Healthcare World Magazine | Issue Three by TheTradeAgency

L E A D I N G T H E D E BAT E I N I N T E R NAT I O NA L H E A LT H CA R E & L I F E S C I E N C E S

Issue Three | Spring 2022

Welcome back to Arab Health

Overcoming workforce challenges

The inexorable rise of digital healthtech

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Dubai: A Destination for Health Investment

Contact:

Dr. Ibtesam AlBastaki, Director | +971 4 219 7644 | IIALBastaki@dha.gov.ae Ahmed Faiyaz Sait, Advisor | +971 4 219 7695 | afsait@dha.gov.ae Investments and PPPs Department

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EDITOR’S WELCOME

Welcome to Healthcare World

Printed by Atlas Group, Dubai - www.atlasgroupme.com

elcome to another edition of Healthcare World Magazine. We’re delighted to be back at Arab Health – I think it’s safe to say everyone has missed the buzz of this amazing conference. It’s always a pleasure to be back in Dubai and we are looking forward to meeting as many experts, innovators, businesses and consultants as possible. Hopefully, we can now say it looks as if science is beginning to get to grips with the sudden appearance of COVID-19, and we’re coming to terms with the fact that there’s a global division between the ‘have-vaxxes’ and the have-nots. While we can accept it’s a little like the aircraft safety instructions – make sure you have put on your own lifejacket before you help others – we need to step up to the reality of the situation. And in many ways, we have. The plethora of digital innovation and its uptake is on a scale previously inconceivable. In a fascinating article for Healthcare World, Iqvia’s Alistair Grenfell examines how the pandemic has changed the face of healthcare for the good. Healthcare and data will finally be united, underpinned by technology, but public and private bodies will need to communicate effectively to maximise the benefits of digital advancements. Methods Analytics examines whether it will be possible to bring the best solutions together in one system, while SMEs and innovators outline their solutions to issues such as streamlining hospital processes, price benchmarking and hospitals at home. There is a willingness to examine concepts that would have been dismissed as fantasy just two years ago, but our experiences and our vision have widened. And maybe it’s not an exaggeration to say we are entering a new era in healthcare. Consultant and former Medicaid Director for New York State Jason Helgerson is a luminary in healthcare

Sarah Cartledge Group Editor solutions. In a fascinating feature for the magazine he outlines his belief that healthcare is going “Back to the Future”, as it bases itself in the home again with the help of digital technology. All these new digital solutions can be adopted in any country or jurisdiction. Here at Arab Health there are many people who can help innovative companies expand into new markets. In particular, the Department of International Trade at the British Embassy can provide expertise in entering the UAE and navigating its regulatory and legal requirements. Mazin Gadir, government health adviser and Director of Partnerships and Strategic Alliances at Iqvia also offers guidance in his article on the UAE market, while Ernesto Chanona at CSSI Life Sciences proffers sound advice for entering the US market. The economic impact of the pandemic and the restrictions on travel have added to the global workforce scarcity. James Campbell, Director for Health Workforce at the WHO looks at the reality of the situation and how governments can use new initiatives and technology to overcome the current difficulties. We’re also looking at the need for global clinical standards that can bring together all the learnings and enhance medical care for the whole global population. The Healthcare World Standard will be the first truly global standard, beginning with Primary Care, so do read our fascinating articles on the subject and join us on our journey. By achieving these standards, we could be well on the way to achieving Universal Health Coverage (UHC), giving all citizens equal opportunity to the best solutions and practices in healthcare today. In our next issue we’ll be reporting on this year’s Arab Health and looking forward to more innovation and expertise, so please contact me at sarah@thetradeagency.co.uk if you would like to comment or write an article for the magazine.

The Healthcare World team

Steve Gardner

Sarah Cartledge

Emma Sheldon MBE

Joe Everley

Emma Williams

Fabian SutchDaggett

Ritu Chopra

Managing Director

Group Editor

CCO & Head of Consultancy

Art Director

Operations Manager

Features Editor

Business Development Manager

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Contents 3 8

10 16

Editor’s Welcome Entering the UAE health sector

The UK and the UAE have a long-standing tradition of partnership and enterprise, says Simon Penney, British Consul General for Dubai & Northern Emirates and UK Trade Commissioner for the Middle East

News

The latest in healthcare from around the world

The astonishing speed of pandemic healthcare innovation

Back to the future?

The healthcare industry has met the pandemic challenge and changed the face of healthcare for the future, says Alistair Grenfell, President, EMEA, IQVIA

Healthcare World Magazine | Issue Three

Jason Helgerson, Founder and CEO of Helgerson Solutions, believes the pandemic will ultimately prove a catalyst for home healthcare

The urgent need for vaccine parity

As the Omicron variant spreads across the world, Dr Nicholas Crisp, Acting Director-General of South Africa Ministry of Health, speaks to HW Editor Sarah Cartledge about the importance of assisting other countries to help themselves

Transforming Healthcare from the ground up

Any pandemic or health challenge cannot be fought without education, says Professor Ramneek Ahluwalia CEO of HIGHER HEALTH in South Africa

Streamlining hospital processes

Hospitals need all the help they can get to manage patients successfully, says Elliott Engers, CEO of Infinity Health

Building a healthy future

Putting health at the heart of infrastructure is key to building a healthy future, says Richard Cantlay, Mott MacDonald Global Health Portfolio Leader

Why digital health interventions fail

Healthcare World’s Data Correspondent Simon Swift speaks to Dr Steve Hajioff about the shortcomings of digital health innovations, and how their failures can be corrected

Bringing medical expertise to the patient

Award-winning health platform Altibbi is bringing its telehealth service to North Africa

Funding vaccine research at Oxford University

A £50 million donation will create a new centre for the world-class Jenner Institute, says Healthcare World Editor Sarah Cartledge

The need for standardising healthcare recruitment in the digital age

Jim Campbell, Director of Health Workforce at the World Health Organization, speaks to Sarah Cartledge about the need for an international healthcare workforce register in the current climate

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CONTENTS

34 44

Overcoming workforce challenges

The UK-KSA collaboration on healthcare is a common approach to quality assurance and competency-based training, says Ian Wheeler, Senior Lead Technical, Collaboration and Consultancy at HEE

Cyber-resilience in the Middle East healthcare sector

Healthcare providers are seeing an increase in cyberattacks, says Russell Mayne, Dell Technologies Healthcare Field Director for Middle East, Russia, Africa, and Turkey

Creating hospitals at home

Enabling people around the world to live longer and more fulfilling lives through technology is a realistic goal, Huma CEO Dan Vahdat tells Sarah Cartledge

Healthcare Transformation in the UAE

The region is implementing legislation aimed at integrating international standards, says Christina Sochacki, Senior Associate at law firm Al Tamimi & Company

Meeting the unmet need

The key to success in US market entry is picking the right commercial partners, says Ernesto Chanona, Director of Business Development at CSSi Life Sciences

Creating a digitally integrated health system

Healthcare World’s Steve Gardner speaks to Richard Oakley, Neil Mason and Jodi Carter of Methods Analytics about the intricacies of developing and building a fully digitally integrated health system

Integrated care – a new reality?

Meeting consumer expectations in a hybrid health IT landscape

Body language

For Dr Charles Gutteridge, Clinical Engagement Lead at SNOMED CT the safe, accurate and effective exchange of health information is an essential part of the foundation to improve global healthcare

Operating in the shadows

Procurement Spend Analytics is critical to hospitals realising maximum value, Mat Oram CEO of AdviseInc tells Sarah Cartledge

Putting patients at the heart of the system is the way forward, says Carly Caton, Partner at Bevan Brittan LLP

Patients are increasingly expecting a fast, smooth, digitaldriven experience with their healthcare providers that resembles what they can do in other aspects of their lives, says Royston Adamson-Green of NextGate

The International Affiliate Network – a pathway to better patient care

Sarah Cartledge speaks to Alistair Russell, Head of Business Development at Imperial Private Healthcare

Introducing Healthcare World Standards

To understand the quality of our healthcare delivery we must understand the quality of our healthcare outcomes, says Emma Sheldon MBE, Chief Operating Officer, Healthcare World

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64 64

The Healthcare World Primary Care Standards

Right care, right time, right person

The need for a global clinical standard

The Importance of Standards in Healthcare

Developed with Primary Care experts Health Care First and our data partners at Methods Analytics

Features Editor Fabian Sutch-Daggett speaks to Jyoti Mehan CEO of Health Care First Partnership Commercial Lead Dr Patrick Wynn about the need for global clinical standards in order to improve primary care delivery Defining quality is not easy and there is not always consensus on what good quality means, says Alf Theodorou, CEO and Founder of NewCourse

Global standards could significantly improve patient safety, efficiency and effectiveness of healthcare systems, says Josie Winter, Clinical Director at Advanced Clinical Solutions

Making healthy living easy

Connected intelligence

COVID has created the understanding that data is key, Amit Sadana, General Manager Africa, Middle East and South Asia, IQVIA, tells Sarah Cartledge

The UK Midlands Region

Arab Health is the key event for our companies to showcase the best the Midlands and UK has to offer in the sector, Shaz Chaudhary, Deputy Director, UK Government Midlands Region tells Healthcare World

Time to Consult

In today’s healthcare environment, your offer should match the new needs, says Emma Sheldon MBE, COO Healthcare World

Opinionated

Notes from a Pandemic

Digital technology can aid prevention in healthcare but uptake is key, Mona Hayat, CEO and Founder of Nexus Digital Technology tells Sarah Cartledge

Entering the UAE market

Well-researched homework is the key to success, says Mazin Gadir, Government healthcare adviser and Director of Partnerships and Strategic Alliances, Iqvia

The urgent need for healthcare super apps

Emirati entrepreneur Ali Sajwani calls for SMEs and entrepreneurs to develop healthcare super apps to improve health of UAE residents

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Entering the UAE health sector The UK and the UAE have a long-standing tradition of partnership and enterprise, says Simon Penney, British Consul General for Dubai & Northern Emirates and UK Trade Commissioner for the Middle East

ike many people, I am delighted that this year’s Arab Health is taking place. Once again, a great many UK companies will be visiting the exhibition and doing business with one of the most vibrant regions in the world. It is always a pleasure to welcome trade missions and help them make the most of the opportunities that exist here.

As the economy matures, it is becoming more complicated to enter the healthcare market. The UAE is clear about its requirements in the sector, and UK companies should understand that a quick profit is not the name of the game – rather, the UAE is looking for partners that intend to commit for the long term.

Recently, we were delighted to support the signing of two MOUs between the Department of Health in Abu Dhabi, AstraZeneca and GSK. The UK and the UAE share an important trade and investment relationship, with total trade of £18.6bn in 2019, and two-way investment of £13.4bn in 2019, promoting innovation, jobs and economic development in both nations. But this is not solely due to major corporate agreements. The UK’s SMEs are driving innovation and change, particularly in the area of digital health, as a result of Covid-19. Smaller companies can also thrive here, and the the Department of International Trade (DIT) is a rich source of knowledge to help you navigate your way to success.

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EXPORT & TRADE Simon Penney

the UK Pavilion at Expo 2020 Dubai. Make the most of all events and garner as much information as you can. I would emphasise that while people are willing to be helpful, it doesn’t do to waste their time in this environment if you are not export-ready. It’s important that you take local cultural norms into consideration. Here, great emphasis is placed on partnership. Do your research and be aware of any issues that may apply to you – do not underestimate the value of relationships and stakeholder management. Identify your risk appetite, put your funding in place, make regular trips to understand the market, understand the competition, and be clear about your differentiator. That way you will find the ideal partner. How the DIT team can help

Preparing for export The business and regulatory landscape in the UAE provides ease of access for companies looking to enter the market. I would stress it’s highly competitive, and for this reason it’s vital that you are exportready when you approach the DIT team. If you are just looking to explore possibilities, it’s best to start with Healthcare UK at the Department for International Trade for initial guidance as they set up regular live or virtual trade missions which are the best way to explore options and prepare accordingly. Arab Health is an excellent event where you can dip your toe in the water. The DIT is hosting roundtables and seminars, and a reception, which this year will take place at

The DIT healthcare team assesses those UK companies that approach them, and matches them up with UAE requirements. If companies are the right fit, we can send our business guide that goes into further detail, for example how to register medical devices in the UAE. We can also introduce you to distributors or advise on the different options for setting up a company in the region. Recently, we ran a virtual meet-the-buyer event and made more than 20 introductions, which we follow up by guiding companies through the partnership process. We can help companies engaged in innovative pharma and therapeutics, and can also signpost them to our investment colleagues, who can also look at potential investment into companies back in the UK for investors here. We can also point companies to consultants and lawyers in the area who can provide additional advice and support. Investing in the UAE As I said before, don’t come into the market purely trying to sell a product. Instead, focus on solving a problem or creating a solution that will help the country in the long term. A wonderful product is not enough these days. You have to expand that offer and have a wrap around. So what is your investment into the UAE? It doesn’t have to be a monetary investment - it can be time or resources, clinical trials, training and expertise, or knowledge and information. The UAE is keen to work with the right partners to develop this relatively new sector. These elements are all valued by the UAE as it develops its own ambitious

Simon Penney British Consul General for Dubai & Northern Emirates and UK Trade Commissioner for the Middle East

“The UAE is looking for partners that intend to commit for the long term” healthcare and life sciences market. Understanding what that partnership might look like is really important, and putting that offer on the table from the outset will put you head and shoulders above the competition. I’m delighted to say that we have a new team dedicated to SMEs which launched on 3rd of January. The Enhanced International Support Service (EISS) is a completely new programme offering in-house, personalised overseas trade support for UK based SMEs looking to export to any of the 12 markets in the Middle East, Afghanistan and Pakistan (MEAP) region. EISS will facilitate those companies that have high exporting potential by providing market intelligence, access to trade specialists and in-market service providers. The team can provide services around diagnosis, desk-based market research and general market advice. Advisors can also make key introductions and provide directions on further in-market services. For technical or specialist export advice and support services, companies can benefit from working with a partner in our Overseas Referral Network (ORN). As a gateway to the region, the EISS MEAP Hub is based in Dubai with expert trade advisors located across the UAE, Saudi Arabia, Jordan and Qatar. If you are a UK based SME looking to explore opportunities across the MEAP region, the EISS MEAP Hub is the best place to start. Please engage with your local International Trade Advisor or reach out to us via email and one of our regionally based trade advisors will be in touch: ditmeap.enquiries@fcdo.gov.uk With all this in mind, I look forward to Arab Health 2022 and wish everyone a successful event. Contact Information

https://ukhealthcarepavilion.com/events/ arab-health-2022/seminar-programme/

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Fabian Sutch-Daggett

NEWS

Features Editor

Breakthrough COVID-19 vaccine trial in Africa examines vaccine efficacy in people living with HIV The ‘Ubuntu’ study is the first to research the relationship between vaccine efficacy and HIV status A landmark clinical trial in eight subSaharan nations is set to be the first to evaluate the efficacy of mRNA COVID-19 vaccines in people living with HIV, including those with poorly controlled infections. Furthermore, this study will be the first to evaluate the efficacy of vaccines – in this study, the Moderna vaccine – against the Omicron variant. In addition to researching the impact of HIV on vaccine efficacy, the researchers aim to identify optimal treatment and vaccination regimens for the populations studied, and which factors should be considered regarding previous COVID-19 infection. The trial will be conducted in East and Southern Africa – regions of the world that have been highly impacted by HIV. At present, it is expected to enrol more than 14,000 volunteers at 54 different clinical research sites in South Africa, Botswana, Zimbabwe, Eswatini, Malawi, Zambia,

Uganda and Kenya, where adult HIV prevalence ranges from 4.5 per cent to 27 per cent. “Sub-Saharan Africa has been hit hard by the COVID-19 pandemic, but access to effective vaccines, especially mRNA technology, has been very limited,” says Dr Nigel Garrett, co-chair of the study and head of Vaccine and HIV Pathogenesis Research at the Center for the AIDS Program of Research in South Africa (CAPRISA). “The Ubuntu trial will provide safety data to regulators and assess correlates of protection from COVID-19, and it will answer important questions on mRNA vaccine dosage regimens among people living with HIV,” he added. To compare the efficacy and safety of COVID-19 vaccines with regards to HIV status, more than 12,600 people living with HIV and around 1,400 who are HIV-negative will be enrolled. The study aims to recruit 5,000 volunteers who have previously

had Covid-19, confirmed by an antibody blood test performed at initial enrolment. All participants will receive the Moderna vaccine, but dosages and schedules will vary depending on previous COVID-19 infection. Organisers of the study also stated that people living with HIV will receive access to optimal HIV treatment throughout the course of the trial. “This region faces a huge HIV burden,” says Dr Glenda Gray, Ubuntu lead protocol adviser and President of the South African Medical Research Council (SAMRC). “Although safe and effective vaccines have been developed for COVID-19, HIV and COVID-19 are on a collision course,” she adds. “The impact of COVID-19 on people living with HIV is a concern for the continent, particularly in light of the recently-sequenced Omicron variant set to drive South Africa’s fourth wave and further infections globally.” “These communities have been disproportionately impacted by the twin pandemics of HIV and COVID-19, and they now have an unprecedented opportunity to help advance science and improve our understanding of the immune response to SARS-CoV-2 in the context of HIV,” says Dr Philip Kotzé, one of the lead investigators for the study.

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NEWS

Omicron variant of COVID-19 shown to have a higher rate of asymptomatic carriage Studies from South Africa have shown a notable increase in asymptomatic ‘carriage’ than in previous variants

workers who were fully-vaccinated with the Johnson & Johnson vaccine, a single dose form of the COVID-19 vaccine. Compared with previous variants, such as Beta and Delta, the rates of asymptomatic infection rose from just 2.6 per cent to more than 16 per cent. “As we witness the quick, global spread of Omicron , it is clear that we urgently need a better understanding of the transmission dynamics of this variant,” says Dr Lawrence Corey, the senior author of the paper. “Since so many people may be asymptomatic, we can’t always know who is carrying the virus, but we do know what we can do to protect ourselves and to help

prevent further spread: Wear a mask; wash your hands; avoid large, indoor gatherings; and get fully vaccinated as soon as possible,” he added. Dr Glenda Gray, president of the South African Medical Research Council, stressed that the findings are preliminary, but appear to be in line with the bigger picture coming together about Omicron’s high transmissibility. “Some larger studies were designed to analyse data at the intersection of COVID-19, vaccines, and people living with HIV, but they also are giving us useful information about Omicron and how its spread differs from those of previous variants of concern,” she says.

Markers of brain cell damage higher over short term in COVID-19 patients than in Alzheimer’s patients

infection, when patients either recovered and were discharged, or died. A second analysis found that a subset of the damage markers in patients hospitalised with COVID-19 were significantly higher over the short term than in patients diagnosed with Alzheimer’s disease, and in one case more than twice as high. “Our findings suggest that patients hospitalised for COVID-19, and especially in those experiencing neurological symptoms during their acute infection, may have levels of brain injury markers that are as high as, or higher than, those seen in patients with Alzheimer’s disease,” says lead author, Professor Jennifer A. Frontera, MD. “Traumatic brain injury, which is also associated with increases in these biomarkers, does not mean that a patient will develop Alzheimer’s or related dementia later on, but does increase the risk of it,” says senior author Thomas M. Wisniewski, MD, the Gerald J. and Dorothy R. Friedman Professor in the Department of Neurology and director of the Center for Cognitive Neurology at NYU Langone. “Whether that kind of relationship exists in those who survive severe COVID-19 is a question we urgently need to answer with on-going monitoring of these patients.”

Preliminary findings from clinical trials in South Africa have suggested that the Omicron variant of COVID-19 could have a far higher rate of ‘asymptomatic carriage’ than other variants. This higher rate of carriage could be a factor in the rapid transmission of the variant, which has broken records for daily cases in nations around the world. In the United States, the CDC has reported that the variant is responsible for more than 98 per cent of new COVID cases, and has replaced the Delta variant in less than one month. The study in South Africa examined more than 500 South African healthcare

Blood proteins indicative of neurological damage were higher in COVID-19 patients Patients hospitalised for COVID-19 had higher levels over the short term of blood proteins known to rise with neurological damage than non-COVID-19 patients diagnosed with Alzheimer’s disease, a new study has found. Led by researchers at NYU Grossman School of Medicine, researchers found higher

levels of seven markers of brain damage (neurodegeneration) in COVID-19 patients with neurological symptoms than those without them, and much higher levels in patients that died in the hospital than in those discharged and sent home. Published in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association, the study was conducted over two months early on in the pandemic (March-May 2020). Any determination of whether patients with COVID-19 are at increased risk for future Alzheimer’s disease, or instead recover over time, must await the outcomes of long-term studies. The study identified 251 patients at 71 average years of age, all of whom had no record or symptoms of cognitive decline or dementia before being hospitalized for COVID-19. These patients were then divided into groups with and without neurological symptoms during their acute COVID-19

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Professor Sir Jonathan Van-Tam to become Pro-Vice-Chancellor for Medicine & Health Sciences at the University of Nottingham Professor Sir Jonathan Van-Tam will become the University of Nottingham’s next Pro-Vice-Chancellor for the Faculty of Medicine & Health Sciences. He will take up the Executive Board-level role on his return to the university when he steps down as the Deputy Chief Medical Officer (DCMO) for Health Protection in England. A specialist in influenza, including its epidemiology, transmission, vaccinology and pandemic preparedness, Professor Van-Tam was Professor of Health Protection in the Faculty’s School of Medicine prior to his secondment as DCMO. He is also an alumnus of the University and graduated from the School of Medicine in 1987. A familiar public face during the COVID-19 pandemic, he was one of four Deputy Chief Medical Officers (DCMO), where he has been a key provider of independent advice to the Government on COVID-19, leading on health protection and regularly presenting at Downing Street press conferences. He received a knighthood in the most recent

New Year’s Honours for his services to public health. As the DCMO for Health Protection, Professor Van-Tam has played important roles in a number of different incidents in the UK, including domestic outbreaks of MERS and Monkeypox, the 2017/18 influenza season and most notably the response to the Novichok attacks and the COVID-19 pandemic where he worked on the Vaccine Taskforce and supported the development of treatments. “My time as DCMO has been the most challenging of my professional career, especially the COVID response. We all wish COVID had never happened. Notwithstanding, it has been the greatest privilege of my professional career to have served the people of the UK during this time,” says Professor Sir Jonathan Van-Tam. “I want to pay tribute to Professor Chris Whitty, the CMO team, my fellow scientists, public health professionals and clinicians whose support, wisdom and energy

The International Centre for Recurrent Head and Neck Cancer launches at The Royal Marsden in London We like to think of the start of a new year as a new beginning, and that is certainly the case at The Royal Marsden where I am proud to say that we have launched the world’s first centre for recurrent head and neck cancers, says Professor Chris Nutting, Clinical Director at The Royal Marsden in Cavendish Square.

Our aim is to create a centre of international excellence and set international standards in the curative treatment of recurrent head and neck cancers. The International Centre for Recurrent Head and Neck Cancer (IReC) will work to accelerate research and improve outcomes for patients with recurrent head and neck cancer. It will also collaborate with other international centres to set standards for management of recurrent HNC and conduct novel research in surgery, radiotherapy, drugs and biomarkers. The IReC’s objectives are also to: • Develop a national tissue bank to support laboratory and translational research • Create a research environment that will support research students and

has been inspiring. There are countless numbers who work behind the scenes - all of whom have an unrelenting commitment to help and support the British public. It has been an honour to work with them all.” Vice-Chancellor Professor Shearer West said: “All of us at the University are incredibly proud of Professor Sir Jonathan Van-Tam’s work as Deputy Chief Medical Officer, in which he has played a major role in steering the nation through the COVID-19 pandemic.” The University’s Faculty of Medicine and Health Sciences consists of four Schools encompassing Medicine, Health Sciences, Life Sciences and Veterinary Medicine and Science. It educates more than 5,000 students and conducts world-leading translational, applied and clinical research with a focus on making a real-life impact to patients and the public. Last year it celebrated its 50th anniversary of teaching Medicine and 30th anniversary of teaching Nursing courses. multicentre research, and be competitive in grant funding • Teach and train future academics in the management of recurrent HNC • Act as a national focal point for head and neck cancer patients, carers and support groups, to help inform research and management priorities for recurrent HNC Cancer recurrence is a major concern of patients and their families. Recurrence can vary widely between cancer types and within certain types according to stage and many other factors. In broad terms the rate of recurrence of HNC is not as high as many other cancers, however it is a significant issue and one which deserves dedicated research and focus. The IReC is truly world-class in its field. No other research departments are able to demonstrate a similar spectrum and volume of research activity on recurrent cancers. Collectively we participate in several industry trials and are supporting seven future academic clinicians who are performing research in areas such as molecular/genetic science, robotic surgery and functional outcomes for patients.

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DIT

The UK Health 2022 The UKPavilion PavilionatatArab Arab Health 2022

NEWS

24 -- 27 27 January January 2022, 2022, Dubai Dubai 24

The British Government, namely the Join us on the UK Pavilion stand at Arab Department for International Trade (DIT), Health 2022 to discover how to enhance is delighted to be attending Arab Health in your GCC strategy for the Life Sciences January and we would like to invite you to or Healthcare market. meet with us at the show.

We would be delighted to meet with private and Event Details public healthcare providers. The UK is very interested to showcase UK innovations Date: 24 - 27 January 2022 and work with the GCC region in continued collaboration. Time: 10:00 - 18:00 Location: Dubai World Trade Centre or visit us on Please do book meetings in advance Stand: The UK Pavilion, 2 - E30 the UK Pavilion stand atHall the show.

New to 2022, the Department for International Trade In theand UK,Association the government recently launched its UK (DIT) of British HealthTech Industries Life Sciences Vision setting out a 10-year strategy for (ABHI) will be combining programmes and hosting For more information please contact: the sector to solve some of the biggest healthcare one stand - the UK Pavilion at Arab Health. E: dithealthcare@brayleinoevents.com problems of our generation, including cancer and T: +44 (0)117 933 9467 Event Details DIT has developed a programme of activity to dementia. benefit international buyers and UK companies at Date: 24 - 27 January 2022 Joint collaboration: Arab Health 2022. As a government The healthcare challenges all nationsorganisation, currently face Time: 10:00 - 18:00 one of our ambitions is the promotion of the best 24 27 January 2022, Dubai is growing. One of our ambitions for this show is to Location: Dubai World Trade Centre of UK innovations, and2022, the roleDubai this is playing in 24 27 January share learnings and2022, debateDubai these key issues, 24 -- our 27 January defining the future of healthcare. Stand: The UK Pavilion, Hall 2 - E30 and the role this is playing in defining the future of TUESDAY 25 JANUARY, AT VOCO HOTEL, 14:30 – 16:00 The British Government, For more information please contact: Combining healthcare. with the DIT activities is the ABHI UK namely forart simulated Next Steps forE:UK dithealthcare@brayleinoevents.com Digital Health pavilion, the and Department their state-of-the We would be delighted topotential meet with private and The British Government, the Digital transformation of healthcare has the to redefine how We will be promoting the bestnamely of British innovations operating theatre. It celebrates collaborations International Trade (DIT), is W: ukhealthcarepavilion.com Join us on the UK Pavilion stand at Arab Event Details publicare healthcare providers. Theheart. UK is very interested healthcare services delivered with digital at their This exciting at the show andfor we International hope you canclinicians join us. and between healthcare providers, Department Trade (DIT), delighted to be seminar will provide an excellent opportunity to hear from leaders and experts Health 2022 toattending discover how to enhance to showcase UK innovations and work with the GCC healthcare technology companies, allowing visitors Date:digital 24 - transformations 27 January 2022 is delighted to be attending Arab Health in regarding the future in the UK and UAE. Arab Health in January and we region in continued collaboration. Our Programme to watch the UK’s best surgeons in action. Watch the your GCC strategy for the Life Sciences January we would to invite you to Time: 10:00Dr-Tim 18:00 DIT is hosting programme of activity at the show: Ourto Expert Panel Speakers: Ferris, Director for Transformation, NHS latest developments the UK like Healthcare sector has would likeand toa invite you to meet or Healthcare market. England and Improvement, Ali Parsa, CEO, Babylon Health, Dr Richter – Location: Dubai World Trade Centre meet with us at the show. Please do book meetings in advance orDirk visit us on offer by leading providers: Royal Brompton Hospital, hosting a number of seminars at local hotel venues; with us at the show. Senior Advisor with the Department for Health Dubai, Dr Mubaraka Ibrahim – Guy’s NHS Foundation Trust, Bupa Stand: The UK Pavilion, 2 - E30 the UK Pavilion stand atHall the show. hosting oneSttoThomas’ one business meetings; and bringing aChief Information New toand 2022, the Department for International Trade Acting Officer, Ministry of Health & Prevention UAE In the UK, the government recently launched its UK Cromwell Hospital and Healthcare. (DIT) and Association ofHCA British HealthTech Industries delegation of NHS Trusts to the show, to explore new Life Vision setting outwith a 10-year strategy for THURSDAY, 27For JANUARY, 2022, AT DUBAIplease WORLD contact: EXPO 2020, 11:00 - 12:00 (ABHI) will be combining programmes and hosting DIT &Sciences ABHI are running a joint more information opportunities and collaborate the region. DIT will be to hosting asome number of interesting business the sector solve of the biggest healthcare one stand - the UK Pavilion at Arab Health. stand which is showing live E: dithealthcare@brayleinoevents.com seminars alongside Arab Health to connect UKEmpowering People: Better Health and Care with Technology problems of our generation, including and Our programme has a number of NHScancer and other streaming surgical simulations, T: +44 (0)117 933Hawaa 9467For Event Details and Chair: H.E. Al Mansoori , Deputy Medical Director, companies to a wide of healthcare providers the latest information on seminar DIT has developed arange programme of activity toOpening Address dementia. government senior representatives from the UK and seminars in our booth theatre, and Consultant Endocrinologist and Diabetologist and Member of the Federal in the region. The seminars are open to both UK registration and 1-2-1 Commercial benefit international buyers and UK companies at Date: 24 27 January 2022 National Council of UAE. DIT market from the Middle and other other interesting programmes. On East and overseas organisations. Joint collaboration: Arab Healthadvisers 2022. As a government organisation, The healthcare challenges all nations currently face Time: 10:00 - 18:00 Officers bookings. Register your countries inambitions attendance. the website you can see all the UK one of our is the promotion of the best A panel discussion on how health systems can adopt technology to empower details to be updated on the latest is growing. 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The seminars are open to the both UK registration and 1-2-1 Commercial providers: Royal Brompton Hospital, Guy’s and St countries such as India, Israel, Jordan, DIT market advisers from the Middle EastKuwait, and other For more information please contact: and overseas organisations. Officers bookings. Register your Thomas’ NHS Foundation Trust, Bupa Cromwell Oman, Pakistan, Qatar, Saudi Arabia, Switzerland countries in attendance. E: dithealthcare@brayleinoevents.com details to be updated on the latest Hospital and HCA Healthcare. and Liechtenstein, Turkey and UAE.week, is Expo In Dubai, taking place in the same W: ukhealthcarepavilion.com developments on the UK Healthcare 2020, andExpo our UK healthcare and life sciences At Dubai 2020, from the 26 January, we are Pavilion at Arab Health and the week. This provides UK companies withweek evenon more running a special healthcare focused the UK programme of activities. opportunities to uncover a host interesting Pavilion. 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doingis business MENAsimulations markets and how stand, the ABHI in surgical and their to overcome them. state-of-the art simulated operating theatre. It HWM_003 - News.indd 13 with buyers, and exhibitors to establish DIT FP 1/22.indd 1 •celebrates Network collaborations between healthcare

20:06 17/01/2022 09:29

Long term exposure to air pollution may heighten COVID-19 risk Exposure to ambient air pollution may heighten the risk of COVID-19 infection, suggests research published online in the journal Occupational & Environmental Medicine. The association was strongest for particulate matter, with an average annual rise of 1 µg/m3 linked to a 5 per cent increase in the infection rate. This equates to around an extra 294 cases per 100,000 people a year according to the findings, which focus on the Lombardy region of Italy. Northern Italy was badly affected by the pandemic, with Lombardy the worst affected region in terms of both cases and deaths. Several reasons have been suggested for this, including different testing strategies and demographics. While further research is needed to confirm cause and effect, the findings should reinforce efforts to cut air pollution, according to the researchers who ran the study.

Estimates from the European Union Environmental Agency show that most of the 3.9m Europeans residing in areas where air pollution exceeds European limits live in Northern Italy. Recent research has implicated airborne pollution as a risk factor for COVID-19 infection, but study design flaws and data capture only up to mid-2020 have limited the findings, according to the researchers. To get around these issues, they looked at long term exposure to airborne pollutants and patterns of COVID-19 infection from the start of the pandemic to March 2021 among the residents of Varese, the eighth-largest city in Lombardy. After accounting for age, gender, and care home residency, plus concurrent long term conditions, averages, both PM 2.5 and PM 10 pollution levels were significantly associated with an increased COVID-19 infection rate. For every 1 µg/m3 increase in long term exposure to PM 2.5, a 5 per cent

increase in the number of new cases of COVID-19 infection was seen, equivalent to around 294 extra cases per 100,000 of the population per year. The observed associations were even more noticeable among older age groups, indicating a stronger effect of pollutants on the COVID-19 infection rate among 55–64 and 65–74 year olds, suggest the researchers. However, this is an observational study, and as such, can’t establish cause. Although the researchers considered various potentially influential factors, they weren’t able to account for mobility, social interaction, humidity, temperature and certain underlying conditions, such as mental ill-health and kidney disease. “Our findings provide the first solid empirical evidence for the hypothesised pathway linking long-term exposure to air pollution with the incidence of COVID-19, and deserve future generalisation in different contexts,” say researchers. “Meanwhile, government efforts to further reduce air pollution levels can help to mitigate the public health burden of COVID-19.”

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NEWS

Consumer health sector commits to an industry-wide environmental pledge The charter aims to reduce the impact of self-care on the environment The Global Self-Care Foundation (GSCF) has recently announced the launch of the Charter for Environmentally Sustainable Self-Care, a global commitment from the consumer health industry to ensure the sustainability and eco-friendliness of self-care. The pledge itself has identified reducing the impact of self-care products on the environment, and ensuring better health outcomes, product safety and access to effective treatment options as its key goals. Self-care products encompass items such as over-the-counter medicines, food supplements including minerals and vitamins, and medical devices such as bloodpressure readers and sleep apnea machines. “Voluntary and proactive action across the consumer health industry is essential to find urgent, sustainable solutions to address the sector’s environmental impact,” says Judy Stenmark, Director General at the GSCF.

“That’s why I am very pleased to see the Charter come to fruition at a time when we are truly seeing a collective global movement from business to address sustainability, both through making tangible commitments and delivering on them. The Charter provides an ambitious platform for all our members globally to drive innovation in sustainability.” Members of the GCSF, including consumer health manufacturers and suppliers, have made a range of commitments as part of the Charter, based on their individual sustainability goals and programs. The Charter itself is primarily focused on three priority areas where the industry has the greatest impact and influence: plastics and packaging, pharmaceuticals in the environment and carbon footprint.

These members have pledged to reduce plastics and packaging wherever possible, striving less waste and more sustainable production methods within manufacturing. The industry also continues to take measures to reduce the presence of pharmaceuticals in the environment, which include promoting the safe disposal of unused medication. With regards to carbon footprint, GSCF members and the broader industry are adopting emissions reduction targets that accelerate the transition to the low carbon economy, in line with the Paris Agreement. “Minimising the impact of self-care products on the environment while safeguarding access to effective treatment and well-being options for people is a critical issue for the consumer health industry. Member companies have already embarked on the sustainability journey individually; with the Charter we establish a platform for good practice sharing and collaboration with an objective to create collective actions and move the needle forward,” says Jurate Svarcaite, Director General at the AESGP.

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17/01/2022 20:07

The astonishing speed of pandemic healthcare innovation The healthcare industry has met the pandemic challenge and changed the face of healthcare for the future, says Alistair Grenfell, President, EMEA, IQVIA

he COVID-19 pandemic has been the most disruptive event in global affairs for half a century. A virus for which there is no known cure swept today’s globalised, hightech world and revealed vulnerabilities across health systems. As governments grappled with the spread of the virus, by closing down entire economic sectors and restricting social activity, health services were severely impacted. While across the world, in non-COVID cases, there have been significant reductions in screening, testing and diagnosis. The resultant delays in diagnosis are impacting treatments and patient outcomes. The effects of which are likely to continue for many years to come. For example, we know that approximately 1bn fewer diagnosis visits were made to HCPs in the US throughout the pandemic and across major world healthcare systems, oncologists report that caseload in 2021 is still below pre-pandemic levels by between 25 per cent and 50 per cent. Healthcare innovation, however, has come to the rescue. With astonishing speed, entirely new vaccines have been developed, the evolution and the transmission of the virus has been tracked and therapies have been repurposed. Just 11 months ago the first person to receive a non-trial COVID vaccine occurred, and this just 11 months after the first sequencing of the virus. The road to recovery In many areas, the healthcare industry rose to the challenge of tackling the pandemic through accelerating research to repurposing medicines and develop novel vaccines in the span of 12 months. Collaborative partnerships have allowed us to distribute vaccines to a third of humanity from across the globe and counting.

Reflecting on the part of the world where this conference is hosted, countries such as the United Arab Emirates and the Kingdom of Saudi Arabia have been at the forefront of using latest technologies and data to manage the pandemic. These countries have been some of the earliest ones to introduce vaccine passport applications, and ahead against many others to manage their Covid-related fatalities. The United Arab Emirates has moved rapidly with more than 95 per cent of its population having received a first vaccination.

Alistair Grenfell President EMEA, IQVIA

“Public and private bodies will need to continue collaborating to safely connect healthcare and data, underpinned by technology” On a local level, everyone has had to adapt by using technology to continue their daily lives. Patients received remote consultations and diagnosis over videoconferencing tools, prescriptions have been sent to pharmacies electronically, and medicines delivered direct to the patient’s home. T hese multichannel healthcare tools introduced during the pandemic are changing operating models, as hospitals, companies, and governments continue to invest heavily in digital infrastructure. Italy, for example, will seek to invest approximately 1bn euro into telehealth

alone. And, in the U.S., telehealth now makes up 8 per cent of all claims. We are seeing clinical trial activity recover which suggests the engine of innovation is back up and running. Our data demonstrates that overall clinical trial activity rose by 20 per cent in 2020, driven by an acceleration of remote, virtual or decentralised clinical trials. This is only possible through continued and sustained investment from the private and public sectors. In the EU alone, tens of billions of dollars of public sector investment will be used to digitise healthcare. Future outlook We are still in a high-risk world and building the resilience of our health systems has never been so urgent. Advances in healthcare accelerate as our understanding of genetic

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HEALTH SYSTEMS IQVIA

causes of disease, and other aspects of human science, grows. New therapeutic approaches like cell, RNA, and gene therapies are being incorporated into clinical practice alongside new digital technologies to improve human health. The application of data science and analytics to big data in healthcare have further supported this progress. Analytics have been used to assess the value of these new therapies, speed the path of innovative therapies to market, optimise health system performance, advance disease prevention, and improve the treatment and delivery of human health services. A modern, resilient health system opens up many possibilities such as flexible innovation, where telehealth can facilitate hybrid or decentralised trials that enable efficient studies of larger patient populations in the real-world setting. Compared to 2016, the proportion of all

trials that now use connected medical devices has doubled. Another key opportunity is that provided by personalised medicine, where decisions are made based on a patient’s genetic make-up and their environment. Developments such as this will be crucial to advancing healthcare to the next level. Key investments are still required ,however. For example, the diversity of genomic data must be improved to avoid the risk of health data poverty, and by extension, health inequalities. Doctors must be able to incorporate more sources of data and more sophisticated data analyses into their clinical workflow. These changes should be introduced so that the basics of data analysis and coding are a fundamental part of the medical undergraduate curriculum. Hence, there needs to be major investment over the next five years to bring the benefits of these innovations to every patient.

Conclusion To unlock these opportunities, public and private bodies will need to continue collaborating to safely connect healthcare and data, underpinned by technology. We will need to build broad, deep genomic databases; we will need to enable health systems to better connect and leverage their data through training and platform investment. We will then be able to deliver care at earlier points in the patient journey, potentially deflecting serious disease later on and in doing so, improving outcomes and increasing quality of life for patients across the world. Contact Information

www.iqvia.com

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17/01/2022 20:11

Back to the future? Jason Helgerson, Founder and CEO of Helgerson Solutions, believes the pandemic will ultimately prove a catalyst for home healthcare

n the 1985 hit science fiction movie – Back to the Future – a high school student played by Michael J. Fox utilised advanced technology to travel back in time. You may ask what possible link there may be between that movie and global healthcare post-pandemic? My answer is, that like the movie, we will utilise technology to go back in time to the era in which healthcare came to us - in our homes - and this change will be far more impactful than many believe.

Until roughly the 1950s, healthcare was commonly provided at home. Doctors regularly visited patients, and we only used hospitals and even clinics in extreme circumstances. As technology advanced and doctors could no longer fit the new tools of their trade in their bags, it became necessary for patients to travel to healthcare. The transition to a world in which healthcare requires patient travel has profoundly impacted how these vital services are provided. Beyond just patient

inconvenience, this change has led to a massive shift in the relative power dynamic between patients and providers. As a result, providers are at the centre of the healthcare delivery system in almost any country you look at. Practically all aspects – from office hours to service locations, even to how and by whom services are provided – are built around the needs of providers. Patients are simply expected to adjust and comply. As healthcare policy analyst and commentator Roy Lilley recently said when I interviewed him for the podcast Health 2049, a patient’s time is considered worthless. As a result, the overall experience most of us have when it comes to consuming healthcare services is inconvenient at best and de-humanising

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HEALTH SYSTEMS Helgerson Solutions

My description of the present state should in no way be seen as an effort to disparage healthcare providers. Many, if not most, are equally unhappy with the current situation because they are forced to operate within a financial model that runs them ragged every day. Most didn’t spend years getting advanced degrees to work on a treadmill every day, in which they are expected to do more and more every single day. The current system is leading to provider burnout at a record pace in countries around the world. While the provider may be the system’s centre, those on the frontlines aren’t very happy with how that system works for them or their patients. Putting the patient at the heart of healthcare

at worst. We are almost always asked to wait, and when we do get to see someone, the visit is frequently brief, and the person opposite us is harried.

Jason Helgerson Founder Helgerson Solutions

“My belief is that consumers will prefer to get as many services as possible from their homes and will not want to go back to waiting for services”

I am an optimist by nature. That optimism leads me to believe that post-pandemic, we will quickly move to a brave new healthcare world in which patients are once again the centre of the universe and providers can meet patient needs in a rewarding and sustainable manner. The key to this revolutionary change will be technology that will allow people to be served from the comfort of their homes, either by fellow humans or increasingly by machines. The pandemic has taught us a tremendous amount about how much can be done from the comfort of home. Lockdowns forced us to work virtually in almost every industry. We learnt that we can be highly productive in this virtual world, with many businesses operating today as ‘virtual first’ or ‘hybrid’ companies. Healthcare has been no different with a global explosion in virtual visits. All of this happened practically overnight with no new technology other than a Zoom subscription. Specifically, in healthcare, the transition has been amazing. Virtual visits have been available for years but rarely used. Providers were never willing to integrate them, and patients didn’t often know they might be an option. While some companies were in the vanguard by offering virtual care to patients, the overall utilisation remained stubbornly low. The pandemic changed all that with lightning speed. My belief is that consumers will prefer to get as many services as possible from their homes and will not want to go

back to waiting for services. Additional technology will be deployed which will make it easier for providers to serve those in their homes. Virtual care will be more efficient for both providers and patients, making it more attractive to both. This fact will drive both supply and demand. The Holy Grail of care-on-demand I also believe that in the not-too-distant future, machines – powered by Artificial Intelligence – will begin to replace humans in providing some healthcare services. This advancement will make it possible to offer many patients 24/7 access to ‘care-on-demand.’ Long waits will become a distant memory. While machines will never replace all providers, it will become the default for many services, such as diagnostics, radiology and even chronic care management. This change will help providers because it will allow them to transform how they practice, because they will have more time to spend with the patients who need them most. The changes I describe will profoundly change the relationship between providers and patients. Providers will no longer be expected to be supercomputers with instant recall who can diagnose even the rarest conditions with limited information at the drop of a hat. Patients will have access to accurate information about their health care status and treatment options informed by their own health care information, not a few random Google searches. Technology will level the playing field between providers and patients, profoundly impacting how services are provided and how needs are met. Back to the Future in global healthcare will mean that more and more care will be provided to people in their homes in better and more convenient ways. Fortunately, to get to the better days ahead won’t require a time machine but rather a smartphone and internet access. I, for one, look forward to those days. Contact Information

connect@hsg.global www.hsg.global

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17/01/2022 20:10

The urgent need for vaccine parity As the Omicron variant spreads across the world, Dr Nicholas Crisp, Acting Director-General of South Africa Ministry of Health, speaks to HW Editor Sarah Cartledge about the importance of assisting other countries to help themselves

he sudden recent emergence of the new Omicron coronavirus variant has led to the unwelcome tightening of restrictions globally. First detected by South African scientists, it appears to affect younger people who have not been vaccinated. The instinctive reaction to ban flights from the country has finally provoked the wider conversation that has been put on hold for more than a year – the urgent need for vaccine parity. South Africa has suffered more than most African countries from the effects of COVID-19. With deaths in excess of 200,000 and the Beta variant identified as originating there, the health department is fighting to vaccinate the population rapidly, despite slow uptake and political obstacles. Heading up the task is Dr Nicholas Crisp, a retired public health official who was originally brought back to set up the new office for the proposed national health insurance programme. On his arrival in June 2021 he was also asked to run the struggling vaccine programme, and he went on to stand in as Director General when the incumbent was placed on precautionary suspension. With a wealth of national and international public health experience, he is fighting many battles and the most important is to contain the anticipated fourth wave. Each wave has been more aggressive than the previous one, but vaccination rates have been good in parts. Around 14.5m people have received both doses, with 22m vaccines administered thus far. Changing the distribution strategy Much of this success has been achieved despite the cuts in the healthcare budget of more than 6 per cent. Many donors have come to their aid and the large private sector has been closely involved. The US and UK government among others have helped with vaccine supplies, while the

German government has assisted with refrigeration and digital solutions. But the wider issue lies with South Africa’s porous borders. With six neighbouring countries – Botswana, Namibia, Mozambique, Lesotho, Swaziland and Zimbabwe – and 1,740 miles of coastline with many ports, South Africa has to remain vigilant. “We have to be able to vaccinate everybody who comes here, whether they’re legal or illegal,” says Dr Crisp. “And the more they can be vaccinated in their own countries, the less they want to come here for vaccination. We need countries to understand that it doesn’t help to keep giving us donations – it needs a different structure. “Let’s create a pool that donates to neighbouring countries which South Africa will facilitate. We will help to get their vaccination programmes going as people move regionally between these borders for work and trade and so forth. It’s in all of our interests that we vaccinate everybody.” He feels that South Africa is being held to ransom by global pharma companies as the country is too large to qualify for COVAX donations and is hampered by the healthcare budget cuts. “COVAX has been disappointingly supported by other countries and it doesn’t serve anyone’s interests to have this global apartheid,” he says. “We’re strongly in favour of pooling our resources, whether it’s patents or vaccines. We’re aiming towards getting

the vaccines made here, along with other drugs and APIs so we can be more self-sufficient, working together with the African Union. Rolling out the vaccine

Dr Nicholas Crisp Acting Director-General South Africa Ministry of Health

“Let’s create a pool that donates to neighbouring countries which South Africa will facilitate”

South Africa was hit hard at the start of the pandemic. “The first wave was huge but we managed to get private and public hospitals to accept patients,” Dr Crisp says. “Now the clinicians have more experience of the virus and we have worked out who is more likely to get sick, but at the time we had lockdowns which affected both the tourism and hospitality sectors enormously.”

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HEALTH SYSTEMS South Africa

After some false starts the Pfizer vaccine has been the mainstay of the programme and, following distribution issues, the Johnson & Johnson vaccine is also in use. With 1800 primary vaccination sites, many with their own satellite sites, there are 12,000 vaccinators and more than 65 per cent of over 60s have now received at least one jab. Surprisingly, the rural areas have been more successful in achieving a good coverage rate. Political and religious leaders have been travelling around their communities in advance of the mobile clinics, encouraging people to attend. In contrast, larger urban groups have been more difficult to reach.

“The urban vaccination sites are static and people are reluctant to spend money to travel to them,” he adds. “We also have a lot of anti-vaxxers and negative media, so we have devised a demand creation strategy which uses our government communication systems together with a full range of private providers who have come mostly voluntarily to the system, such as private radio stations and print media. This is vital as coronavirus has decimated the economy of communities and created massive mental health and education issues.” The speed of the South African medical community in identifying a new strain

shows the important work being done behind the scenes. For South Africa to face renewed economic hardship as a result of closed borders seems harsh to many. However, Dr Crisp is realistic about the situation. “Our allies are the BRICS and not so much the West,” he says. “If the West wants to stay friends with Africa, then they have to be really interested in opening up trade and helping us grow our economies. COVID has taught us that if we don’t stand up for ourselves in Africa, we’re going to end up being the poor kid in the corner with the leftover porridge. And that’s not OK.” 21

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Transforming health from the ground up Any pandemic or health challenge cannot be fought without education, says Professor Ramneek Ahluwalia CEO of HIGHER HEALTH in South Africa

outh Africa’s alert to the world that it had identified the new COVID variant, Omicron, at the end of last year has pulled its scientists and clinicians into sharp focus. The country has a reputation for innovative thinking and it is tackling coronavirus and HIV in positive ways, the most successful of which is its programme to address health issues and learning for the country’s students via its HIGHER HEALTH organisation. Run by Professor Ramneek Ahluwalia, HIGHER HEALTH addresses nine areas of focus for 2m students in 26 universities, 50 Technical and Vocational Education

colleges, and 9 Community Education and Training colleges by improving their health and wellbeing. Its health, wellness and psychosocial services across 420 campus sites and rural, informal and urban settings in all 52 districts across South Africa identifies students that would benefit from help via a series of questionnaires at the start of all higher level courses. The key areas are alcohol and drug abuse, mental health, sexual and reproductive health, HIV, STIs and TB, disability, LGBTQI, gender-based violence and now COVID-19. “The important thing is that an educated young South African

has a power of influence. Perhaps not many people in the family are educated, so the one with the one who’s educated will pay back in the form of looking after the entire family,” says Professor Ahluwalia. “We seek to reduce the effect of healthrelated conditions that often challenge students in tertiary studies and which, if left unaddressed, can lead to students delaying the completion and even abandoning their studies. There is a huge challenge with mental health issues among young people so high risk students are linked to care. To date we have referred about half a million young people.” Deeply ingrained issues Professor Ahluwalia’s vision is to build families for the future. South Africa has social ills, exacerbated by the legacy of apartheid, that will take time and funds to resolve, but he is convinced that improvement can be accelerated through education. With the support of university Vice-Chancellors and major institutions such as the World Bank

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EDUCATION & TRAINING HIGHER HEALTH

Professor Ramneek Ahluwalia CEO HIGHER HEALTH

“We seek to reduce the effect of health-related conditions that often challenge students in tertiary studies” huge challenge amongst our youth and across the world, and specifically in the area of higher education. We also have a proper curriculum of understanding LGBTQI because of our throughput in the LGBTQI community. So before they join a company employee wellness programme, students will have had exposure to health and wellness projects from the beginning.” Expanding the programme’s reach

and the European Union, the programme has considerable success in the country. Referred to as the 2nd curriculum, opportunities for learning and development are offered to students outside of formal academic studies. It includes a range of campus activities – such as student clubs and societies – and, most importantly it includes a system for volunteers to become peer educators and mentors. The message is that an individual’s health is in their own hands and access to help is broad and available. “We’re not looking to compete with the current curriculum in health sciences or humanities, “ he says. “Our curriculum runs alongside the academic one to bring help to the community and enable students to continue their education despite their personal challenges.” The programme expands provision in clinics in higher education locations to help students deal with the issues that arise. HIGHER HEALTH envisages that every campus of every public university and TVET college will in future have either an on-site clinic service or a health, wellness

and psycho-social “linkage to services facility”, because students have shown a clear preference for the convenience these facilities afford while allowing them to stay focused on education. HIGHER HEALTH also promotes the prevention, early detection and management of non-communicable diseases (NCDs). Not only is type 2 diabetes increasingly common among children and young adults across the world, but South Africa has a specific problem of hypertension among young people. The latest South African Demographic and Health Survey, undertaken in 2016 and published in 2019, found that 17 per cent of young women and 20 per cent of young men (aged 15 to 24 years) had hypertension. “We’re dealing with many issues in South Africa, such as 8m people living with HIV, a high rate of unplanned teenage pregnancies that lead to a drop off in education, gender-based violence and even human rights issues because South Africa was a colonised country,” Professor Ahluwalia says. “Drugs and alcohol are a

The UN Assembly invited Professor Ahluwalia to speak about good practice in higher education healthcare, and he also spoke about it at the EU Parliament. Different UN agencies are in the process of taking the model to several African countries, such as Libya, Malawi and Nigeria. There is also a pilot project at the University of Zimbabwe, and a strong relationship with UN Women around sexual reproductive health issues. HIGHER HEALTH’s policies have helped write an HIV policy for Nigeria that has already been adopted as a test. “We’re looking to further strengthen and expand partnerships with higher education institutions, government departments, funding and donor agencies, and other organisations in the broad field of student health, wellness and development,” says Professor Ahluwalia. “Our biggest challenge is how to move into artificial intelligence. We think in future the world will be on a hybrid system and we need to learn to adapt quickly to go online with easily accessible attractive and animated curriculums.” Contact Information

higherhealth.ac.za

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Streamlining hospital processes Hospitals need all the help they can get to manage patients successfully, says Elliott Engers, CEO of Infinity Health

s hospitals and healthcare outlets struggle to manage the after-effects of COVID-19, digital technologies offer many solutions. But it’s an uphill struggle for UK innovators as they try to convince the NHS to implement simple strategies that would make life easier for patients, clinicians and hospital staff. Elliott Engers, CEO of Infinity Health, puts it very clearly. “We just haven’t embraced

what technology is capable of doing,” he says. “From the moment someone enters an NHS hospital, the first interaction and beyond is fraught with inefficiencies and even clinical safety issues that patients may never be aware of. Healthcare moves at an unnecessarily slow pace which means it is far behind where it could be. “The process that’s designed to protect people and minimise risk is now introducing or perpetuating risk that

could be eliminated tomorrow with digital solutions,” he continues. “Other industries have spent 20 or 30 years developing new tools, and it’s clear to everyone that healthcare is lagging behind.” Many digital innovations are clinicianled, developed at the coal face by doctors looking to make their working lives easier. Where they can manage nearly every facet of their daily lives digitally, they are often still dependent on paper lists in their work environment. While Elliott himself doesn’t have a medical background, he developed the Infinity concept in conjunction with Dr Adam Benton, an orthopaedic surgeon. They had studied together at school, and when Elliott left university to join Virgin Records he saw how Apple disrupted the music industry with the invention of the iPod.

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HEALTH SYSTEMS Infinity Health

“We were curating the music, signing the acts, marketing them, making videos, doing all the press and promotion planning, but we had no direct relationship with actual listeners,” he says. “Then Apple demonstrated the technology that can emerge if you become the interface. They transformed an industry with that mindset, and they continue to do so. “I could see that a similar approach would work with healthcare and that the possibilities were endless. It was finding the right problem to solve that took the time, until I heard Adam trying to do his surgical handover on the phone with a colleague and realised there was no simple way for them to do it without speaking to each other or leaving handwritten notes.” The issue was how a small start-up could do anything meaningful in a space with such big incumbents. At the time mobile devices were beginning to last the whole day and their potential was quickly being tapped. “We developed a useful patient and task list that could be instantly updated and Infinity grew from there,” Elliott says. Solving daily issues Infinity is a task management platform for staff to share and coordinate in real time, using and modern mobile device or desktop computer. It can even be used on an iPod. It eases the burden on NHS staff by helping them to manage their workload more easily, collaborate with colleagues from across specialties, and gives visibility of the information they need, when they need it. Using Infinity solves many communications issues and risks that arise with current paper-based processes, and that lead to more than one third of adverse events in healthcare. The platform integrates with and sits alongside EHRs and EPRs, supporting staff to seamlessly coordinate from the point of care. This is safer for them, safer for patients, and more efficient. “The NHS has different systems that work across hospitals, GP surgeries and in the community. We describe Infinity as being the glue and the lubricant between the different parts of the system because it is provider agnostic,” says Elliott. “We give staff the tools they need to work safely and effectively across different environments.”

By using the platform, clinicians and healthcare workers have greater visibility of their workload, enabling them to communicate more effectively. Crucially, it reduces the chance of things being missed, and saves many hours of valuable clinical time. The real time dashboard helps to improve patient flow and prevent bed-blocking, and improves handovers by sharing information in real time. “We have a substantial resource management platform that can solve problems such as portering and bed blocking,” says Elliott. “We handle about 200,000 portering requests across two North London hospitals right now. Until then, requests for porters were done via paper and delays were inevitable as porters returned to base to pick up the next job. Clinicians would find their patients sitting in corridors and there would be no record of how long the porter would take to arrive. It created a huge amount of frustration and certainly didn’t promote teamwork. Now everyone has complete visibility and the process is much smoother.” An unexpected outcome from the data was discovering just how hard porters were working and not being credited enough for accomplishing tasks in a difficult environment. “We have good understanding of how bad things are, but often not how good they are,” Elliott adds. “We need the tools to co-ordinate the care really well and let the clinicians know so they can review patients and move them along. Digital is the only way to do this.” Helping hospitals with COVID solutions The pandemic created an additional administrative burden for the NHS, requiring trusts to know the COVID status of their staff as much as possible. Here Infinity has been able to help several NHS trusts by providing a solution for staff to enter their test results and be notified if they need to isolate. University Hospital Southampton NHS Foundation Trust (UHSFT) rolled out Infinity’s staff selftesting system over a two-week period, along with The Royal Wolverhampton NHS Trust, The Royal Marsden NHS Foundation Trust, Stockport NHS Foundation Trust, and Barts Health NHS Trust. As the UK faces the greatest ever waiting lists in the history of the NHS

Elliott Engers CEO Infinity Health

“We describe Infinity as being the glue and the lubricant between the different parts of the system because it is provider agnostic”

– some 5.7m – Elliott is confident that Infinity can help prioritise the caseloads. “I’m concerned about the huge staff burnout and the perfect storm that’s coming as winter approaches,’ he says. “We know that Infinity can help solve these problems and we are collating evidence that proves how much time can be saved by using our system. “Much of our work is behind the scenes. For example, we can co-ordinate bed flow by creating task lists for cleaning teams, so the beds are turned around much more quickly. We can achieve this in much less time - minutes rather than several hours. The hospital management teams have to recognise the value within digital and not be constantly asking for more and more pilots. COVID has proved the NHS can act quickly and it needs to continue to do so.” It’s clear that Infinity has only begun to scratch the surface of the administrative problems it could resolve. “Ultimately, we support hard working people caring for vulnerable patients,” he says. “We can help organisations that have workflow challenges and cost management problems, and we charge fair licencing fees. We’re not trying to make money out of integration - we want to demonstrate how much money can be saved and how many serious incidents can be avoided by using effective and even simple digital solutions that don’t cost a fortune. That’s what drives us.”

Contact Information

hello@infinity.health infinity.health

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Building a healthy future Putting health at the heart of infrastructure is key to building a healthy future, says Richard Cantlay, Mott MacDonald Global Health Portfolio Leader

he pandemic has had an unexpected consequence in that it has focused our minds on how and where we live. We have become acutely aware of the space around us – the home environment or the public spaces we need to visit – and how they contribute to our physical and mental wellbeing. While governments talk about ‘building back better’, at Mott MacDonald we have always thought about building better. As a management, development and engineering consultancy with many different arms, we are always looking for ways to create the optimum environment for the people who inhabit it. Health plays an integral role in this – we need to do all we can to contribute to the overall goal of healthy populations. Our Global Health team brings together more than 100 experts from a wide range of fields, from epidemiologists and clinicians to healthcare planners and health economists. We are passionate about creating health equality for all and our vision is to create environments that lead to healthier populations across the globe. We deliver services around three key strands of work: • Public health programmes including health system strengthening in low / middle income countries (majority of which are official development assistance programmes); • Healthcare system design and reconfiguration including healthcare infrastructure delivery; and • Embedding health considerations across the work that Mott MacDonald does in other sectors. Public health programmes in low and middle income countries We deliver public health programmes in low and middle income countries for international donors such as FCDO, GAVI, the Gates Foundation and others. We are currently managing the Country, Regional and Fellowship grants portfolio for Fleming Fund, a £265m UK aid programme managed by the Department of Health

and Social Care supporting up to 24 countries across Africa and Asia to tackle antimicrobial resistance (AMR). We are also supporting the delivery of the UK aidfunded Better Health Programme, which is tackling noncommunicable diseases and quality of patient care in South Africa. Healthcare systems fit for the future Our experts provide support across the entire spectrum of healthcare from system design, planning and delivery of healthcare infrastructure to evaluation and monitoring. Moving forward, the focus needs to be on more sustainable healthcare systems with less emphasis on large acute hospitals and more focus on integrated care models. The application of digital technology will go a long way to achieving this as more and more people globally become increasingly technologically adept. COVID-19 demonstrated that digital healthcare can be delivered successfully. We hope to help fast-track some of the technological advances that have been made, so we can help governments deliver healthcare more effectively to their citizens. But we will of course still need hospitals, and our focus here is helping deliver hospitals fit for the future. Focusing on prevention Alongside the work described above, our future focus will also be on engaging with clients in other non-health related sectors to encourage them to think about their projects in an integrated way, with health outcomes being an important lens through which to view all projects. Every time our

clients carry out a project we want to help them understand how the social determinants of health impact the health of populations – and how they have a role to play in creating better health outcomes through the delivery of their projects. Open spaces, better places to live and work, easy access, cycle and walking routes, all these can contribute to healthier living and reduce the disease burden. Moving on from there, it’s about getting governments to think strategically, rather than assuming that more hospital buildings will resolve the issue. With less emphasis on healthcare and more emphasis on prevention, we can all help reduce the healthcare burden no matter where we are. Therefore, arguably, it’s this third strand of our work that can have the most impact on health outcomes. By putting health professionals alongside engineering and infrastructure professionals at the start of long-term infrastructure plans, we can have a positive impact on health outcomes on non-health related projects. It’s about putting health considerations at the heart

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HEALTH SYSTEMS Mott MacDonald

of everything we do, reducing demand by focusing on prevention and helping people to lead healthier lifestyles. Architects, developers, engineers and master planners don’t always understand the health implications of the design decisions they make, so we are keen to keep health considerations at the forefront of the work we do.

Richard Cantlay Global Health Portfolio Leader Mott MacDonald

“We expect an increased demand from clients for pandemic resilience to be built into infrastructure projects”

At the beginning of the COVID-19 pandemic, Mott MacDonald’s aviation team were working on the redevelopment of JFK Airport in New York and the client was looking to understand how they should react to the virus. We put our aviation experts together with our clinicians and epidemiologists to help the client understand the principles of infection prevention control to reduce the risk of transmission. This led to input into the restart programme for their airports as well development of their plans for pandemic resilience in their operations and new set of service excellence standards during a viral pandemic. Every year the WHO estimates that 200 potential pandemics occur. Now that we know the devastation on human life and the economic impact a pandemic can cause, we have a shared interest in avoiding another one. We expect an increased demand from clients for pandemic

resilience to be built into infrastructure projects – in a similar vein to how we are now seeing climate change addressed at all stages of a project. Ultimately, the optimum solution is to design cities and the built environment with health in mind. With less pollution as a result of reduced traffic, easier options for people to exercise and take care of themselves along with healthier buildings, we should all be able to play our part in reducing the global healthcare burden. We can achieve this, not only by taking greater care of our own health, but also the health of the people around us. Contact Information

www.mottmac.com

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Why digital health interventions fail Healthcare World’s Data Correspondent Simon Swift speaks to Dr Steve Hajioff about the shortcomings of digital health innovations, and how their failures can be corrected

igital health, as a concept, has one purpose - to help people. Not just clinicians, not just healthcare workers or management, but everyone. It’s a noble idea - and absolutely fantastic when it works. However, all too often, we see digital health innovations turn out to be a complete dud. Sometimes they just don’t work; sometimes they try to solve a problem which isn’t there. Sometimes they even identify a problem but the solution provided is poor and doesn’t solve it. This makes many digital health ventures

low impact or even entirely useless - they act as a detriment to higher quality, higher value, personalised, healthcare. I spoke to Dr Steve Hajioff, CMO of Sana Life Sciences and Consultant in Health Policy and Technology, about the issues which often arise within digital health models and solutions - and what can be done throughout the process to ensure that interventions identify solutions accurately, provide benefits effectively, improving outcomes and delivering better value healthcare.

The seven points of failure Steve has seen a wide range of system failures within digital health and has identified one of a set of seven points of failure each and every time. 1. The Deus Ex Machina The belief that data, and data alone, holds the power to solve problems, without any thought or process applied to managing or understanding what to do with the data itself. 2. The User Experience Catastrophe When a project is designed and built to specification, without thought put into the experience of the people who will have to use it on a day to day basis. A building built without an architect. 3. Good Idea, Bad Approach When the best intentions exist to solve a problem but insufficient user consultation, poor planning and

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ANALYTICS Methods Analytics

research, and lack of focus lands the project in no man’s land, with a team who have no idea which direction they actually want to take it in. My idea is right, but the world is wrong The classic enthusiast’s tale of tunnel vision, failing to realise that what you believe is correct may not be applicable to, or even possible, in the world at large - or even your target audience. If you build it, they will come A lack of proactive consultation and user engagement. Projects and products need to have a pull, a reason for customers, patients, and organisations to make the jump towards you and engage with your idea. They won’t mind The failure to correctly identify the needs and desires at the end-user level, rather than the C-Suite level. Again, a lack of consultation. We’ve got the solution, now what do we fix? The problem where a project develops a great solution for… something? By failing to identify a key target issue, perhaps due to the scope of a project they actually fail to solve any real world issue at all, but not for want of trying.

people still struggle to stop doing it and we still can’t stop people from taking it up,” says Steve. “So we started implementing tools to help them change their behaviour - for nicotine cravings, smoking cessation tools, or therapeutic services. However, these were delivered in a piecemeal approach, and for a long while we failed to see a great deal of change in attitudes towards smoking,” “However, we then saw systemic change - the smoking and advertising bans, higher rates of taxation and health risk mandates. As a result, tobacco usage plummeted

Dr Steve Hajioff CMO Sana Life Sciences

“It’s about having an a priori understanding of how people change their behaviours and why systems change the way that they behave”

because we knew how to use the data, and how to affect the change on a systemic level. This is the same in any behavioural or organisational change pattern. It’s about understanding the drivers of behaviour data is only one of them, but if we can use it properly, we can bring about massive change.” As such, the reason digital health interventions fail is multifaceted. Problems can arise at any point in development but the crux of the issue is change itself. If we cannot guide people to understand the benefits of solutions to them, and ensure that they are utilised and able to be used in an effective manner, then we cannot begin to start using them for the better. People must understand and agree with the need to change before we can see digital solutions thrive. Contact Information

simon.swift@methods.co.uk www.methodsanalytics.co.uk

This isn’t an exhaustive list but it includes some of the major flaws that can occur in the development of a digital healthcare project – and can ultimately lead to why they fail. So how can we prevent this? Understanding change To understand where solutions fail, a large part rests on the inability to change behaviours - the simplest of concepts, but one of the most difficult to manage. The lack of solutions, or the failure to utilise them properly, is a failure to recognise the benefit, or the belief that the benefit is one thing when it is not. A viable solution is not simply a system which puts out data for the sake of it, but rather engages with it, understanding how to use it in a day-to-day basis and in a long term strategy; and crucially, the support it requires in order to make it work. “It’s about having an a priori understanding of how people change their behaviours and why systems change the way that they behave. For instance, everyone has known that smoking is detrimental for over half a century, yet 29

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20:27 17/01/2022 20:23

DIGITAL HEALTH Altibbi

Bringing medical expertise to the patient Award-winning health platform Altibbi is bringing its telehealth service to North Africa

hen mobile phones were in their infancy, few people would have imagined the world of knowledge they would deliver. Nearly 15 years and a pandemic later, the ubiquitous phone is now the source of medical information, bringing much needed help to remote parts of the globe underserved by doctors or medical institutions. Altibbi is the first platform in the Arab world to provide a remote medical consultation service that allows patients to communicate with accredited doctors directly by phone call or text chat. More than 85,374 certified and trusted physicians are available to provide instant medical consultations, in addition to providing the largest comprehensive Arabic medical content covering a wide range of illnesses and conditions. Users simply enter their symptoms and an accredited physician will respond within minutes. The service aims to be affordable for most citizens, providing unlimited consultations each month for just $5USD. However, the platform has launched a new method of consultations in Egypt, designed to provide instant, easy and affordable access to healthcare. Egyptians can dial 1130 and connect with a certified doctor directly. Payment is taken via phone credit per minute. By enabling those without a smartphone or internet connection to access healthcare services, Altibbi is extending healthcare

coverage to a wider audience in Egypt. Altibbi is committed to delivering quality healthcare services for all and reducing inequalities in access – particularly pertinent in Egypt given the complexity of its healthcare system due to social and economic challenges. The hotline is available anywhere in Egypt and Altibbi’s aim is to provide 2m consultations in Egypt by the end of Q2 2022. The service was launched in collaboration with the Jordanian and Egyptian authorities through their respective national COVID-19 hot-lines. These were vital in easing the pressure on the national healthcare systems, connecting users to certified doctors and combatting the transmission of the coronavirus. “We are excited to announce Altibbi’s new hotline service,” says Jalil Allabadi, founder & CEO of Altibbi. “With Egypt representing one of our key markets, we wanted to address the gaps in its complex healthcare system and this initiative does just that. By providing a simple hotline service, accessible to all, Altibbi is enabling fast, easy and affordable access to healthcare services throughout the nation. It represents another important step in our efforts to delivering quality healthcare services for all in the region.”

and new mothers. The Altibbi Mama App is the first Arabic app to provide such help; a vital lifeline in a region where more than 400m people lack basic health services including access to medical information and advice. Again with affordable subscriptions, the app plugs the hole in maternity provision with an easy to access service while raising awareness of reproductive health. The app features detailed information on pregnancy weeks, illustrating the symptoms and the required tests of every stage to ensure safe pregnancy. With ovulation and due date calendars, fetus growth tracking and even suggested names, mothers are guided through their pregnancies with the reassurance that doctors are on hand 24/7 at the end of a phone. Equally as important is the information on early years’ development and health of newborns. Tips and techniques for sleeping, weaning and teething are available, as well as information on common ailments and nutrition. The app also notifies mothers about vaccination schedules and other developmental reminders in conjunction with Ministries of Health. Altibbi’s website won the World Summit Award for Best Digital Health Content and the Schwab Award for Best Social Institution. Founded in 2011, Altibbi has grown to become the largest digital health provider in the Arab world with more than 2m pages of content, 24/7 telehealth service in seven Arab countries and more than 500,000 daily users. In 2020 alone, the platform delivered healthcare services to over 300 million patients worldwide, expanded its services to 12 countries and created job opportunities for 60,000 doctors around the region. This major 1130 hotline follows the launch of Altibbi’s medical academy in October 2021, aimed at strengthening virtual pharmacy care across the Middle East. All the courses are certified by the Royal College of General Practitioners in the UK and delivered through a partnership with Primary Care International. All 1,500 Altibbi doctors will be enrolled by the end of 2022. Contact Information

Maternity support Altibbi recently launched a maternity app in the MENA region to support pregnant women

www.altibbi.com

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Funding vaccine research at Oxford University A £50 million donation will create a new centre for the world-class Jenner Institute, says Healthcare World Editor Sarah Cartledge

he AstraZeneca vaccine was one of the first weapons against COVID-19, developed by Professor Dame Sarah Gilbert and her team at the Jenner Institute at Oxford University. Within just 65 days the vaccine was ready to start clinical trials and since then more than 1.5 billion doses have been deployed, potentially saving millions of lives.

As a leading vaccinologist, Professor Gilbert now has other vaccines in her sights, including Ebola, Zika, Rift Valley Fever, Dengue and even the Plague. While funding has been an issue in the past, the sudden arrival of COVID-19 has put the spotlight firmly on preparation against future pandemics. As a result, Oxford University has received the largest-ever gift for vaccines research

from Serum Life Sciences, wholly-owned by the Poonawalla family of the Serum Institute of India, who have dedicated their life’s work to the development, manufacture and supply of affordable vaccines to low-and middle-income countries. “Vaccines save lives, and the development of vaccines has been the lifelong focus of the Poonawalla family,” says Natasha Poonawalla, Chair, Serum Life Sciences. “We are committed to developing and supplying vaccines to people who need them most. We are making this keystone donation to give the world-class team at Oxford a brand-new facility from which to take their research to the next level.” The Poonawalla Vaccines Research Building will be built on the same site as the recently announced Oxford

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RESEARCH Oxford Vaccines

University Pandemic Sciences Centre, on the University’s Old Road Campus. The buildings will share infrastructure and support facilities for scientific research and academic teaching and together will form a unique hub that will significantly contribute to global pandemic preparedness and responsiveness. The main focus of the research taking place in the Poonawalla Building will be vaccinology. Housing more than 300 research scientists, the facility itself will provide the focus and scale for the University’s major vaccine development programmes allowing a rapid, productive and timely expansion of this fast-growing translational area. “The COVID pandemic has shown us our strengths and weaknesses. While we

cannot eliminate risk, we have shown that innovation, determination and partnership can transform our ability to counter and constrain global health threats. This generous gift will help

Natasha Poonawalla Chair Serum Life Sciences

“We are committed to developing and supplying vaccines to people who need them most”

create a world-leading hub for pandemic research and innovation,” says Professor Sir Peter Horby, Director, Pandemic Sciences Centre. The donation reinforces and builds on the Serum Institute of India’s longstanding partnership with Oxford University. Importantly, the Poonawalla Building will house the headquarters and main laboratory space of the Jenner Institute, the world-leading academic vaccine institute named after Edward Jenner, the father of vaccination. The Jenner Institute brings together investigators who are designing and developing numerous vaccines to generate an exceptional breadth of scientific know-how and critical mass, whilst still allowing the individual investigators to remain independent and accountable to their funders and stakeholders. The most recent Serum Institute-Jenner Institute collaboration saw the rapid development and global roll-out of the Oxford/AstraZeneca COVID-19 vaccine at scale. “The striking success of the collaborative programmes on both the malaria and COVID-19 vaccines between the Serum Institute of India and Oxford University has highlighted the great potential of partnerships between leading Universities and largescale manufacturers to develop and supply vaccines for very cost-effective deployment at exceptional scale,” says Professor Adrian Hill, Director of the Jenner Institute. Further Serum Institute-Jenner Institute collaborations include an agreement for Serum Institute to manufacture and develop, with large scale supply, the Jenner Institute’s promising R21/Matrix-M malaria vaccine, currently in Phase III trials, prioritising countries “The University has longstanding ties with the Poonawalla family and we were delighted to confer an honorary degree on Cyrus Poonawalla in Summer 2019 in recognition of his extraordinary work manufacturing inexpensive vaccines for the developing world,” says Professor Louise Richardson, Vice-Chancellor of the University of Oxford. “I am delighted that through this generous gift we will be able to further our work on vaccines which have proven so critical to global health. We will also ensure that we are never again caught unprepared for a global pandemic.” 33

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The need for standardising healthcare recruitment in the digital age Jim Campbell, Director of Health Workforce at the World Health Organization, speaks to Sarah Cartledge about the need for an international healthcare workforce register in the current climate

orkforce has always been a pivotal issue within healthcare discourse, even before the Covid-19 pandemic threw global healthcare systems into total disarray. As the world’s population continues to increase exponentially in some areas and ageing populations further develop in others, the question of how we can continue to provide and better our healthcare systems is a conundrum with no simple answer. However, the pandemic has provided us with more information than we once thought. By showing us what doesn’t work and which systems are no longer sustainable, we can garner key lessons and kickstart a new strategy that will enable healthcare systems to thrive. Slowly but surely, governments are beginning to recognise the major healthcare problem is with workforce and it needs to be addressed effectively. “A series of reports and reviews of the Covid-19 pandemic recommendations clearly say that in European healthcare systems, the public health requirement, and the preparedness element of our organisations have seen massive underinvestment for far too long,” says Jim. “A good comparison is a budget airline; there’s no bandwidth. If you sell every ticket and 10 per cent of the tickets twice to account for no-shows, if everyone does turn up, you’re overcrowded - and overcrowded means underfunded and understaffed. It’s the reality.” As such, the world is waking up to the workforce problem. With underfunding, lack of resources, and poor recruitment into health services greatly exacerbating the issues which we have faced throughout the pandemic, now is the time to refocus efforts. Yet, when the issue is not only monetary, but largely a human resource issue, where do we begin?

The digital solution The rise of digital health solutions has been one of the most important aspects of the pandemic. Innovators and entrepreneurs have responded rapidly with platforms and apps that have accustomed healthcare workers and patients alike to a new way of viewing their health. Telehealth and mHealth technologies, health monitoring apps, and tracing have all been tools which have rapidly developed throughout the past two years, and the benefits of which have been seen in all fields - chiefly due to the requirement born out of social distancing. Yet this is not something which only fulfils a purpose within the pandemic. Digital health will continue to be the sharp end of healthcare in the 21st century, and long after the pandemic becomes endemic. However, what can digital do to improve the issues within the healthcare workforce? The answer, Jim suggests, lies in regulation. “I personally believe that we should have a global register. We have the technology to do this, instead of having separate registration systems and medical registers, a global system which still operates through licences. We’ve been seeing the use of digital solutions around

Jim Campbell Director of Health Workforce WHO

“In practice, we now have an open mechanism to facilitate qualification, which can be transferable across jurisdictions”

data, information, recordkeeping and vaccinations all come through into a totally different age and now being used to enable public health and safety measures. “Yet, are we ever going to see this change in regulatory behaviour? In practice, we now have an open mechanism to facilitate qualification, which can be transferable across jurisdictions - and could potentially save the industry billions of dollars.” The global scramble for health workers In the UK, a huge portion of the NHS relies on staff who are not domestically trained but have been brought in from abroad - chiefly Asia. However, this is not a sustainable model nor a strategy for a pandemic, especially now that many NHS staff are leaving the organisation to work elsewhere. So, how can the NHS continue

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WORKFORCE WHO

to attract, and most importantly, deliver talent? “At present, the NHS has put £25m on the table to pay for flights for anybody who wants to come and take advantage of the vacancies in the NHS. To say we welcome you with open arms, we will facilitate your migration to the NHS is very positive, especially within the context of the pandemic,” observes Jim. “There was recently a discussion between President Kenyatta of Kenya and Boris Johnson which touched on the unemployed nurses in Kenya who have the opportunity to come and work in the NHS. But you have to ask the question - why are they unemployed in Kenya? It’s not that Kenya doesn’t need these nurses; they just can’t afford them.” So despite arguments to the contrary, the wealth in healthcare is in the population. As education improves and the standard of living continues to rise in LEDC’s, people

will naturally begin to expect more out of life. Within the NHS, career development aspirations, especially for people with tertiary education, are much more available. The person who comes to the NHS is going to benefit, but they will take their skills home. But the pandemic has seen travel restrictions and other curtailments that have impacted the healthcare workforce. “We have seen a moratorium placed on the licensing of health professionals to travel abroad, which can have a huge impact on migrant workforces. The Philippine government put a moratorium on newlylicensed nurses which has since been lifted because they needed the people to be working through the pandemic,” says Jim. Thankfully, the only stoppages of migrant workers we have seen so far have been temporary. However, if situations deteriorate in future, we know that it is

feasible for governments to entirely halt the movement of healthcare workers abroad - which could be devastating for those healthcare systems that rely on foreign workers. In the meantime, a global register of healthcare workers would give an instant overview of availability and capacity. It would cut down recruitment times and enable testing to take place easily. Such systems already exist to enable nurses to renew their licences in some countries, so it could easily be extended to create a global directory. There are still issues which this shift can pose - and many questions which arise from it. Who regulates the data? How can we standardise this? These are issues which need consideration - but at least we understand that we have the ability to do so. Only time will tell if we can successfully achieve this - or not. 35

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Overcoming workforce challenges The UK-KSA collaboration on healthcare is a common approach to quality assurance and competency-based training, says Ian Wheeler, Senior Lead Technical Collaboration and Consultancy at HEE

s the global pandemic has brought healthcare workforce issues to the fore, it has reinforced the need for cooperation across the world. Sharing of knowledge and training has long been a goal within the UK National Health Service (NHS), and through Health Education England (HEE) it is working with key partners to aid in upskilling clinical staff. As the the strategic workforce planning and education and training body of the NHS, HEE is responsible for supporting the NHS workforce through the development and commissioning of education and training programmes. By supporting the system in such a way, it ensures the NHS has the right numbers of staff, with the right skills, in the right place. This expertise can also be applied overseas, and in the Kingdom of Saudi Arabia (KSA) HEE has been working with key stakeholders to develop a common approach towards quality and competencebased training and assessment. HEE are currently supporting KSA achieve its Vision 2030 goals with respect to health in two areas: the development of nursing support roles and training Saudi doctors in the UK via the International Post Graduate Medical Training Scheme (IPGMTS). Nursing roles An effective nursing workforce is critical to the delivery of cost-effective and high-quality care. The Health Academy in Saudi Arabia completed an independent evaluation to identify tasks carried out by Registered Nurses which could be carried out by other healthcare workers. They then developed a project to consider the development of new roles to allow Registered Nurses to focus on core nursing tasks and responsibilities. The initial review suggested a potential of 39 new roles with the aim of creating a compassionate, competent, and confident qualified workforce. At this point, the

Saudi Commission for Health Specialties (SCFHS) approached HEE to help review the potential options as a key part of their international benchmarking process. “I’m delighted to be able to work with professional colleagues in the Kingdom of Saudi Arabia on the nursing agenda,” says Liz Fenton, HEE’s Deputy Chief Nurse. “This is a fantastic opportunity to share and learn from each other and promote the critical work of nurses in England and KSA.” HEE will use their strategic workforce skills to benchmark against several roles that the SCFHS have identified as being of critical importance. Furthermore, HEE will act as a critical friend through the quality assurance of international benchmarks of other key roles. Based on this, HEE’s internationally respected nursing team will undertake an evaluation of the proposed new roles project as situated in the nursing transformation agenda of Saudi Arabia’s Vision 2030. HEE will work closely with SCFHS colleagues to contribute a forum being planned in the Kingdom in early 2022. Here HEE and SCFHS will build on the partnership outlined above and showcase the power of UK-KSA collaboration. International Post Graduate Medical Training Scheme The NHS is internationally renowned for the quality of its medical education and training. The International Postgraduate Medical Training Scheme (IPGMTS) enables overseas doctors, by arrangement with international governments, to undertake full specialty training to UK standards. The scheme takes doctors from entry to the Certificate of Completion of Training (CCT) and recognition in the GMC specialty register in England before returning home to practice as consultants in their chosen field. Training for doctors is founded on proven systems for driving high quality and standards and delivered in cutting-edge

training facilities of the University Hospitals Birmingham NHS Foundation Trust and the wider West Midlands. The first Saudi doctors arrived in the UK in 2020 and are Ian Wheeler Senior Lead Technical Collaboration & Consultancy HEE

“The NHS offer on strategic workforce planning, workforce transformation and the human resources for health agenda are its unique selling points”

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EDUCATION & TRAINING Health Education England

training in specialties from Obstetrics & Gynaecology to Renal Medicine to Trauma and Orthopaedic Surgery. A current IPGMTS trainee listed the benefits of training in the UK as including ongoing educational activities held despite the difficulties posed by the COVID pandemic and a well-organised training scheme tailored to every registrar’s interest. She reflected that she was made to feel welcome and able to express her thoughts to both fellow junior doctors and consultants. She is confident that going back to Saudi Arabia as a CCT qualified physician will create a positive impact. The unique selling point of IPGMTS is that doctors on IPGMTS receive exactly the same training experience as UK funded

trainees. They have access to the relevant Royal College curriculum and exams and recognition from the General Medical Council, resulting in being added to the specialist register on successful completion of the programme. This means the calibre of IPGMTS doctors’ qualifications are recognised worldwide. Health Education England’s offer to Arab Health The NHS offer on strategic workforce planning, workforce transformation and the human resources for health agenda are its unique selling points. HEE’s global offer helps deliver on the organisation’s commitment to the UK’s global health

system strengthening priorities and does so through collaboration and partnership. IPGMTS currently operates in Kuwait as well as in KSA and HEE are beginning to see the outcomes of partnership development efforts in Saudi Arabia and the wider region. HEE are keen to explore partnerships to jointly overcome health workforce challenges and build on successful relationships in Saudi Arabia and other Arab states. Contact Information

TCC@hee.nhs.uk www.hee.nhs.uk

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17/01/2022 20:13

Cyber resilience in the Middle East healthcare sector Healthcare providers are seeing an increase in cyberattacks, says Russell Mayne, Dell Technologies Healthcare Field Director for Middle East, Russia, Africa, and Turkey.

ver the last few years we’ve seen bad actors increase their interest in healthcare organisations around the world. While banking and retail have been able to largely secure systems and control access, healthcare presents a specific challenge in terms of the number of non-technical end-users needing access to highly valued patient data. In fact, healthcare providers continue to see an

increase in cyberattacks, with 53 per cent of healthcare organisations being subject to attacks in 2020. In addition, • 35 per cent of UAE tech executives were attacked by ransomware during the past year • There were more than 2.5m phishing attacks in the Middle East between April and June 2020

• A 600 per cent increase in phishing in the UAE from February to June 2020 has been reported • More than $6.5m cost per data breech in the Middle East Dell Technologies is committed to supporting our Middle East healthcare clients, ensuring health data remains accessible for patient care but secure from intrusion. Cybersecurity incidents can create both measurable and soft costs to organisations. Research from Comparitech found that providers have spent at least $160m in recovery costs since 2016, and these direct costs only represent a small portion of the impacts. Personally, I look behind the commercial loss caused by a security breach and recognise the very real impact a breach has on patient care and reputational damage for healthcare providers.

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SECURITY SYSTEMS Dell

loop in which attackers are motivated to keep on targeting organisations and refining their attacks with no consequences for their actions. We believe that security must be intrinsic to every aspect of a digital organisation, from the core, to edge, to the cloud. There are available solutions to ensure that your organisation deploys the right mix of automated, intelligent, and intrinsic security to address emerging threats in our rapidly changing environments. ‘Resilience’ means the ability to prepare for and adapt to changing conditions, and withstand and recover rapidly from disruptions. This includes the ability to withstand and recover from deliberate attacks, accidents, or naturally occurring threats or incidents. Cyber Resilience is a strategy that incorporates people, process and technology into a holistic framework that protects an entire business organisation. Supporting healthcare organisations further secure their IT environments

The importance of Cyber Resilience As a clinician with more than a decade in clinical practice I recognise the immense cost when critical healthcare systems go down. It is standard international practice that healthcare providers have clinical plans in place should the system go down, although recovery from a system outage may take 10 hours for every hour of outage. Even so, we should remember that a healthcare organisation exposing a large attack surface is at high risk of being taken down for a considerable amount of time. A cyber intrusion is fundamentally different to a “normal” system downtime. While recovery from a ransomware attack can span years due to the remediation efforts required, taking the shortcut and paying the ransom is simply is not worth it. This is relevant given the fact that a Sophos report shows that more than 28 per cent of organisations in the Middle East paid a ransom. Paying the ransom creates a vicious

Secure Care capabilities must be intrinsic in everything, extending across all touch points and workstreams. Organisations must enhance all facets of security including staff, endpoint, and network security to deliver continuous remote access to anyone, anywhere, anytime. Organisations need to identify where their data assets currently reside and understand the importance of their data to apply appropriate protection. Modern data protection solutions help address current threats, while ensuring data security and compliance to help organisations maintain continuity of care and readiness for what’s coming next. Healthcare providers need to align strategically with key partners that can provide security solutions from the point

Russell Mayne Healthcare Field Director Dell Technologies

“Organisations need to identify where their data assets currently reside and understand the importance of their data to apply appropriate protection”

of care to the data centre to the cloud. A recent study found that 80 per cent of organisations rely on security solutions from multiple vendors. The study went on to show that organisations which work with multiple vendors face an increased risk in protecting their environments. Those that work with a single vendor see half the downtime cost and 20 per cent the data-loss cost, representing considerable savings and reduction of risk. All CIO’s, CISO’s, Chief Medical and Nursing executives have a duty to ensure that their business and clinical staff are fully equipped to respond correctly to cybersecurity threats. We encourage training that mimics realworld threats with simulations on how to best automate and respond to cyberattacks. Protecting your future investments in data Healthcare organisations should reassess the distribution of their cybersecurity investments, placing more emphasis on response and recovery while allocating more budget to cybersecurity. As technology becomes more advanced, data grows exponentially – becoming a more attractive target for sophisticated threats. The HIMSS 2020 Cybersecurity survey found that only 6 per cent of healthcare organisations dedicate 10 per cent or more of their budget to cybersecurity. By leveraging a comprehensive portfolio of offerings, healthcare providers can secure their data across the health system continuum which is more important than ever as our new ‘work-from-anywhere’ environments aren’t going away. Healthcare security solutions should encompass physical security, staff training, network security, endpoint security, data protection and data recovery. Together, these solutions and services allow the creation and maintenance of a secure care environment while improving efficiencies and streamlining patient care. I want to live in a world where all healthcare organisations are prepared and resilient in the face of this real threat.

Contact Information

www.dell.com

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Body language For Dr Charles Gutteridge, Clinical Engagement Lead at SNOMED CT, the safe, accurate and effective exchange of health information is an essential part of the foundation to improve global healthcare

hen Dr Charles Gutteridge rearranged his consulting room so that patients could sit alongside him and look at their test results on a computer screen, the response was more than encouraging. “It was transformative,” he says. “Patients became engaged and invested in their own health. They felt represented electronically and empowered.” The veteran haematologist and specialist in clinical

informatics was immediately convinced of the power of sharing electronic medical data. For the past five years, Dr Gutteridge has been monitoring similar benefits in the expansion of SNOMED CT, the world’s most comprehensive computable language of health for use in electronic health records. Standing for “Systemised Nomenclature Of Medicine”, it has been nearly two decades in development, with specialist programmers

and clinicians creating a vast dictionary of clinical vocabulary that stands to become the medical equivalent of Google’s codification of the English language. Since forming in 2007, the company has been operating as a non-profit organisation to prioritise the strategic development of this system to meet the healthcare sector’s needs. Now, simply by entering a code in an electronic health record, a doctor can bring optimal care to a patient by accessing test reminders, academic resources and everything else available on this global research system. With more than 350,000 medical concepts available, it offers an infinite amount of combinations to describe the human condition; which promises better health and improved patient outcomes.

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HEALTH SYSTEMS SNOMED

Global healthcare language The safe, accurate and effective exchange of health information is an essential part of the foundation to improve healthcare around the world. SNOMED CT can be routinely integrated into healthcare information systems so users can record patient data more accurately and comprehensively – and use tools and analytics to provide better patient care and health management. SNOMED CT has been developed collaboratively to ensure it meets the diverse needs and expectations of clinicians worldwide and is now accepted as a common global language for health terms. As the most comprehensive, multilingual clinical healthcare terminology in the world, it is a resource with comprehensive, scientifically validated clinical content. It enables consistent representation of clinical content in electronic health records and is mapped to other international standards.

The SNOMED CT clinical terminology has unmatched depth, enabling clinicians to record data with enhanced accuracy and consistency. SNOMED CT remains a growing and evolving product made better by the Community of Practice. It is currently used by 40 member nations, through a licensed model based on a country’s size and wealth. For the past two years, every GP and major hospital in Britain has had it embedded into their electronic systems, meaning that Dr Charles Gutteridge Clinical Engagement Lead SNOMED CT

“The more people participate, the better it will be, and the more benefits for patients everywhere”

millions of UK patients are already reaping the benefits of having their records encoded. For Dr Gutteridge, the biggest challenge has been persuading practitioners to change old habits and “to adopt digital health systems in place of writing with a gold pen”. But he hopes they will begin to add data and create an ever-expanding research system for global use. The rewards for those who do will be increasingly advanced personal health records, new medical discoveries and information sharing with any health system in the world. “The more people participate,” says Dr Gutteridge, “the better it will be, and the more benefits for patients everywhere.” Contact Information

www.snomed.org

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17/01/2022 20:04

Operating in the shadows Procurement Spend Analytics is critical to hospitals realising maximum value, Mat Oram CEO of AdviseInc tells Sarah Cartledge

elping suppliers get the best products into the market is a simple concept but one that is not necessarily at play in the UK healthcare sphere. Many hospital groups still procure independently, from one NHS organisation to another, leading to disparity of pricing and often overspending. Within the NHS, which has more than 220 provider trusts, the price gaps can seem

incomprehensible to those outside the system, but fortunately there is help at hand. AdviseInc is a small but dynamic health tech company that sees its goal as helping healthcare organisations make sense of their spend data, thus saving money. They achieve this by connecting product knowledge with Artificial Intelligence and analysing millions of rows of line level

purchasing data to identify discrepancies and anomalies, resulting in huge savings for the hospitals that consult them. Once clients understand the value in their data, they continue to use AdviseInc to analyse an ever-increasing data set and drive more insight. For CEO Mat Oram, this is the optimum result. Five years ago the company was delivering a national price benchmarking tool to every NHS trust in England until NHS Digital brought the service in-house more recently. Now Mat and his team work directly with many countries and hospitals including NHS Wales, Health and Social Care Northern Ireland, Guy’s and St Thomas’s and Integrated Care Systems,

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ANALYTICS AdviseInc

more expensive equipment out of habit, or because they have been sold it when they didn’t need it. We came across one case where a particular surgeon insisted on continuing to use a certain brand of orthopaedic implant because he had always used it, and he cost the hospital £0.25m extra a year as a result.” Pulling together the data sets

including Bath & Wiltshire and Cheshire & Merseyside to impact the bottom line – more than 70 NHS organisations & growing. “We operate in the shadows and few people outside the procurement and finance teams know we exist,” says Mat. “The better teams will introduce us to the wider hospital team, including clinicians, so we can produce the optimum result for them, but a number of teams don’t always know who their clinicians are, and we often end up making the introductions ourselves. “Once we explain the benefits of our analytics to the surgical and healthcare teams, they can understand how their choices drive variation and how they can reduce it to save money. Often, they use

Currently AdviseInc manages a number of different procurement applications. Now they are developing a single structure called Control Tower to aid procurement managers who run many teams in different hospitals. “It will give regional and trust leadership all the KPIs and the information they need to stay in control of their region. At the moment there are many varied data sets so we’re starting to pull them all together to drive these KPIs in one place,” says Mat. Control Tower is planned to launch in Q2 of 2022. “Our applications have grown organically over the years and they are often bespoke to a particular need or pain point for a procurement team. Now they will be under one framework, which is going to have a new look and feel and will be consistent regardless of which modules a customer wants to buy into,” he says. But pulling together the data is just the start. The process then relies on the internal teams to look at the data and work out where the savings can be made. Sometimes other factors come into play and it’s not possible to make the changes, but often the investigations yield positive results. “We really need the hospital concerned to engage because we can only do so much with the analysis,” says Mat. “In general, the NHS really needs to invest more in analytical capability within procurement teams and upskill staff regarding data literacy to get the most out of our tools and analytics. “Aortic valves are a good example, with one hospital being shown why they’re an outlier in terms of the products they work with. From a price point of view they were getting a good price compared to peers, but were buying the platinum version of the product. After studying the brand and product variation analysis, we showed them how many high-tech (high cost) products they were using versus the rest of the country who all used a great percentage of low-tech (low cost) products. For a specialist hospital this may be the case, but not for all.”

Mat Oram CEO AdviseInc

“It’s only when we connect a hospital’s disparate datasets together do we see the real value within”

Value-based procurement By analysing the data and price benchmarking, Mat estimates the NHS could save between £70m and £300m each year. For him, the most successful and sustainable route is value-based procurement. “Initially suppliers saw us as a threat with our price benchmarking, uncovering the different prices they charged to clients,” he states. “Now many suppliers understand that if they can demonstrate reductions in patient stay in hospital or a better patient outcome, we can actually back this up with the data to demonstrate overall value and not just the lowest price. If we can introduce hospitals to different suppliers to save money in this way, then we do so.” In addition, Mat and his team can help overseas suppliers understand the best approach to the NHS, having worked in it for over 17 years. The entry point for most overseas work for AdviseInc is in product price benchmarking service, which is simple for the client to understand and delivers the most value quickly. It’s most successful within hospital groups who could be looking to understand how to save money across multiple sites. Most companies start on a small scale with Mat’s team to prove the concept. “Once we’ve taken them on the journey and proved the solutions pay for themselves quickly, we’re then asked what else we can do. Because we can connect the data like no one else in the market, we’re able to release more value than traditional, basic spend analysis and benchmarking.” Contact Information

support@adviseinc.co.uk www.adviseinc.co.uk

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Creating hospitals at home Enabling people around the world to live longer and more fulfilling lives through technology is a realistic goal, Huma CEO Dan Vahdat tells Sarah Cartledge

he idea of hospitals at home has been gaining traction in recent years as secondary care buildings require constant updating as medicine advances and populations increase. Thanks to the rapid uptake of digital technology in the healthcare sector, the concept is becoming reality with companies such as Huma spearheading the way. Huma’s vision is very simple. Instead of patients accessing healthcare through hospital or clinic appointments, an application connects a series of devices so that patients can interact and be connected

to the care centres. The platform is configured for different use cases, diseases and conditions and the data gathered enables care to be more predictive, effective and scalable. The pandemic has accelerated this trend as patients have become used to the idea of taking more responsibility for their own conditions. Huma has worked with the NHS in the UK and with key institutions in Germany to roll out the platform and has seen it more than double the capacity of hospitals within a short space of time. “Once you could look after 1000 patients with four doctors and nurses; now you can

look after 2000 patients with the same team,” says Dan Vahdat, CEO of Huma. “You need to have a small portion of your staff focussed and dedicated to looking after these patients in a new way, but ultimately it prevents a lot of the repetitive work that was done previously.” Benefitting the patient Most patients visit a clinician, often via an outpatient appointment, two or three times a year to monitor an ongoing condition. However, they can deteriorate at any point and 98 per cent of the time they are left alone in the real world. “By bringing a technology that can simply sit in your pocket and is always with you, it helps you to be connected to your care team and to be educated about it. This way you can look after yourself and change behaviours so you’re better off,” says Dan.

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HEALTH SYSTEMS Huma

“Collecting the data also enables your care team to flag you through a system automatically, communicate with you and get to you proactively before a condition becomes really complicated. It’s a no brainer because the alternative is, if you’re at home and something goes wrong, you’re severely deteriorated by the time you show up in hospital.” With elderly patients, the concern has been their lack of exposure to digital technology. However, Dan has found that in the past two years the number of seniors adopting technology has increased by 38 per cent. “The biggest age group on our platform is between 60 to 80 years old and they’re using it, so I think that shows to some extent that most elderly people will use a solution if it helps them. For those who might not be able to do so, we have created a feature called caregiver or proxy, which is a family member or carer. You can interact and input information on the patient’s behalf.” Utilising the data The intersection of technology, computing, AI and medicine is now creating the ideal conditions for proper research into many areas. “Suddenly you have real time, clean, organised, actionable data that, on the clinician or hospital side, means we can flag the patients automatically. We can start predicting certain trends if need be. And this way we’re always ahead of problems and we can make the care more proactive rather than reactive. That’s the big promise that everybody has been looking to deliver for many years,” says Dan. The platform can also be used to monitor patients in clinical trials or research studies so, as well as being cared for remotely, they are also providing data to verify the drug is doing what it is supposed to do as the patient lives their daily life. “Historically clinical trials were more controlled but this is a better development as it considers the lifestyle of the patient,” Dan says. “Sometimes a drug might help you to keep pain free but it could mean you are sleeping all day or you are immobilised, so it’s not necessarily the best treatment. This kind of technology brings the human aspect of your life into the trial as well.” Data provided by Huma on COVID wards was instrumental in helping to update government guidance on blood saturation

Dan Vahdat CEO Huma

“I want to have hospitals at home in each country in the world and enable participants and patients everywhere in the world to be part of studies and clinical research” levels to spot hypoxia and to deal with it straight away. “It’s the simplicity of the deployment,’ says Dan. “When we entered the market in Germany we went from nothing to having a platform that was ready and deployed across all the major health care systems in the country. This important because if you can learn something in a few weeks and can double the capacity of your hospitals without needing to build hospitals, which take time and are expensive, then the healthcare system sees immediate benefits.”

Currently Huma operates in the UK, Germany, France, the UAE and Saudi Arabia where there are national initiatives. They are also rolling out in India, demonstrating for Dan that such technology is not just for modern countries but can be implemented across the board. “The beauty is it relies on the mobile phone so many people can access it in a very democratised way,” he says, adding; “This delivery of care gives access to hospitals in ways that weren’t possible before, so how can we make it better, more personalised for the patients, more predictive, more human? We always try to add the right features to make it as simple as possible for the patient because at the end of the day you want to have it running in the background. “I want to have hospitals at home in each country in the world and enable participants and patients everywhere in the world to be part of studies and clinical research. And if you make that happen, it’s good for everybody.” Contact Information www.huma.com

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Healthcare transformation in the UAE The region is implementing legislation aimed at integrating international standards, says Christina Sochacki, Senior Associate at law firm Al Tamimi & Company

ver the past year, the healthcare and life sciences regulators have been very active across the Middle East. Amidst the continued plethora of COVID-19 related legislation, the regulators have continued to advance their healthcare systems and implement legislation aimed at integrating international standards. The region continues to focus on healthcare transformation.

UAE Healthcare Overview The UAE is a confederation of seven emirates. While the most well-known are Dubai and Abu Dhabi, the other emirates are Sharjah, Ajman, Fujairah, Umm al-Qaiwain and Ras al-Khaimah, often collectively referred to as the ‘Northern Emirates’. At the federal level, the Ministry of Health and Prevention (MOHAP) oversees

the implementation of federal government policy in relation to the provision of comprehensive healthcare for all UAE citizens and residents. MOHAP works in collaboration with the local emirate health authorities to ensure that all public and private hospitals are accredited according to clear national and international quality standards of medical services and staff performance. The emirates of Abu Dhabi, Dubai and Sharjah have established their own health authorities, the Department of Health (DOH), the Dubai Health Authority (DHA), and the Sharjah Health Authority respectively. The remaining Northern Emirates rely on the MOHAP to act as their regulator to oversee delivery of healthcare services. Dubai and Abu Dhabi have the most developed rules and regulations among the seven emirates with respect to healthcare

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LAW Al Tamimi & Company

matters. Both regulators have been extremely busy in 2021, not only keeping up with the fight against COVID-19, but also issuing a plethora of new and updated regulations. Telehealth Telehealth has remained a hot topic through the pandemic. Accordingly, in 2021, the DHA issued a swathe of new and updated legislation aimed at telehealth, including a new telehealth policy setting out the regulatory requirements for licensure of telehealth services. Telehealth services are divided into six key areas: 1) teleconsultation; 2) telediagnosis; 3) telemonitoring (remote patient monitoring); 4) mHealth (mobile health); 5) telerobotics and robot-assisted services; and 6) telepharmacy. All telehealth services and

telehealth platforms operating in Dubai must be licensed by DHA. Telehealth services are licensed under one of the following areas: 1) call centre; 2) telebooth; or 3) add-on services. It is not permitted to store, develop, or transfer data and health information outside the country that is related to health services provided within the country, except in limited cases. In addition to the new telehealth policy, the DHA’s telehealth services standards were updated. Version 3 issued several updates, including requiring all facilities providing telehealth services, as well as all telehealth platforms intended for internal or commercial use, to obtain approval from the DHA prior to providing such services. Also included are updates to: the exceptions to store, develop, or transfer data and health information outside the country; requirements for electronic consent; and certain subsections related to telepharmacy. Further, a new version of the DHA’s guidelines for reporting telehealth key performance indicators was issued. All telehealth service providers are required to adhere to the quarterly collection and reporting of performance indicators within the two-week deadline, as specified in the new version 3 of the guideline. Among other updates, the new version has added reporting deadlines and a new KPI on the percentage of telehealth calls from outside the Emirate of Dubai. A variety of clinical guidelines pertaining to managing various symptoms through telehealth were also issued by the DHA. The guidelines are presented in a format comprising of clinical history/symptoms, differential diagnosis, investigations, and management. In addition, compliance is required with, amongst others: federal laws regarding telehealth services, the use of the information and communication

Christina Sochacki Senior Associate Al Tamimi & Company

“Dubai and Abu Dhabi have the most developed rules and regulations among the seven emirates with respect to healthcare matters”

technology (‘ICT’) in healthcare, and medical liability; the National Electronic Security Authority Standards and Guidelines for Cyber Security; the Telecommunications and Digital Government Regulatory Authority for Voice Over Internet Protocol channel requirements related to telehealth; the Dubai Health Insurance Corporation requirements for telehealth approval processes e-claims, reimbursement, and documentation; and applicable DHA standards. Artificial Intelligence Keeping pace with developments in digital health, the DHA issued a new policy on artificial intelligence (AI) solutions for healthcare. All AI solutions used in the delivery of healthcare must conform to international, UAE federal, and Emirate of Dubai information laws, regulations, and guidelines with respect to human values, patient autonomy, people rights, and acceptable ethics. The policy applies to: a) all healthcare facilities and professionals licensed by DHA utilising AI in healthcare services; b) national and locally based international AI developers that utilise Dubai based population or patient clinical and nonclinical data to develop AI solutions; c) UAE based pharmaceutical manufacturers, health insurers, public health entities utilising AI solutions for healthcare services in Dubai; d) all AI solutions used by healthcare researchers involved in human research in Dubai. Healthcare Data Privacy & Security On the horizon, we can expect the UAE to continue to develop its legislative framework concerning healthcare information data privacy and security, which will impact any entity that processes health related information. In 2019, the UAE’s federal law on the use of information and communications technology (ICT) in health fields (ICT Health Law) introduced national regulations to allow the MOHAP to collect and analyse health data at a state level in the UAE. One of the most impactful provisions of the ICT Health Law was that it mandated that health information and data related to services provided in the UAE could only be processed, generated, or transferred outside of the UAE in cases prescribed by virtue of a decision issued by a local Emirate health authority, in coordination with MOHAP. 47

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Christina Sochacki Senior Associate Al Tamimi & Company

“We continue to anticipate promising opportunities to enter the market or expand existing businesses” In April 2021, the MOHAP issued a Ministerial Resolution that introduced several clarifications and exceptions to the data localisation restriction in ICT Health Law (Resolution). The Resolution defines the phrase ‘health services provided within the [UAE]’ as ‘any health work or procedure carried out by a health facility operating within the [UAE], whether it is within the scope of diagnosis, prevention, treatment, rehabilitation or health monitoring’. Generally, the default position remains that health information and data may not be stored or transferred outside of the UAE. However, the Resolution expressly provides for 10 circumstances wherein the transfer of health information and data outside of the UAE may be permissible. Additionally, the DHA issued a new policy concerning healthcare data quality. The policy is intended to cover all patient information that is recorded within the healthcare facility. The principle emphasis of

the policy is on electronic medical records (‘EMR’), the documents used to populate those electronic systems, and the data extracted from them. The policy must be followed by all healthcare facility staff involved in the collection, recording, storage, processing, or use of patient-related data, regardless of their role within the healthcare facility. All digital solutions that manage medical records/patient administrative data (e.g. EMRs, revenue cycle management) must be certified by DHA to ensure that it has the required functionality and security. Patient data covers anything that relates to health interventions, including administrative information, demographic data, diagnosis, treatment, prescribed medication, laboratory tests, physiologic monitoring data, hospitalisation, insurance, etc. Hospital Accreditation In line with the Dubai Health Sector Strategy 2021 – 2071, the DHA issued a new hospital accreditation policy. It requires that all DHA licensed hospitals are accredited by an International Society for Quality in Healthcare (ISQua) International Accreditation Programme approved accreditor within 24 months from the point of licence activation. Hospitals should fulfil the standards for operation as a hospital including, but not limited to, outpatient, inpatient services,

operating theatre, and pharmacy. In addition to hospital accreditation, accreditation for other specific units, services, and/or specialised services is required – such as laboratory services – stipulated in other policies, standards or circulars issued from DHA. Evidence of maintaining accreditation must be submitted annually during facility licensure through the online Sheryan licensing system. Further, all hospitals operating within the jurisdiction the DHA must ensure that they are onboard to the NABIDH platform as a pre-requisite to applying for a new or renewed hospital licence, effective 31/12/2021. All hospitals should have an electronic medical record (EMR) that complies with the NABIDH Minimum Data Set and standards. Hospitals have the right to choose any EMR in the market that complies with NABIDH requirements. As the regulations in the region continue to rapidly progress, and the doors to doing business in the Middle East become more agile, we continue to anticipate promising opportunities to enter the market or expand existing businesses. Contact Information

c.sochacki@tamimi.com www.tamimi.com

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17/01/2022 20:27

Meeting the unmet need The key to success in US market entry is picking the right commercial partners, says Ernesto Chanona, Director of Business Development at CSSi Life Sciences

he first half of 2021 has seen more investment into the biotechnology sector than in the entire year of 2019, as reported by the Silicon Valley Bank. It is an excellent time to be in the life sciences sector, and as such, many would like to take the necessary steps to enter the US market by obtaining regulatory approval for medical devices, diagnostics, biologics, vaccines or drugs. As it stands, currently 35 per cent of approved medical devices in the United States, 40 per cent of finished pharmaceutical drugs for the United States, and 80 per cent of APIs (active pharmaceutical ingredients) are manufactured or compounded from foreign entities. While entering the US market can be a tedious and costly task, the great news is success and commercialisation are an attainable goal for those who seek to understand the process. Many companies that are not properly prepared can find themselves having difficulty crossing the all too well-known “valley of death”. Seeing the success of other companies proves, though, that there is a pathway to the other side of the valley. Taking the first step First, companies need to ensure that they are prepared. When entering the US market, foreign companies should spend time on market and revenue research, creating a comprehensive project timeline, and estimating costs. As this process unfolds, there are a few questions to consider: • What unmet public need are we solving with this product? • Are we planning to launch our product in multiple markets? • How much should our product cost in each market? • Are we seeking dilutive capital from US investors to support regulatory approval and commercialisation? • Do I meet all regulations and requirements required by the FDA? • How do I establish a business in the US?

• Who are the stakeholders (economic development, academic, government, services) in our US biotech hub that could support my company and my technology? These questions are best answered by a consulting team that have made this journey already, and have in-depth knowledge of the path ahead. Picking the right partners is the key to commercial success, whether it be to out-license or sell a technology, or find the right distribution partners for entering the hospital supply chains in the US. As a foreign company looking to enter the US market, designating a United States agent is required by the FDA. They must reside at a US address and will act as a liaison between the FDA and the life sciences company. Selecting the right US Agent liaison can best position a company for a swift and cost-effective regulatory approval, connectivity to supportive partners and investors, and the successful accomplishment of commercialisation goals within the allotted timeframe and budget. In the case of medical device companies, for instance, the regulatory requirements that need to be met include a Quality Management System that meets US standards, approval through the appropriate filing process with the FDA, and annual reporting and registration. There are four common types of premarket submissions: 510(k) (Premarket Notification), PMA (Premarket Approval), De Novo Classification Request, and HDE (Humanitarian Device Exemption). The regulatory path that a device depends on the case that is made to the FDA. Your regulatory consultant will write and deliver the case to the FDA and obtain the agency’s buy-in to secure the swiftest, most affordable path forward. Some of the questions they will answer include: • • • •

What submission is best for my device? What is the most suitable indication? Is a clinical trial required? How extensive? Are we eligible for any special designations from the FDA?

Ernesto Chanona Director of Business Development CSSI Life Sciences

“Many companies that are not properly prepared can find themselves having difficulty crossing the all too well-known ‘valley of death’”

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HEALTH SYSTEMS CSSI Life Sciences

Getting the numbers right Investor relations is another important aspect to successfully commercialising technology in the United States. Finding the group with an investment thesis that aligns with your technology and goals can be challenging. Moreover, understanding the needs of the American investor community is not always straightforward. In short, investors want to see clearly defined milestones and the costs associated with them. The team should be able to elaborate on the rationale behind the costs assigned to aspects such as manufacturing, FDA

submissions, and testing. The timeline for the return on investment should also be clearly defined. By understanding your technology and the FDA requirements, your regulatory team will be able to generate this information, further de-risking your technology to investor groups. There are many moving pieces to the US market entry process and having a strong team to support each piece is the key to commercialisation success. While the entirety of this process can be overwhelming for companies who are not specialised in it, collaboration and partnerships with experienced consultants

and organisations can give foreign life sciences companies the counsel and expertise needed to make the journey more navigable. Proper guidance makes any FDA entry journey, no matter how challenging, achievable. Contact Information

echanona@cssilifesciences.com www.cssilifesciences.com

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17/01/2022 20:14

Creating a digitally integrated health system Healthcare World’s Steve Gardner speaks to Richard Oakley, Neil Mason and Jodi Carter of Methods Analytics about the intricacies of developing and building a fully digitally integrated health system

ver the past 40 years, technology has changed the world in a way not seen since the industrial revolution. If you told someone in the 1980s that we’d be watching television on our phones, and have the ability to shoot studio-quality videos accessible to everyone around the world in just a few seconds, all from a device the size of your wallet, they wouldn’t believe you. HD TV would be jaw-dropping. Cryptocurrency? Artificial Intelligence? Virtual Reality? Don’t even try to explain. But it’s not just smartphones that have had a profound impact on the world. The digital age has completely revolutionised every sector of human interaction both in business and our day to day lives. Yet, within healthcare, the sheer potential of this new age has not been realised - not even close.

Consider the health systems that you may have on you as you read this. A smart watch, for instance - which can not only monitor your pulse and oxygen saturation, but also detect atrial fibrillation. Steptrackers which record your daily exercise without even thinking about it. Continuous glucose monitors that can notify diabetics at a moment’s notice of their blood sugar levels. These are only a select few of the multitude of personal health devices we can now access. The technology today enables people to take charge of their own healthcare like never before. Yet, this itself is an issue. While the benefit of personal digital health solutions, and the data from them is potentially profound, how can we apply this to health systems at large? Obviously, the data collected from just one person’s digital health profile alone would be huge so from a few thousand individuals? Astronomical.

Then how do we bring this data together and produce meaningful and actionable insight to improve the health of individuals and populations? This is why I spoke to Methods Analytics’ Richard Oakley, Head of Data Science and Artificial Intelligence, Neil Mason, Head of Healthcare Strategy, and Jodi Carter, Head of Healthcare Sector, to understand how we can build a digitally integrated healthcare system. If all the current apps, technologies, websites and more were merged together, would we have everything we need to create an end to end digitally integrated health system? Neil: I’d say no - but we are on our way and getting close. We’re fortunate, particularly in the UK, to have a National Health Service that collects a huge amount of data, but it is very disparate. If you could pull it all together, you would have a wonderful resource. It’s the quantified self that is still nascent - all the personal data that people are amassing now. How easy it is to share the data is a big question, yet in the relatively near future we will be at a point where you could begin to think that you might have sufficient to start transforming the way we deliver and think about healthcare.

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ANALYTICS Methods Analytics

Do we have all the software and apps that we need but just don’t know how to connect? Or do the technologies still not exist? Jodi: Somewhere there is an app or a piece of software that covers most parts of the system - the problem is that not everybody is using that one bit. So there may be one provider who is really good at the front end delivery of consultations, for instance, and they have great data or a great app for that, but then they don’t do anything after that point. There will certainly be many use cases with no current visibility, let alone solution. So is it a question of language then? Is it about getting all the diﬀerent technologies to talk to each other? Richard: I don’t think it’s a simple integration or interoperability question. It’s more of a problem of transforming a health service. Simply having an app doesn’t make people behave differently. For instance, fitness trackers are a great example – there’s a huge amount of virtue in having one for people who are looking to improve their fitness and lose weight as they can be a really good way of monitoring their progress. However, it doesn’t change the fact that individuals have to make a conscious personal decision to engage with their device for that purpose; the concept of ‘patient activation’ comes in here. That’s the missing piece – all these apps etc are great, but is it in the best form for it to work for individuals and the health service? For these services to work, people have to choose to engage with them, and I don’t think we’re there yet. For instance, in the UK at the moment GP’s are overloaded. As a result, people think the only way they can access the health service is via the

Richard Oakley Director of Data Science & AI Methods Analytics

“People should be talking less about digitising health systems and more about totally rethinking how we approach healthcare in the light of the technologies available to us”

emergency room, so they go there to see a human being, despite the fact that emergency rooms are over-capacity too and are actually not remotely optimised as settings for non-urgent care. In this instance I don’t think apps are going to help. It’s a much bigger challenge than the integration and interoperability problem, which can be solved with improving standards and good collaboration between companies. It’s a system problem, a behaviour problem and a question of ambition. Is it about driving cultural change and getting people to accept the idea that their healthcare can be delivered digitally through apps and wearables? If so, how can it be achieved? Neil: Sticking with the example of the UK, the capacity in the NHS is strained right now, and I don’t see that changing any time soon. Apps certainly can alleviate some pressure in particular areas if people accept digital solutions, such as a remote consultation with a GP that results in a treatment that is monitored remotely. We do need to see people accept that more. The fundamental missing link is a ubiquitous solution or app that everyone knows. For example, the COVID-19 NHS App has driven people’s awareness of the national NHS app. As people have started to use it, more are starting to self-service prescriptions and access services via the app though this is relatively limited in scope. Most importantly, we need it to be trusted, and I’m afraid people don’t necessarily have that trust in digital health solutions just yet. When they do, you start to see channel shifts and certain types of healthcare being delivered truly digitally. Will we look back in 20 or 30 years and realise that the idea of sending ill people to places full of other ill people might not have been the best idea? Jodi: COVID has highlighted many things that people knew but weren’t talking about. GP’s probably shouldn’t be seeing dozens of sick people every day and should be using digital solutions where they can. But there’s been no push to force people into that conversation until now, so if some of these changes stick, that will be positive in terms of digital care.

How digital do we need to be? Richard: The UK is not unique in the way we set up our care system by any stretch of the imagination. The role of the GP 100 years ago was to visit people at home, even if there was little they could do for them. Nowadays, there is so much we can do for people with a body of medicine that has far exceeded the capabilities of any one individual. So the GP became the foundation of the NHS, treating most people and signposting those that needed specialist care, and that’s how we choose to use them in the UK. The same is true of technology. We started with virtually no apparatus, and it’s become more about digital, more about data. Take patient records. They went from paper to digital, and the benefit was clear. Now all administration at a surgery is digital so doctors can do more work than before. But is this the right way to run the system today or will it compound issues or reduce value from something which is, relatively speaking, already optimised? So the question is not so much how digital do we need to be, but are we digitising the right thing? For me, across the world people should be talking less about digitising health systems and more about totally rethinking how we approach healthcare in the light of the technologies available to us. That will move us on in ways that we can’t imagine right now, but I guarantee that proactive digital-led care rather than reactive physical care will be a huge part of the story. Conclusion So there you have it. This group of experts thinks we already have some of the answers, but they are not properly aggregated, nor are they always used or trusted. The answer appears to be a completely new way of thinking that uses digital in totally innovative ways. If we start thinking about new approaches to healthcare as a whole, we may actually end up with a system or systems that work in today’s interconnected world. Contact Information

analytics@methods.co.uk www.methodsanalytics.co.uk

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17/01/2022 20:09

Integrated care – a new reality? Putting patients at the heart of the system is the way forward, says Carly Caton, Partner at Bevan Brittan LLP

ere in England our health system is currently undergoing (another) transformation and reorganisation. We are awaiting the passing of the Health and Care Bill, which is currently at committee stage in the House of Lords. Integrated Care Boards were meant to be up and running and take legal effect by 1 April 2022, but this date has just been postponed by 3 months to 1 July 2022. The driver behind these proposed changes is to achieve a more integrated

health system, putting patients at the heart of the system and achieving a joined up care pathway where all parts of the system are working in partnership with the same end goals. This is a concept that has been around for a long time and almost everyone, across political parties, seems to agree it is a good idea. While there are pockets of good practice in England, this has never been achieved at a grand scale – but there has never been legislation behind it before. Will it work now and what are the factors needed for true integration?

What would great integrated care look like? • The bringing together of data and information from health, social care and other support organisations in relation to care delivery, care outcomes and workforce wellbeing and satisfaction. • A people / patient centred health system. • People working together to understand a patient / service user, their needs, putting them in control and coordinating services for the best outcomes. • All of the above? When I looked for definitions or explanations of ‘integrated care’ I was met with scores of different ways of explaining

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LAW Bevan Brittan

• Success is more likely where there is a specific focus on working with individuals and informal carers to support self-management. The COVID-19 factor

it. That is because there is no ‘right’ answer and individual parts of the health system view this in their own way. A patient receiving care or services would see this differently from a health provider or a commissioner of health services. Everyone is looking through a different lens.

Carly Caton Partner Bevan Brittan LLP

“People’s health is influenced by so much more than the health system they happen to live under”

Some countries are held up as demonstrating good examples of integrated care. For example, the Kings Fund carried out a study several years ago entitled ‘Providing integrated care for older people with complex needs: Lessons from seven international case studies’. The document compared lessons from seven different countries - Australia, Canada, the Netherlands, New Zealand, Sweden, the UK and the US. Key findings from the report showed that: • Putting in place an integrated care system is a process that must be led, managed and nurtured over time. • There is no single organisational model or approach that best works. The starting point must be improving care for people and not pre-determined.

Solutions that work in one country may well not do so in another country. Lessons can be learned from examples and good practice, but people’s health is influenced by so much more than the health system they happen to live under, such as their environment. A report written by Katharina Viktoria Stein entitled ‘Integrated Care around the world. Examples to help improve (primary) health care in Poland’ surmised that ‘health is not by any means only achieved in and influenced by the health system’. In fact, it was suggested that the health system itself only accounts for about 10 per cent of a person’s health status with social and lifestyle determinants such as smoking, obesity, stress, nutrition, blood pressure, alcohol or drug use accounting for 51 per cent, with the environment accounting for 19 per cent and human biology accounting for 20 per cent of a person’s health. This underlines the importance of the prevention and education agenda starkly, because if you buy this concept then the health system alone can never make wholescale change on its own. And what about the influence of COVID-19 and the fact that health systems around the globe have been thrown into disarray over the past two years? Many would say that this has in fact assisted with the integration of care. We have become better at finding different ways of doing things, making things happen quickly, cutting down organisational silos and boundaries which previously existed. Now it just remains to be seen whether this will be the decade when integrated care becomes a reality, rather than a much talked-about goal. Contact Information

carly.caton@bevanbrittan.com www.bevanbrittan.com

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Meeting consumer expectations in a hybrid health IT landscape Patients are increasingly expecting a fast, smooth, digitaldriven experience with their healthcare providers that resembles what they can do in other aspects of their lives, says Royston Adamson-Green of NextGate

ne-click shopping, locationbased services, and automatic account recognition are the norm in the consumer world, creating frustration among patients who wonder why healthcare seems so far away from catching up. Despite the best efforts of dedicated information management professionals,

health systems are rife with data integrity errors, leading to poor experiences and higher costs. Experts commonly cite duplicate health record rates of around 20 per cent in U.S. health systems, leading to $2000 per patient in unnecessary or repeated medical expenses, totalling $6 billion annually. A combination of suboptimal technologies, human error, and the

fundamentally complex nature of patient information is to blame. Today’s hybrid IT environment demands that healthcare leaders engage in more comprehensive patient record matching and identification approaches. While electronic health records (EHRs) have become commonplace, the disjointed, competitive nature of systems within a typical healthcare organisation contributes to an influx of duplicate, fragmented and disparate data. Patient matching functionalities within EHRs often lack the complexities to unify information from external systems. Poorly designed systems that fail to integrate or communicate with one another exacerbate inefficiencies, generating millions of duplicate and incomplete records that lead to patient safety errors, skewed reporting and analytics, administrative burdens, and lost revenue. While most data entry errors are preventable, lack of an enterprise patient

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HEALTH SYSTEMS NextGate

systems and third sector such as blue light, voluntary groups, and charities to build a complete picture of one’s care. Since the health of individuals is heavily influenced by socioeconomic and behavioural forces, assembling a comprehensive view of one’s health and wellness needs is critical to achieving community-based outcomes. Rise of consumerisation and the promise of digital identity

identification system to automate record matching and clean-up puts patients at risk and prevents physicians from making informed, life-saving decisions. As data sharing matures and the industry pivots toward collaborative, whole-person care, an enterprise view of high-quality, de-duplicated data is essential for better outcomes and operational efficiencies. Enterprise master patient indexes (EMPIs), for example, allow organisations to identify and link patient data spread throughout multiple disparate systems and sites of care. EMPIs can also provide extensive data stewardship capabilities to maintain the integrity of patient records. Tired of EHR systems that only provide a limited view of their patient’s needs, progressive healthcare organisations are leveraging EMPIs as a strategic advantage to integrate social determinants of health (SDOH) data. For many institutions, EMPIs are quickly transforming from a line of

defence against duplicate medical records to the default approach for interoperability and population health management. As a patient matching solution that extends an organisation’s ability to leverage evolving sources of data beyond non-clinical or traditional healthcare settings, an EMPI can help incorporate data from outsourced

Royston Adamson-Green Director of Channel Sales NextGate

“The ideal digital identification solution merges simple, seamless interfaces with advanced privacy and consent features”

As healthcare becomes consumer-driven, it is equally critical to consider use of other identification mechanisms to ensure that patient demographic information is accurate and up-to-date across systems and institutions. Use of personal smartphones, for example, to streamline registration and allow patients to play an active role in managing and updating their data can help to improve patient matching efforts at key stages where data errors often occur— during enrolment and at registration. The adoption of mobile technology has become part of everyday life. Smartphones have fuelled high expectations for on-the-go, always-connected consumers. Whatever they want, they want it now, so for healthcare organisations aiming to win over customer loyalty and improve the patient experience, harnessing the power of digital identity can be a crucial element of doing business. In broadest terms, an individual’s digital ID will tend to incorporate some aspect of a person’s legal identity, such as a driver’s licence or passport. These IDs tend to focus on uniquely identifying attributes of an individual such as their legal name, date of birth, gender, and physical address. In healthcare, a digital ID, or credential, can also include one’s private healthcare insurance card or state health system identification number. Despite the heightened privacy and security concerns, there are enormous opportunities to better integrate digital identities into the healthcare process using a patient’s own mobile device. Patient registration, for example, is fraught with record look-up and data capture issues. A recent assessment found that one in every 3000 U.S. patient registrations is an exact match to an existing patient with the same first name, last name, and date of birth. Organisations will always have a difficult time knowing that these records should be kept separate, especially without cuttingedge patient identity matching infrastructure in play. 57

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Royston Adamson-Green Director of Channel Sales NextGate

“Empowering patients to take control of verifying the accuracy of their own demographic data would result in fewer overall errors” Healthcare can learn from the successes of other industries by creating a digital identification wallet managed by the patient and seamlessly integrated into the provider’s health IT environment. This strategy will let patients take the lead in double-checking their own data for errors and providing informed consent for data access across providers, all from their own personal devices. The ideal digital identification solution merges simple, seamless interfaces with advanced privacy and consent features. Patients could download a digital wallet app

to create a personalised ID card containing information such as demographics, insurance coverage, and care team members. A green light could even let providers automatically generate clinical worklists for the encounter ahead, ensuring comprehensive, high-quality care. To reduce crowding and keep staff and patients safe during the evolving COVID-19 pandemic and emerging threat of the Delta variant, providers could enable remote check-in from the car park, or use location services to begin the check-in process for patients who have just arrived at the clinic. Patients could also use their digital wallet to authenticate requests for information from new or current providers when initiating a new clinical relationship. This would allow users to automatically populate forms and share selected clinical data while remaining fully in control of those accessing their personal information. Meanwhile, empowering patients to take control of verifying the accuracy of their own demographic data would result in fewer overall errors. With more current, complete, and accurate information, providers can avoid duplicate records and feel more

confident in the integrity of their data throughout its lifecycle. At NextGate, we believe digital identity is the future of enabling fast and convenient care for consumers, while providing secure, efficient, real-time patient identification for health and social care providers. Backed by an EMPI, individuals can be correctly identified, verified, and tied to their health data for a 360-degree patient view. This twopronged approach provides unequivocal matching accuracy while reducing the redundant and paper-based interactions that slow down care delivery. With these new digital tools in the hands of consumers, healthcare organisations can finally offer the frictionless patient experiences they have been chasing and take one big step closer to conquering 100 per cent patient identification and verification so physicians and other care providers can truly “know their patient.” Contact Information

royston.adamsongreen@nextgate.com www.nextgate.com

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20:27 17/01/2022 14:03

The International Affiliate Network – a pathway to better patient care Sarah Cartledge speaks to Alistair Russell, Head of Business Development at Imperial Private Healthcare about their latest venture to ensure better patient experience

nsuring the best patient care is a constant battle for healthcare institutions around the world. It starts from the bottom up – to ensure a quality standard of care, an entire organisation must be operating efficiently throughout, and always striving to improve. For this reason, Imperial Private Healthcare is developing a new collaborative membership, the

International Affiliate Network, to ensure care pathways are seamless between Imperial Private Healthcare and member organisations, and promote the development and training of healthcare. Imperial Private Healthcare is managed by Imperial College Healthcare NHS Trust, one of the largest teaching hospital groups in the UK, and has private patient units on each of its five hospital sites across north and central London:

• The Lindo Wing at St Mary’s Hospital • The Thames View at Charing Cross Hospital • The Robert and Lisa Sainsbury Wing at Hammersmith Hospital • The Sir Stanley Clayton Ward at Queen Charlotte’s & Chelsea Hospital • The Western Eye Hospital “Each of the five hospitals has a long track record in the research and education sphere, influencing clinical practice nationally and worldwide. We provide private patient healthcare in dedicated facilities on our sites, including our prestigious flagship facility, the Lindo Wing at St Mary’s,” says Alistair. Building an international presence The vision of the new project is to create a global network of aspirational healthcare organisations from all corners of the world, working with Imperial Private Healthcare to improve patient care.

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HEALTH SYSTEMS Imperial Private Healthcare

“The network’s ethos is principally around developing healthcare capability around the world, improving healthcare in the regions where we continue to receive patients,” says Alistair. “It’s about supporting the patient experience. We work collaboratively with healthcare professionals to complement and develop local healthcare by advancing clinical services and extending pathways of care with an overseas referral pathway to Imperial Private Healthcare.” Dedicated relationships In order to develop new care pathways and improve existing ones, member organisations work with a dedicated relationship manager to agree a programme of bespoke education and advisory services which are specifically

tailored to their own objectives. Crucially, especially in the age of coronavirus, this programme can be delivered online, locally, or at Imperial Private Healthcare’s London facilities. “The pandemic has actually helped because these days we’re used to doing everything remotely,” says Alistair. “Now Imperial Private Healthcare is set up with so many digital solutions that we’re in a much better place than we were six months ago. But you can’t take away the fact that our clinicians will be having an in-person relationship with member hospitals. Our teams will go out to the hospitals and support them in their development, and to perform teaching and training. We also hope to welcome them to Imperial Private Healthcare.” Furthermore, establishing complex overseas care pathways will potentially

Alistair Russell Director of Business Development Imperial Private Healthcare

“We want to help our member hospitals improve as individual organisations and build a referral network on a global scale” enable patients to be discharged back to their local hospital sooner than they would be with a standard overseas referral, making the patient journey that much easier. The Imperial Private Healthcare advocacy service will also make an invariably challenging experience as straightforward as possible for those who may find themselves in an entirely unfamiliar part of the world – benefiting both patients and hospitals. In addition to the mutually beneficial patient pathway, members also receive tailored benefits – allowing them to receive dedicated advisory services surrounding clinical change, pathway design, technological integration, and governance advice. “We want to help our member hospitals improve as individual organisations and build a referral network on a global scale,” says Alistair. The network is available to overseas members now and the first affiliate will be in place this year. “Our plan is to expand the International Affiliate Network worldwide and we will always be open to conversations”,’ he says. “The key point for us is that we are really invested in improving and advancing healthcare at the local level and building from there.” If you would be interested in joining Imperial Private Healthcare’s International Affiliate Network, please contact Alistair Russell, Imperial Private Healthcare: Contact Information

Alistair.russell1@nhs.net www.imperialprivatehealthcare.co.uk

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Introducing Healthcare World Standards To understand the quality of our healthcare delivery we must understand the quality of our healthcare outcomes, says Emma Sheldon MBE, Chief Operating Officer, Healthcare World

s the way in which we deliver healthcare has evolved, so should the way in which we measure its effectiveness. There is more data available to us now than ever before and, as such, we should be utilising that data to understand how well our systems, hospitals, clinicians and treatments are performing. It is no longer good enough to grade a healthcare setting based on its facilities or whether it employs the right practices and procedures. It is the function of healthcare to optimise health, and therefore the clinical services we provide should be based on outcomes. This is where the concept of the Healthcare World Standards comes in. The simplest metric of all is an understanding of the number of patients that come to a provider sick and leave well. But that is, of course, a massive oversimplification of what we’re trying to achieve. To provide a meaningful analysis we need to consider a huge range of factors and those factors need to be broken down into the full spectrum of specialisms. The measures of success in cancer care, for example, may have commonality with those of general practice but they will differ in some crucial ways. And to understand whether those measures represent high quality healthcare we need some baseline measurements against which we can measure success. Enter Healthcare World The Healthcare World Standards story begins in 2019 when a round table discussion, facilitated by Healthcare World Magazine between payors and providers in the Middle East, reached the question of quality. Whether you are a payor or a patient, the most obvious question around the treatment of specific conditions is always going to be where, who and what. If I am suffering from a particular condition, my primary concern is going to be the best place for treatment, who

will be the doctor treating me and which procedure are they are going to follow. But at the truly primitive level my question will be far simpler, will you make me better? Our panel concluded that, beyond existing accreditation of facilities and policies, there is no standard way to define which hospital would be the best place to be treated other than anecdotal evidence. Whether we are talking about a stroke, a heart attack or maternity care, there is simply no reliable way of telling facilities apart. The solution to the problem came in the creation of a set of individual standards for particular specialities and areas of care which we started to develop in 2020, starting with an initial grouping of the most obvious and common areas of treatment to include: • • • • • • • •

General Practice (primary care) Maternity Cancer Orthopaedics Cardiothoracic Mental Health Paediatrics General Surgery

Benchmarking The real issue with creating these standards, though, was the question of how to benchmark. What could we find that would create a real and meaningful Emma Sheldon MBE Chief Operating Officer Healthcare World

“It is the function of healthcare to optimise health, and therefore the clinical services we provide should be based on outcomes”

yardstick against which to measure the quality of clinical services from all around the globe? Headquartered, as we are, in the UK, the answer was staring us in the face - the UK’s National Health Service or NHS. Formed in 1948, the NHS is the world’s only truly free at the point of delivery health system. Paid for by taxation and available to every citizen of the United Kingdom, the NHS has a track record of delivering the highest quality of specialist care at an incredible level of value to the taxpayer. It is independent of insurers or commercial issues and has been ranked

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HEALTHCARE WORLD STANDARDS

consistently over the last ten years as the best health system in the world by the Commonwealth Fund. It is this independence from global markets along with the demonstrable quality and reputation of the NHS, combined with some of the world-renowned names such as Great Ormond Street Hospital for Paediatrics and The Royal Marsden Hospital for Cancer, which makes the NHS the ideal health system against which to benchmark our Healthcare World Standards. As you will see over the next couple of pages, in 2022 we came together with Health Care First, an NHS primary care provider in

the North of England, Methods Analytics as a data consultancy working with NHS England, and Cigna as a global insurer representing the markets we are looking to serve to create the first Healthcare World Standard. Measuring the efficiency and quality of primary care against the levels of quality, provision and access to care enjoyed by UK citizens is the first step for the Healthcare World Standards programme. Over the coming months we will be working with a variety of NHS organisations to create standards in all of the specialist areas described above.

By mid 2022 we expect to be able to offer healthcare providers, regulators and insurers all over the world the first truly meaningful, outcomes-based accreditation standards in clinical services. We hope you’ll join us on the journey. To find out more please email emma.sheldon@thetradeagency.co.uk In partnership with:

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The Healthcare World Primary Care Standards Developed with Primary Care experts Health Care First and our data partners at Methods Analytics

very patient in any country has the right to expect a quality of service that is measurable and measured. Standards are the explicit statements of expected quality in the performance of a healthcare activity against which these services can be evaluated. In addition, standards allow healthcare institutions to demonstrate internationally recognised levels of performance and outcomes. They can include governance, leadership, infection prevention and control as well as clinical practice guidelines, standard operating procedures, critical paths and treatment protocols. Standards can also be used to allow benchmarking between various organisations, enabling improvements to be incorporated. By giving reassurance to patients that their treatment and healthcare

facility operates at a recognised national or international level, they are able to have confidence in the declared outcomes. Equally, standards give governments and ministerial healthcare departments a measurable system for an overview of national healthcare offerings. Wellconstructed indicators can inform improvement through understanding how a healthcare system works and how it could be improved, to monitor how a healthcare system or service is performing against standards and provide accountability to patients, to providers and to national healthcare bodies. Developing and implementing a robust clinical standard Access to data permits measurement and meaningful standards, enabling easy cross

reference across various specialities. It provides an understanding of the service, its scope, size of cohort of patients and how it fits with wider healthcare systems. Thorough metadata should answer a number of questions and provide measurements to answer what, when, how, where and why. It also provides knowledge of types of indicator - count, rate, ratio, percentage, mean and binary. By ensuring the data is consistent across healthcare providers, it can be constantly reviewed to ensure the indicators are meaningful and provide insight. As healthcare becomes ever more complex, performance and accountability are important to ensure equitable high quality care. By monitoring a system or service to ascertain whether it is performing against expectation, the healthcare organisation provides accountability not only to themselves but to patients, other providers, national healthcare bodies and insurers. Background Patients and payors have a clear interest in understanding healthcare provision. The Healthcare World Standard for each

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HEALTHCARE WORLD STANDARDS

speciality is supported by leading NHS institutions, outlining best practice and the highest quality care. Developed with Primary Care experts, we created a set of standards that can be used to look at Primary Care Organisations and the services they provide to ensure an equitable high quality of care regardless of location. Initially we started by researching primary care services and what standards and best practice already exist, and thinking about what good quality of care looks like for a primary care organisation. After compiling an initial list of more than 50 areas to explore further, there were discussions with primary care clinicians and management to refine and focus the standards, resulting in the final set of standards. How the Standard is measured Each theme covers the areas subject to rigorous examination that form the bedrock of the standard. For primary care, the themes are accessibility, system inclusion, information, long term condition management, organisation, responsiveness, safety, structured management and workforce. We structured the approach under 10 overarching themes, such as accessibility,

high level concepts that matter in the delivery of primary care. These split into 24 sub-standards and then these again split into 43 Standards and 111 measures. This hierarchy allows users to understand how measures contribute up, or to see how a theme, sub theme or standard is measured. Each standard thus has its own set of measures to allow data to be collected and quality of care monitored. Standards can be viewed as a whole, or by theme or sub theme depending on the purpose of review and what the audience requires. Each measure has a rationale and technical metadata to inform what data is required to be collected. The graphic below shows the standards and measures which fall under the ‘accessibility’ theme. Under the overarching theme of accessibility, there are 3 sub themes – diagnosis, appointments and access, the standards, and then the relevant measures which together make up the standard. To go alongside this high level diagram is a detailed metadata document which provides further information and guidance regarding all the individual measures. For example, in the above, the detail for the ‘timely, accurate and definitive diagnosis’

THEME

standard and the contributing ‘time to diagnosis’ measure comprises of: Indicator type – Mean Rationale - Delayed diagnosis is common and prevents effective management Numerator – Of those in the denominator, the total time (in days) from initial appointment to confirmed diagnosis Denominator - Total number of patients diagnosed with colorectal cancer (* example condition) Conclusion The Healthcare World Standards will improve health, care and choice for all. They will ensure high quality care to satisfy both patient and payer by giving a measurable value to facilities such as clinics, hospitals or walk-in facilities, backed up by the world-famous NHS expertise. In partnership with:

Accessibility

SUB THEME

Diagnosis

Appointments

Access

STANDARD

Timely, accurate and definitive diagnosis

Ease of access to appointments

Range of appointments available

MEASURE Time to diagnosis

Proportion of patients who were diagnosed longer than xxx months after initial appointment

Proportion of patients who are misdiagnosed

Average wait time to access appointment booking by telephone

Availability of appointments

Is there the ability to visit a patient’s home for an appointment if required?

Does the primary care provider deliver the provision of an out of hours service to patients who require it?

Proportion of patients who have a offered appointment within x days of request

Are video or telephone appointments made available?

Is there an online appointment booking system available to patients?

Example Standard

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Right care, right time, right person Features Editor Fabian Sutch-Daggett speaks to speak to Jyoti Mehan CEO of Health Care First Partnership Commercial Lead Dr Patrick Wynn about the need for global clinical standards in order to improve primary care delivery

rimary care is a subject that has been at the forefront of the healthcare discourse over the past few years. The level of investment, training, and dedicated primary care models have also been on the rise, and the all-important connections between primary care and secondary, tertiary, and community level services. However, this is not the case across the globe. In many countries, developing primary care is not a priority - especially

with the enormous and urgent need for acute hospital services due to the Covid-19 pandemic. Hospitals are still the forefront, and sometimes only, provider service which is used - whether that be for a routine check-up, management of chronic conditions, or simply for a bug that won’t go away. All the while, these same hospitals are dealing with critical patients, emergencies, and palliative care. And it is easy to understand why this system has naturally emerged. Implementing a community, consultation-

driven health service, providing the stages of care to meet the needs and requirements of the local population is a task that takes careful planning, assessment, feedback, staffing, training, and of course, time. These concerns are often not a factor when large population centres are in urgent need of health services - something we have seen firsthand in the UK and abroad in recent times with pop-up hospitals required to manage Covid-19 outbreaks effectively. Over time, without the correct primary care pathways for patients, it becomes all too common for highly-skilled clinicians and doctors to be occupied with conditions that they do not need to be treating themselves. This is a triple-edged sword too - if doctors and specialists are overburdened with procedures that do not require their level of expertise, those jobs cannot be performed by nurses or appropriate clinicians either - resulting in less availability for the doctors - and fewer jobs for nurses. Then, it becomes

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PRIMARY CARE Health Care First Partnership

Jyoti Mehan CEO Health Care First Partnership

“It’s about the expertise that we have from a primary care sector and then working alongside a market that is looking at primary care to share what we know”

incredibly expensive for the provider. Health Care First Partnership is a primary care group in West Yorkshire with 6 practices, employing 9 full time and 8 part time GPs. “It’s important that patients understand the role of a primary care service,” says Dr Wynn. “It’s about the right care at the right time by the right person. “If a gynaecologist performs a smear test, patients love it even though it’s incredibly expensive and a highly trained person is taken away from more specialised work. In the UK, a nurse will do the smear and it will be equally good. It’s a different way of approaching it, and it’s not hospital-centric. “So if I was paying for a health service, I would not want to be paying for consultants to do smear tests, but rather, seek a primary care alternative. Equally, I wouldn’t want to pay for someone with a headache to see a neurologist as the first port of call. If you’re providing a state service, you require a primary care service to access the frontline and serve as the firewall that filters through appropriate

sectors to then be seen by those specialists in hospitals, GPs and A&E.” Yet, while the benefits of a primary care system are clear - it’s far easier said than done. Healthcare operators and providers may not even know where to begin with implementing a primary care system, or even creating the modelling necessary to start the strategy for one. The Healthcare World Standard Through developing a set of standards of best practice for primary care, markets that are looking to develop a system can share in the vast knowledge and lessons learned from the NHS in order to build a primary care framework from scratch without having to endure the trial and error of the past 75 years. In addition, these standards allow healthcare institutions to achieve internationally recognised levels of performance and outcomes. This is where the Healthcare World Standard comes in. A comprehensive set

of standards, tailored to every specialty, created by clinicians in collaboration with healthcare experts are designed to ensure a quality level of service that is measured and measurable. These standards are the explicit statements of expected quality in the performance of a healthcare activity against which these services can be evaluated. The Health Care First Partnership is helping to shape the Healthcare World Primary Care Standard. “It’s not about imposing bricks and mortar. It’s about the expertise that we have from a primary care sector and then working alongside a market that is looking at primary care in its concept to share what we know and how to build it up,” says Jyoti. “This can be created as like for like or it can be built into the infrastructure that is already emerging within those markets. “These standards exist as a document that defines what good looks like. It is a journey to be undertaken, and it’s about having the correct support around it. For us, we would have learnt more as a GP practice if we had had that guidance so it’s incredibly important. “The NHS and primary care providers have been on a long journey to get to today and with all its flaws, it provides exceptional quality and access for patients. And that doesn’t mean we don’t cater to organisations and geographies. The Healthcare World Standard is a framework that needs to be tailored, which is where we are providing our skills and expertise.” Contact Information

www.healthcarefirst.co.uk

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The need for a global clinical standard Defining quality is not easy and there is not always consensus on what good quality means, says Alf Theodorou, CEO and Founder of NewCourse

he on-going pandemic has been an incredible challenge for all of us, none more so than those involved in healthcare delivery across the world. In all corners of the globe, people took note of the extraordinary efforts of those working to provide care to our sick and needy, standing in unison to show their support for the new heroes of our generation. The pandemic also brought into sharp focus key elements of healthcare delivery, from the role of technology and attitudes to whether bricks and mortar hospitals are the right places to receive care; to the importance of leadership, the human workforce and the stark inequalities in funding, resources and capacity that exist. We have also seen rapid innovation, the like of which we might not have seen for many years to come, with young and old, clinical and non-clinical embracing technology; and a seismic shift in attitudes to our expectations of care and the importance of healthcare to us.

What do we mean by good quality care? Perhaps the best place to start is to say that we all want to be able to access high quality care - that is, care that is most likely to result in the outcome we want. Defining quality is not easy and there is not always consensus on what good quality means. If you ask a clinician you will get a different answer to a patient, and again asking a friend or relative of those needing care and your answer might change again. Across the world’s economies and healthcare systems you will also see variation in definition. It is a question that needs answering. Healthcare organisations, regulators, governments and accreditation agencies have all defined quality either on a national or international basis. There are plenty of league tables that rank hospitals, and their criteria as well as defined healthcare standards – such as the Care Quality Commission in the UK – are

easily available. Good quality can mean that other clinicians would recommend a hospital; it can mean an excellent patient experience with hotel-like infrastructure and waterfalls in reception. Good can mean that care is evidence-based or that the results of treatment are positive. The definition, like the delivery of healthcare, is subject to huge variation. And we have not tried to measure anything yet. Why is it important to think about what good looks like? Healthcare consumption – if I can use that expression – has changed forever. From a patient perspective we are much more aware of our expectations from our healthcare provider and much more informed about our options for care. As measures of quality from patient experience to clinical outcome become more readily available, we will want to compare and contrast our options more than ever. Globalisation – despite the restrictions of the pandemic – has seen significant movement of people both for work and pleasure. The result is that we are often accessing healthcare in a country we were not born in and so we inadvertently begin the internal process of benchmarking against what we know. Health funders and payers are ever more conscious about the need to achieve value

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STANDARDS NewCourse

through ensuring the right care is delivered at the right time and with the right outcome. Reducing variation and ensuring that care delivery is evidence-based allows them to keep costs down and strive towards accessible and affordable care. We are more conscious of the inequalities in access and quality across the world’s economies than ever before. From a healthcare provider perspective, hospitals across the world are committed to delivering high quality care and in most cases strive to get better. For many that means understanding performance, reducing variation in practice, learning and understanding what good looks like and working to improve. If we want to improve, defining the right standard is the starting point. This allows us to benchmark care and plan for improvement. It was Taiichi Ohno, the founder of Toyota’s Production System who said; “without standards, there can be no improvement.” How do we measure quality or set standards? Local or international regulators - from the aforementioned CQC to companies like Joint Commission International (JCI) or Accreditation Canada - spend a huge amount of intellectual resource and experience defining standards. In many respects there is huge consistency amongst regulators. We see increasing reference to global healthcare delivery priorities from safe surgery and the correct identification of the patient, to hand hygiene or infection control processes and informed consent. It is perhaps fair to say that we have a good idea about what appropriate governance and patient safety look like. At the same time, regardless of the presence of strong local regulation, the appetite for healthcare providers across the world to engage in international accreditation programmes has moved the conversation about clinical governance, risk management and patient safety forward a huge amount in the last couple of decades. The criticism of many of these systems, however, is that they are heavily process driven, focusing on the production of policy rather than good outcomes. Of course, a hospital that has the right infrastructure in place and is committed to, or required to, comply with standards will have many of the building blocks in place that will likely lead to better care. However, we know huge variation exists between healthcare

providers who have achieved any of these recognitions. We also know that having excellent governance processes in place will not tell us where a hospital’s expertise or clinical focus areas lie. In essence, it can be an indication of good quality or good attitude but for those involved in making decisions about where to access care, it would not identify, on its own, the most appropriate cancer hospital or the best place to have a baby. Accreditation systems, especially on an international level, tend not to focus enough on clinical data – be it contextual data, volume or outcome – to allow benchmarking or understanding of clinical capability. And for healthcare users, that is a significant gap. How do we measure effectiveness? To measure effectiveness requires clarity on what we are trying to answer. The move towards a more data-driven standard might seem an obvious step, but it is not one that cannot be taken without careful consideration. While good data might remove unnecessary subjectivity, we must consider the reliability of the data and that the metrics are fit for purpose, cautioning against over-, or mis-interpretation. One of the significant benefits of the right data model is that the measurement of improvement, definition of better and clearly articulated targets are easier than policy driven systems. Without measures of patient outcome it is really hard to get a measure of quality or to ensure we are talking the same language. Many regulators and accreditors use a combination of self-assessment (audit), evidence review and onsite inspection. High variation often occurs between documented process and reality and so clinical review remains a key component of appropriate assessment, regardless of the quality of the data collected. The best measure though is likely to be a combination of policy, infrastructure, outcome and patient experience. Who can do this? Defining and measuring quality is an open market. International accreditation has been dominated by the US, Canada and Australia and there is an argument that developed healthcare markets such as these have significant experience to share. The UK health system has ventured globally in pockets of activity and the NHS remains

Alf Theodorou CEO NewCourse

“If we want to improve, defining the right standard is the starting point” one of the best examples of a free-at-thepoint of access healthcare system that is driven by the same purpose and founding principles that saw it established. It is also worth noting the body of work completed in the UK that looked at separate standards and measures at a service line level that would add significant value to the definition of quality at a global level. We can also see examples of incredible innovation in developing healthcare markets that offer opportunities for more established health economies to learn from. Whoever it is that decides to look at clinical specialty level standards will need to be able to contextualise healthcare delivery in diverse cultures and challenging health economies. It will involve the collaboration of a cross section of professionals, including patients, and should be driven by a desire to understand what good outcome looks like, robustly measured and focused on driving improvement. The challenge of developing clinical standards Once there is clarity on what we want to measure, the individual clinical standards and metrics will start to take shape. The process of defining and agreeing standards is not an easy one. Consensus might take time and we might have to accept a more iterative development process, especially as we look to define thresholds. What is certain is that multiple perspectives from patients, clinicians, managers and regulators will be vital. The drive to understand what excellent care looks like for an individual specialty should build off the positive work that has been done over the last years to understand the pillars of good governance and patient safety. Objective measures of quality will need to respect local custom and regulation, not conflict with them. An awareness that perspective and culture might not only challenge our pre-conceived notions of ‘best’ but also that readiness to discuss 69

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Alf Theodorou CEO NewCourse

“There are significant gaps in our measurement of good quality care at a specialty level, certainly on a global perspective” certain topics is not the same the world over. Whether it is the stigma of mental health, attitudes to pregnancy or legislation about guardianship, a global healthcare standard needs to be cognisant of all of these elements. The challenges of good quality, reliable and robust data will need to be looked out as we know that the information we get out of a system is only as good as the information put in. We also need to be realistic that variation in healthcare exists and that not all

healthcare systems are currently at the same starting point. Most accreditation systems set a standard that everyone needs to achieve in order to earn their badge. One benefit of driving to improve the outcomes of care could be the opportunity to recognise where providers are on their own improvement journey; recognising quality in context and creating a tiered solution that can inspire continuous improvement. The rapid innovation and changes to healthcare delivery seen during this pandemic period have highlighted the need to be adaptable. Not just in what we measure but how we measure. The focus should be on consistency and fairness and creating a non-punitive environment that will drive continuous improvement and learning. So do we really need to do it? The delivery of healthcare cannot stand still. Healthcare organisations need to continually improve the care they provide and improvement starts with knowing how

good you are. Accreditation systems and local regulation have played an important role in focusing minds on key topics of patient safety and clinical governance. However, there are significant gaps in our measurement of good quality care at a specialty level, certainly on a global perspective. A focus on this important area has the potential not only to improve our understanding of care but to make that objective and data driven. This will offer opportunities to learn, innovate and drive continuous improvement that will tackle the burden of rising healthcare cost and inequalities in care. Ultimately, being able to define clinical standards will improve outcomes for patients. And that is a worthwhile use of our time. Contact Information

alf@newcourse-healthcare.com newcourse-healthcare.com

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18/01/2022 11:19

To Solve. For Good.

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HW003_Ads.indd 6 1/22.indd 1 Methods Analytics FP

17/01/2022 19:49 20:27 13/01/2022

The Importance of Standards in Healthcare Global standards could significantly improve patient safety, efficiency and effectiveness of healthcare systems, says Josie Winter, Clinical Director at Advanced Clinical Solutions

t’s not unreasonable to assume that standards exist in healthcare. Most sectors have guidelines so that everyone can be reassured that best practice is taken as read. But as technology and digital health evolve ever faster, it’s becoming clear that healthcare needs to have a global set of standards so that there is equality and reassurance in treatment in every country. Standards are systematically developed ‘sets of instructions’ to assist clinicians and patients around decisions of appropriate health care for specific circumstances. These days quality and safety are more important than ever, with avoidable harm occurring globally in as many as 4 in 10 patients. Clearly there will always be discrepancies in the ability of certain countries to have the most up to date equipment, but if there are standards in place, clinical outcomes can be evaluated. Global standards could significantly improve patient safety, efficiency and effectiveness of healthcare systems. Their potential to improve both the quality or process of care and patient outcomes is also self-evident, and will encourage healthcare providers to seek out such certification as competition in healthcare becomes more driven. The importance of high quality care and services I’ve worked for the NHS - originally as a theatre nurse - and for private healthcare organisations including a large corporate med-tech organisation. I’ve developed and delivered hundreds of clinical audits and quality improvement plans and trained thousands of healthcare staff in various clinical skills. Realising the lack of training and support around patient safety, I co-founded and head up Advanced Clinical Solutions, a professional services provider of patient safety, regulatory compliance, and quality improvement support to private healthcare organisations.

Our experts help other healthcare professionals deliver high quality clinical care and services, through a unique holistic partnership approach involving evaluation, audit, research, inspection, training and education. But beyond this we’re keen to fly the flag for patient safety. Surprisingly it’s not always top of the agenda in an obvious way, and it needs to be more prominent. Challenges Healthcare is often regional, fragmented and heavily regulated, so most regulators are now defining standards to meet national rather than global goals. The WHO has made incredible strides to provide guidance and standards for a global audience, but more could be done. Some areas of healthcare are fast moving which increases the risk of standards having out-of-date recommendations. There are somewhere in the region of two million papers and articles published every year, so how do we keep up with what is relevant and truly innovative and how does this shape practice? Clinical audit is a way to find out if healthcare is being provided in line with standards. But how do we know if this is happening if there are no agreed standards and how can quality and outcomes be continuously improved? Most clinicians (particularly my nursing colleagues) have had no formal training in audit and this is worrying . We would not

Josie Winter Clinical Director Advanced Clinical Solutions

“Patients themselves will begin to understand they need a reliable measure to judge their care”

expect a nurse to put in a catheter or take our blood without training. Why is this the case with a critical skill that determines if we are meeting the standards? A potential solution The benefit of our highly-communicated world is that we can keep up to date with new ideas, but it’s sifting through the relevant ones that is the hard part. For this reason it would be sensible to seek out systems already in place, such as The Living Standard (a coin termed in Australia by a group developing standards for COVID-19 care during the pandemic). The aim is to provide specific, patientfocused standards and recommendations for the clinical care of particular patient

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STANDARDS Advanced Clinical Care

groups. These are ‘living’ guidelines, updated with new research in near realtime in order to give reliable, up-to-the minute advice to clinicians providing frontline care. Another option could be adopting systematically reviewed literature and developed recommendations using GRADE. The Grading of Recommendations Assessment, Development and Evaluation (short GRADE) working group began in the year 2000 as an informal collaboration of people with an interest in addressing the shortcomings of grading systems in healthcare. The working group has developed a common, sensible and transparent approach to grading quality (or certainty) of evidence and strength of

recommendations. Many international organisations have provided input into the development of the GRADE approach which is now considered the standard in guideline development. Systematic reviews of the effects of healthcare provide essential, but not sufficient information for making wellinformed decisions. Reviewers and people who use reviews draw conclusions about the quality of the evidence, either implicitly or explicitly. Such judgments guide subsequent decisions.

themselves will begin to understand they need a reliable measure to judge their care. It will provide reassurance if they fall ill abroad and perhaps don’t speak the language, or they can judge their clinician and treatment against familiar themes. And we can’t underestimate the importance of patient confidence at the end of the day. Contact Information

A global standard However, the concept of a global standard is still far from a reality, but as healthcare innovation develops apace, patients

josie@advancedclinicalsolution.co.uk www.advancedclinicalsolution.co.uk

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Making healthy living easy Digital technology can aid prevention in healthcare but uptake is key, Mona Hayat, CEO and Founder of Nexus Digital Technology tells Sarah Cartledge

s digital healthcare solutions multiply as a result of the pandemic, it’s no surprise that many innovators have a background in the UK National Health Service or NHS. As the oldest free-at-thepoint-of-delivery state healthcare it has grown into a huge siloed organisation in its 80 plus years, and many clinicians have become frustrated at its lack of technology. “I saw so much inefficiency in my 25 years in the NHS,” says Nexus founder Mona Hayat. “Patients would have to give the same details over and over again, and there was no way to link information across systems. Like everyone who has

worked in the NHS I am a huge fan, but it needs to take up digital solutions rapidly to reduce clinical risk.” It’s for this reason that many clinicians are branching out on their own to produce solutions that make life easier for both patients and healthcare staff. Mona’s background is as a mental clinician, but she decided to pivot and go into commissioning. It was while she was working in West London as director of programmes that she was asked to commission the physical and mental health programmes following the shocking fire at Grenfell Tower in Kensington, when 72 people died in the 24 storey blaze and 70 others were injured.

As she spent time with this underprivileged community in one of London’s wealthiest boroughs, she began to pull together the concept of Nexus. “People are now in a position where they can realistically manage their own health and I wanted to give them a tool to do so,” she says. “At Nexus, we are one of the frontrunners that can demonstrate how, by giving citizens the opportunity, information, knowledge and understanding of how they can support their own health and well¬being, they are less likely to wait until such time that they get sick and subsequently go into the healthcare system. They are more likely to be able to fix an issue and start to look after their health in a meaningful way and one they can manage at their own pace.” Healthcare as an integrated whole Nexus has been designed as a platform where people can find the resources they need to keep them healthy. By partnering

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DIGITAL HEALTH Nexus

with nutrition, exercise, language and medical companies, to name a few, users are encouraged to monitor both their physical and emotional wellbeing with structured goals that are tailored to each person. “I firmly believe that the current position in global healthcare is not sustainable unless there is a significant rise in uptake in digital innovation, so I brought together a group of reputable experts in the field of healthcare, behavioural science and technology who understand about health and wellbeing connectivity and have the same shared vision. With an ageing population there are many and varied comorbidities. The healthcare spend before COVID for 2020 was estimated at 8.1 trillion dollars, and it will be much more now,” Mona says. “What sets us apart from other health and wellbeing devices platforms is that this is not about people needing to walk 10000 steps a day,” she continues. “We work in a non-prescriptive and meaningful

way because we’re trying to target people who have or are much more likely to develop long term conditions. Many wouldn’t consider downloading a health and well-being app, so we’re seeking out patients who have ended up in a perpetual cycle in the health care system as a result of sedentary lifestyles, diabetes, cardiovascular, respiratory or other issues. We’re targeting people who are not going to naturally gravitate towards health and well¬being and who will benefit from it.” Nexus has identified eight areas of wellbeing – emotional, physical, social,sexual, intellectual, environmental, financial and spiritual. “Nexus is designed to put you in control of your health and wellbeing,” says Mona. “We do not tell you what ‘good looks like’ and there are no scores or assessments. Instead, you decide what you would like to achieve and we help you do it.” The platform is aimed at organisations and healthcare providers to educate and empower their patients and employees to live active, long and healthy lifestyles. “We don’t want people to be going perpetually round the healthcare system – we want them to enjoy looking after their own health,” she adds. To date, Nexus has secured a 5-year contract with Guys and St Thomas’ NHS Foundation Trust, a leading London hospital for digital innovation. The contract includes the rollout of the platform to as many prostate cancer patients as possible within the UK. The platform was also selected to be a part of the Microsoft for Startups Programme in 2021 and was named one of the “Top 100 Startups” by the World Business Angels Forum in 2020. Expanding in the UAE Mona spends much of her time at the moment in the Middle East where her advisory board includes H.E Sheikh Abdulaziz bin Duaij bin Khalifa al Khalifa of Bahrain. “We are aiming to create a sustainable lifestyle behaviour change in the region,” she says. “We are committed to building healthy lifestyles and a greater awareness of the importance of wellbeing. In 2019 she won the Top 100 Healthcare Leaders Award from the International Forum on Advancements in Healthcare in Dubai. As she said when she collected her award; “After 25 years in the NHS, I wanted to build a company that transforms the quality and efficiency of local healthcare systems

Mona Hayat CEO Nexus Digital Technology

“I firmly believe that the current position in global healthcare is not sustainable unless there is a significant rise in uptake in digital innovation”

by shifting the balance from medical interventions to digitalised wellbeing, prevention, and early intervention.” Nexus’s solution allows real time transparency and tracking of user health and wellbeing choices. “We’ve created an integrated platform where service users can purchase any of the services available on our platform,” she elaborates. “We have so many wonderful services, from book clubs to gym classes to language lessons, and users can choose any of these. The platform is also tailored to each individual’s specific health needs, and at the end of each month, it provides a dashboard informing them of their wellbeing progress, how many people they have connected with that month and loads of other data which motivates people to keep going.” By partnering with the University of Health & Research in Dubai and the University of London, Nexus is developing a research programme backed up by their data. It has also developed a revenue-generating health and wellbeing coaching programme that provides coaching via the Nexus app. “So, in summary, what we do is we create the tools to give everyone the best chance at optimising their personal health and well¬being,” concludes Mona. “Our ambition is to educate the global healthcare sector into understanding that we need a paradigm shift from undertaking traditional ways of making savings to one where we focus on patient behaviour and empowerment to achieve long-term sustainability.” Contact Information

www.nexus-dt.com

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Entering the UAE market Well-researched homework is the key to success, says Mazin Gadir, Government healthcare adviser and Director of Partnerships and Strategic Alliances Iqvia

he Middle East market is full of opportunity but navigating it can be complex for companies looking to enter it. While the obvious benefit is familiarity through language for English companies, the routes to entry can be varied. For this reason, spending time to research the market is invaluable, especially for SMEs with limited resources. It’s important to scope the market, customise or localise your value proposition and understand the lay of the land for success. Those who do this efficiently can hit the ground running. The British Business Group, based at the British Embassy, is an invaluable resource which can help companies build networks and navigate regulatory requirements. The Department for International Trade in the UK conducts trade missions and makes introductions, supporting partnerships between UK companies and overseas healthcare providers. Once you have done your preliminary research, it’s a good idea to continue it in country. Dubai hosts many conferences and these can be a good place to start. Arab Health at the end of January is the best place to make contacts and begin to understand the requirements for British companies. There are plenty of opportunities for start ups to showcase their innovations and capabilities, particularly in technology, such as GITEX Technology Week, which is one of the biggest conferences we have in October of every year. These are also stepping stones for SMEs and innovators to come in and establish relationships. The UAE health system Dubai has an insurance driven and mandated health system, which means that more than 99.98 per cent of Dubai residents have to have insurance. Most of the insurance comes through employers, so when you set up your own business, you have to cater for the insurance of your employees as part of the visa issuance process.

As a very business-oriented ecosystem, the Dubai focus is always on growing the private sector. Most of the inpatient and outpatient visits happen in the private sector as only 5 or 6 out of 34 hospitals are public. The vast majority of healthcare services are provided by the private sector and we have around 60 different insurance companies playing in the Dubai healthcare market, which caters for more than 4.8m people approximately. Abu Dhabi is a different ballgame because it’s almost a single payer system and state insurer Daman is the most dominant insurance company. In this regard it is similar to the UK. That’s why, by default, when you come into Abu Dhabi, you get insured by the government system. The private sector is growing in Abu Dhabi, but the dominance is with the public sector. Setting realistic goals for market entry Any company that is looking to come into the UAE for quick returns is not going to find it easy. Business here is very much built on relationships, so it’s important to understand this and realise it’s unlikely you will see any return in the first 18 months. So, for small companies, establishing partnerships and strategic alliances with well-established regional companies or working with free zones is often the route to market.

Mazin Gadir Government Healthcare Advisor/Director of Partnerships IQVIA

“Business here is very much built on relationships, so it’s important to understand this and realise it’s unlikely you will see any return in the first 18 months”

There are many start up communities and programmes across the UAE, from the Dubai Future Foundation to the programmes in the Chamber of Commerce in Dubai. Plug and Play, powered by the Abu Dhabi Investment Office, is the prime innovation platform in the Middle East, matchmaking start-ups with major corporations and investing in them. There are also many incubator hubs, such as the one at the Dubai Science Park, that will support companies looking to grow. There are a number of family-owned companies that facilitate entry to the market with a some form of investment. They can help with trade licenses and

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EXPORT & TRADE Mazin Gadir

they are a good vehicle for those who have some money to bring in - they have the reputation and they are well known, although often they have strict requirements for acceptance. They can be a good alternative for companies who don’t want to go down the free zone route. Free zones are a good option for those companies that want to come in alone and be able to establish entities working, collaborating with governments. Free zones are becoming more and more competitive, and offer a faster way of establishing yourself. Others may prefer to be onshore to help you bring in your

registration, your visa screener, visas and other requirements to establish your presence in the region. But again, for the British companies that do not have that type of adventurousness for resource intensive entry mechanisms, they should look at partnerships. There is also the option to establish yourself via the Saudi offshore route. If your company or healthcare facility provides medical and pharmaceutical devices, these have to be approved, certified and authorised at the federal level. If you’re in Dubai, a facility licence comes from the Dubai Health Authority, in Abu Dhabi, the Department of Health, and

in the Northern Emirates from the Ministry of Health and Prevention. In conclusion, if you are looking to enter the UAE market, access governmental support from the UK government to start with, such as trade missions and business councils. Also use conferences to come and feel the water as they bring everybody together and make the journey easier. Contact Information https://www.linkedin.com/in/mazingadir-phd-msc-beng-pmp-proscilssgb-ebas-agile-b4a4533/

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The urgent need for healthcare super apps Emirati entrepreneur Ali Sajwani calls for SMEs and entrepreneurs to develop healthcare super apps to improve health of UAE residents

ncreasing healthcare costs, need for on-demand solutions, and growing health consciousness among consumers indicate a necessity for the development of healthcare super apps. The global mHealth market size is estimated to reach US$166.2 billion by 2028, so now the time is right for SMEs and entrepreneurs to play a leading role in further developing the mHealth sector in the UAE.

According to Emirati entrepreneur Ali Sajwani, general manager of operations for global real estate development company DAMAC Properties, the COVID-19 pandemic is driving demand for healthcare ‘super apps’ in the UAE. Sajwani, who has led the digital transformation within DAMAC, is calling for entrepreneurs and SMEs throughout the UAE to channel their creativity and innovation

into accelerating the development of a healthcare super app to enhance the wellbeing and health of the nation. Super apps offer online messaging, social media, marketplaces, and other services under one umbrella. In emerging markets, super apps such as China’s WeChat and India’s Paytm and PhonePe are already transforming the services ecosystem. WeChat, for example, is one of the leading social networks, with 1.25 billion monthly active users worldwide in Q2 2021, according to Statista. In healthcare, although super apps are still in their embryonic stage, medical devices are getting smarter by the day. iWatch, Fitbit, BLE heart rate monitors, pulse rate monitors, diabetes checkers and many more devices provide a detailed insight when paired with mobile apps. Medical

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DIGITAL m-Health apps

health records are also easier to manage online and accessible to the doctors as well as the patients, up and down the country. Keeping Dubai citizens healthy According to Dubai Health Authority (DHA), 30 per cent of the Emirate’s population is either diabetic or pre-diabetic and 27.8 per cent of the adult population is overweight. Healthcare super apps have the potential to empower patients to make better lifestyle choices and offer better access to healthcare professionals. By encouraging daily self-management and providing routine follow up care, super apps can offer a holistic approach to health and wellness where healthy behaviour is incentivised and communication with practitioners is streamlined.

“Super apps have the potential to revolutionise the healthcare sector by adopting an approach that offers convenience and simplicity to patients. There is an increasing need for on-demand

Ali Sajwani General Manager of Operations DAMAC Properties

“Super apps have the potential to revolutionise the healthcare sector by adopting an approach that offers convenience and simplicity to patients”

healthcare solutions that goes hand in hand with the increasing awareness and health consciousness among consumers,” says Sajwani. “As super apps are slowly finding their way into Western markets, the time is right for the UAE to engage its entrepreneurial spirit and accelerate the development of one single mobile app solution. One that provides a high level of convenience for patients, allows for data sharing across platforms and service providers, and eliminates the complex processes and procedures involved in managing healthcare,” he added. The UAE is ranked first regionally in the 2020 Global Innovation Index and has taken several steps to promote and encourage innovation, in line with the ‘United in Knowledge’ pillar under the country’s Vision 2021. For example, the recently announced Emirates Development Bank Strategy provides AED 30m in support for the UAE’s startups and SMEs, which form the backbone of the country’s business ecosystem. Incubators such as the Dubai Future Accelerators initiative were created specifically to enable rapid deployment of transformative technologies such as artificial intelligence (AI), robotics, biotechnology and 3D printing. Meanwhile, Smart Dubai, which plays host to many emerging technology-backed applications, is working with the Dubai Health Authority on a smart inventory app that allows users to process warehousing transactions and track the supply chain for medicines from anywhere using a smartphone, tablet, or any portable device. Having inherited an entrepreneurial mindset from his father Hussain Sajwani, the founder of DAMAC Properties, Ali Sajwani is also the founding board member of Emirates Angels Investors Association. This non-profit organisation aims to positively contribute to the early-stage investment ecosystem through its investor network, and works side by side with startups and the relevant authorities to create the best investment environment possible. “With the global mHealth market size estimated to reach US$166.2 billion by 2028, it is too big to ignore,” says Sajwani. “Therefore, start-ups and entrepreneurs in the UAE should consider channelling their energies into playing a more prominent role in this market, by becoming invaluable players in the super app space.” 79

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Connected intelligence COVID has created the understanding that data is key, Amit Sadana, General Manager Africa, Middle East and South Asia, IQVIA, tells Sarah Cartledge

s governments all over the world have battled to limit the effects of COVID, our knowledge of this new virus is constantly growing. From the start through to the development of vaccines and now medication, scientists have worked tirelessly to collate information. And key to this has been the data, once an almost negative word in the healthcare sphere but now the beacon of hope for this and future pandemics. “Governments are now understanding how important data are,” says Amit Sadana, IQVIA General Manager for Africa, Middle East and South Asia. “At the outbreak of the pandemic there was

chaos as many health departments didn’t even know what equipment such as X-ray machines or oxygen cylinders were present in their countries. Now they have become very focussed on collecting and utilising the data. “At IQVIA, a key success factor, whether it’s our tech or our services, is helping customers collect data, analyse data, provide services on data, helping them to be more impactful from healthcare data point of view,” he continues. “We bring standardisation so that systems talk to each other while applying a variety of privacy-enhancing technologies and safeguards to protect individual privacy.

We are not focused on systems integration, though. We are a data integrator. We see ourselves as building the pipes through which information flows.” Enhancing public health Currently IQVIA is working on several projects with different countries in various areas such as COVID vaccine rollout, diabetes risk and progression, antimicrobial resistance (AMR), implementing and administering national level insurance policies as well as digitising electronic medical records for health authorities. “It’s the human aspect that is technology-enabled which allows us to collect data,” Amit says, adding; “We ensure that we explain the process clearly which entails describing the way we collect data and protect individual patient privacy as well as clarifying how we reimburse for providing them. We’re very transparent and I believe customers feel comfortable in

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HEALTH SYSTEMS IQVIA

giving us the opportunity to collect data on their behalf. “Governments are also looking to digitise everything. So, what is emerging is that not every country or every hospital or a clinic will need a new system, platform, or software, but instead would require someone to integrate what is already in use. That’s the role we see ourselves playing, particularly as regions may have their own healthcare traditions such as acupuncture in China and Ayurveda in India.”

Amit Sadana General Manager Africa, Middle East and South Asia IQVIA

“We bring standardisation so that systems talk to each other”

Equally as important is managing data at the population level of each country and integrating it with health authorities. “For example, the Emirates airline is linked to the Dubai Health Authority, so they have a view on population and case movement,” adds Amit. “Country level data now has to be the key focus to identify risks and assess the current healthcare level to understand which section of the population is most at risk.” Partnership culture IQVIA’s footprint extends to many countries around the world, and they are keen to link their partners together so they can exchange information for the greater good. The HCP Space app links healthcare professionals across Africa, India and the Middle East in a holistic learning and networking environment, while similar microsites connect pharmacists, patients and life sciences

companies. By hosting online conferences and networking events, IQVIA can help their clients understand and benefit from digital technology. “We see ourselves at the centre of the healthcare ecosystem” Amit concludes. “Our aim is to drive healthcare forward. We work with both the public and private sectors, and we assist the various stakeholders to leverage data, transformative technologies, advanced analytics and domain expertise to discover previously unseen insights, drive smarter decisions, and unleash new opportunities. This is what the connected intelligence we deliver enables them to achieve.” Contact Information

www.iqvia.com

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The UK Midlands Region Arab Health is the key event for our companies to showcase the best the Midlands and UK has to offer in the sector, Shaz Chaudhary, Deputy Director, UK Government Midlands Region tells Healthcare World

ocated in the centre of the United Kingdom, the Midlands is both the heartbeat and the engine-room of the nation’s economy. Not only is it home to one of the most important Life Sciences ecosystems in the UK with more than 1,200 life science companies, but it boasts 33,000 highly skilled jobs. The second largest concentration of MedTech companies in the UK is based in the region, generating £1.6bn for the UK economy every year. As a stable, ethnically diverse population of over 10m citizens, the Midlands makes the ideal test bed for global health and multimorbidity interventions. It is also a major centre for clinical research, which stems from its high number of world class universities, research centres and incubators. As the largest global health exhibition in the world, Arab Health is an important event for Midlands-based companies. “It is with great excitement that DIT Midlands will be leading our local companies on our 5th trade mission to Arab Health this year,” says Shaz Chaudhary, Deputy Director, UK Government Midlands Region. “The Healthcare and Life Sciences industry is of particular importance to us in the Midlands, generating notable exporting successes during the past five years.” Companies attending their first Arab Health value the support they are receiving to maximise the business potential of the event through an organised trade visit with the Department of International Trade (DIT). “As a result, we can stay focused on our core objective - finding new opportunities to integrate digital health solutions to improve patient outcomes and increase the capacity of healthcare systems globally, says Chris Barker, CEO, Spirit Health. “Attending Arab Health provides a great opportunity for us to meet and connect with new potential partners who are interested in implementing digital health technology at scale.” Some exemplar Midlands companies attending Arab Health and located on the UK Government – Midlands region stand in Hall 2 stand G18 this year:

• 4R are introducing a newly-designed, market -eading innovative health product to the Middle East that enables health professionals to offer a tried and tested (clinically tested in the UK) method to stop Teeth Grinding and Clenching (BRUXISM) in their patients • Advancis Surgical is a medical device manufacturer that has created a platform serving the operating room environment with a focus towards ground-breaking medical device technologies. Its flagship product, The Hemosep System, salvages blood loss during surgery and recycles it so that it can be transfused back to the patient • AG Instruments designs and manufactures the world’s only All-inOne piped medical gas analysers. The MGPS1000 gas analyser combines all the gas measurements required by any of the ISO7396, HTM02-01 or NFPA99 standards in one compact instrument which uses optimal gas sensing technologies to measure the required gases simultaneously • Ariane Medical Systems developed a X-ray Brachytherapy System for the management of lower rectal tumours, known as the Papillon Technique. The Papillon treatment is well recognised for the treatment of rectal cancers in inoperable patients, be this due to fragility, age or associated comorbidities • DDM Health provides clinically proven digital therapies (apps) that are used to

Chris Barker CEO Spirit Health

“Attending Arab Health provides a great opportunity for us to meet and connect with new potential partners who are interested in implementing digital health technology at scale”

treat and self-manage a range of health conditions including obesity, prediabetes, type 2 diabetes, cardiovascular disease, long COVID and mental health • Derwen College is an award-winning UKbased specialist further education college delivering exceptional programmes and a rich learning environment for young people, aged 16-25 years, with special educational needs and disabilities (SEND) including Autism, Down’s Syndrome, Behaviours of Concern, Profound and Multiple Learning Difficulties (PMLD) and other physical, developmental and learning disabilities • EIDO Healthcare provides health professionals with resources and support around informed consent. EIDO provide a complete and comprehensive range of content, processes, systems and solutions to successfully manage and deliver patient education for informed consent • The Gulf UK Gateway is a British company that provides businesses in the Arabian Gulf with legitimate access to the UK healthcare and pharmaceutical

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EXPORT & TRADE UK Midlands Engine

marketplaces to help them source high quality and excellent value genuine British products • Lifeplan Products manufactures the highest quality health supplements for customers worldwide under its Lifeplan, Healthilife and OatWell brands. Lifeplan health supplements use only the best quality ingredients and are formulated by in-house nutritional biochemists, who constantly innovate to ensure they deliver to the highest standards for their customers • Medalin is one of the largest UK manufacturers of specialist medical textiles and consumer hosiery • Morningside Pharmaceuticals are a manufacturer, wholesaler and exporter of branded and generic medicines and healthcare products. Morningside has exported to more than 120 countries globally and has over 240 generic and branded licensed medicines in the UK and the EU. As well as products delivered twice daily to UK pharmacies and hospitals, Morningside is also expanding into new international markets, where product

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registrations in individual countries offer an opportunity to grow into the public and private sectors Nemaura Medical has developed diagnostic and digital tools for a wide range of medical conditions. Founded in 2011, Nemaura Medical set out to develop a single platform technology using noninvasive microsystems to measure blood markers at the surface of the skin NeoKare Nutrition manufacture human milk products for premature, low weight babies and infants NuVision® Biotherapies has developed and commercialised innovative and clinically disruptive tissue-based therapies to effectively manage soft tissue damage situations across multiple clinical specialities across a global market, including ophthalmology, dry eye disease, diabetic foot ulcers and wider wound care The Oxygenstore (Bar O2 Ltd) is a UK based supplier of oxygen related products distributing products worldwide. A specialist in the supply of parts and filters and accessories for most major portable

and static oxygen concentrator brands including Caire, Drive Devilbiss, Inogen, Philips, Invacare, Nidek, Kroeber and many others • RW Search is an Executive Search firm specialised in the medical devices sector. RW Search works globally with a diverse range of clients from start-ups to global corporations • Select Health Care UK (SHC) designs, develops and manufactures patient moving and handling equipment. A well-established and highly regarded leader in the UK market, SHC also serves a wide range of international customers. With more than 30 years of healthcare experience, it is invariably a first choice for occupational therapists, nurses and carers working across the UK National Health Service and in a variety of private and social care environments • Shakespeare Pharma supplies parallel pharmaceutical imports to the UK and International Export wholesale markets. Working with its partners in Europe, Shakespeare Pharma are able to 83

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source, supply and distribute quality pharmaceutical products at competitive prices. It also works with the NHS to drive prices down to provide savings that can be used in improving healthcare for patients in the UK Spirit Digital delivers innovative digital solutions that combine years of healthcare experience with marketleading technology. CliniTouch Vie is a multi-award-winning digital health platform, providing effective remote patient monitoring, patient education, and self-management Spirit Healthcare is one of the fastest growing privately held companies in the UK. It is an established and market leading organisation based in Leicester with an impressive track record of launching and distributing medical devices and services into the UK health economy. Spirit Healthcare are looking to find new partners, manufacturers and/ or suppliers of innovative, high-quality medical device and pharmaceutical brands that will improve patient care Starfish Labs work with international clients to create bespoke solutions to clients’ requirements, including User Interface design, multilingual UI design, full stack development, database integration, data gathering and analysis tools and deployment through mobile or web app interfaces. Starfish Labs specialises in healthcare, training, education, learning disabilities and supporting healthy ageings Surgins manufactures surgical instruments and is able to offer a total solution to instrument procurement VeinTrain offers high quality healthcare training programmes and contributes to the standardisation of the healthcare sector. VeinTrain’s low-cost model means everyone can use a simulation device to master the control of the equipment

With representatives from more than 60 countries, there will be 3,590 exhibiting companies and 56,028 healthcare and trade professionals over the four days of the event. “Arab Health opens the door to a global audience of potential customers and partners all under one roof,” says Mark Davies of Ariane Medical Systems which has developed a X-ray Brachytherapy System for the management of lower rectal tumours, known as the Papillon Technique. “NuVision Biotherapies are extremely excited to be attending Arab Health 2022 to be able to connect with new and existing customers and distributors,” adds Andrew Hopkinson, Founder and CSO, Nuvision Biotherapies. “The Department of International Trade has been paramount in

supporting NuVision in being able to attend such an event. Following our visit to the trade show in 2020, we were able to develop an invaluable relationship with our Kuwaiti distribution partner and look forward to more opportunities to develop international growth.” “Arab Health is the key event for our companies to showcase the best the Midlands and UK has to offer in the sector,” Shaz Chaudhary says. “With Birmingham in the Midlands hosting the Commonwealth Games 2022 and Data Driven Healthcare being a key theme within it, we are looking to forward to capitalising on this and our attendance at Arab Health will help to continue our growth in this leading sector.” The UK Government – Midlands Region stand is in Hall 2 stand G18.

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Labgnostic is a unique international product which enables any diagnostic laboratory to electronically refer test requests or results to any other laboratory on our network through a single connection. Labgnostic enables diagnostic laboratories to improve and optimise patient outcomes in the referral process through its efficient and automated workflows. As a data- and systems-agnostic hub, Labgnostic is a tried-and-test universal solution for healthcare organizations around the world to overcome the challenges associated with connecting to multiple diagnostic systems. Labgnostic offers a hub through which any diagnostic laboratory, using any system with an HL7 interface, can digitally exchange diagnostic

test referrals and results with any other laboratory or arm of a diagnostic organization. The service revolves around agnostic systems-connectivity and is fully interoperable. Labgnostic connects all users, via the Cloud, to a network of other users through one connection. Labgnostic is a proven product which holds 95% market share in the UK (under the brand name, NPEx or the National Pathology Exchange) and has been used since 2006; it is the solution of choice for the UK’s National Health Service and is used by Public Health organizations, private laboratories, proficiency testing providers, and specialist diagnostics organizations in the UK, Ireland and France and is currently being deployed to earlyadopters in the USA.

Labgnostic is designed, built, and delivered by X-Lab. X-Lab are on a mission to change diagnostic healthcare; our vision is to be the leader in connecting the world’s diagnostic systems to improve healthcare for all. We are a longstanding member of the diagnostics community and we are constantly searching for ways to enable healthcare providers to deliver quality care.

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CONSULTANCY Emma Sheldon

Time to consult

’ve spent my whole career working in and around the international healthcare space. With Healthcare UK I helped UK NHS Trusts to make their first steps to sell their services overseas. With Vernacare we exported a UK product to more than 50 countries around the world, for which I was honoured to be awarded an MBE for services to export. Our businesses have been subjected to unprecedented levels of uncertainty over the last year or so, with a lack of clarity and understanding about everything. That uncertainty leads to fear and doubt and there has rarely been such a shared volatile business environment in which to operate. Yet even a volatile business environment offers the potential for significant opportunity, when your offer matches the new needs. Smart businesses have seen opportunities to match their innovations with need, to speed up adoption of their technologies to improve patient care, and to share their successes as widely as they can to help others. To support our entrepreneurs and businesses they need the right advice, the right people, and the right money. This requires a massive investment of time and effort and sometimes we’re running so hard at our goal that we fail to take the time to reflect on the changes that have impacted us. Equally, to understand where our offerings can best fit, we aren’t

able to shape and hone our strategy in the right way or we don’t have the time to refine our messaging in order to make an impact with the right people. This is where an experienced and independent pair of eyes is invaluable, equipped to support you in assessing where you are against where you want to be. By helping you to plot your path to success, providing a diagnostic to help you identify and address any gaps in your business planning, at TTA we can create the environment to allow the best chance of success to be achieved. Maximising the potential for success In order to understand where you are and where you want to get to, there a number of critical areas to consider. The first is Proposition Development, crafting and shaping your proposition for the best chance of success. Next is Marketing, making an impact in the right places, generating leads and strengthening your message with strong targeting and significant amplification. International planning with the right strategy for specific markets should include good external intelligence, recommendations, insight and support. Equally Strategy Development, including a review of your business, the current situation and your ambitions, the competitive landscape and the strategic

EMMA SHELDON MBE imperatives for success are vital. Prepare for investment by identifying the key criteria to support the right investment, and ensure you tell your story succinctly and correctly. Recruiting for growth by finding the right people - remember that poor, costly recruitment decisions can be the most expensive mistakes you can make and ensure you engage the right people for the design of your organisational culture as you grow. For Market and Customer Analysis, focus is critical when growing a business but narrowing down markets or sectors can sometimes stop progress for business owners who are conflicted by numerous choices. So prioritise markets, sectors and customers, and design in metrics that will help you see how your choices are making a difference and ensure you are able to quickly assess when to change direction. Business Development - once your strategy and messaging are where you want them to be, reaching the right potential customers quickly and efficiently is vital. Use contacts, strong networks (like those of Healthcare World) to ensure you’re getting to the right customers. Throughout the life cycle of any business, all these elements will be required, and never more so than now, as we live through a situation which is delivering a complex and fast changing landscape for our businesses, people and ideas. emma.sheldon@thetradeagency.co.uk 87

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Opinionated

Steve Gardner Managing Director

Notes from a pandemic

lmost two years ago to the day was the last time that those involved in the international healthcare sector gathered in Dubai for Arab Health, with little idea of what was to come. At the point we arrived in the UAE there were 3-4 cases of the newly christened COVID-19 virus in the Emirate; by the time I returned to the UK there were many more. I remember getting on the plane home, looking at all of my fellow passengers wearing masks and thinking that perhaps this virus wasn’t going away quickly. ‘2020 - What’s Next for Healthcare?’ was the line on the cover of our magazine. If we had known that the answer would be pandemic, lockdowns and the fastest vaccine rollout in history, would our global healthcare systems have handled things any differently? Particularly in terms of our public health messaging. Looking at the responses of different health systems to the pandemic, there was a marked difference in the ways in which countries and their governments responded to the threat. The Middle East, New Zealand and Singapore, to name a few, locked down hard immediately and got ahead of the virus,

minimising cases and managing the load on their health systems while the rest of us tried to figure out what we had on our hands. In these countries the messaging was firm, clear and swift - stay at home, minimise contacts with others, wash your hands. For the UK and the US however, along with many other nations, the messaging was confused. The British Government was slow to act and when they did it seemed rushed, even reticent. The US was even slower and who can forget the confusion emanating from their leader who told US citizens that this was no worse than flu and, at one point, seemed to indicate that drinking bleach was the answer. Of course the paucity of movement from the UK and US Governments pales into insignificance compared to the situation in Brazil, where the president simply ignored the existence of the virus until cases and deaths had reached incredible proportions. As the pandemic moved through its various phases, UK messaging became more and more confused, many of these may be familiar: Go out and eat in restaurants to help the economy, but not in groups of more than 6 unless you’re in a bubble, in which case it’s fine.

Wear a mask, if you want to. If not, wear a lanyard explaining why you don’t want to. Work from home. But if you work in a variety of ever changing sectors, go to work, and your children can go to school, or at least some of them can. You MUST get vaccinated, if you want to, and have a booster. If you want to travel, you must have a vaccine passport, but if you don’t want to then it’s easy enough to fake a lateral flow test. (Particularly if you’re very good at tennis and want to travel to Australia which has faced severe restrictions). Don’t have parties, unless you’re the Prime Minister of a small North Atlantic nation. Oh, and feel free to visit pretty landmarks, but only if you need to test your eyesight before a long drive (only some of you with knowledge of the UK will get this one). The point of all this is the learning we need to make for the future. Public health messaging is key. Clear, succinct, easy to understand and not constantly changing messaging ensures better healthcare, not just in a pandemic but at all times. Something we can learn from our hosts here in the UAE?

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Healthcare consultancy for the future We are a unique, forward thinking and specialist global health consultancy focused on healthy populations. Together with our clients we are influencing the factors which affect health outcomes – both in terms of preventative measures and healthcare interventions. Our experts connect thinking between health and infrastructure to embed health considerations in other sectors which affect health outcomes. In all our work, we take a digital first approach. We offer a broad range of skills and expertise to support clients design, plan, implement and evaluate their healthcare services. Our services include:

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Opening opportunities with connected thinking. richard.cantlay@mottmac.com mottmac.com

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Live, in-person: 24-27 January 2022 Dubai World Trade Centre, UAE Online: 5 January - 28 February 2022

United by business, forging ahead 3,590+

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healthcare & trade professional visits

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Healthcare World Magazine | Issue Three

Articles inside

Opinionated

Time to Consult

Connected intelligence

Entering the UAE market

The urgent need for healthcare super apps

The UK Midlands Region

The Importance of Standards in Healthcare

Making healthy living easy

The need for a global clinical standard

Right care, right time, right person

Introducing Healthcare World Standards

The Healthcare World Primary Care Standards

Meeting consumer expectations in a hybrid health IT landscape

The International Affiliate Network – a pathway to better patient care

Creating a digitally integrated health system

Integrated care – a new reality?

Meeting the unmet need

Healthcare Transformation in the UAE

Creating hospitals at home

Operating in the shadows

Cyber-resilience in the Middle East healthcare sector

Body language

The need for standardising healthcare recruitment in the digital age

Overcoming workforce challenges

Funding vaccine research at Oxford University

Bringing medical expertise to the patient

Why digital health interventions fail

Building a healthy future

Transforming Healthcare from the ground up

Back to the future?

Streamlining hospital processes

News

The urgent need for vaccine parity

Entering the UAE health sector

The astonishing speed of pandemic healthcare innovation