, there was full development in the technology only after 1990. Puma 560, for example, in 1985, found the cannula to be in the right place for a brain biopsy.

Subsequently, specialised camera-guided robotic surgical systems, such as Neuro-Mate, Minerva, and robot-assisted microsurgery systems, have been used in brain surgery settings. In addition, accurate-engineered micro-mechanical robotic appendages have proven beneficial in surgical settings that require highly accurate positioning for patient safety and operational effectiveness.

Robotic surgical systems, such as one named “da Vinci Surgical System,” are beneficial in a wide variety of surgeries, including spinal, neck, head, and urological surgeries.

The lengthy time of the laparoscopic procedure makes surgery in urology very expensive. Surgeons use remote-controlled surgical instruments to reduce the severity of necessary surgical cuts. In addition, they give the doctor better control over the procedure at hand.

Robots in pharmacy assist pharmacists with many repetitive tasks, from prescribing a drug to delivering it without error.

The use of Robots in pharmacy has grown. The Children’s Specialty Hospital, Al Jalila, one of Dubai’s best pediatric specialty hospitals, became the first to use robotics in its outpatient pharmacy. The authority is looking to automate its inpatient pharmacy workflow by extending the benefit of Pharmacy Robotics. Generally, the robotic arms can pick the right capsules, medicinal packets or collect and label the medicine.

You can use the robot to deliver blood or urine samples and other items to the appropriate hospital staff.. In addition, robotics find applications in phlebotomy, where they can help collect blood samples and label them accurately, which saves time and reduces the workload on nurses.

Self-propelled robots work with humans to deliver food to patients who have to live in seclusion in their own homes, effectively eliminating the risk of spreading the infection.

Rehabilitation robots serve patients of stroke and those having neurological disorders. They help patients to perform rehabilitation exercises. While engaged in these activities, these robots provide a video gaming experience using 3D video technology.

Robot-assisted rehabilitation therapy helps the patient recover faster. It also allows caregivers to undertake heavy-duty tasks, such as transporting elderly patients during rehabilitation care.

The robotic system acquires patient-specific data like power used, range of motion, balancing capacity, etc., contributing to customising the treatment based on the individual’s progress.

The exoskeleton is helpful for rehabilitation therapy procedures such as walking training to help paralyzed patients recover after a stroke, brain injury, or spinal cord injury. Soft robotic gloves are another example of a wearable robot designed to aid individuals unable to hold objects due to chronic neuromuscular or musculoskeletal disorders.

For example, Cyberdyne’s Hybrid Assistive Limb (HAL) exoskeleton, which uses sensors mounted on the skin to detect small electrical signals in a patient’s body and respond to joint movements, is designed to help rehabilitate patients with lower limb disorders. These disorders include spinal cord injuries and strokes. Although expensive, these devices are life-saving.

The shortage of healthcare professionals and the lack of special care in remote areas are the main factors for using robots in telemedicine. Telerobotics, which are modeled as human-sized robots, facilitate remote patient monitoring, communication, and timely and specialised patient care.

Patients in remote areas can access high-quality emergency consultations for stroke, cardiovascular, and burn services. In addition, advisors can remotely log into robotic systems and clinical data and act on alerts.

Functions of robots include non-contact-based temperature measurement through infrared light and sending and receiving patient photographs to assist the doctor in the diagnosis.

These robots can move around the hospital, supply themselves wherever they are wanted, and monitor patients in quarantine due to infectious diseases. If patients need urgent help, the robot acts as a telephone portal for doctors.

Usually, several items are displaced daily in an average hospital setting, including batches of medicine, meals, linen clothing, and garbage pounds. As a result, healthcare workers often have to commute to and from the hospital. Autonomous robots meant for mobile transport can tackle many of these tasks. These robots help reduce waiting time and work stress. These robots can navigate freely throughout the hospital using sensors. Robots are also used to carry patients. Such robots are highly beneficial for the care of elderly patients.

Challenges to Tackle
The adoption of robots in the healthcare domain is slow. Self-guided vehicles require installing navigation equipment in a dedicated hall or entire facilities, such as floor tracks. Other robots operate with the help of a laser-drawn map of the hospital, which includes elevators, turns, and automatic doors. This process is also quite expensive.

Robotics requires a relatively high capital investment that delays the adoption of this technology. Hospitals with limited bed capacity cannot invest in automated technology for ROI. Evolving technological advances in the future may add cost to sophisticated robots. Then the requirement of technology-driven infrastructure. In addition, technical skills and space limitations hinder the robotic process. Also, reliability concerns are present. Uncertainty exists in complex processes. However, the increased adoption of AI technology is making them more reliable. Robotics is an ever-evolving domain. Healthcare organisations may avoid adopting it first and opt for a wait-and-watch approach.

Training human staff for robotic tasks is costly. However, the goal of robotic technology is to complete human skills, reduce workload, and enable professionals.

Can Robots Replace Medical Crew?
Though robots provide more accuracy, minor damage, and easier and faster access, they are not a replacement for surgeons. Robotic assistants cannot replace basic human contact. The surgeon is always in complete control of the system. Instead, robots are for enhancing the skills of the professionals, improving their efficiency, and reducing their workload.

Although technology is expensive and some have taken years to implement, robots are changing healthcare. Organizations are adopting robotic technology to automate their work in healthcare. It is worthwhile for medical professionals to look at robotics’ vast potential and future benefits in healthcare. They are exploring ways to utilize innovative but mature robotic technology and engage in it to automate their hospitals and medical services.

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Covid-19 has further exposed the cracks that exist in the healthcare sectors in countries like Africa. According to the World Bank, Africa requires around $100 billion to successfully tackle Covid-19 impact across all verticals. The World Bank said, “Since the start of the Covid-19 crisis, the Bank Group has committed over $157 billion to fight the impacts of the pandemic. Provided from April 2020 to June 2021, it includes over $50 billion of IDA resources on grant and highly concessional terms. Our support is tailored to the health, economic, and social shocks that countries are facing.”

The impact of Covid-19 is not just limited to healthcare. African nations such as Kenya and Nigeria have been also impacted. The lockdowns and stay-home orders issued to curb the spread of the virus has had implications on food security. The Covid-19 pandemic has also taken a toll on the mental health of many Africans. Many cases of healthcare workers, Covid-19 patients, youth, or even the elderly suffering anxiety and depression have been recorded. It has become of utmost importance to integrate mental health education and counselling with psychosocial support during these testing times.

The World Health Organisation said, “This unprecedented public health emergency has demonstrated that health facilities, medical transport, patients as well as health care workers and their families can – and do – become targets everywhere. This alarming trend reinforces the need for improved measures to protect health care from acts of violence. During the Covid-19 pandemic more than ever, protecting the health and lives of health care providers on the frontline is critical to enabling a better global response.”

Vaccination drives in Africa were slow to start with. Most of the African nations rely on the COVAX programme, whereas some have managed to get vaccines as donations or through bilateral trades. Africa’s aim is to vaccinate at least 40 percent of its population by the end of this year, however, most of the nations will fail to hit the target, unless the vaccination drives pick up rapidly in the remaining days of this year.

Covid-19 in Africa
Around 8.5 million cases of Covid-19 were reported in African countries till since the beginning of the outbreak, as per official data. The World Health Organisation found that less than 15 percent of the Covid-19 cases in Africa were reported correctly. It is estimated that nearly 60 million people contracted the virus in Africa. Dr Matshidiso Moeti, WHO Regional Director for Africa said, “With limited testing, we’re still flying blind in far too many communities in Africa. Most tests are carried out on people with symptoms, but much of the transmission is driven by asymptomatic people, so what we see could just be the tip of the iceberg.” She said that test numbers have been rising in Africa, but this community-based initiative is a radically new approach that should help significantly raise detection rates. “More testing means rapid isolation, less transmission and more lives saved through targeted action,” she added.

Besides infecting people, the Covid-19 pandemic is also disrupting health services in Africa. The pandemic has undermined the progress made when it comes to fighting deadly diseases that have plagued Africa for years. The fight against diseases such as human immunodeficiency virus (HIV), tuberculosis (TB), and malaria, which continue to be the leading causes of death in the region have taken a back seat.

A study revealed that the mortality rate has increased too. It was reported that there has been an increase of up to 10 percent, 20 percent, and 36 percent due to HIV, tuberculosis (TB), and malaria respectively during the pandemic. The pandemic has also disrupted the fight against HIV in Sub-Saharan Africa. During the pandemic, adding to the HIV death burden. An analysis on HIV treatment forecasted that a disruption in treatment as a result of the pandemic could lead to an additional 500,000 HIV deaths in Africa.

In 2020, access to healthcare services declined significantly not only in Africa but throughout the world as a result of the pandemic. This is because people were afraid of contracting Covid-19 from their visits to hospitals. Other factors such as patients’ inability to reach healthcare facilities due to lockdown measures, disruptions in public transportation, and stay-at-home orders also played a part.

Africa’s healthcare system over the years has faced multiple challenges be it lack of funds, poor infrastructure, inadequate healthcare workforce, or its high burden of disease. The pandemic has only made matters worse by adding to the existing double burden of communicable and non-communicable diseases. Other factors contributing to this are the higher poverty rate in African countries and poor health literacy.

Like many other regions across the globe, Africa too saw an aggressive second wave. Far more cases were registered by the end of 2020 as compared to the first wave. One of the long-term impacts of Covid-19 will be that the gains made when it comes to increasing child mortality and poverty in Africa 2025 and 2030 will be lost.

Hospitals and healthcare facilities across are facing financial challenges as a result of the Covid-19 pandemic. This is attributed to unexpected changes in demand for health services. Due to the pandemic, many people have stopped visiting hospitals and many surgeries have been postponed. Significant declines in demand for routine services have impacted revenue. Also, the virus has increased demand for specialised acute care that has imposed unexpected or have taken a financial toll on the healthcare service providers.

Covid-19’s impact goes beyond healthcare
Women and children across the globe have been affected by the pandemic, especially in the African continent. It is estimated that Covid-19 has pushed around 150 million people around the world into poverty. African nations such as Kenya and Nigeria have been also impacted. The lockdowns and stay-home orders issued to curb the spread of the virus has had implications on food security.

In Africa, many children are provided with food in their respective schools. Such programmes are designed to provide children from marginalised communities with nutrition. The closure of schools due to the pandemic has impacted these children’s nutrition. The pandemic has also impacted many daily wage earners, thus leading to the loss of human capital. The pandemic has also affected the mental health of many Africans, be it a daily wage earner, a mother, or a healthcare worker.

Many cases of healthcare workers, Covid-19 patients, youth, or even the elderly suffering anxiety and depression have been recorded. It has become of utmost importance to integrate mental health education and counselling with psychosocial support during these testing times. A survey by WHO revealed that the Covid-19 pandemic has disrupted or halted critical mental health services in 93 percent of countries worldwide while the demand for mental health is increasing. “The survey of 130 countries provides the first global data showing the devastating impact of Covid-19 on access to mental health services and underscores the urgent need for increased funding,” the World Health Organisation said.

In many African nations, the indirect health effects of Covid-19 showed disruptions in essential health services. Even though the pandemic has negatively impacted the healthcare sector like the economy across the globe, it also presents an opportunity to reshape healthcare systems. The pandemic highlighted the shortcomings of the African healthcare system. Now, the government in these African nations can plan accordingly and direct funds to bolster their respective healthcare systems.

“Doctors’ associations across the world have also initiated talks with authorities to make their work environment safe from infections and to better protect health care providers outside the hospital. Through its Health Care in Danger initiative, the International Committee of the Red Cross published a checklist for a safer Covid-19 response addressed to managers of healthcare services, individual practitioners and health policymakers. WHO and partners are also conducting communication and outreach campaigns at country-level to support governments in addressing attacks on health care,” the WHO said.

Vaccination in Africa
The Covid-19 vaccination drive has been slow in Africa since it began on March 1st,2021. According to WHO, just five African countries, less than 10 percent of Africa’s 54 nations, are projected to hit the year-end target of fully vaccinating 40 percent of their population. African nations struggled to get their hands on vaccines initially, but the situation slightly improved since September as vaccine production was ramped up everywhere. Wealthier countries or vaccine-making nations pledged to make donations to the COVAX programme or even directly to African nations during the G7 summit held in the month of June in the UK.

WHO said, “This comes as the region grapples to meet the rising demand for essential vaccination commodities, such as syringes. It also said that three African countries- Seychelles, Mauritius and Morocco have already met the goal that was set in May by the World Health Assembly, the world’s highest health policy-setting body. At the current pace just two more countries, Tunisia and Cabo Verde, will also hit the target.

The vaccination rollout has been uneven across Africa because of the unsteady supply of vaccines and financial crunch. Most of the African nations are relying on the COVAX programme by WHO and on donations and bilateral deals. According to a World Bank report published in early October, “Of the 6.4 billion vaccine doses administered globally, only 2.5 percent have been administered in Africa – even though the continent accounts for a little over 17 percent of the world’s population.”

G20 countries have received 15 times more Covid-19 vaccine doses per capita than countries in sub-Saharan Africa, according to an analysis conducted by science analytics company Airfinity. With most of Africa relying on the COVAX programme, a delay in shipment or a supply chain crisis further adds to Africa’s woes. Another reason for the slow rate of vaccination is vaccine hesitancy or skepticism.

WHO has further revealed that more than 50 nations have missed their target of vaccinating around 10 percent of their population by the end of September. Most are these countries are in fact in Africa. According to WHO, only 4.4 percent of Africa was fully vaccinated in October. Comparatively, nearly 66 percent of the whole population has been fully vaccinated. In the EU, 62 percent of the population has been fully vaccinated and 55 percent of the population in the US.

“The looming threat of a vaccine commodities crisis hangs over the continent. Early next year Covid-19 vaccines will start pouring into Africa, but a scarcity of syringes could paralyze progress. Drastic measures must be taken to boost syringe production, fast. Countless African lives depend on it,” Dr. Matshidiso Moeti said.

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Even prior to the pandemic, the country was a major contributor to healthcare. According to KPMG, the UAE government contributed 66 percent of its total healthcare spending which stood at $15 billion in 2018. In the following year, the government outlays comprised approximately 70 percent of total GCC healthcare expenditure and the UAE government-funded approximately 69 percent of its total healthcare expenditure of $16 billion. According to GCC growth forecasts, contributions from the private sector are expected to grow at a compound annual growth rate (CAGR) of 7.4 percent compared to a CAGR of 4.9 percent for the government sector during the period between 2018 and 2022.

With the pandemic, the dynamics within the sector are dramatically changing. There is a drive to promote private spending in the healthcare sector by encouraging the adoption of public-private partnership (PPP) models. Since the public-private collaboration has worked well for the UAE, it could further drive the growth of the healthcare sector and prove to be a model for other economies, not only in the Middle East but across the world.

Why public-sector cooperation is key?
To ensure that the healthcare sector was sustainable and ready to tackle the problem of Covid-19, an important decision that the administration took was to promote partnerships between private and government healthcare institutions. One of the biggest challenges that the healthcare providers in the UAE needed to address was to test, identify, isolate and treat Covid-19 patients according to their conditions. In the initial days of the pandemic, this required huge manpower, funding and resources. The government in the UAE was quick to recognise this. The UAE has anticipated the need for testing in gigantic numbers and quarantining facilities. This is where public-private cooperation has helped the UAE healthcare sustain itself. Many private hospitals and healthcare firms in the UAE have stepped in. In May, the UAE achieved a milestone for carrying out the highest number of Covid-19 testing per capita in the world.

Working in close collaboration with the government, the private healthcare sector has brought in its expertise and manpower to fight the virus. What resulted was that the public sector joined forces with the private sector, setting up field hospitals for thousands of Covid-19 patients across the UAE, while private organisations have helped in managing those by providing human resources. With the public-private cooperation in the healthcare sector helping the UAE to fight the future, there is anticipation that the collaboration will see new advancements in the region. Many experts predict that such collaboration holds the key to the development and growth of the overall healthcare sector in the UAE.

Richard Stolz, Associate Director, Advisory, KPMG Lower Gulf told International Finance, that there is a drive to promote private spending in the sector by encouraging the adoption of public-private partnership (PPP) models. “One key driver for the promotion of private investments is the increased need to bring in niche healthcare sector skills, for example, cardiology, that are not yet widespread in the UAE,” he said. “From 2018 to 2022, private-sector healthcare spending is forecast to increase at a cumulative annual growth rate (CAGR) of 9.5 percent, compared with the government contribution growth rate of 4.4 percent.

“Growth is mainly supported by the rising emergence and support for PPP, as well as the increasing demand for treatment and hospital beds amongst an ageing population. Further, the privatisation of hospitals and mandatory medical insurance, especially in Dubai and Abu Dhabi, will likely encourage spending and contribute to a more integrated health system.”

To curb the spread of the virus, lockdown measures were introduced in the UAE and had forced citizens to follow social protocols. On the bright side, there was significant growth for digital health. Many healthtech companies rose during the period to fulfil the demand. For example, Meddy is a GCC-based healthcare firm that allows patients to find doctors, hospitals and book appointments with them through its web-based platform. In light of public-private cooperation in healthcare, Meddy’s Chief Executive Officer Haris Aghadi, told International Finance, that he firmly believes that public-private cooperation in healthcare holds the key for the sector’s development.

“I believe that the pandemic put us in such a situation that we had to come together as a nation to combat it. The healthcare sector in the UAE has witnessed significant growth over the past few years and for it to grow more, the government’s association is key—whether it is in keeping regulations favourable for the private sector, aiding in the healthcare setup, or diminishing problems as we are currently doing in the case of Covid-19,” Aghadi said. Another important aspect of the healthcare sector in the UAE is that most of the population comprises expats. Around 82 percent of physicians and 96 percent of nurses in the UAE are expatriates. Also, citizens above the age demographic of 50 years merely make up 5 percent of the population. This highlights the importance of grooming homegrown talents for the healthcare sector and it can be effectively achieved through public-private cooperation.

Tech innovation improves patient outcomes
KPMG, in its ‘Who cares, wins, the first edition of our UAE healthcare perspectives report’ said that digital innovation is a growing priority. In the present day, a rising number of technologies are disrupting the healthcare information technology (HIT) space and at a very rapid pace. On a global level, administrations are understanding the important aspects of HIT. Additional funds in the form of administration and private investors are being poured into developing technologies that deliver faster, cheaper and more accessible care—while keeping patients well informed. In the UAE, the government is leveraging healthtech and smart healthcare to promote an integrated experience and improve patient outcomes. In particular, the local government seeks to tackle lifestyle diseases putting the country’s healthcare system under pressure.

According to KPMG, the UAE accounts for approximately 26 percent of the total healthcare spend in the GCC. It is ranked among the top 20 countries in the world in healthcare spending per capita, at $1,200. In short, the UAE’s health regulators are increasingly considering the adoption of new smart technologies. A study published by PwC last year shows that 67 percent of consumers in the Middle East are willing to receive healthcare services through virtual means. Some of the UAE’s health regulators are increasingly considering the adoption of new, smart technologies to modernise the healthcare ecosystem. The country is predicted to add an additional $182 billion to its economy by 2035 on the back of accelerated artificial intelligent adoption, further contributing to its vision of becoming a leading, global technology hub for healthcare.

Stolz said, “New models of care are likely to emerge, for example, greater digitalisation with a focus on remote monitoring and consultation. Telehealth, the use of communication technologies to access healthcare remotely, is likely to be integrated into PPP models and government healthcare systems. We will see increased spending on healthcare R&D and innovation.” According to KPMG, the UAE government plans to prioritise fostering the development of future technologies. Regulatory authorities’ openness toward futuristic technologies and their application in the healthcare industry creates an agile environment.

Telehealth is a big game-changer
Telehealth is a game-changer and it is here to stay. Telehealth eliminates the need to physically visit a doctor’s clinic or the hospital and the pandemic has given this a significant push. To curb the spread of the virus, social distancing measures were introduced by the government and this has resulted in telehealth becoming an important communication and treatment tool during the Covid-19 pandemic.

Telehealth facilitates either a synchronous or asynchronous session between the patient and his doctor. Companies providing such services grew significantly in the last year globally. While many new startups providing telehealth services have sprouted since the beginning of last year, big players have also set up their telehealth platforms to tap into the growing segment.

Richard Stolz believes that digitalisation and telehealth have the potential to revolutionise the healthcare sector. Given the implementation of online collaboration tools and platforms driven by the outbreak of the Covid-19 pandemic, remote monitoring and consultation solutions will likely become predominant in the future healthcare landscape. Stolz said, “The UAE has witnessed multiple private-sector hospital players embark on the telehealth journey throughout 2020 – within a short time of the outbreak of the pandemic, several had set up digital telehealth offerings that were quickly absorbed by the market.”

“Patients can consult specialists from the comfort of their homes and offices, get e-prescriptions and sick leaves on their phones, and their medicines re-filled and delivered by the pharmacy to their doorstep,” Aghadi explained. “Telehealth has made treatment convenient for both the patient and the doctor, in terms of cost, effort and comfort.”

The UAE’s pronounced efforts in medical tourism
KPMG estimates the global health tourism industry to have generated revenues of approximately $32.5 billion in 2019 at a CAGR rate of 17.9 percent for the period 2013 to 2019. According to the World Tourism Organization (UNWTO), the medical tourism industry is expected to become a $207.9 billion industry by 2027, expanding at a CAGR of 21.1 percent. The growth is attributed to the growing middle-class populations, especially in regions such as Southeast Asia. Their ability to board a flight seeking medical treatment is enhancing medical tourism. Inbound medical tourism in the UAE has grown steadily. Visitors often arrive in the UAE seeking treatments such as surgery, rehabilitation and cosmetic corrections. Dermatology, orthopaedics and ophthalmology are in their prime at this point. According to the latest Medical Tourism Index Ranking, Dubai and Abu Dhabi ranked sixth and eighth for the best global destinations for medical tourism.

What makes the region attractive for medical tourism is its wider tourism ecosystem. The UAE has a strong tourism sector supported by its tourism attractions, hospitality, entertainment and the provision of world-class aviation and transport logistics. These factors, along with low cost contribute to the UAE’s growing medical tourism industry. KPMG said in its report that the average cost of a hip replacement in developed countries such as the USA and Switzerland is $26,500 and $19,722 respectively; however, when it comes to the UAE, the same procedure costs under $15,000. On the downside, the UAE exhibits higher costs of medical treatments and services compared to countries such as India, Thailand and Singapore, which could push local patients to seek treatments abroad, KPMG said in its report.

Aghadi explained that Dubai is the top Arab destination for medical tourism. It is slowly becoming the hub for offering world-famous treatments with its high-end facilities and medical staff. This in return is boosting the healthcare industry in the region more than ever. “Licenced healthcare professionals are becoming skilled; the entire experience is no less than a vacation with a bonus for travellers as well. And it is important not to forget the economic boost, increase in local employment, and improved tourism activity, with the government’s focus on aiding and improving the healthcare sector in the country,” Aghadi added.

Work models likely to change for greater digitisation
Certainly, healthcare in the UAE remains one of the fastest-growing sectors. This is attributed to the growing number of hospitals and clinics in the country. Aghadi said that in some ways, the pandemic has acted as a catalyst for the healthcare sector in the country. Stating Meddy’s example, he said that within a time frame of two weeks, their team created a HIPAA compliant, which is a telehealth platform that allows patients to access doctors on video calls from anywhere, at any time. “The entire process of consulting the doctor from the payment to the follow-up was shifted online. Similarly, pharmaceutical companies have been in a rush to develop, clinically test, and supply vaccines,” Aghadi further explained. “However, alongside the quick innovation and collaborative problem solving, the virus has left the healthcare industry drained—overworked staff, lesser space, higher costs, and unemployment are just a few of the issues which have arisen during the outbreak. This pandemic has allowed the healthcare sector to always be ready for the future.”

The level of merger and acquisition (M&A) activities not only in the UAE but across six countries of the GCC has increased significantly since last year. Due to the pandemic, many smaller private healthcare providers were hard hit by the lockdown and many of them were mandated to allocate resources to fight against Covid-19. This has to some degrees impacted their liquidity significantly and some were even on the brink of closing their business.

On the other hand, larger private healthcare groups acquiring smaller healthcare players seeking financing aid and support seemed to be a viable option to sustain themselves amid the pandemic. “Increased consolidation through merger and acquisition activity in the global and regional healthcare sectors, as smaller private healthcare groups increasingly face liquidity difficulties caused by the Covid-19 pandemic,” Stolz said, additionally pointing out the phased return of elective surgeries were postponed during the pandemic. Teleradiology and online pharmacy retail are witnessing unprecedented demand. An increasing number of citizens in the UAE are adopting these kinds of new services which were still relatively new to the sector.

The pandemic has also led to greater government focus on healthcare spending, in terms of emphasizing an efficient, robust and dependable healthcare sector for the welfare of its people. As a result, Stolz hopes that policies and decision-making will likely be conducted in a more efficient and coordinated manner. Additionally, the pandemic is anticipated to drive global intergovernmental collaboration. For example, the World Healthcare Organisation and other international and national healthcare authorities will jointly monitor the potential emergence of viruses, Stolz added.

“New models of care are likely to emerge, for example, greater digitalisation with a focus on remote monitoring and consultation. Telehealth, the use of communication technologies to access healthcare remotely, is likely to be integrated into PPP models and government healthcare systems. We will see increased spending on healthcare R&D and innovation,” he added.

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New uses for EHRs 

The underlying aspect is that technological revolutions in healthcare have been constrained until more recently. For example, it wasn’t until 2009 when the Health Information Technology for Economic and Clinical Health Act was enacted for the adoption of EHRs in the US—which then led to significant progression from 13.4 percent in 2008 to more than 90 percent of non-federal acute care hospitals by 2017. Despite the dramatic increase, the timeframe has lagged behind in other countries like the UK where EHRs were established in nearly 100 percent of primary care settings by the mid-2000s. This trend is quite similar to Japan and far more advanced than African countries where considerable barriers remain. 

On the global front, uneven distribution of EHR adoption has worsened the disparities between low-income and high-income countries in regard to rapid technological investments. As intimidating as this observation is, today’s EHRs are used for tasks beyond billing and documentation of patients’ diagnosis. By definition, EHRs can be regarded as one of the key factors to improve individual patient outcomes and supply longitudinal data for public health initiatives. Clinical decision support systems can assist in the fundamentals of patient care such as reminders for vaccinations, identifying patients with communicable diseases and alert physicians on potentially hazardous drug interactions when prescribing. Combined with effective modules that integrate evidence-based clinical guidelines to help direct patient care, EHRs can offer one of the biggest returns on investment for a health system. 

But a more relevant question is: What makes EHRs part of the new data frontier in healthcare? Health systems are starting to monetise the vast amount of patient data in their EHRs for further drug discovery or repurposing and clinical research. This can amount to millions of dollars to hospitals and healthcare organisations from pharmaceuticals to technology companies. In fact, the more robust a hospital or health system’s EHR is, the move valuable it can be—both financially and clinically. 

Connected devices for clinical trials 

The global connected health and wellness devices market is poised to grow exponentially. For example, smartphone adoption has become virtually ubiquitous over the past two decades despite its global location—be it Kentucky, Kenya or South Korea. Data from these devices could be fed into EHRs with the decision to support algorithms to help physicians identify patients who are at risk of complications from procedures or with poor control of their health conditions before the symptoms are clear. The value from EHRs and connected devices takes on significant importance when they are combined. 

More importantly, new applications of connected devices can be found with clinical trials. A significant challenge is that patient enrollment in some trails can falter causing them to stop prematurely and limiting the data from the study. “Digital” clinical trials utilising wearable devices such as smart watches or fitness trackers are offering pharmaceuticals and device companies a way to increase enrollment and run their trials more efficiently—as they can yield essential post-market evidence in realistic patient populations.  

Optimisation: The creation of  SuperDoctor

Radiologists are able to diagnose breast cancer before it becomes obvious on a mammogram or a simple eye scan can identify diabetic retinopathy which can be performed at home using a smartphone determining which family members will suffer from a hereditary disease while their relatives are unscathed.  This is not a futuristic fantasy of the medical world but an emerging reality using data analytics and machine learning to optimise patient care and research. Such examples are the reason behind big data becoming the next frontier in patient care. The more data is available to clinicians and researchers, better AI algorithms can be developed for long-term predictions. 

Data analytics like this are currently expensive, but what we have seen with most technologies is that the cost decreases and the value for money increases over time. To further explain this progression, it is weighed against the benefits of previous disease detection with improved prognosis, lower treatment costs, elimination of low-value care, increased efficiency in drug development and declining costs of technical investments in comprehensive EHRs. In fact, the incredible progress made in genomics should drive this point home. 

Interestingly, for each advancement affecting patient care, new companies are emerging with an intent to invest in advanced technologies and national healthcare policies are favourably changing. It is important to continue the current momentum of scientific and healthcare collaboration across borders to build a truly global healthcare industry where all stakeholders can make smart decisions based on evidence rather than status quo.

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In May, the UAE set up a massive coronavirus testing lab to address the need for population-scale detection and diagnosis. It was in the same month it achieved a milestone for carrying out the highest number of coronavirus testing per capita in the world. “Since the start of the coronavirus pandemic, the UAE has conducted 4,461,205 that have allowed the country to diagnose 56,711 total cases as of July 19. The rate of people who tested positive is just 0.6 percent, which is considerably lower than the global average and one of the lowest total cases-to-tests rates in the world,” Gupta and Das said. The country’s aggressive approach to testing has proved to be an effective strategy in keeping pace with detection of the infection.

Sophisticated research in testing has proved effective
In June, Mediclinic Middle East and King’s College Hospital London—the two of the largest private hospital groups in the country have started to offer the SARS-CoV-2 IgG antibodies test which is used to confirm the presence of antibodies produced by the immune system to fight the coronavirus. In theory, these antibodies are likely to be caused by an infection from the coronavirus resulting in Covid-19 in patients. It is found that this type of test is useful in confirming the diagnosis of infection that did not show major symptoms in patients, or may have shown a negative result on a standard polymerase chain reaction test. The test is reported to have shown 95 percent accuracy in individuals exposed to the infection.

In July, private hospitals in Abu Dhabi announced that they do not have patients detected with the infection anymore. This is impressive considering that the infection is hard to contain and most economies in the world are struggling to bring down the numbers since the beginning of the epidemic. The collective efforts of the UAE government, hospitals and research groups have helped to achieve substantial findings of lowered coronavirus patients. For example, the Mohammed Bin Rashid University developed a groundbreaking analysis of the strain of coronavirus in the country. In another example, the government announced extensive stimulus packages totalling almost Dh126 billion which includes fees waivers, utility subsidies and cancellation of certain fines and penalties.

A unified approach to beat the coronavirus battle
The government’s approach to limit the rising number of coronavirus patients has been well-thought. The first measure was to conduct coronavirus tests at no cost for citizens, domestic workers of UAE citizens, specific categories of residents such as people of determination, pregnant women, aged citizens, and residents who display symptoms of coronavirus or interact with those infected. The second measure was the launch of the drive-through child vaccination programme to inoculate children in vehicles parked outside health centres as part of the National Immunisation Programme. The third measure was implementation of administrative violations and penalties ranging from Dh 3,000 to Dh 1,00,000 for not limiting the spread of the infection. The fourth measure was the introduction of various initiatives such as the coronavirus testing centre, ‘Be Well’ community campaign to protect health and safety of workers and ‘Be the Safety Bridge’ initiative to support physical and psychological health of women among other initiatives. The fifth measure was the grant of a golden resident visa for 10 years to frontline health workers who treat coronavirus patients at the Dubai Health Authority.

This explains the country’s integrated healthcare system. The Covid Central Command Centre is a key facility where all initiatives, programmes and challenges are translated into unified practices and policies. Eyad Al-Musa, Partner, Digital Health at PwC told International Finance, “I think the UAE has made great strides in supporting its frontline staff in recognition of their dedication and commitment to serving patients during the pandemic. For example, Dubai has granted frontline workers the ability to get a 10 year residency visa. There was also a government announcement to provide key sector workers with a bonus scheme for their contribution to the pandemic efforts. Several experiences have also been made to deploy robots to help front-line staff in critical coronavirus areas of the facilities.”

The coronavirus is speeding up technology advancements
Another factor determining the country’s course of action to contain the spread of the infection is its well-planned ehealth strategy which is developed to accelerate digital adoption. The coronavirus is in fact catalysing this strategy which is constantly evolving on the back of advanced technologies and research. “With the attention of the key healthcare services towards the pandemic, this has brought about the urgent need to look for contactless channels to deal with non-Covid-19 patients needing emergency treatment. The acceleration of the digital adoption has been noticed in both private and public sector providers,” Eyad Al-Musa said. “This is clearly manifesting itself in an uptake in virtual care solutions. While lots of digital healthcare solutions have been started, the pandemic has made these solutions more prominent and more important.”

A holistic approach to virtual medicine is on the horizon. A study published by PwC showed that 67 percent of consumers are willing to receive healthcare services through virtual means in the Middle East. “The more we can bring the healthcare services much closer to the patient’s own environment and setting, the more we are going to succeed at getting better results and better support for our patients.,” Eyad Al-Musa said. In March, the UAE Ministry of Health collaborated with Du, a leading telecom company for setting up the first virtual hospital in the Middle East. While this new set up is aimed at providing remote care to patients it also helps to contain the spread of the infection.

“The UAE has been no exception to the trends happening around the world in terms of acceleration of adoption of the virtual care solutions. Anything ranging from using video consultation to remote patient monitoring at home are becoming the norm in terms of healthcare provision,” Eyad Al-Musa explained. “Several key procedures have been introduced to safeguard the safety of both public, patients and key staff to avoid any unnecessary risk being taken under the current circumstances. We believe that the trend is going to keep the same level of acceleration during and beyond Covid-19. Anyway Covid-19 has been the catalyst and the driver for the acceleration in Digital Health Services.”

ehospitals curb infection spread and win profits
In fact, all leading public and private hospitals have established virtual clinics such as Aster DM’s Virtual Outpatient Department and TruDoc 24×7’s Health & Wellness Virtual Clinic—demonstrating examples of how ehealth is becoming a popular trend in the country. One proof that ehospitals have become so versatile is because highly recognised hospitals like Mulk Healthcare has launched its first ehospital through an app to provide global healthcare services with the assistance of medical experts from the US, the UK, Thailand, Pakistan, Europe, India and other GCC nations. Even the UAE Ministry of Health Prevention upgraded all its hospital’s outpatients clinics to virtual.

“Till May, virtual clinics of the Ministry of Health Prevention provided services to more than 15,000 patients,” Gupta and Das said. The popularity of ehospitals can be attributed to its vision in supporting the greater objective of the country—which is to improve the “accessibility of healthcare services in rural and remote areas, decrease healthcare costs, reduce the burden on healthcare systems, provide preventive care and catapult digital transformation by embracing new technologies in such setups.” Today, the concept of virtual hospitals have become even more important than ever in the country because the increasing need of ICU beds has put a lot of pressure on hospitals to expand capacity with Covid and non-Covid patients in critical conditions. “With the shortage of bedside staff and intensivists, the need to look at solutions such as Tele-ICU is becoming more important. Such solutions deployed in a central hub model can provide resources where they are needed and increase the coverage of ICU beds,” Eyad Al-Musa said.

According to Gupta and Das, some of the smart solutions deployed to fight the coronavirus are laser-based DPI technology for test, smartwatch to monitor self-isolating patients, AI in taxis to contain the infection spread, StayHome app for self-quarantining individuals and Virtual Doctor for Covid-19 which “allows people to assess whether their symptoms could be associated with the novel coronavirus.” It seems that a myriad of solutions are designed to virtualise healthcare in the country’s private and public sectors. For individuals, all the resources are instantly available in their own environment with an “ability to monitor them 24/7 remotely from a central location resembling a command and control system.” This model is still in the experimental stage. Although “early indications are showing positive results, we are far from this model becoming the norm,” Eyad Al-Musa concluded.

The post How the UAE is managing the coronavirus appeared first on International Finance.

The funding round for Gero was led by venture capital firm Bulba Ventures.

Other existing investors of Gero also participated in its funding round.

The deal will see co-founder of Bulba Ventures Yury Melnichek joined Gero’s Board of Directors.

Gero’s founder Peter Fedichev said in the statement, “We are happy with the recognition and support from these strategic investors who themselves are acknowledged leaders in the fields of AI and biotechnology. This will help us attain the necessary knowledge at the junction of biological sciences and AI/ML technologies that is necessary for the radical acceleration of drug discovery.”

“We hope that the technology will soon lead to a meaningful healthspan extension and quality of life improvement,” he added.

The Singapore-based startup, which develops new drugs to combat aging and other disorders, has raised around $7.5 million in funding so far.

According to Gero, it will use the latest funds to further develop its AI platform for analysing clinical and genetic data to find treatments for “complicated” diseases, such as age-related chronic illnesses, mental illnesses and others.

Last month, Singapore-based healthtech startup Plano announced a strategic alliance with Japan’s Santen Pharmaceuticals, to tackle myopia.

Myopia is one of the most common health problems in the world, affecting an estimated 2 billion people, or about 28 percent of the world’s population. The number of people with myopia is expected to increase to 5 billion by the year 2050, which is about half of the world’s population.

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According to Deloitte, rapid increase in healthtech investments and innovators leveraging artificial intelligence, machine learning and the Internet of Things to enable products and solutions was evident in the last two years. While the country has been embracing digital change in healthcare, the Covid-19 pandemic is expected to give the industry a timely boost.
The pandemic has accelerated digital transformation as startups offering remote monitoring and telehealth platforms are seeing substantial increase in businesses. Also, a notable trend is observed in the use of AI-enabled assessment apps and devices.

Egypt-based startups Chefaa, Vezeeta and D-Kimia are among the leading healthtech startups revolutionising the industry on various levels. It is clear that rapid advancements in digitisation are changing every aspect of our lives, with technology innovations such as blockchain, Internet of things and artificial intelligence being applied in almost all sectors to improve efficiency—and healthcare is no exception.

The global digital healthcare market was valued at around $147 billion in 2019. A Global Digital Health Outlook 2020 report published by Frost & Sullivan noted that the sector will be valued at around $234.5 billion in 2023.

Healthtech startups wrestle Covid-19 spread
The healthcare sector started leveraging digitisation at the beginning of the decade. After a number of US-based startups raised funding, the trend was soon followed by other emerging markets across the globe. The fact that digital disruption was first seen in other sectors such as finance, logistics and education has helped the industry to leverage technology easily. Over the years, we have also seen numerous digital innovations which have helped save lives or make life easier for millions affected by at least one medical condition globally.
Healthtech is playing a prominent role in fighting against the disease and curbing its spread globally. It is reported that the pandemic has posed to become one of the greatest healthcare challenges in the world.

Established in 2017, Chefaa, an Egypt-based healthtech startup manages chronic patient’s monthly prescriptions and all pharmacy needs with the use of AI and GPS technology. Its cutting-edge technologies are managed by a domain expert team.

“We have witnessed an increase by 300 percent, driven by chronic patients needing to secure their monthly prescriptions amid the lockdown especially that chronic patients are among the risk groups for Covid-19. Since chronic patients are among the risk groups, it was very important to help them secure their prescriptions regularly and sustainably and avoid unnecessary exposure; pharmacies are excluded from lockdown,” Dr. Rasha Rady, co-founder and chief operating officer at Chefaa, told International Finance. “Our 24/7 chat support is managed by licensed pharmacists who help assure and serve patients, answering their questions in light of the published instructions by the Egyptian Ministry of Health (MOH). Also, they would answer patients’ questions and give relevant pharmaceutical consultations. Our Arabic speaking pharmaceutical blog educates the public about sound protective measures as well as sound use of medicine.”

Vezeeta, another leading healthtech company operating in Egypt as well as the Middle East has launched a free medical consultation service for anyone experiencing flu-like symptoms. Such services are being offered by the startup without any charges.

Driving force behind Egypt’s healthcare digitisation
The Egyptian government is pushing for universal healthcare and cross-industry partnerships. With that, digitised hospitals are emphasising on connectivity and hardware and software developments related to big data, machine learning, artificial intelligence and the Internet of Things—a pathway for innovators in healthcare worldwide.

In comparison, Egypt’s approach to healthcare is quite similar to other African countries. For example, in Africa, different startups are using artificial intelligence to diagnose diseases, provide treatment recommendations and data management solutions to its users.

Likewise, advancements in heathtech in Egypt are driven by artificial intelligence. An article published in the MIT Technology Review pointed out that artificial intelligence has the potential to save cost by taking over diagnostics procedures previously carried out by health workers. However, with the integration of artificial intelligence hospitals will be able to better utilise the resources.

According to a PwC report titled The Potential Impact of AI in the Middle East, Egypt is aiming to have 7.7 percent of its GDP derived through artificial intelligence by 2030. The Egyptian government is driving digitisation in the country across sectors.

More recently, it developed a national AI strategy to integrate artificial intelligence in different sectors such as healthcare, education, smart cities, infrastructure and transport among others.

Telehealth is fostering healthcare in rural Egypt
Especially during uncertain times like now social distancing has become pivotal in the fight against Covid-19. Against this background, telehealth is proving to be a useful tool to ensure healthcare is provided to all Egyptians. It has the potential to reach those who are deprived from proper healthcare in rural Egypt—meaning that it can establish convenience and allow healthcare workers to have a wider reach to a greater population compared to conventional methods. In short, telehealth and telemedicine have seen a substantial rise in Egypt since the country entered into a state of lockdown to curb the spread of the disease.

In a country as vast as Egypt, huge amounts of medical data are being generated every day in hospitals, healthcare units, pharmacies and labs, in addition to some data generated by healthcare consumers. But the common problem lies in making sufficient use of the data available.

Every time a patient seeks services from a healthcare worker, new data is created. For that reason, integrating cloud-based data systems, data such as medical history, diagnoses, treatments and past appointments could be stored digitally and made available when patients or doctors require it in real-time. The main purpose of these innovators are to lower costs and improve access to healthcare.

Egypt records a population of nearly 98 million people. Investments are being made in healthtech over the years to reduce the cost curve and bring the Egyptian population under the healthcare umbrella.

Outlook for Egyptian healthcare system
The outlook for the Egyptian healthcare and healthtech sector is quite positive. The pandemic is only expected to increase investments into the sector. While most of the funding is seen from foreign investors, the pandemic is expected to catch the attention of local investors.
Experts believe that the healthcare sector will go through a major disruption in the next two decades. Dr. Rady explained that “The healthtech sector in Egypt is expected to grow significantly. Covid-19 crisis may have driven the change toward a new normal, but all healthcare stakeholders will seek more online presence like reaching out to patients through technology, while patients on the other hand are learning to deal with the ‘new normal’ by trying out different services which makes healthcare quality management, patient safety and cost-effectiveness the key differentiating criterion.”

In her view, “Moving toward the digital transformation era of healthcare in Egypt is inevitable as Covid-19 has made it quite clear. The pandemic has driven people who previously never thought of online being safe or even a reliable tool to offer services in the healthcare sector, to start exploring it, discussing the pros and cons and perhaps even trying it. I expect significant growth in the sector with the key differentiating criterion.”

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Besides including a coronavirus health assessment tool and clinical decision support software, the package launched by Illara Health contains a self-assessment chatbot and a clinic-based triage tool for symptom checking.

Emilian Popa, chief executive officer and co-founder of Ilara Health told the media, “Our Ilara Health COVID-19 readiness package is focused on protecting and preparing the small clinics we work with in usually forgotten areas, such as the peri-urban communities. Our accessible point of care systems can identify those patients with underlying conditions who are most susceptible to serious COVID-19 complications and can play a crucial role in patient triage at the primary care level.”

The package launched by Illara Health is designed to help small health facilities tackle the coronavirus pandemic with a better point of care diagnostic equipment and tools for improved clinical decision support and guidelines for self-care.

Another Kenya-based healthtech startup Afya Rekod has launched its artificial intelligence (AI) and blockchain-based health data platform to help fight the spread of the novel coronavirus. The platform will help people across the globe to store their health data in real-time.

According to John Kamara, founder and chief executive officer at Afya Rekod, its platform enables the storage of medical data in real-time which will help authorities monitor areas where the cases of novel coronavirus have been growing and act accordingly.

So far, Kenya has officially recorded around 184 cases. Two people have died in the country due to the coronavirus, as of April 9, 2020.

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Public-private collaboration and coordination is key to the UAE achieving its strategic smart healthcare goals. Helping the government in the delivery of integrated healthcare delivery are a group of healthtech companies that are trying to leverage the latest technologies including artificial intelligence and machine learning in integrated healthcare delivery. Today, the UAE is in the early stages of extracting value from telemedicine, blockchain, artificial intelligence, cloud technology and mobile technology to bolster integrated healthcare delivery.

Currently, the UAE accounts for 26 percent of the total healthcare spend by the GCC — and is ranked among the top 20 countries in the world in healthcare spending with $1,200 per capita spend on healthcare.

“The UAE’s health regulators increasingly consider the adoption of new smart technologies to modernise its healthcare ecosystem,” says Richard Stolz, Associate Director – Global Strategy Group, KPMG Lower Gulf in an interview with International Finance. The country is predicted to add an additional $182 billion to its economy by 2035 on the back of accelerated AI adoption, further adding to its goal of becoming a local medical tourism hub.

Tackling the lifestyle disease epidemic

The incidence of chronic and lifestyle diseases are reaching epidemic levels in the Middle East and the UAE is not different. The UAE Artificial Intelligence Strategy 2031 is particularly focused on the use of AI tools to reduce chronic diseases in addition to developing algorithms to reduce the processing time for x-ray scans.

Health experts have warned about a surge in lifestyle diseases in the UAE. According to the 360 Well-being Survey conducted by Cigna Corporation last year, heart disease and high blood pressure are set to increase in the country. The study showed that nearly 30 percent of the population suffers from heart disease, while 32 percent of them have high blood pressure attributed to stress. For that reason, 28 percent of respondents use wearable technology for heart health and 43 percent said that their companies have set up workplace wellness programmes

In fact, the Dubai Health Authority has carried out many AI-driven proofs of concepts and the results have been impressive. For example, the DHA-operated Dubai Diabetes Centre conducted a proof of concept project using AI to detect diabetic retinopathy. The project was run in cooperation with a healthtech startup Artelus. It appears that the system requires only 10 minutes to detect diabetic retinopathy from the time of patient test until physician’s review of the test results, as opposed to four working days.

According to international diabetes treatment standards, 14 retinal images are required per diabetic — and there are more than 1 million diabetics in the country. By numbers, it needs more than 50 eye specialists working full-time to interpret 14 million images per year. But it is possible to accurately identify diabetic retinopathy and other ophthalmology-related issues with the help of a deep learning system (DLS) using AI.

For that reason, the DHA launched its Innovation and Artificial Intelligence strategy which seeks to use AI and robotics to automate the healthcare process. This strategy will be the cornerstone of all DHA’s projects, initiatives and development programmes. The emirate is also testing neuro bands to detect strokes and flow cell sensors which are designed to alert sudden drops in vitals of critical patients.

The implementation and outcomes of these transformational technologies is anticipated to impact thousands of people in the country creating a more sophisticated healthcare system — which is in line with the UAE Vision 2021.

Innovation jointly driven by public and private sectors

While local governments in the UAE are interested in piloting niche smart healthcare technologies as soon as they become popular in the developed world, the private sector, especially healthtech companies provide the key technology components and inputs to make integrated healthcare delivery a reality.

Last year, Smart Dubai launched a new AI system in collaboration with the Dubai Health Authority and IBM. The system allows physicians to predict patients’ conditions by tracking blood pressure, temperature and the pulse among other vital signs. A pilot project was carried out on thousands of patients across Rashid Hospital, Latifa Hospital, Dubai Hospital, and Hatta Hospital.

The AI system was found to have enhanced precision. It was trained to process those patients’ data and offer a comprehensive reading of their medical conditions. As part of the process, the data was fed into the system and then, it predicted the patient’s medical progress and suggested necessary precautions.
The trial showed that the system detected patients’ deteriorating health conditions anywhere between an hour to 20 hours in advance — with 90 percent to 98 percent accuracy. The AI system demonstrated advanced capabilities of determining the exact moment when a patient’s health condition is likely to deteriorate from the time of exiting the intensive care unit.

The Dubai Health Authority, the four hospitals, and most importantly the patients are set to benefit from this sophisticated AI system. First, its high potential to save patient lives by extracting data for pre-emptive detection of critical conditions is vital to medical care and patient care. Second, hospitals will be able to efficiently manage human resources, while enhancing the performance of medical teams. The data generated from the AI system is proved to offer profound insights into patients’ conditions which are usually produced from years of experience in the medical field.

Healthcare robots are a revolution. In fact, the Ministry of Health and Prevention launched a robotic surgeries programme which is specialised in gynaecology and obstetrics. The programme is the first of its kind in the UAE fostering scientific innovation in healthcare delivery.

Because technological assistance in surgeries is vital, significant efforts have been made by both public and private sectors to introduce the latest robotics. Their enhanced visualisation and high degree of dexterity are anticipated to help surgeons conduct surgeries accurately.

Rashid Hospital in collaboration with the DHA will start using robotic technology to perform knee replacement surgeries in the future. A specialised team of doctors from Rashid Hospital have undergone training in this field and are expected to use this technology in ortho trauma surgeries. The hospital has already deployed the three-in-one system, otherwise known as O-Arm, which is a 2D or 3D imaging system designed to suit surgical requirements. It is proven that the system enhances patient care during hospitalisation and post-surgical hospital stay, resulting in faster recovery, minimum incisions, reduced pain and blood loss, lower need for blood transfusion and reduces basic scarring.

The DHA also emphasises the importance of 3D printing technology. Early this year, it opened a 3D Printing Lab at its Innovation Centre to assist medical professionals with patient-specific anatomical models. In turn, these models will support extensive preoperative analysis and improve patient communication across all DHA hospitals.

Healthtech startups drive integrated healthcare

Healthtech startups in the UAE play a key role in bringing the delivery of integrated healthcare closer to patients while optimising costs. Specialised in telemedicine services, UAE healthtech startup Health at Hand has developed its own proprietary apps that allow patients and doctors to connect through videos.
In an interview with International Finance, Dubai-based telehealth startup Health at Hand CEO Charlie Barlow points out that queuing algorithms will take patients into a virtual meeting room while doctors examine their medical notes. After the consultation comes to a close, the patients will receive their diagnosis report and a prescription if required, which can be delivered to their location in Dubai within an hour.
For both payers and insurers, Health at Hand alleviates the need for unnecessary consultation visits and associated tests. “Being able to offer sick-notes, eprescriptions, ereferrals and laboratory tests through our apps has set us apart from our competitors. We have our own built-in Electronic Medical Record system to geolocate patients before offering drug delivery. This is what has led us to become one of the most sophisticated telehealth platforms in the MENA market,” Barlow explains.

The UAE government has realised the need to support telehealth initiatives. “The UAE’s major health regulators are progressively developing an understanding of the value proposition telehealth solutions present and how they can be implemented most effectively throughout the UAE,” KPMG’s Stolz tells International Finance.

The changes healthtech startups bring in the UAE are transforming the delivery of primary healthcare with a more integrated approach of healthcare delivery while closing loopholes for ethical malfeasance. “We intend to stop corruption that is inherent in healthcare systems including the overprescribing of medicine,” Barlow says. “As an independent company we have no vested interest in over-treating patients. We store patient data with the highest level of security as per the DHA guidelines.”

Other startups are using AI-based models to create unified and intergrated platforms of healthcare delivery. For example, Dubai-based healthtech startup HeyDoc! is building a unified and integrated healthcare platform that uses AI to help with detection and triage which is also integrated with wearable devices. “This will help to understand the problem by continuously learning about patients’ health and proactively monitoring them,” says CEO and co-founder Ahmad Al-Hidiq tells International Finance.

HeyDoc! is also democratising healthcare by increasing medical accessibility to patients despite their circumstances. “We have launched an initiative called Salamtak! that aims to provide people in refugee camps, developing countries and rural areas with free healthcare advice through our partner NGOs and government entities powered by an open source version of HeyDoc!,” Ahmad Al-Hidiq explains.

Dubai’s smart healthcare model and its subsequent effects

Four years ago, Dubai launched the Dubai Health Strategy 2021 with four approaches, six objectives, 15 programmes and 93 initiatives. The profound effect of this strategy is that it is delivering the highest quality of medical care for chronic diseases, promoting early detection and raising awareness in the country.
The effort began in 2013, when the DHA launched the Dubai Smart Healthcare Model to implement applications and advanced technology such as telemedicine in hospitals. “Since 2017 there have now been two updates to the DHA telehealth regulations and we have attended numerous roundtable discussions to help modernise the offering around telehealth,” Barlow tells International Finance.

It is apparent that Dubai’s healthcare policy makers pursue a proactive agenda to seek collaboration with private sector participants through public private partnership models, adds Stolz of KPMG. The Smart Healthcare Model also offers guidelines to help healthcare providers to become more automated. Many hospitals in the UAE are embracing this model.

In fact, it was reported that Dr. Sulaiman Habib Hospital in Dubai Healthcare City (DHCC) has started electronic collection and storage of patients’ biometric data. Also, the hospital’s pilot project used Google Glass to communicate with doctors in the field.

This model helps hospitals to benefit from a prototype SmartDesk application using touchscreen technology. The first facet of the model allows patients to check-in using an ID card, while doctors can fully access patients’ profile and history. The idea is to not only enhance customer experience but also deliver sophisticated healthcare services. The second facet constitutes smart apps with customer-centric features, while the third facet focuses on smart operations including use of advanced technologies to boost efficiency and facilitate internal operations.

The demand for smart healthcare services is only seen rising in Dubai where the population reached 3.35 million last year — and is expected to reach between 4.96 million to 5.73 million by 2030.

Public-private collaboration key to UAE’s smart healthcare future

The private sector has a key role to play in meeting the demands of smart healthcare in the UAE as elsewhere in the Middle East. Meeting the demands of integrated healthcare for the population depends upon close collaboration between the government and the private sector. “It is of utmost importance to have “continuous collaboration between government policy makers and the private health sector to develop and implement advancements in healthcare technology in the UAE,” Stolz tells International Finance.

However, healthtech startups in the UAE might, however, face challenges in scaling up because of challenges in the healthcare and entrepreneurial ecosystem. According to Ahmad Al Hidiq, funding opportunities are sufficient in healthcare services and facilitations such as portals and booking platforms. However, they are inadequate when it comes to innovations around triage, patient records, wearable devices, vital analytics and other innovative technologies. This gap can be bridged if “investments and partnerships with hospital groups and research centres that closely work with governments and established investors open the door for entrepreneurs who are looking to solve key healthcare challenges,” he says.

Barlow also shares a similar view on healthcare investment, emphasising that there is lack of sophistication across the GCC region in terms of venture capital and private equity. “But if you have a strong value proposition and a path to scale outside the UAE, the opportunities for capital are greatly increased,” he adds.
That said, UAE healthcare is still young and has the potential to lead to interesting opportunities for healthtech investors. In this regard, KPMG’s Stolz told International Finance, “Certain first movers in the UAE’s healthcare technology might enjoy greater influence with regard to healthcare policy specific to their technologies.”

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