Healthcare World Magazine | Issue Fourteen

TRANSFORMING ATTITUDES TO THE FUTURE OF HEALTHCARE

Clinically proven predictive healthcare

HNisanaward-winning companythatpredicts andpreventsunplanned careevents.

Ourapproachisunique.

Wecombinedata scienceandclinical coachingtoidentifyand supporthigh-need patientstoimprovetheir healthoutcomes.

BasedontheGoldstandardofevidence,HN's interventionis:

WELCOME TO HEALTHCARE WORLD

The rapid advance of Artificial Intelligence or AI in healthcare has been increasingly evident in the past year. For the sector, it has a fundamentally important role in treating patients and populations with more rapid diagnoses and responses. But there is a larger issue at stake, as highlighted by the recent Nobel Peace Prize for Physics.

The 2024 prize has been awarded to John Hopfield and Geo rey Hinton who used tools from physics to develop methods that are the foundation of today’s powerful machine learning. These artificial neural networks play a fundamental role by allowing machines to find and recognise patterns in extremely large datasets. Geo rey Hinton, now at the University of Toronto, le Google when he felt the company put profit before ethics, and feels it’s his duty to warn the world of the dangers of AI which potentially could lead humanity to lose control of its future.

In this latest Healthcare World issue, we take a Deep Dive into the questions surrounding AI in healthcare, and how they can be managed for the greater good. This October we are at Global Health in Riyadh in Saudi Arabia, where the Kingdom is undergoing the largest healthcare transformation programme ever seen. Saudi Arabia is where digital health and AI will have a huge impact, enabling this vast country to pull together its healthcare resources and deliver a 21st century healthcare provision to all its citizens.

Al Tamimi & Company looks at healthcare and AI in the Kingdom and its significant achievements on pages 33-36. Vincent Buscemi and Dan Morris at Bevan Brittan discuss the role of ethics in the development and deployment of AI and data-driven healthcare solutions (pages 44-46) while Gerard Hanratty at Browne Jacobson looks at approaches to AI regulation on page 51. From a practical point of view, Ian Chambers of Linea examines whether there is a rush to jump on the AI bandwagon without

SARAH CARTLEDGE EDITORIAL DIRECTOR

considering whether it’s really necessary on pages 48-50. Alongside these discussions we look at Digital Health, from the potential for a Pan Arab health record on pages 70-72 to Albert Health’s chronic disease management platform on pages 68-69. The Learnery’s microlearning platform makes ongoing education manageable in busy healthcare setting (pages 57-59), and BeeHealthy reveals how their solutions can rapidly enhance healthcare provision (65-66). Gemma Badger and Rob McGough at Hill Dickinson (pages 61-63) examine how digital health solutions and medtech can align with value-based healthcare to create mutually beneficial outcomes.

The key to all of this, of course, is healthcare data. Harmonised data sets can deliver vital insights, creating global solutions to seemingly localised challenges. Promptly is already doing this work and in just a few years has emerged as a global provider of end-to-end real world evidence solutions. Health Navigator is applying its AI tool set to identify patient risks, enabling them to provide preventative care to free up hospital resources. And not forgetting the hospital infrastructure where these digital and AI solutions will be deployed in many cases. Brian Niven, Management Consultant at Mott Macdonald, discusses how the KSA clusters should examine the delivery of healthcare services through a strategic whole systems approach, while his colleague Andrew Parks shows how an optimised approach to healthcare infrastructure programmes is the key to developing successful healthcare facilities. For Talha Maqsood at Colliers, PPP holds immense promise for transforming Saudi Arabia’s healthcare landscape.

To return to the power and potential of AI, perhaps the answer lies in awareness and responsibility. Just as we are all aware of the potential for digital solutions to mislead us in our daily lives, so we should be keenly alert to the potential for such events to happen on a larger scale. While regulation is key, so is self-regulation, along with human oversight, accountability and international co-operation by those who develop and disseminate AI solutions to manage the risk.

An

Dr

BRG’s

Cross-border

importance

Vincent Buscemi and Dan Morris, Partners at Bevan Brittan LLP, discuss the role of ethics in the development and deployment of AI and data-driven healthcare solutions 48 The Rush to Adopt AI in Healthcare

Ian Chambers, CEO of Linea, asks if providers solving problems or just chasing trends 51 Approaching AI regulation

Gerard Hanratty, Head of Health and Life Sciences at law firm Browne Jacobson, examines the methods of some international jurisdictions

Phil Anderton PhD, CEO ADHD360, argues we need to learn from past mistakes to deliver the healthcare of

Fighting the Forgetting Curve

Nick Dobrzelecki, MBA, BSN, RN, co-founder and CEO, The Learnery, on revolutionising healthcare learning

61 Mapping the benefits of Value-Based Healthcare

Gemma Badger, Senior Associate, and Rob McGough, Partner, at Hill Dickinson LLP, examine how digital health solutions and medtech can align with VBHC to create mutually beneficial outcomes

65 Healthcare innovations across borders

Healthcare World Editor Sarah Cartledge finds BeeHealthy’s digital platform can rapidly enhance healthcare provision

68 Increasing treatment adherence in chronic diseases

Recai Serdar Gemici, co-founder & CEO Albert Health, on the importance of personalised programmes for everyone

70 A pan-Arab personal health record

Dr Mohammad Al-Abuydli, CEO of Patients Know Best, tells Healthcare World Editor Sarah Cartledge about his recommendations to create a comprehensive record system

74 Building the health data infrastructure

Pedro Ramos, CEO Promptly, explains how to multiply the value of healthcare data

76 Looking at the full picture

Brian Niven, Management Consultant at Mott Macdonald, discussed how the KSA clusters should examine the delivery of healthcare services through a strategic whole systems approach

81 Public Private Partnership in Saudi Arabia

Healthcare Sector

Talha Maqsood, Head of Development Solutions I Healthcare I Education I PPP, Colliers, on the immense promise PPP’s hold for transforming Saudi Arabia’s healthcare landscape

82 Opinionated

Fight the forgetting curve

The LearneryTM is a unique microlearning platform that revolutionizes the way health professionals train and upskill. Unlike traditional learning models that deliver large amounts of information all at once, The Learnery breaks content into microlessons and repeats them, so they’re easier to digest and remember.

Up to 70% of what we learn is lost after 24 hours.*

*Ebbinghaus Forgetting Curve

• More effective training & knowledge retention

•Improved compliance

• Enhanced employee confidence & satisfaction

• Reduced employee frustration & turnover

NHS LONDON TRIALS DRONE DELIVERY FOR

BLOOD SAMPLES

In a groundbreaking initiative, Guy’s and St Thomas’ NHS Foundation Trust is set to trial drone delivery for vital blood samples, aiming to improve patient care and reduce environmental impact. The project, a first for London, will transport samples between Guy’s Hospital and St Thomas’ Hospital, cutting down delivery times from more than 30 minutes by van or motorbike to less than two minutes using electric drones.

The drones will be part of a six-month pilot starting this autumn, following approval from the Civil Aviation Authority (CAA). The collaboration involves four key organisations: Guy’s and St Thomas’ Trust (GSTT), healthcare logistics company Apian, drone delivery firm Wing, and the CAA. Apian, founded by NHS sta ,

has previously worked on rural UK drone trials, and this project marks a significant expansion of their operations.

The primary focus of the trial will be delivering blood samples for patients at high risk of surgical complications due to bleeding disorders. Faster delivery will enable quicker analysis, allowing medical sta to make timely decisions on patient care, such as whether surgery can proceed or if a patient can be safely discharged.

Professor Ian Abbs, CEO of GSTT, hailed the project as a step forward in improving both healthcare delivery and sustainability.

“The drone pilot combines two of our key

RAISING HEART DISEASE RISK THROUGH DIET

Anew study by Oxford University suggests that just three weeks of consuming high-saturated fat foods can sharply increase the risk of heart disease, even without weight gain. The research, funded by the British Heart Foundation and presented at the European Society of Cardiology Congress in London, followed 24 participants who were split into

two groups. One group consumed a diet rich in saturated fats, while the other ate healthy fats such as polyunsaturated fats.

A er 24 days, MRI scans and blood tests revealed that those on a high-saturated fat diet—eating foods like cakes, pastries, and butter—experienced a 10 per cent rise in total and “bad” cholesterol levels. They also saw a 20 per cent increase in fat stored

priorities – providing the best possible patient care and improving sustainability,” he said.

By switching from traditional courier methods to lightweight electric drones, the Trust expects a significant reduction in carbon emissions and tra ic congestion. The drones can cut CO2 emissions by up to 99 per cent compared to non-electric vehicles, o ering a greener alternative for medical deliveries.

Local leaders hope this trial’s success will lead to wider drone adoption across NHS London, revolutionising healthcare logistics in the capital.

in the liver, a known risk factor for type 2 diabetes and cardiovascular diseases.

In contrast, the group that consumed polyunsaturated fats from foods such as oily fish, nuts, and certain vegetable oils saw significant health improvements. Their cholesterol levels dropped by around 10%, and they had increased energy reserves in their heart muscle.

“It’s the type of fat, not the amount, that matters”, says lead researcher Nikola Srnic. The study highlighted how quickly the body can respond to di erent types of fats, showing that even a short period of poor diet can negatively impact heart health.

While the study involved a small sample, experts believe the results add to the growing body of evidence that saturated fats pose a serious risk to heart health.

Clare Thornton-Wood of the British Dietetic Association said the study reinforces existing knowledge about the benefits of polyunsaturated fats and the dangers of saturated fats.

Researchers hope further studies will confirm whether these short-term changes could lead to long-term heart problems.

Hill Dickinson’s health and life sciences team provides practical, commercial legal advice to public sector organisations, regulators and businesses at all stages of development, from start-up to established multinational.

The firm has a strong international focus and has been supporting healthcare clients looking to work in the Middle East region for many years.

We can support you to exploit opportunities in the region, with our understanding of the legal landscape and local connections to give you access on expertise including:

• Regulatory compliance, licensing and permits

• Intellectual property protection and exploitation

• Information governance, data protection and hosting

• Employment rules and residency

• Distribution and reselling agreements

• Public procurement

• Investments and transactions.

For an initial discussion please contact:

Rob McGough Partner

+44 (0)113 487 7972 robert.mcgough@hilldickinson.com

hilldickinson.com

Jamie Foster Partner

+44 (0)20 7280 9196 jamie.foster@hilldickinson.com

Monica Macheng Partner

+44 (0)20 7280 9159 monica.macheng@hilldickinson.com

NEW AI TECHNOLOGY DETECTS EARLY SIGNS OF 1,000 DISEASES

Agroundbreaking AI tool, MILTON, has been developed to detect the early signs of more than 1,000 diseases, long before symptoms appear.

According to new research by AstraZeneca, the computer algorithm analyses routine patient test results to identify patterns that predict future diagnoses with high confidence, potentially years in advance. MILTON works by processing data commonly collected by GPs, such as blood and urine test results, alongside checks on blood pressure, respiratory performance, weight, age, and sex. The AI tool also examined data from 50,000 UK Biobank volunteers on 3,000 proteins found in blood plasma, which are crucial to various bodily functions, including the immune and hormonal systems.

Slave Petrovski, who led the research, explained to Sky News that the tool can detect disease signatures long before

CREATING A ‘SMOKE-FREE’ GENERATION

The new Labour government is moving forward with plans to toughen smoking regulations, aiming to make the UK ‘smoke-free’ by 2030. This target, defined as having smoking rates drop below 5 per cent, builds on the Conservative government’s initiative to ban cigarette sales to anyone born in or a er 2009. The legislation, which had been delayed by the election, aims to prevent younger generations from ever legally purchasing cigarettes.

In addition to cigarette restrictions, the government is exploring a ban on outdoor smoking in public spaces such as pub gardens. The broader goal is to reduce exposure to harmful tobacco smoke and further discourage smoking across all age groups.

Plans are also underway to regulate the sale and marketing of e-cigarettes,

patients show clinical symptoms. “We can pick up signatures in an individual that are highly predictive of developing diseases like Alzheimer’s, chronic obstructive pulmonary disease (COPD), kidney disease, and many others,” he said.

The research, published in Nature Genetics, highlights MILTON’s “exceptional”

particularly to young people. A proposed ban on disposable vapes is part of the strategy, amid concerns about their rising popularity among teenagers. While e-cigarettes do not contain tobacco, they o en include nicotine and other chemicals, with little long-term evidence about the health e ects of vaping for non-smokers.

According to the O ice for National Statistics (ONS), young adults aged 16-24 were the most likely to use e-cigarettes in 2023, with 15.8 per cent of this group vaping. However, the biggest rise in use was among

performance for predicting 121 diseases, and “highly predictive” capabilities for an additional 1,091. AstraZeneca developed the AI tool to accelerate the creation of more e ective, targeted treatments but is also making the data freely available to researchers worldwide. This could lead to the development of diagnostic tests for early preventative treatments.

Professor Dusko Ilic of Stem Cell Sciences at King’s College London (KCL) called the tool’s predictive power “remarkable,” emphasising the possibility of earlier interventions, personalized treatments, and reduced healthcare costs. But he also stressed the importance of strict guidelines and oversight to ensure the tool is used responsibly, without compromising individuals’ rights or privacy.

Professor Tim Frayling, a Professor of Human Genetics at the University of Exeter, believes that the tool’s main impact will be on advancing our understanding of how diseases develop, rather than accurately identifying who will develop them.

UK vaped in 2023, with 5.9 per cent of those aged 16 and over using e-cigarettes daily. Public health advocates welcome these moves but stress that more support is needed. Hazel Cheeseman, CEO of Action on Smoking and Health (ASH), told the BBC that continued investment in smoking cessation programmes is vital to help the 6m current smokers quit. Respiratory physician and ASH chair, Prof. Nick Hopkinson, called for swi action to pass the Tobacco and Vapes Bill, reinforcing vaping as a tool to quit smoking, rather than

Making healthcare smarter. For you and your patients.

The awarded digital healthcare platform with proven business impact for healthcare providers.

BeeHealthy is a digital healthcare solutions provider in the EMEA region. The modular, white-label SaaS platform equips primary and secondary healthcareproviders and insurers with all the tools for building a modern digital-physical service provision – with proven business impact.

The BeeHealthy platform is an enterprise solution for healthcare providers with tools for patients, professionals, and power users. The platform includes all the modules and features for enhancing doctor work, automating mundane admin tasks, and streamlining patient journeys for better patient outcomes. Unlock the potential of digital transformation and start delivering better health care to your patients today.

Creating exponential growth for healthcare providers

Drive e iciency and cost savings in care provision

Cut admin costs by o ering selfservice solutions to patients, tackle care personnel scarcity and build cost e icient care provision with innovative professional tools, while simultaneously prioritising patient

Increase customer loyalty and acquisition with superior customer experience

Lower barriers to care through on-demand services and continuous 24/7 availability of comprehensive care resources, ensuring patient convenience, all while fortifying and expanding market presence and nurturing customer loyalty via a world class online booking solution integrated into modern, user-friendly mobile apps.

Explore and test new revenue streams

Test and increase revenue streams by cross-selling services to your patients, while also attracting new customers through the creation of innovative digital services.

Deliver outcomes at scale, without compromising on quality

Improve treatment adherence through digitally guided integrated care journeys, connecting physical and independent care for improved availability and earlier interventions. Utilise on-demand and remote care solutions, standardise protocols,

NEW HANDHELD SCANNER DIAGNOSIS

Researchers in the UK have developed a ground-breaking handheld scanner that could transform the diagnosis of cancer and arthritis. The new device can generate highly detailed 3D images in seconds, o ering the potential for earlier disease detection and more precise clinical assessments.

A study led by Professor Paul Beard from UCL Medical Physics and Biomedical Engineering revealed that the scanner is between 100 and 1,000 times faster than existing devices. This speed allows for realtime imaging without the risk of motioninduced blurring, a significant improvement over traditional scanners that take several minutes per image.

“The acceleration in imaging time is a major breakthrough,” said Professor Beard. “This speed means we can now visualise dynamic physiological events and produce detailed images without needing patients to stay perfectly still.”

One potential use of the scanner is in diagnosing inflammatory arthritis, which requires scanning all 20 finger joints. With older scanners, this process could take nearly an hour—too long for many frail patients. The new scanner can complete this in just a few minutes.

COMBAT MISINFORMATION AND PROMOTING HEALTH LITERACY

The World Health Organization (WHO) and TikTok have announced a year-long collaboration to provide reliable, science-based health information to users worldwide. This partnership reflects WHO’s ongoing e orts to leverage digital platforms to promote health literacy and encourage healthy behaviours in a rapidly digitising world.

With more than 1 billion users, TikTok reaches a global audience, especially younger generations. These days social media plays an influential role in shaping

health-related behaviours, with one in four young adults seeking news content on platforms like TikTok. However, the rise of misinformation and malinformation on these channels poses significant challenges. The WHO-TikTok collaboration aims to counteract this by promoting evidencebased content and fostering positive health dialogues.

“This collaboration can be a turning point in how platforms can be socially responsible,” said Dr. Jeremy Farrar, WHO Chief Scientist. “By working with TikTok, we

The scanner uses photoacoustic tomography (PAT), which employs lasergenerated ultrasound waves to examine tiny veins and arteries up to 15mm deep. Previous PAT technology was too slow to produce high-quality images, but this new advancement drastically reduces the time required, making it more suitable for a wider range of patients.

The device was tested on 10 patients with conditions such as type 2 diabetes, rheumatoid arthritis, and breast cancer, alongside healthy volunteers. It successfully produced detailed images of feet a ected by diabetes and revealed skin inflammation linked to breast cancer.

Dr. Nam Huynh, one of the developers, believes the scanner could help cancer surgeons identify tumour tissue during surgery, reducing the risk of recurrence.

This breakthrough could be available in clinical settings within five years, subject to further testing.

can help people access credible information and engage in scientific discourse that supports a healthier future.”

As part of this initiative, TikTok will utilise its platform to raise health awareness and increase access to trustworthy information. By sharing impactful stories, providing resources, and building supportive communities, TikTok aims to make a positive impact on its users’ well-being.

Valiant Richey, TikTok’s Global Head of Trust and Safety Outreach, emphasised the platform’s commitment to delivering engaging and authoritative mental health content through its collaboration with WHO’s Fides network of more than 800 health content creators. With a reach of 150m people, the network will play a key role in delivering science-based information in relatable, digestible video formats on TikTok.

“Creators who understand their audience’s needs have a unique opportunity to bridge the gap between science and everyday life,” says Dr. Alain Labrique, WHO’s Director of Digital Health and Innovation. “This is where WHO can step in to support influencers in delivering evidence-based information.”

JON PICKERING

JON PICKERING

CEO, Mizaic

The perennial problem in delivering quality healthcare stems from fragmented health systems and patient data. The core issue facing clinicians is that they need rapid access to accurate patient information at the point of care. Interoperability is critically important to minimise the number of di ering systems in hospitals that healthcare professionals need to access. The solution to this dilemma is linking siloed systems and data to create a single source of truth and a consolidated view of each patient.

Jon Pickering, CEO of Mizaic, has made it his mission to resolve this problem.

As a former engineer who pivoted into technology and healthcare, he knew he could make a real di erence, leveraging

technology to streamline processes towards healthier outcomes. Seeing and resolving such issues within the NHS, he is now expanding his focus to international markets, using his expertise to support the development of modern healthcare systems in regions like the Middle East.

What made you want to pursue a career in healthcare?

The intersection of technology and healthcare has always fascinated me. Earlier in my career, working as a technical consultant in healthcare, I witnessed the immense potential of digital transformation within the NHS at Guys and St Thomas’s. Being involved in projects that directly improved patient care and streamlined

clinical workflows showed me the farreaching impact that well-executed IT solutions can have on healthcare delivery. This experience was the start of my passion for driving positive change in healthcare through technology. This inspired me to create my first tech business that could harness this potential.

Describe your career journey to date

A big moment in my career was shi ing from engineering to technology - one that would push me to adapt quickly and navigate a fast-paced, ever-evolving landscape.

In 2006, I built and scaled an IT business, called Block Solutions, which focused on infrastructure projects for hospitals. The projects, myself and the team, undertook here laid the groundwork for many hospitals’ digital strategies, ensuring their infrastructure could support the enterprise applications they needed to run and use.

CEO INTERVIEW Jon Pickering

Following this, I became CEO of a workplace data analytics firm, navigating the challenges of COVID-19. Finally, in September 2022, I joined Mizaic as CEO. I was excited by the opportunity to get back into healthcare, and impressed by the company’s ambitious growth plans, the culture, and the focus on driving digital transformational change and impact in the UK NHS, specifically in digitising patient records and leveraging unstructured patient data to deliver better care.

Why is Mizaic’s o ering so important to the healthcare sector?

Mizaic’s MediViewer is more than just an electronic document management system (EDMS); it’s a tool that fundamentally enhances the clinician : patient experience. It is transforming healthcare by empowering clinicians with a complete, data-driven view of each patient, at the point of care, through an intelligent and intuitive user interface. Integrating seamlessly with electronic medical record systems (EMRs), MediViewer enables hospitals to organise, search, and analyse unstructured records – both digital and physical – unlocking instant insights into a patient’s medical history.

MediViewer’s advanced search capabilities, such as Optical Character Recognition, enable rapid and e icient access to patient records, linking content to patient events in chronological order. Additionally, it addresses critical operational challenges by digitising vast paper record archives, thereby freeing up valuable hospital space for clinical use and improving overall e iciency.

Our o ering is also important to the healthcare sector because it’s not just about the so ware – it’s the personalised service and expertise we provide that truly di erentiates us and holds huge value for our healthcare customers. We don’t provide a one-size-fits-all solution – our dedicated transformation team, trainers, and project managers work closely with each hospital to fully understand their unique needs. From implementation to adoption, we are committed to being a long-term partner, not just a supplier. That means building trust and fostering deep collaboration is at the heart of everything we do. This was a key part of my approach at Block Solutions and is central to everything we do here at Mizaic.

What are your major areas of focus?

Our primary focus is on innovation in healthcare technology, with a particular

emphasis on AI and automation. This year, we’re launching a new Subject Access Request (SAR) solution using robotic process automation (RPA) to streamline and speed up what has traditionally been a manual, time-intensive task for hospitals.

We’re also introducing new AI capabilities to enhance our search capabilities and introduce handwriting recognition and the ability to handle more complex forms of unstructured data such as photographs,

JON PICKERING CEO Mizaic

“The

healthcare market in the Middle East is poised for substantial growth, with increasing demands on clinicians and a pressing need for efficient, scalable digital health solutions”

audio and video files. AI will continue to be significant in enhancing the core functionality of MediViewer. These developments are part of our ongoing commitment to continually enhance our o ering, making it much more than a traditional EDMS solution. Our aim is to provide a clinical content services platform capable of dealing with all types of digital content, with the primary goal of making it easier for clinicians to find meaningful patient insights at the point of care.

How important is the Middle East region for Mizaic’s solutions?

The Middle East is a key focus for Mizaic, as we see huge potential to replicate the transformative impact we’ve had in the UK. The healthcare market in the Middle East is poised for substantial growth, with increasing demands on clinicians and a pressing need for e icient, scalable digital health solutions. Core to any e icient health system is the ability to share and access accurate patient data. Our experience in addressing similar challenges

in the NHS positions us well to support this transformation and contribute meaningfully to the region’s healthcare evolution. We are currently exploring possibilities around population health and how our data could be exported and utilised in structured data models, feeding that into clinical trials and wider research projects linked to preventative care.

Do you feel it is a good time to invest in Saudi Arabia now?

Yes, as it is important to understand that while the nation is one of the wealthiest in the world, in recent times it has rightly shi ed its focus to selecting suppliers based on trust, integrity, and proven capability. This focus links tightly to our core values as a business. We see this as a great opportunity for us because of our relationship-first approach, coupled with great technology that delivers clinical value. UK healthtech companies, especially those experienced in transforming the NHS, are well-positioned to meet these expectations and bring genuine value to the Saudi healthcare sector.

Also, we are experts at operating both within individual hospitals and a wider regional level making us a good fit for working within the Clusters. With the interoperability capability we bring, we have the ability to deliver a single application platform that could serve a region.

What opportunities do you see in the UAE for Mizaic?

The UAE presents exciting opportunities due to its advanced digital ambitions. While they have made significant strides in recent years from a digital standpoint, we still believe there is a significant opportunity to improve how patient data is used across hospitals, health systems and the wider region to deliver a better overall healthcare system for the UAE population.

As we’ve seen with the NHS, the healthcare sector in the UAE faces similar challenges –particularly the need to digitise healthcare infrastructure in a way that is scalable and consistent across the region. Our experience in addressing these challenges makes us uniquely positioned to help.

In addition to solving core digitisation issues, we can also support broader initiatives, such as improved population health management. Fragmentation remains a significant hurdle, especially in areas like Dubai, and this is another area where our expertise can bring real value by helping to unify systems and streamline operations.

Also, both markets are increasingly focused on leveraging unstructured patient data – an area where Mizaic excels.

As we continue to explore opportunities and build relationships in the region, our focus will be on understanding the specific needs and requirements of these markets. Establishing ourselves as a trusted and credible partner is key, and we are excited about the role we can play in healthcare transformation here.

How does MediViewer fit into the overall concept of interoperability for the UK NHS and elsewhere?

Interoperability is crucial for creating a seamless healthcare experience, and MediViewer is designed to break down the digital silos that o en hinder this. By integrating with various clinical systems through APIs, for example, MediViewer joins the dots and delivers a unified patient record that clinicians can access at the point of care, supporting a patient-centric approach to healthcare.

Additionally, MediViewer’s ability to apply Optical Character Recognition to all ingested content allows for the export of this data into structured models, enhancing its value for research, analytics, and broader healthcare system interoperability. It avoids the need for multiple applications and provides much needed integration into di erent systems.

What is your vision for Mizaic in the medium and long term?

In the short term, Mizaic is focused on managing unstructured content, making medical documents and photographs more accessible at speed. In the medium to long term, our vision is to evolve towards managing unstructured data – extracting and making sense of the information within these documents to provide actionable insights. We’re absolutely focused on our end users – the clinician and healthcare teams - but we’re also looking at developing new products that complement MediViewer, and importantly, impact the patient pathway.

We’ve established a clinical advisory group, comprising of experienced Chief Clinical Information O icers (CCIOs) from our customer base, to guide our future product development and this will remain in place. Their input ensures that our solutions are aligned with the needs of clinicians and that we continue to develop our o ering, which is important in such a dynamic market. Additionally, as I’ve mentioned previously, we’re exploring AI and automation to further broaden our product portfolio, always with the goal of improving patient outcomes and operational e iciency in healthcare.

But our overall long-term vision is to continue to make an impact on digital transformation in the UK healthcare market and establish ourselves within the Middle East. We are keen to add the same value to the UAE and Saudi – transforming patient data into rapid clinical insight which, in turn, has a massive impact on the patient pathway. We have already undertaken several trips to Saudi Arabia and plan to visit the region every couple of months to meet key stakeholders as part of our commitment to the region.

REVOLUTIONISING HEALTHCARE BY EMBRACING DIGITAL INNOVATION IN KSA

Dr Gireesh Kumar, Associate Partner, Healthcare Advisory Services, and Shatha Alwethinani, Healthcare Consultancy Analyst at Knight Frank, explore the trends within Digital Health sector in the Kingdom of Saudi Arabia.

Transforming healthcare through digital health initiatives is one of the key components of Saudi Arabia’s Vision 2030 transformation programme. The Saudi government has allocated over SAR 214 Bn on healthcare and social development sector in 2024 in comparison to SAR 167 Bn in 2020, representing a CAGR of 6.4 per cent.

This growth in budget allocated towards this sector indicates focus on meeting the objectives of Health Sector Transformation Program (HSTP) as mentioned in the image on the right.

The Global Digital Health Monitoring Survey (2023) which included responses

from 63 countries identified Saudi Arabia’s digital health ecosystem as advanced, earning a maturity score of 5 out of 5 across domains such as

strategy and investment, workforce, leadership and governance, standards and interoperability, infrastructure, services and application, and policy and compliance. This rating positions Saudi Arabia ahead of other MENA countries and highlights its substantial investment in digital health.

The journey of shi ing to a tech-driven healthcare system started in 2010. However, the COVID-19 pandemic has acted as a catalyst for accelerating the digital health agenda and increasing the adoption of digital solutions.

Key initiatives in the government sector

Sehhaty

In 2023, the app was observed to have 30m beneficiaries - a 15 per cent increase from 2022.

Brief: An application which enables users to access personal health information such as lab reports, medical records, managing appointments and medications, and more End User: B2C, All citizens and residents of KSA

Outcome: The app is a transformative shi towards a more e icient, patient-centred healthcare system empowering individuals to be actively involved in their health management.

Seha Virtual Hospital (SVH)

Established in 2022, SVH has a network of 170 hospitals catering to 123,000 beneficiaries.

Brief: A pioneer project and one of the largest virtual hospitals uses innovative technology to support hospitals through a telemedicine network with a variety of services including, but not limited to, emergency and critical care, cardiology, psychiatry, neurology, and other specialised clinics. SVH also uses Augmented Reality to guide surgeons during procedures.

End User: B2B: Hospitals

Outcome: Facilitates easy access to specialised healthcare and contributes towards promoting knowledge transfer to improve patient outcomes.

National Platform for Health and Insurance Exchange Services (NPHIES)

Since its launch in 2023, the programme has served 14m beneficiaries and processed over 350m insurance transactions

Brief: A centralised service facilitating the exchange of accurate and updated data between healthcare providers and insurance companies to automate workflow for verifying treatment eligibility, medical approvals, and financial claims.

End User: B2B: Claims Management Companies, Healthcare Providers, Insurance Companies.

DR GIREESH KUMAR Associate Partner, Healthcare Advisory Services Knight Frank, KSA

“As the country continues to embrace innovative solutions to strengthen healthcare capabilities, it is paving the way for numerous opportunities for the private sector”

Outcome: Enhances patient experience by reducing claim rejection and expediting claim processing.

Wasfaty

Since its establishment in 2022, the programme has a iliated with 2,226 primary care centres, 340 hospitals and more than 5,000 pharmacies processing in excess of 115m online prescriptions.

Brief: The MoH and National Unified Procurement Company (NUPCO) have an agreement to provide a platform which connects primary care centres and hospitals with a vast network of community pharmacies.

End User: B2B: Government Primary Healthcare Centres and Hospitals.

Outcome: Ensures the availability of medications, minimises stock expirations, and improves both patient experience and safety.

Key initiatives in the semi-government sector

EyenAI

Launched in 2023 the programme provides ophthalmology results in 10 seconds. It can cater to more than 4m Saudis that are diabetic, with 20 per cent of them having diabetic retinopathy.

Brief: An advanced AI technology that detects signs of diabetic retinopathy through an AI model. It has been developed through a collaborative e ort of the Saudi Data and AI authority (SDAIA), King Khaled Eye Specialist Hospital, LEAN Business Services, and the Saudi Company for Artificial Intelligence (SCAI).

End User: B2B: Hospitals

Outcome: Maximises early detection, reduces waiting time and cost of examinations.

Key initiatives in the private sector

Labayh

Since establishment in 2018, 2.2m beneficiaries have been served by more than 1000 mental health specialists providing in excess of 70m counselling minutes.

Brief: A private telepsychology platform that delivers therapeutic and well-being services, o ering access to specialised psychological counselling.

End User: B2C, Worldwide access for patients.

Outcome: Increases accessibility and user engagement through interactive and personalised features.

Tele-ICU

Operating 139 ICU beds in 6 MoH hospitals it features one of the largest Tele-ICU Command Centres in the world with the capacity to manage more than 1,000 beds.

Brief: Dr. Sulaiman Al Habib Medical Group (HMG) partnered with GE Healthcare to adopt Tele-ICU technology which helps monitor patients with chronic conditions remotely within HMG network and some MoH hospitals.

End User: B2B: Hospitals

Outcome: Improves patient management and operational e iciency.

These examples depict the volume of engagement across various digital health platforms in KSA, demonstrating that end users have adopted these platforms as they provide greater access to healthcare services.

According to the Ministry of Investment, KSA’s digital health market size stood at SAR 698m in 2022 and is expected to witness a CAGR of more than 25 per cent between 2022-2030. The Kingdom of Saudi Arabia ranked 6th globally in the E- Government Development Index (2024) among G20 countries, jumping 37 places since 2020, which means there is a promising investment opportunity in the digital healthcare space.

In essence, as the country continues to embrace innovative solutions to strengthen healthcare capabilities, it is paving the way for numerous opportunities for the private sector under PPP or PSP models within health clusters in areas such as tele-ICU and remote monitoring.

Some of the key projects to look forward to in 2024 include remotely controlled tra ic lights by ambulance for emergency cases, and digital health solutions for early detection of chronic diseases including breast, and colon cancer. With opportunities for more projects within this space, KSA will mark a new era ensuring a future ready, techdriven healthcare ecosystem.

THE FUTURE OF HEALTHCARE INFRASTRUCTURE

An optimised approach to healthcare infrastructure programmes is the key to developing successful healthcare facilities, says Andrew Parks, Managing Consultant at Mott MacDonald

Healthcare infrastructure programmes throughout the world are fraught with di iculty. Planning and funding approvals are rushed, and processes are heavily influenced by political agendas and optimism bias. Construction o en runs over time and over budget. Then, the combination of short cuts in early decision making, combined with the speed of clinical and technological innovation, means. this immovable structure, once finally opened, quickly becomes obsolete

and reflects an outdated clinical practice that cannot cope with a changing patient population. Yet, all indicators point to the need for more and more healthcare facilities, so we must find a way to deliver more e ectively that isn’t a burden to Governments and taxpayers.

Where are we getting it wrong?

A look at previous health infrastructure programmes indicates that they go wrong for several core reasons. These appear to

be ine ective governance and decision making, inability to manage the inherent complexity and constant reinventing solutions to the same problem and not learning.

Firstly, ine ective governance and politically motivated decision making, based on biases and assumptions, causes subjectivity and overoptimistic estimates. There is a lack of evidence-based decision making. Decisions are rushed and based on narrow data sets and too many assumptions, concluding the best option is to build acute hospitals before thorough analysis has begun. The only question asked is what should be built, not should we build. Evidence shows, however, that to cope with growing demand, allow flexibility and improve patient experience and outcomes, there needs to be a shi away from the provision of all care within an acute setting, to a system that can utilise community and at home services, driven by technology and digitally enabled care

that allows patients to take more control. Simply put, huge capital investments are committed without thoroughly testing alternatives approaches.

Secondly, project management and technical capability is not able to manage the high degree of complexity in healthcare infrastructure. Instead of the integrated approach required, a linear, fragmented methodology is used with each element developed in isolation. Healthcare delivery systems are highly complex, adaptive systems and represent a “wicked” problem. Without understanding the interfaces properly, any changes intended to solve one issue will unintentionally create issues elsewhere in the system. This approach drives constant scope changes and design di iculties which are expensive and, when combined with human behaviour, drives decision making that results in short cuts.

Healthcare infrastructure projects are high risk, yet few lessons are learned and passed on between projects, repeating the

same mistakes. In addition, every hospital is seen as special and bespoke, and new solutions are created to solve the same problem. This is clearly problematic and ine icient, but more importantly creates productivity challenges for the construction industry. A single hospital project is a highly complex building programme – if every hospital is built di erently, the risk profile never reduces, no delivery learning is passed on, so productivity never improves. However, it is possible to adopt an approach to develop healthcare infrastructure that allows for objective decision making, one that meets present and future need, solves the design challenge once, balances the multiple perspectives with the needs of the patient at its core. This approach creates an environment that sta want to treat patients in and is ultimately systematised so it can be used repeatedly and improved.

What can we do about it?

An approach that harnesses systems thinking to solve these issues and optimise the way healthcare infrastructure is delivered is possible. This approach responds to the need for better decision making and embraces new care models to meet changing demand and demographics. It uses systems thinking and systems engineering to manage the complexity and interfaces. It adopts an innovative industrialisation model to learn lessons and drives e iciency to deliver new infrastructure within constrained social infrastructure budgets. The opportunity is greatest when this approach is applied to a group of healthcare projects as it drives economies of scale.

Strategic healthcare planning

Step one is to be disciplined in establishing and defining the future demand and system

ANDREW PARKS Managing Consultant Mott MacDonald

“Healthcare infrastructure projects are high risk, yet few lessons are learned and passed on between projects, repeating the same mistakes”

level change requirements. An aspirational future state developed using advanced demand and capacity modelling should reflect the ambition to optimise models of care and create new ways of working, not simply to justify capital investment. It is here where alternative options need to be fully tested and supported with real world data.

From this analysis, a set of aspirational, transformational principles are established to define the strategic purpose of the programme. This set of principles needs to be converted into measurable programme goals that define the transformational vision of the programme and the core focus areas.

Using systems thinking to manage complexity and drive integration

Healthcare infrastructure programmes are o en wide ranging and ambitious, and the scale and complexity lend itself to systems thinking. The sheer quantity of people, scale of resources and other factors creates a complex, adaptive system. Using systems thinking allows a holistic approach to conceptualising this complexity and helps to find system logic.

This logic can be mapped, and limits and remits established. Combined with the strategic programme goals, it allows a programme strategy to be defined, allowing all stakeholders to work to the same understanding and start to create a single integrated approach with a common purpose by reimagining the traditional approach to problem solving.

Systems engineering and developing a platform

This programme strategy is then handed to a multidisciplinary team to establish a set of corresponding programme requirements. Through identifying best practice and lessons learned, they develop a ‘platform’ of standardised solutions or a kit of parts that meets these requirements. This platform is ideally broken down into a series of groupings or modules of individual solutions to help manage the complexity and create the opportunity for repetition, learning and specialist knowledge to developed in defined areas.

The approach taken to develop this platform is not traditional and instead uses an industrialisation process to remove unwanted variability. Designers start with how the infrastructure will be built and how operational interfaces work.

ANDREW PARKS Managing Consultant Mott MacDonald

“Every time we build new healthcare infrastructure, we learn and get even better at building it”

By integrating functions such as clinical, operational, technical, commercial, delivery and digital they find the best delivery method, and manage the interfaces and operational functions for each optimised component. In learning from other industries implementing similar approaches, early consultation with the market is key to clarify any core strategies (e.g. modularisation) that might cause issues and to identify any areas of supply constraint that might require substantial market change.

In essence, this set of rules enables the development of infrastructure to move forward within parameters that reduce variation, increase repeatability, and provide more granular information with the pipeline of demand, supporting more detailed engagement with the market and stakeholders - ultimately reducing risk and allowing for productivity improvement. The programme then uses configuration management to test and validate the platform ensuring it achieves maximum impact and is aligned to the core transformational objectives.

Implementation and deploying the platform

Elements of the platform are then taken and assimilated into each project in the programme. As a result, rather than the same problem being repeatedly solved, the platform has already identified best practice and opportunities for repeatability still allowing for the right level of variability for key stakeholders. At this stage an innovative procurement model is required that allows deeper early contractor and supply chain collaboration. The proposition is that the supply chain is entering a streamlined workflow where variations in the brief have been significantly reduced.

Buildability has been considered a core principle, and there is still time to influence the design development. It is important to consider alternative delivery models to open the market to new entrants. This critical step will bring two key benefits: improving delivery performance while simultaneously opening the opportunity for more innovation.

Due to the nature of healthcare programmes, it is highly likely that time pressure will be a factor. Therefore, the

implementation of the approach can align to the sequence of the development of each project. The programme can achieve benefit at all levels of maturity of the platform. Immediate impact can be achieved by simply reducing variability and stabilising design requirements. It is vital to continuously check back and validate the performance of the platform against the measurable objectives during both the development and deployment phase to ensure alignment with programme goals.

The principles set out in the programme strategy become a core component to achieving early impact. If an early adopter can achieve the principles of the programme through a traditional delivery method while the platform is developing, the programme can both move forward, and critically, learn lessons. The new delivery methodology that the platform enables then cuts into the programme at the most appropriate times. Ultimately,

facilities developed using the full platform will have maximum impact, but this e ect will take time to achieve and needs learning from experience to get to this point.

Future optimised delivery

If this process is done right, this approach can transform the way healthcare infrastructure is delivered for governments. The ‘platform’ can evolve into a space where continuous

improvement, lessons learned, and innovation can continue to thrive. In essence, every time we build healthcare infrastructure, we learn and get even better at building it.

RESOLVING THE GLOBAL HEALTHCARE WORKFORCE CRISIS

Various factors contribute to the global shortage, finds Helen Featherstone, Director and General Manager GMCSI

In order to hit the UN’s sustainable development goal of universal health coverage (UHC) it has been estimated by the World Health Organisation, that we will need another 10m healthcare workers globally by 2030. This shortfall comes against a backdrop of greater attrition rates, falling numbers of young people entering the health workforce and an extreme regional imbalance, in terms of workforce numbers.

While the primary purpose of regulators is to protect patient safety by ensuring healthcare practitioners’ competency, probity and fitness to practise, the panel examined if they could also play a role in solving the issues around the lack of healthcare workers and addressing shortage and distribution challenges.

This role could be enabling healthcare workers to move more easily between

global health economies by reducing the time it takes to obtain registration in the new country. It could also provide equivalency between systems to allow professionals to operate at the top of their licences. In addition, it could ensure that any influx of trainees or re-entrants to the professions are suitably qualified to do so and are properly regulated. However, in the GMC’s view, it is an extremely complex situation as mutual recognition of medical qualifications is currently not an option due to the di ering standards of medical education around the world. This is a significant hurdle to overcome.

This topic was debated in a Healthcare World Series webinar with a panel consisting of:

• Steve Gardner – Managing Director Healthcare World (Chair)

• Colin Melville – Medical Director and Director of Education and Standards –The General Medical Council (UK)

• James Campbell, Director for WorkforceWorld Health Organisation

• Professor Ged Byrne – International Director – NHS England

• Vivian Lin - University of Hong Kong, Elizabeth Oywer - Nursing Regulator, (Kenya)

• Joan Simeon – CEO Medical Council of New Zealand

• Jishnu Das -Center for Policy Research (India)

Multi-dimensional crisis

The panel found that the crisis is multifaceted. While there is high

production of medical doctors around the world, there is poor absorption capacity into jobs, or poor management and retention of those jobs in certain countries, rather than simply a supply-side education shortage. In many African countries, there is now a plethora of medical schools but

HELEN FEATHERSTONE Director & General Manager GMCSI

“Workforce migration is a complex puzzle to

solve. Each aspect of the healthcare system has a role to play”

not all the graduates are being employed locally due to ine icient workforce planning. Many are leaving for other countries, creating a workforce shortage in their own country with resulting clinical burnout for those in post. Yet in countries such as the Philippines, reports show that the higher the demand for Filippino nurses overseas, the larger the supply response, creating more nursing sta who remain behind in the Philippines.

Thus, the shortage appears to be a supply and demand phenomenon. Health is now internationalised and democratised by providers and those workers who are willing to move can do so, if they want to. For this reason, areas such as subSaharan Africa are being denuded of their healthcare workforce, creating a workforce shortage in the respective countries. The NHS is focussing on loan return to help the international workforce by o ering short term periods where they gain additional skills in the UK and then return to their country of origin (known as earn, learn and return). New Zealand has an excellent programme and registration pathway, that is temporary and time bound for doctors in the Pacific Islands to spend up to two years training in New Zealand, but a erwards they must go back to their home country. Similar sponsorship opportunities are also available in the UK.

Redistributing the workforce through regulation

The panel agreed that the idea that every healthcare worker globally is overworked is not backed up by the data. In countries such as Kenya, Vietnam and India, smaller primary care centres sometimes only see one patient a day. So there is a question regarding how many people are able to access healthcare, and for those who can’t, why not? Conversely, the growth in unmet needs across the world is increasing exponentially with the current economic circumstances, driven predominantly by conflict in Eastern Europe and the Middle East.

In New Zealand, the majority of people can access the healthcare they require, and those who don’t are o en indigenous or disadvantaged people. Indigenous people may prefer to visit a more traditional healer rather than a medical doctor. Equally, there is a need to consider how to provide the right healthcare in the places where people live, such as geriatric provision in coastal retirement

towns. As such, there are both supply and distribution issues and not just a supply issue. Furthermore, countries need to consider the balance between their need for specialists against their needs for more generalists. Many countries are experiencing shortages of general practitioners as medical students gravitate more to the specialty areas for the many prestige and financial rewards.

Educators could possibly influence workforce by requiring graduates to work in general practice, for example, to see how healthcare is delivered in local communities. Therefore, perhaps educators need to think about medical education di erently. Blended learning programmes are one of the mechanisms to increase supply; yet there are large swathes of professionals in the world who carefully maintain their professional boundaries which potentially impacts on supply. So new ways of working for professional groups that analyse and utilise skill mix, based on population need, could be the way forward.

Finally, the panel agreed that there is a need to train more regulators while there is also a need to strengthen regulations in the interest of patient safety. In addition, there should be a professional qualification leading to regulation, so that regulators and professionals are clear about the regulations. One approach is to undertake more research and to publish more literature as the evidence base is currently lacking. In this way, with emphasis on regulation, the workforce challenges can begin to be addressed successfully.

Understanding the reasons behind workforce migration

The GMC has subsequently published a report Identifying Groups of Migrating Doctors that analyses the reasons behind such movement. In the UK, there are clear groups that are considering migration, each for their own specific reasons. These reasons are categorised into into Deep Discontent, System Sceptics, Burnt Out, Mobile Career Developers, Open to Opportunity and Happy in the UK. The Deep Discontent group is dissatisfied on all fronts. The System Sceptics are concerned about the direction of the UK healthcare system and dissatisfied with their own working conditions. The Burnt Out group is defined by a focus on personal wellbeing

and work-life balance, with UK practice being found wanting for both. The Mobile Career Developers are a segment with a high proportion of doctors who qualified overseas, who tend to be neutral about working in the UK, but could be tempted to leave if faced with obstacles to their career progression. On a more positive note, those Open to Opportunity are a relatively content group of doctors, some of whom would consider working abroad for a new challenge. Finally there are those who are Happy in the UK - a high proportion of doctors who qualified overseas, but many of whom will return to their home country at some point.

The report finds that some migration is inevitable and natural as doctors return to

their origin country (33 per cent of leavers) and some are intent on experiencing new challenges abroad (20 per cent of leavers). Retention strategies that focus on working conditions and the UK’s competitive position, including pay, are likely to be most e ective among doctors in the Deep Discontent, System Sceptic, and Burnt Out segments. These groups make up most of the doctors who say they are very likely to leave: 34 per cent, 33 per cent and 15 per cent respectively.

Identifying reasons for migration is hugely helpful for policy makers, so how well do countries understand such reasons and do the trends above in the UK sound familiar? Workforce migration is a complex puzzle to solve and there are

many factors involved. Each aspect of the healthcare system has a role to play. Here is a simplistic example using medical doctors. Medical schools can provide their numbers of students about to graduate (undergraduate) and the numbers of specialists due to complete their training (post-graduate) on an annual basis. This data collection feeds into a national dataset where an analysis can be performed of many undergraduate and post-graduate students entering the workforce on an annual basis. Regulators, Ministries of Education or Ministries of Health should ideally have access to this data as they are likely to be tracking student numbers as their role to assess the

quality of the medical schools. This data then feeds into the data modelling of healthcare providers who can plan their workforces accordingly, ensuring there are adequate places available for these graduates to be absorbed into the workplace. This may discourage some migration as career opportunities exist and further training is provided within the workplace. Such a method enables an entire healthcare system to work in collaboration to meet the needs of the workforce whilst simultaneously protecting the patient.

Should your organisation require trusted business advice on the required data and data analytics processes, market research

in identifying reasons behind workforce migration or surveys, to understand the current issues being experienced by the workforce, GMC Services International (GMCSI) can assist. As a wholly owned subsidiary of the General Medical Council (GMC), GMCSI utilises the subject matter expertise from within the GMC as trusted regulatory advisors, providing recommendations and practical advice based on its 160 year experience.

AI

HEALTHCARE AND AI IN THE KINGDOM OF SAUDI ARABIA

Saudi Arabia’s developments in AI in healthcare present significant opportunities for healthcare companies and digital tech providers, say Andrea Tithecott, Partner, Head of Healthcare & Life Sciences, Andrew Fawcett, Partner Digital & Data, and Christine Khoury, Senior Counsel Digital & Data at Al Tamimi & Company

Saudi Arabia is one of the leading countries in the region in adopting and regulating artificial intelligence (AI) across several sectors including the healthcare sector. The country has issued ministerial resolutions, guidelines and policies concerning the use of AI and Big Data in medical devices, data management, and AI governance.

By virtue of Council of Ministers Resolution No. (292), the Saudi Data & Al Authority (“SDAIA”) is the competent authority

mandated to develop policies, governance mechanisms, standards, and controls related to data and AI and to monitor compliance upon issuance. AI is defined by SDAIA as: systems that employ methods that can gather data and use it to predict, suggest, or make decisions with varying degrees of autonomy and select the best course of action to accomplish particular objectives.

In September 2023, SDAIA issued the Principles and Controls of AI Ethics (the ‘Principles’); then in January 2024, issued

two versions of Generative Al Guidelines, one for the government, and the second for the public (together the ‘Al Guidelines’). SDAIA has analysed global practices and standards to develop these Principles and Guidelines which aim to support the Kingdom’s e orts towards achieving its vision and national strategies related to adopting AI technology, encouraging research and innovation, and driving economic growth for prosperity and development.

Similar to principles/standards adopted by many countries and international companies, the Principles set out seven pillars:

(i) fairness

(ii) privacy & security

(iii) humanity

(iv) social & environment benefits

(v) reliability & safety

(vi) transparency & explainability

(vii) accountability & responsibility.

The first document entitled ‘Generative Artificial Intelligence Guidelines Public’ applies to the public, including developers and users of generative AI (GenAI) based in the Kingdom. Comparable to the Principles, the Guidelines emphasise fairness, reliability, safety, transparency, accountability, privacy, and social and environmental benefits. They aim to mitigate risks such as deepfakes, misuse, and security

Al Tamimi & Company

“The country has launched several initiatives and projects to leverage AI for improving healthcare outcomes”

threats, ensuring that GenAI systems are used ethically and responsibly.

SDAIA also issued the ‘Generative Artificial Intelligence Guidelines for Government’ regulating the use of GenAI by government employees. It also outlines the same principles for a responsible use of GenAI. The Guidelines assert the importance of compliance with existing regulations, such as data governance and privacy laws o ering practical advice for using

GenAI, addressing potential risks, and ensuring the ethical use of AI systems. Specific best practices and examples are provided to guide government entities implementing these guidelines e ectively. This framework also sets out the roles and responsibilities of SDAIA and its bodies, such as the National Information Center, the National Center for Artificial Intelligence, and the National Data Management O ice.

It is worth noting that apart from the Principles and the AI Guidelines, there are no AI specific laws or regulations promulgated; however, there are many other regulations indirectly tackling AI, such as data protection laws, intellectual property laws, cloud computing regulations, the Internet of Things framework, and the cybercrime law, to name a few. These measures aim to ensure the safety, quality, and

e ectiveness of AI-based solutions including the healthcare sector, as well as to protect the privacy, confidentiality, and rights of patients and users.

AI and healthcare

The Saudi Food & Drug Authority (SFDA) has published specific guidance on the use of AI and Big Data in medical devices, covering the review and approval process for AI-based medical devices, ensuring

“Saudi

CHRISTINE KHOURY Senior Counsel Digital & Data

Al Tamimi & Company

Arabia has made remarkable progress in AI in healthcare and has established a robust regulatory and governance framework for data and AI”

they meet standards for accuracy, security, and clinical e icacy. The guidance also defines medical ‘Big Data’ as various kinds of medical information, including medical records, biometric information, medical images, and genetic information. So ware is classified as a medical device based on its intended use, with certain types of so ware excluded. Security requirements include server access control, user authentication, encryption, and de-identification. These measures are part of Saudi Arabia’s broader e orts to integrate AI into various sectors while maintaining high standards of accountability and transparency. The country has launched several initiatives and projects to leverage AI for improving healthcare outcomes, such as the National Unified Medical Record, the Saudi Health Information Exchange, and the National Strategy for Data and Artificial Intelligence. The country is also actively participating in international forums and collaborations related to data and AI, such as the Global Partnership on Artificial Intelligence and the G20 Digital Economy Task Force.

Saudi Arabia’s progress in AI in healthcare is evident from its achievements and innovations in this field. For example, the country has developed and deployed AI-based solutions for detecting and diagnosing diseases, such as breast cancer, COVID-19, and diabetic retinopathy. The country has also established specialised data and AI centres, such as the Saudi Center for Disease Prevention and Control, the Saudi Health Council, and the King Abdulaziz City for Science and Technology. The country has also invested in building national expertise and capacities in data and AI sectors, such as through the Saudi Data and AI Academy and the National Center for Artificial Intelligence.

Saudi Arabia’s developments in AI in healthcare present significant opportunities for healthcare companies and digital tech providers in this country. Companies can seek medical device marketing authorisations for AI-based medical devices by adhering to the new SFDA guidelines. There is an opportunity to develop AI so ware that can be configured with hardware for clinical decision support or computer-aided detection/ diagnosis. Manufacturers must establish data management policies for training/ learning data integrated into the so ware. The guidelines provide for di erent cloud configurations (private, public, hybrid), presenting opportunities for cloud service providers. Moreover, companies can benefit from the data and AI capabilities and infrastructure provided by the SDAIA and its bodies, as well as from the research and innovation ecosystem supported by the government and academia.

In conclusion, Saudi Arabia has made remarkable progress in AI in healthcare and has established a robust regulatory and governance framework for data and AI. The country is in line with international best practices and standards and is open to crossborder collaboration and harmonisation of laws and standards to maximise the benefits of AI and use of data while maintaining patient safety, privacy, confidentiality. Saudi Arabia o ers a promising market and a conducive environment for healthcare companies and digital tech providers who wish to tap into the potential of AI in healthcare.

a.tithecott@tamimi.com

c.sochacki@tamimi.com

www.tamimi.com

IDENTIFYING TOMORROW’S PATIENTS TODAY

Dr Joachim Werr and Dr Simon Swi of Health Navigator on their AIpowered solution that identifies patient risks, enabling preventative care

Prevention is the new buzzword in healthcare. Thanks to Artificial Intelligence (AI), a new era could be dawning as tools are created by data scientists and clinical teams to pinpoint problems before a crisis. Linked with huge datasets, there is the opportunity to screen the entirety of a population as part of population health management programmes.

Health Navigator has been working on these solutions for more than a decade. Its AI tool set can identify 80 per cent of patients who may be at high risk of disease progression and hospitalisation between

6-12 months before it happens. This insight has been proven - in clinical trials and real world applications - to save lives, improve clinical and patient outcomes and enhance e iciency for health systems.

Founder and Chair Dr Joachim Werr, a former A&E physician, was inspired to create a solution to prevent the same patients reappearing in the department in crisis by using the existing hospital data. In this way, clinicians could intervene before emergencies arise. “We knew that 5 per cent of patients consume more than 80 per cent of hospital resources, so it

made sense to see if there was a method of identifying those most at risk”.

“Many elderly people go in and out of what you could term a clinical crisis where they need a lot of care,” he says. “Most are vulnerable older people with uncontrolled chronic diseases. Yet 8 in 10 high utilisers are new each year. The interesting thing is that the following year they won’t be high consumers, either because they are no longer with us or those particular issues are resolved. Thus, it became imperative to learn how to find out when these issues would arise in near-real time.”

Pivotal trials

Health Navigator’s data-driven solution is seeing increasing uptake across the UK & Ireland, and further afield, thanks to leveraging technology to shi focus from reactive treatment to data-driven early intervention. Since it was founded in Sweden in 2010 and then established

DR JOACHIM WERR Founder & Chair Health Navigator

“5 per cent of patients consume more than 80 per cent of hospital resources”

in London in 2015, the company undertook randomised control trials in both countries. In 2018 they launched a UK trial to identify patients in real-time, and the published results in 2019 showed a strong impact from AI predictive care.

With advice from the Nu ield Trust and with the support of several NHS trusts, the trial meticulously tracked up to 2000 patient outcomes across multiple trial sites. “It revealed that patients over 75 years of age experienced a significant reduction in mortality rates—up to 50 per cent for elderly men,” says Joachim. For younger patients, while no mortality impact was observed, the intervention still delivered significant reductions in healthcare usage.

The company’s approach is built around a three-tiered system:

1. Predict Platform: The core component aggregates and analyses data to identify individuals at high risk of adverse outcomes. Whether it’s predicting emergency care needs, long term condition exacerbation or potential readmissions, the platform o ers a granular view of patient risk that can be tailored to specific healthcare commissioners’ needs.

2. Engage Platform: Once high-risk individuals are identified, the Engage platform re-identifies and contacts them, inviting them to participate in a personalised care programme.

3. Proactive Platform: Trained clinical coaches, either from the company or from the healthcare provider’s own sta , interact with patients remotely, assessing their needs holistically. Unlike traditional healthcare settings where a cardiac nurse might only address heart-related issues, the proactive coaches tackle all aspects of a patient’s wellbeing—from medication adherence to social support needs.

There is plenty of flexibility in the structure so, for example, some organisations might opt for just the Predict

platform to identify high-risk patients, while others might implement the full suite, including proactive coaching.

The importance of data

The main piece of work is undertaken by their platform, Predict. For data specialist and doctor Simon Swi , it begins with understanding where the data sources are and legal routes for access. “There is some lack of clarity at the moment regarding use of data in this way, the current UK legislation is a bit clunky when applied to this, as the case finding, engagement and coaching is primary purpose but the risk

model training is probably secondary use. This makes information governance people a bit jumpy on occasion”.

Secondly, we look at the structure of this data, along with the data architecture in that particular region and area. “In the UK some ICB’s have integrated data sets that also have a clear interface and agreed governance for secondary use purposes, but others don’t,” he says. ‘We need to see the quality of the data and identify the di erent data sources to access that data, ideally on a daily basis.

“From a patient perspective, we take whatever data we can get and link all those

data sources together on an individual level. Then we can understand exactly what kind of care each individual is able to access and what they need. We create a risk profile for that patient.”

Even if the data available is only hospital data, their predictions have been surprisingly successful, enabling them to work in regions with less integrated data systems.

Engaging the patient

Once the data has been gathered, it is returned to the system to identify those in need of proactive support and coaching.

“It’s quite di erent from the norm where patients seek care. Here, we reach out to them proactively,” explains Simon who goes on to clarify that while some may initially be surprised to be contacted out of the blue, many appreciate the proactive support. “We’ve conducted extensive patient engagement studies and even have video testimonies. Around 70 per cent of patients contacted through this method engage with the service, which is a high uptake,” he adds.

During the initial meeting, the patient and coach review all pertinent medical records, discussing care contacts,

medications, and any other factors that may influence their health. This holistic review o en uncovers issues that might otherwise be overlooked in a traditional care setting. Whether it’s a spouse struggling to provide adequate support or a patient unable to a ord their medications, the coaches work to address these root causes. The company runs an accredited coaching system that follows their own certified methodology and allows the coaches to use the platform.

The aim behind the concept is for the coaches to identify which areas of health and social care the patient consumes most and to try to instill a programme of selfcare that enables them to better look a er themselves. “The coaching intervention normally lasts no more than four months and delivers a total of around between 10 and 12 coaching hours from the nurse to the patient,” Joachim says. “If you look at the impact we achieved in the randomised controlled trial, it’s a very low resource, investment for the return that you get. We found that the patients who received the coaching intervention consumed 32 per cent less non-elective care events in hospital, meaning they had fewer days in hospital. It has a huge potential to decrease A&E activity and urgent care bed utilisation across the NHS by a third.”

Enabling preventative care across providers

Healthcare Navigator’s solutions is a global o ering which can be structured to each region and culture through local partnerships, calibrated to the local population. “It saves money and releases capacity,” says Simon. “That’s the business case that allows us to deliver that win to patients. We can work with insurers and to public sector payers like the NHS, or we can work directly with providers because we decrease demand and release capacity. We reduce the number of people turning up at night to emergency departments and we also reduce hospital bed utilisation so, if a provider has capacity issues, we are a solution for them.”

IMPLEMENTING AI REGULATIONS

BRG’s 2024 Global AI Regulation Report reveals lack of confidence in compliance ability among organisations

More accurate diagnoses. Faster clinical trials for life-saving drugs. Personalised patient communications and treatment plans. Streamlined business functions. These and a myriad of other applications of artificial intelligence (AI) have dominated the attention and headlines in healthcare.

BRG’s 2024 Global AI Regulation Report found that only four in ten surveyed respondents are highly confident in their organisation’s ability to comply with current regulations and guidance. This finding supports similar sentiments shared in BRG’s AI and the Future of Healthcare report. US healthcare professionals surveyed in the fall of 2023 found that only

four in ten indicated their organisations are reviewing or plan to review AI guidance. Areas of greatest concern involved the patchwork of regulations emerging in the US and cybersecurity/data management when it comes to regulatory compliance. BRG is a global consulting firm that helps leading organisations advance in three key areas: economics, disputes, and investigations; corporate finance; and performance improvement and advisory. Headquartered in California with o ices around the world, it comprises an integrated group of experts, industry leaders, academics, data scientists, and professionals working across borders and disciplines.

An emerging global regulatory landscape

Current policy is very much in its early stages, with di erent jurisdictions’ frameworks, guidelines, and requirements in varying stages of maturity—from the European Union’s risk-based AI Act and the Association of Southeast Asian Nations’ (ASEAN) businessfriendly Guide on AI Governance and Ethics to President Biden’s executive order and stateand country-specific laws now taking shape.

Given this patchwork, business leaders view the e ectiveness of current AI policy in di erent ways. Lawyers are far less confident in it than executives, as are North American respondents compared to those in Europe, the Middle East, and Africa (EMEA) and AsiaPacific (APAC). Overall, only about one-third of more than 200 respondents from the Global AI Regulatory Report view today’s policies as ‘very e ective’.

A key concern raised in BRG’s AI and the Future of Healthcare report, echoed by industry experts who were interviewed, is that regulators need to balance safety and e icacy with fostering innovation.

“AI’s potential in healthcare is just beginning to unfold, o ering automation, improved patient experiences, and innovation for health systems of all sizes,” says Julie Coope, Associate Director, BRG, London. “However, these advantages come with cybersecurity risks and potential for compromised patient data. These are universal concerns and demand careful consideration. These challenges are further compounded by the global patchwork of

JULIE COOPE Associate Director BRG

“Challenges are further compounded by the global patchwork of evolving regulations that have failed to keep pace with technology adoption”

evolving regulations that have failed to keep pace with technology adoption.”

Recommended next steps

• Engage with regulators: As the regulatory environment takes shape, healthcare executives have the responsibility and opportunity to work with lawmakers in developing a regulatory framework that balances innovation, e icacy, and safety.

• Develop a robust governance model: Many IT and security governance models are inadequate to manage AI development and deployment. A strong interdisciplinary governance model should be established that manages AI, innovation, and automation initiatives throughout the organization.

• Advance thoughtfully: AI can bring immense value, but tread carefully when it comes to dedicating significant resources in today’s uncertain regulatory environment. Build close relationships with technical leaders, internal AI experts, and vendors.

Key Findings

AI regulation is still emerging, and perceptions of its present e ectiveness are mixed. About one-third of respondents believe current policy is ‘very e ective’, but roughly the same proportion believe it is ‘moderately e ective’ or ‘slightly e ective’/’not e ective’.

• Only four in ten are highly confident in their ability to comply with current regulation and guidance. Respondents cite lack of internal training and inadequate data management/security protocols as primary reasons.

• Less than half of all organisations have implemented internal safeguards to promote responsible and e ective AI development and use. The highest proportion of organisations (45 per cent) have implemented data quality, collection, and storage reviews—as well as data protection, privacy, and security risk reviews. Less than one-third have implemented cross-functional teams to manage AI (31 per cent) or processes to mitigate biases and ensure ethical use (29 per cent).

• Data integrity, security, and accuracy/ reliability are the three main focus areas for regulators and businesses. AI is only as good (or bad) as the underlying data. These were cited as main areas of compliance focus for organisations, as well as the most important for policymakers to address.

• Only 36 per cent of respondents feel strongly that future AI regulation will provide necessary guardrails. At the same time, more than half (57 per cent) expect “e ective” AI policy within three years.

BRG’s inaugural global report analyses sentiment from top business leaders and policy analysts on their current e ectiveness and confidence in complying with AI policies; predictions for the future of AI policy; and what guardrails are most necessary to balance innovation and security.

You can download and read BRG’s full report online at www.thinkbrg.com/airegulation.

MOVING FROM CURATIVE TO PREVENTATIVE HEALTH SYSTEMS

Cross-border data sharing holds key to developing preventative healthcare system writes Charlotte Harpin, partner at law firm Browne Jacobson

Big data and emerging technologies including AI hold the key to developing preventative-based healthcare systems globally, but first there are legal and regulatory hurdles

to navigate. If moving from a curative to preventative system is the diagnosis for how we make healthcare more e ective and a ordable, then data is the medicine. In particular, we need huge amounts of high-

quality data if we are to develop truly actionable healthcare strategies, which may feature value-based payment models, population health interventions and precision medicine.

Mining data from a wide range of health providers, systems and patients helps to paint a more comprehensive picture. As does the ability to share this information across international borders, an issue highlighted by a new UAE-UK Business Council white paper, Opportunities for collaboration between the UK and UAE in cancer care, which advocates for greater

international collaboration in prevention, screening and diagnostics strategies for cancer care.

Successful cross-border partnerships depend on e ective legislation and regulation to ensure privacy concerns, quality standards and commercial issues are properly considered. So how do we achieve this?

Benefits of harmonising frameworks

In June this year, Browne Jacobson joined a panel discussion exploring this issue at the HLTH Europe conference in Amsterdam alongside leaders from Swedish healthcare

consultancy Skane Care, Portuguese health data analytics company Promptly Health and UK business analytics firm Lytix.

The General Data Protection Regulation (GDPR) illustrated how e ective this can be. Introduced by the EU in 2016, it has become the standard-setter for data protection laws, with the UK enacting an identical UK GDPR since leaving the EU. The regulation has also become a model for laws in countries including Brazil, Japan, Singapore, South Korea, Sri Lanka, Thailand and the UAE.

As a result, we have partial harmonisation in core principles around

how data should be shared, an issue that came to prominence during the COVID-19 pandemic as cross-border sharing of knowledge about the disease was vital to the e ectiveness of treatment and vaccine development. A collective determination to fight the disease globally meant countries were willing to put aside their national frameworks temporarily for the greater good.

Emulating this on a more permanent basis, rather than just as an emergency response, could hold the key to harnessing the benefits of data to advance healthcare across the world.

A single health record for the EU In this respect, there is lots of excitement building around the European Health Data Space (EHDS), the first common data space in a specific area to emerge from the EU’s data strategy, and the EU AI Act, which seeks to regulate and enable positive benefit for society and healthcare from AI.

Approved in April this year and now being implemented, the idea behind the EHDS is to create a ‘single market’ for electronic health records across the EU, enabling a free flow of data between countries within the union for research, innovation, policy-making and regulatory activities. It also acts as a so-called “patient passport” by empowering individuals to take control of their health data. The hope is that if it proves successful, its scope could be broadened to other jurisdictions, just as the EU single market signs trade agreements with other countries.

In the UK, data-sharing for research purposes is reasonably well established, but less so for cross-jurisdiction research. This factor is fundamental in clinical trials as drawing people from di erent countries

CHARLOTTE HARPIN Partner Browne Jacobson

“Successful cross-border partnerships depend on effective legislation and regulation to ensure privacy concerns, quality standards and commercial issues are properly considered”

and backgrounds helps to secure a more diverse and representative pool of patients when testing treatment methods, doses or reactions to drugs, for example.

Across the world, there is a growing recognition that having a rich source of data enhances healthcare, whether it’s in the way we develop treatments or technological solutions like artificial intelligence (AI).

Promptly Health, one of the companies in the HLTH Europe panel, is building an

anonymised global data pool that researchers, so ware developers and pharmaceutical companies will pay to access.

Risks and regulatory considerations

Patient buy-in is crucial to the success of any project that requires their personal data to be processed. We must bring people along the journey with us and showcase the benefits while taking transparent actions at every step. Sometimes we can overstate the restrictions that apply, but it ultimately comes down to being very clear at the start of a project about how and where we want to share data, as well as why.

Data is very society-driven and various societies have di erent spectrums of concern about how data is used. We can already recognise this in the divergence in approaches to AI regulation between the United States, which wants to harness its innovation potential with a light-touch regulation regime, and the stricter controls of the EU AI Act.

But where we can be harmonised – as the approach to GDPR demonstrated – is in having common understandings about the principles of data usage in order to maintain public trust.

One of the most sensitive issues relates to individual preferences and the right to “opt out” without sacrificing their access to e ective healthcare.

Linked to this is ensuring that patients who are unable to access centralised data systems, such as patient passports, are not le behind due to factors such as language barriers, lack of digital literacy or the growing numbers of people experiencing digital poverty.

For those institutions that access and control health data, they must develop a culture of data compliance, supported by robust security mechanisms and managing access levels accordingly to di erent requirements.

Adopting these safeguards in partnership across jurisdictions can go some way towards ensuring health data can be safely yet e ectively shared across borders for the greater good.

THE IMPORTANCE OF ETHICS IN AI

Vincent Buscemi and Dan Morris, Partners at Bevan Brittan LLP, discuss the role of ethics in the development and deployment of AI and data-driven healthcare solutions

The role of ethics has received too little attention in the rush to digital transformation of health and care systems around the world. As AI and data-driven solutions become

increasingly integral to healthcare, the role of ethics in their development and deployment has never been more critical. These technologies promise to revolutionise patient care by o ering a

dizzying array of new and enhanced services that o er immense potential to improve patient outcomes and streamline care. However, they also pose significant ethical challenges that need careful consideration and, as the late Henry Kissinger et al remarked, while the number of individuals, corporations and governments capable of creating AI has grown exponentially: ‘the ranks of those contemplating this technology’s implications for humanity – social, legal, philosophical, spiritual, moral – remain dangerously thin.’

VINCENT BUSCEMI Partner

Bevan Brittan

“Do existing regulators have the capacity, the expertise and the adeptness to cope with the novel issues arising from AI and data-driven heath tech?”

At conferences, in boardrooms and even within the corridors of power, the priority has been on how to harness the great potential of AI; facilitate rapid adoption; scale up; drive growth; overcome technical challenges; and maximise return on investment. In short, the commercial imperative has been the engine house of innovation as usual.

Nevertheless, as AI becomes increasingly embedded in healthcare, people are starting to see how it a ects them as individuals, and indeed as populations. As a result, the calls for regulation, guardrails

and standards grow ever louder. But is regulation the panacea that many would suggest it is? Does more regulation really provide the best answer? Arguably, it does not for several important reasons.

The limitations of regulation

Firstly, the regulatory landscape within which AI and data-driven health tech solutions sits is incredibly complex. While regulation can play a crucial role in mitigating risks and guiding the development and deployment of AI, it is not a one-size-fits-all solution and can

be an oversimplification. The e ectiveness of regulation depends on many factors, including the nature of the regulations, the context in which they are applied, the pace of technological development, and the readiness of society and the economy to adapt.

Developers, operators, adopters and even the regulators themselves do not always fully appreciate precise roles, responsibilities or ascertain that compliance has been achieved. This is hardly surprising when there are so many disparate entities involved. In the UK alone, developers and deployers of AI and data-driven solutions might, depending on the nature of a particular product, need to understand and navigate the rules and requirements of the Information Commissioner (ICO), the Medicines and Healthcare products Regulatory Agency (MHRA), and the Care Quality Commission (CQC). In addition, there are di erent digital, clinical and patient safety standards to be considered, plus bright line legal obligations such as arise under the EU AI Act, GDPR, DPA and common law rules of confidentiality.

Secondly, many regulatory bodies are struggling with existing burdens, and e ective regulation requires not just the creation of rules but also their implementation and enforcement. This can be challenging, especially with complex technologies like AI. There may be di iculties in monitoring compliance, interpreting regulations consistently, and applying penalties where necessary. Recent high profile criticism of organisations such as the Care Quality Commission (CQC) and Nursing and Midwifery Council (NMC) have led to genuine concerns about whether some regulators are fit for purpose. The question arises: do existing regulators have the capacity, the expertise and the

DAN MORRIS Partner Bevan Brittan

“The integration of ethics into AI and data-driven healthcare cannot be separated from the commercial realities of the tech and healthcare industries”

adeptness to cope with the novel issues arising from AI and data-driven heath tech. Many reasonable commentators think not?

Thirdly, regulators and regulatory requirements will usually be outpaced by innovation. By the time regulatory standards are put in place and rules are written, codified and disseminated, technological developments will have crossed the finishing line, done a victory lap and be up on the podium collecting medals. This lag can make it di icult for regulations to address emerging risks and challenges, particularly in a global context where regulation involves ethical considerations that are o en subjective and culturally dependent - di erent societies have di erent views on privacy, security, and the acceptable uses of AI and data, making it di icult to create universally acceptable regulations.

Developing ethical codes

If increased regulation is not necessarily the answer, or at least the best answer, how else do we ensure that AI and data-driven health tech solutions are on the side of the right?

The answer, possibly, lies in a combination of ethics, self-regulation, industry standards, education and

awareness. Obviously AI, LLMs and algorithms are incapable of morality; but we humans who are developing and deploying this technology certainly possess this capacity.

But what does this actually mean? What are ethics, whose ethics are we talking about and how are they to be employed?

The answers to these questions are of course beyond the scope of this article. Hundreds of moral philosophers could write yards of library shelves on this subject. However, many of the biggest players in this space are increasingly developing their own codes of ethics for the responsible development and deployment of AI: Microso has its Responsible AI Principles, AWS has its Core Dimensions of Responsible AI. How relevant to AI and data-driven healthcare solutions such codes will be remains to be seen.

So what about ethics and the commercial imperative? The interface between ethics and commercial imperatives adds another layer of complexity, as the drive for innovation and profit must be balanced against the need for patient safety, privacy, and fairness. The integration of ethics into AI and data-driven healthcare cannot be separated from the commercial realities of the tech and healthcare industries. Companies are o en driven by profitability and shareholder expectations, which can sometimes conflict with ethical imperatives such as patient safety, privacy, and fairness. But the best tech will incorporate such considerations and market forces will jettison those that do not, while investors are almost certainly likely to require it and insist that ethical considerations be embedded into the business models and the development / deployment processes from the start.

If, as societies, we do not start thinking about these issues then we will certainly prove Arthur C. Clarke to be utterly correct. Ever the futurologist, he wrote that ‘As our own species is in the process of proving, one cannot have superior science and inferior morals. The combination is unstable and self-defeating’.

Real World Evidence Network

Building a patient-centered Healthcare Data Network with Organizations around Europe and Latin America, helping them secure data collaborations at scale. 20+

PATIENT RECORDS PARTNERS

25m+

Promptly is building the first patientcentered global evidence network, offering real world data sharing and monetization capabilities. Together with a selected network of Partners, we generate new knowledge from harmonized datasets, augmented with the collection of longitudinal patient-reported data and patientgenerated digital biomarkers within a secure and privacy-preserving

environment. We deliver valuable insights to leading health systems, payers, and life-science companies across multiple therapeutic areas, including cardiometabolic, oncology, and immunology. Operating in 10 countries, we promote better healthcare at lower costs for thousands of new patients every day through the use of Real World Evidence.

partner@promptlyhealth.com

www.linkedin.com/company/promptlyhealth

THE RUSH TO ADOPT AI IN HEALTHCARE

Are providers solving problems or just chasing trends?

Asks Ian Chambers, CEO of

Linea

Artificial Intelligence (AI) is rapidly transforming healthcare, with hospitals, clinics, and health systems worldwide integrating AI tools to improve patient care, optimise operations, and drive innovation. However, as

organisations rush to adopt AI, a critical question arises: What problem are we trying to solve?

Rather than strategically applying AI to address specific challenges, many providers are investing in AI without a clear

understanding of their needs. This raises concerns about the real value of AI in healthcare and whether it is being utilised e ectively to improve patient outcomes and operational e iciency.

The current state of AI in healthcare AI’s presence in healthcare is rapidly expanding, with spending in the sector expected to reach between £80 and £96 billion globally by 2026. The growth is driven by applications such as diagnostics, virtual health assistants, and predictive analytics, which are

transforming the way care is delivered. AI technologies, including machine learning and natural language processing, are helping healthcare providers improve diagnostic accuracy, streamline administrative processes, and predict patient outcomes with greater precision. Some notable applications include:

• AI-Driven Diagnostics: AI tools are used to analyse medical images, such as MRIs, allowing for faster and more accurate diagnoses of conditions like cancer or heart disease.

• Predictive Analytics for Patient Care: Hospitals are utilising AI to analyse patient data and predict the likelihood of readmissions or complications, enabling more proactive care.

• Automating Administrative Processes: AI is streamlining repetitive tasks like appointment scheduling, and electronic health record (EHR) management.

• Virtual Health Assistants: AI-powered chatbots assist patients with symptom checks, medication reminders, and answers to basic health questions.

While these applications highlight AI’s potential in healthcare, it’s essential to recognise that not all AI solutions are complex or costly. In many cases, o -theshelf AI products embedded in existing healthcare so ware can provide substantial benefits with minimal disruption.

The urge to keep up

Despite the promising benefits, the rush to adopt AI is o en driven by external pressures. Many healthcare organisations may feel the need to invest in AI simply because competitors are doing so or because AI is a trending topic in industry discussions. The fear of being le behind in the AI race can lead to hasty implementations without a clear strategy, potentially wasting resources and creating unrealistic expectations.

This perception that “AI equals innovation” can push providers to deploy AI in areas where it may not be needed or where simpler, more cost-e ective solutions might work better. Competition in the healthcare space is fierce, and while it drives innovation, it’s crucial that healthcare organisations focus on thoughtful, strategic AI adoption rather than following trends.

The problem with chasing AI trends in healthcare

Healthcare providers o en invest in AI tools before identifying their real problems or assessing whether AI is the best solution. Common pitfalls include:

• Lack of Clear Objectives: AI projects are sometimes launched without a defined clinical goal. For example, implementing an AI-powered chatbot in patient services may not improve patient satisfaction if patients prefer speaking with a human for complex medical issues.

“The

IAN CHAMBERS CEO Linea

fear of being left behind in the AI race can lead to hasty implementations without a clear strategy, potentially wasting resources and creating unrealistic expectations”

• Overcomplicating Solutions: AI can introduce unnecessary complexity into healthcare systems. For example, a hospital may adopt a predictive analytics tool for managing patient flow, but their issues may stem from outdated processes that could be improved without AI.

• High Costs and Low Return on Investment (ROI): AI initiatives can be costly to implement and maintain. Without clearly defined ROI metrics, these investments may yield minimal improvements. However, there are many examples where AI solutions have shown strong returns. In radiology, for instance, AI tools have greatly improved diagnostic accuracy and e iciency, leading to better patient outcomes and cost savings.

• Mismatch Between AI Capabilities and Clinical Needs: Not every healthcare challenge is best addressed by AI. For example, using AI to assist in recruitment for clinical sta may not address underlying issues such as a shortage of trained healthcare professionals, or the need for better hiring practices. That said, AI can streamline recruitment processes by reducing hiring times and improving candidate selection.

The importance of problem identification in healthcare

AI should be viewed as a tool to solve specific healthcare problems, not a blanket solution for improving overall operations. Before adopting AI, organisations should first consider:

• What problem are we trying to solve?

• Do we have su icient, high-quality data to support an AI-driven solution?

IAN

CHAMBERS

CEO Linea

“For healthcare providers, the lesson is clear: don’t adopt AI just for the sake of AI”

• Is AI the best tool for addressing this issue, or could other methods be equally or more e ective?

• What are the projected costs, and is there a clear potential for ROI?

Answering these questions can help healthcare providers avoid common AI adoption pitfalls and focus on meaningful, high-impact applications that directly improve patient outcomes or operational e iciency.

AI success stories in healthcare: Where AI solved real problems

Despite the challenges, many healthcare organisations have successfully leveraged AI to address critical issues:

• AI-Driven Diagnostics: In radiology, AI systems have dramatically improved the speed and accuracy of diagnosing conditions such as lung cancer from CT scans, directly addressing the problem of limited radiologist availability and diagnostic delays.

• Predictive Analytics in Patient Care: AI models are being used to predict patient deterioration in intensive care units, allowing for earlier interventions and better outcomes for critically ill patients.

• Operational E iciency: AI-powered tools for resource management have helped optimise bed allocation and sta scheduling, ensuring that hospitals can meet patient demand more e iciently, especially during periods of high strain like flu season or the COVID-19 pandemic. Similarly, AI has streamlined administrative tasks such as revenue cycle management, delivering significant time and cost savings.

Ethical and practical considerations

As AI becomes more embedded in healthcare, ethical concerns around data privacy, algorithmic bias, and the

risk of over-reliance on technology must be carefully managed. Healthcare organisations should adopt a collaborative approach, engaging IT, clinical, and operational teams to ensure that AI solutions are deployed e ectively and ethically.

A

strategic path forward for AI in healthcare

AI has the potential to revolutionise healthcare, but only when implemented with clear purpose and strategic focus. For healthcare providers, the lesson is clear: don’t adopt AI just for the sake of AI. Instead, focus on identifying real challenges, such as improving diagnostic accuracy, enhancing patient outcomes, or streamlining administrative processes. Continuous evaluation and adjustment are also critical as the healthcare landscape evolves. In the race to embrace AI, the winners will be those who take a thoughtful, problemfocused approach. Those who rush to adopt AI without asking “why” risk wasting resources and missing real opportunities for improvement.

How we can help

Linea specialises in helping healthcare organisations navigate the complexities of operational e iciency. We understand that AI isn’t always the best solution for every challenge. Our approach starts with a thorough assessment of your organisation’s needs, ensuring that technology is used strategically to address real problems, not just trends. If AI is the right tool, we’ll help you implement it e ectively. If a simpler or more cost-e ective solution exists, we’ll recommend that path to ensure your investments are aligned with clear objectives and measurable outcomes. As a government-approved supplier, we provide trusted, reliable services tailored to your organisation’s needs.

APPROACHING AI REGULATION

Gerard Hanratty,

Head of Health and Life Sciences at law firm Browne Jacobson, examines the methods of some international jurisdictions

The AI hype train le the station a long time ago, but governments are finally jumping on board with ideas on regulatory checks for safe development. While the technology moves along the track at supersonic speed, countries are attempting to stay apace by striking a delicate balance between promoting innovation and ensuring accountability.

Establishing clear ethical guidelines and standards for AI development and deployment, underpinned by rigorous testing and evaluation, must be a priority in any regulatory framework. Key issues to address include data privacy, bias and transparency. Mechanisms should be in place to hold AI developers and users accountable for any harm caused by these systems. By regulating in a responsible and thoughtful manner, we can harness the technology’s potential while minimising its risks.

Countries including the US and UK have begun laying the groundwork

GERARD HANRATTY Partner and Head of Health & Life Sciences

Browne Jacobson

“Mechanisms should be in place to hold AI developers and users accountable for any harm caused by these systems”

for AI regulation, but in the absence of comprehensive federal or national laws, they may look to other jurisdictions for key learnings.

EU’s approach to AI regulation

The EU has taken a risk-based approach, with di erent levels of regulation depending on the level of risk posed by the AI system. The AI Act, approved in March, would establish the world’s first legal regulatory framework for AI, including both mandatory requirements and voluntary codes of conduct.

The legislation means the EU has created a ‘black letter’ law approach to regulating AI, including ethical guidelines for its development and use, safeguards on general use and purpose, and transparency and accountability for AI systems. However, detractors have highlighted loopholes for law enforcement, opt-outs for developers and gaps in penalties for the most dangerous AI systems.

Ireland

and UAE’s approach to AI AI strategies adopted by individual countries also provide useful examples. The Irish government’s National AI Strategy, for example, is a policy document that outlines its vision for the development and use of AI, taking into account its EU membership.

Three core principles underpin the strategy to embrace its opportunities –adopting a human-centric approach to AI application, staying open and adaptable to new innovation, and developing strong

governance to build trust and confidence for innovation to flourish. The strategy aims to position Ireland as a global AI leader by promoting research and innovation, developing AI skills and talent, and establishing ethical and trustworthy AI practices.

The UAE has also taken a proactive approach to AI with an adaptable regulatory strategy that aims to flex to new developments in the technology. Among its key features are a “regulatory sandbox” that allows companies to test new AI products and services in a controlled environment, and a certification programme to provide companies with a way to demonstrate their AI systems meet certain standards.

Future regulation in US and UK

The US federal government took its first steps towards regulation with the National AI Initiative Act 2020, signed into law to coordinate AI research and policy as part of its defence strategy. It created an AI advisory committee, and supports the development of ethical AI that is trustworthy, respects privacy and upholds civil liberties. Various frameworks and guidelines have also been developed, including from a White House Blueprint for an AI Bill of Rights asserting equitable access and use of AI systems, which should pave the way for future legislation.

In the UK, a Centre for Data Ethics and Innovation was established to deliver ethical guidelines, and an AI Council to advise the government on its AI policy and strategy. An AI regulation White Paper was published in March 2023 and the previous Conservative government published its response to a consultation in February this year. While the new Labour government has specifically pledged to regulate developers of the most powerful AI models, it has yet to introduce an AI Bill.

However, as members of the G7, the US and UK co-signed the Hiroshima Process International Code of Conduct for Organisations Developing Advanced AI Systems, which lists in detail the actions that AI developers must abide by. Its most specific areas of focus relate to identifying risks.

LEARNING FROM PAST BEHAVIOUR

Phil Anderton PhD, CEO ADHD360, argues we need to learn from past mistakes to deliver the healthcare of the future

Attributed to Mark Twain, it is frequently stated that “the best predictor of future behaviour is past behaviour”. And so it is with the application of medicine to the human body. But, of course, that isn’t correct. If it were, we would not have medical break throughs, the application of new science and incredible developments to prevent and cure illness.

What if we extended the debate to the best predictor of ‘payors’ future behaviour

in healthcare is past behaviour? While accepting that all new breakthrough medical science inventions must be financed to become interventions, we start to argue against our own statement, or do we?

One of the largest challenges to bringing a new way of doing things, or a new product to market, is gaining traction to a su icient level whereby there is a critical mass, a meaningful future ROI and momentum. That’s just an organisational behavioural fact. When we couple that with

the significant challenges of breaking through regulation and ‘red tape’ into medicine, medical devices and service delivery for healthcare, we double the frustration.

When we stray into foreign territories to introduce new ways of doing things, new services or new products, we heighten the hill to be climbed and magnify those issues multi-fold.

But entrepreneurs persist and eventual change can happen.

Changing the mindset

One of the post pandemic ‘breakthrough’ areas of medicine has been the advent of the virtual clinic, utilising new technology to benefit the medical process. It is questionable whether the days of ‘face to face’ clinical

contact will continue - in commerce, remote meetings are leading the cultural change and in warfare the use of unmanned aircra has been dictating the future for a considerable time. To a measured degree some things have changed.

Key tactical questions that inform strategic thinking are found to be:

1. What are the criteria for success for an agent of change?

2. What should change in medicine be measured against?

3. How do we convince the payor to change?

These three seemingly innocuous questions influence our futures, and the answers control progress. If the payor is

stuck in the mindset: this is the way we do things because this is the way we have always done this, then the predictable growth curve is to be flattened, if it exists at all.

Unintended consequences

The USA saw a burst of telemedicine companies post-COVID. While perhaps well meant, they drew the attention of the Drugs Enforcement Agency (DEA) due to what was described as ‘doctor shopping’, and an increase in the flow of controlled drugs into the general market, beyond the intended patient market, was claimed. This led to a set of DEA interventions into the American Done clinic, and subsequent charges being brought against executives of the company for distribution of controlled substances and conspiracy. It is claimed that Done Global, through a new and innovative

telehealth model, e ectively gave access to controlled stimulant medication for ADHD via their telehealth platform when the patients didn’t need them.

The moment those charges were brought, the advances in medicine and treatment for ADHD began to su er, a su ering that had and for some still is, having a sincere impact on treatment availability.

If we throttle advances in medicine because of what we used to do, we stifle innovation. Returning to the known is a comfort zone, and whilst o en an inappropriate place of calm for some, it shouldn’t be the place of calm for innovators and those pushing boundaries forward.

Learning from past mistakes

The UK’s procurement processes, immersed in national state provision of services, have an apparent steadfast resistance to change when engaging progressive services applied to aspects of mental health, such as ADHD, that are at volume and scale. Services of the past were seen as acute, with a focused demand of minor numbers; however, the reality is that many mistakes were made, leading to the current ‘crisis’ of mental health commissioning, so it is hard to believe we can progress without significant change.

Neurodiversity (for this article focussed on ADHD and Autism), is rapidly becoming seen as a drain on limited resources, especially people and financial resources. Services are struggling to commission adequate provision, mainly due to three factors:

• A desire to think as we used to

• A reluctance to challenge self-taught prejudice that stifles change

• A lack of an open mind to truly identify the impact of 1 and 2 on the strategic and tactical thinking that is required to move forward.

As we look to internationalise what is good, maybe great, from UK healthcare, we must also ensure that we correctly identify where failing of thinking has detracted from the overall position of excellence. The NHS badge alone is not a single qualifier of perfection. It is a guide to 75 years of tremendous service delivery, free at the point of need, and o en to an unqualified level of clinical excellence. Where I suspect our institution detracts from perfection is in management, procurement and an overall

capability to listen and learn from the mistakes of the past.

We should categorically ensure that we do not seek to export everything, but only the best elements of what we proudly have.

The future of treatment for neurodiversity

So where does neurodiversity sit? Historically, ADHD sat with psychiatry; it is to do with the brain and synaptic processes. But does treatment require a psychiatrist? Of course it does, some will say, as it o en involves medicine for the brain. These discussion points have validity, but they are also open to challenge. A headache involves the brain, but we treat sometimes with medicine, paracetamol, without the advice of a psychiatrist. And before we cry ‘what about the side e ects of ADHD meds, surely they need a trained doctor’, please do go and look at the side e ects of paracetamol. Similarly, should ADHD sit inside psychology as it is hampered and tempered by nurture? But psychology rarely embraces medical intervention, so the fit is one for challenge.

If those deciding on the future shape of services cannot see mistakes of the past, or the errors on judgement that are still heralded as the way forward, or do not have more progressive thinking available to them, then we are very likely to be back into Mark Twain’s world - where the best predictor of future behaviour is past behaviour.

If he were to have written ‘The best predictor of future behaviour is the learning we can take from past behaviour’, we could progress faster and without some of the challenges of our past. Maybe in this context, we should use the information of our past as handrails, not handcu s, and enjoy a new freedom of interpretation of what will work for the future.

phil@adhd-360.com www.adhd-360.com

A specialist consulting company, specialising in all aspects of the regulation of healthcare practitioners

•Registration of healthcare practitioners

•The revalidation process

•Setting of standards and outcomes of medical education

•Medical school assessment

•Practitioner complaints handling process helen.featherstone@gmcsi.co.uk

A wholly-owned subsidiary of the General Medical Council, based in the UK

DIGITAL HEALTH

FIGHTING THE FORGETTING CURVE

Nick Dobrzelecki, MBA, BSN, RN, co-founder and CEO of The Learnery, on revolutionising healthcare learning through microlearning

In healthcare, our brains are bombarded with information almost constantly and it can be a challenge to keep up. There’s always something new to learn, processes to understand, and protocols to follow.

Healthcare professionals across the industry are required to participate in regular continuing education, but traditional training methods can be few and far between with little reinforcement. The result? Most of what is learned is quickly forgotten. Given the fast-paced nature of healthcare, the ability to retain information e ectively is critical, not just for patient safety but for career advancement.

Without e ective knowledge retention and continuous training, healthcare systems face sta ing shortages, increase turnover, reduced quality of care, and potential legal and financial risks.

The Learnery, a subsidiary of Titan Health Corporation, is transforming how healthcare professionals learn. Developed by clinicians, The Learnery is a transformative, education platform that utilises science-backed microlearning methodology so that users better absorb and retain what is learned, thus ensuring both compliance and better patient outcomes.

As clinicians ourselves, we understand the unique challenges faced by healthcare professionals in keeping pace with constant innovations.

Breakthroughs in treatments, diagnostics, and medical technologies occur daily, improving patient care but also creating a rapidly shi ing landscape that healthcare professionals must navigate. Continuing medical education (CME) programmes, while essential, o en struggle to keep pace with these rapid changes. This knowledge gap can lead to inconsistent care and even medical errors, negatively impacting patient outcomes.

The Learnery was born out of a passion to this gap. My co-founder, Dr. Antony Chu, MD MBA, and I created The Learnery to help healthcare professionals maximise their potential, ensuring they are always up to date with the latest practices and technologies.

NICK DOBRZELECKI, MBA, BSN, RN Co-Founder

The Learnery

“Studies show that microlearning can boost long-term retention by up to 80 per cent, a game changer in healthcare where lives depend on knowledge retention”

Why microlearning?

Traditional training methods such as instructor-led sessions and classroom workshops o er structured learning experiences, but they o en come with significant cost, such as venue rentals, instructor fees, and travel. Furthermore, the overwhelming flood of information in these settings can make it di icult for learners to retain what they need long-term.

Microlearning, in contrast, is a learnercentered approach that breaks information into small, bite-sized chunks to improve focus and long-term retention. It’s a strategy that directly combats the Ebbinghaus Forgetting Curve, a model that demonstrates how memory retention declines exponentially over time without reinforcement.

Dating back to the 1880s and confirmed in recent studies, Ebbinghaus’s research shows that without reviewing or reinforcement our learning, we forget up to 70 per cent of new information within just 24 hours.

Microlearning helps learners fight the e ects of the Forgetting Curve by providing regular reinforcement. Studies show that microlearning can boost long-term

retention by up to 80 per cent, a game changer in healthcare where lives depend on knowledge retention.

How The Learnery works

The Learnery’s unique platform takes complex healthcare and compliance concepts and divides them into ‘bite sized’ parts that are reinforced over time—daily, weekly, or monthly. Built--in assessments allow for competency measurement, ensuring learning outcomes can be accurately monitored. The platform provides Personalised Learning Paths, Corporate Training Solutions, and Upskilling and Reskilling Programmes. The Learnery is currently available in 7 languages and growing, making it a truly global solution.

An Educational Content Partner

The Learnery Product Content Team specialises in creating custom high-quality microlearning content utilising verified subject matter experts (SMEs) across various medical fields. We o er a range of content services to ensure e ective learning experiences:

I.Local Guide: Technical Assistance for In-House Content Creation

• Provides technical support and guidance to organisations using their own sta to create content within The Learnery platform.

• Ensures seamless integration and usage of the platform’s features.

• O ers troubleshooting and best practice advice.

II.Content Connoisseur: Content Creation Assistance

• Assists organisations by providing content creation support for materials supplied by the organisation.

• Formats, edits, and enhances the provided materials to ensure they meet high-quality standards.

III.Custom Maestro: Full-Service Content Creation for Internal Use

• Fully managed content creation process by sourcing specialty-specific SMEs and developing content according to the organisation’s unique specifications.

• Deliver tailored microlearning materials that align with the organisation’s detailed learning objectives.

IV. Global Ambassador: Full-Service Content Creation with Reseller Program

• Fully managed licensed content creation, sourcing specialty-specific SMEs and developing content

according to the organisation’s unique specifications.

• Under this service, the content ultimately can be utilised by other organisations through a reseller program.

• The originating organisation will receive a percentage of revenue from sales to other organisations, creating a new revenue stream.

• Ensures high-quality, marketable content that benefits multiple users while rewarding the originating organisation.

Global Capabilities

The Learnery is adaptable and suitable for a broad range of medical and healthcare settings. The platform is already in use with

the world’s largest NGO emergency medical organisation, o ering educational content to its team of 7,000 emergency medical technicians (EMTs).

At The Learnery, we’re continuously innovating. Our future generations will incorporate advanced functionality such as Artificial Intelligence (AI), Machine Learning (ML), and Nature Language Processing (NLP) to further enhance user experience and improve organisational e iciency. These cutting-edge technologies will not only personalise learning paths but also streamline compliance, making knowledge retention easier and more impactful than ever before.

As Dr Chu says; “From the day we’re born, we’re learning. It’s a lifelong journey.

However, somewhere along the way, learning has become a chore. For many, there isn’t enough time in the day for skill development. We want to change the culture of learning by rekindling human natural curiosity. Microlearning is the secret weapon. It optimises the cognitive process and transforms aspirational learning into actionable, real-world results, allowing healthcare professionals to achieve lifelong career growth.”

www.golearnery.com/demo

YOUR TRUSTED ADVISOR FOR

WELLNESS & LIFE SCIENCES

Liver / Pancreas / Kidney Treatment & Transplant

Medical Education

Wellness & Medical Tourism

Beauty, Cosmetic and Aesthetic Treatments

Neurology and Nephrology Treatment

Rehabilitation / Long-term Care & Home Care

Mother and Paediatric Care

Cardiology and Pulmonary Treatment Life Sciences

ACHIEVED US$ 10+ 500 PROJECTS in the last decade Billion and over

MAPPING THE BENEFITS OF VALUE-BASED HEALTHCARE (VBHC)

Gemma Badger, Senior Associate, and Rob McGough, Partner, Hill Dickinson LLP, examine how digital health solutions and medtech can align with VBHC to create mutually beneficial outcomes

Value-based approaches to healthcare align stakeholders to focus on delivering outcomes which matter to patients. There is no single agreed definition of ‘value’; however, outcomes are commonly measured on both an individual and broader population basis. VBHC targets better patient-centric outcomes at most a ordable cost, but best value does not mean ‘cheapest’. A ordability goes beyond the lowest financial cost of individual inputs. Instead, the measurement sought can be of holistic value achieved through a combination of inputs over time, and, optimally, throughout a patient journey.

Briefly, challenges encountered in healthcare systems globally where VBHC may o er solutions include:

• Financial – the OECD has estimated that growth in healthcare costs is outpacing growth in GDP. Even if money were no object, spending does not automatically improve outcomes - many countries spending the most on healthcare are not achieving commensurately better health results for their population.

• Growth in cost is also exacerbating health inequalities.

• Research produces more treatment

options, but those treatments are expensive, and availability increases demand beyond what is achievable within most systems.

• Healthcare workers risk burning out - there is insu icient funding for professionals required, and those remaining can experience decreased job satisfaction through feeling unable to deliver the best outcomes owing to factors beyond their control.

Aligning VBHC and digital/ medtech solutions

Digital and medtech adoption can be part of the solution to the challenges above. As such, it is not di icult to see how those solutions and VBHC are mutually beneficial, for example: VBHC is patient-centric – medtech and digital solutions o er many options for improving patient outcomes and experience:

Patient focus is a key component of digital innovation. Some of the patientcentric benefits include:

• Waiting list management – options for patients to be seen for appointments more quickly.

• Speed of diagnosis – innovations enabling quicker diagnoses due to better list management, through new technologies enabling clinicians in di erent locations to collaborate to accelerate results or supported through AI.

• Remote / continuous monitoring –monitoring patients without travel for tests, enabling them to manage their conditions more independently by reacting to self-administered testing - thereby feeling more in control, providing more information on condition fluctuations over time to enable clinicians to spot changes and adjust medications accordingly.

• Collaboration – joining up digital records between stakeholders in patient care can improve patient experience in many ways, including avoiding them needing to ‘retell’ their story at every appointment and enabling caregivers to stay informed and react proactively to new information. An example that we are aware of is an app supporting the parents of neurodiverse children who may be managing input from a variety of sources including healthcare, but also social care and education provision.

VBHC prioritises e iciency – digital solutions can deliver this:

While VBHC is about more than the financials, stripping out wasted costs from systems and pathways (if not always reducing the cost of individual inputs) is key. This solution can release funds to spend elsewhere and produce more e icient, e ective systems. Digital solutions which redesign systems and processes, rather than simply digitising existing ones, can increase e iciency and decrease cost, and are therefore key to VBHC. They can deliver benefits across systems, from funders to providers, to suppliers and the broader population.

VBHC is underpinned by powerful data insights:

Simply measuring and recording information will not create value. However, providing healthcare systems and individual clinicians with access to a range of data points to assess how

GEMMA BADGER Senior Associate Hill Dickinson

“Digital solutions which redesign systems and processes, rather than simply

digitising existing ones,

can increase efficiency and decrease cost, and are therefore key to VBHC”

interventions are working and the success of outcomes achieved from a broad range of perspectives (e.g. clinical, financial, patient experience) is a key enabler to producing and demonstrating value. Digital medtech solutions produce, record, monitor and store a wide range of data across full cycles of care. Harnessed and e ectively analysed, this data underpins VBHC approaches enabling healthcare systems and individuals to understand what is working and develop interventions / pathways to improve outcomes.

There are undoubtedly tricky ‘spino ’ issues to resolve relating to data in healthcare systems including agreement on standardised collection and coding for transparency and a ‘single version of the truth’, together with legal questions around recording, access and sharing. However, when these issues are managed collaboratively, data that digital solutions o er is immensely powerful in making VBHC work.

Planetary health is an important stakeholder in VBHC – digital and medtech solutions support this: For example, travel to healthcare settings for appointments is a major source of emissions. Using digital healthcare practices to reduce travel, or localising diagnosis / treatment so that patients / their visitors do not travel far will have a significant impact.

Likewise, any approach that removes waste from the system, including eliminating unnecessary procedures and the physical resource accompanying these, also has the potential to have a positive environmental impact.

Both VBHC and digital solutions o er potential to improve workforce experience:

Caregivers are key stakeholders in VBHC, such that solutions which improve their experience tackling issues including poor working environments, excessive workload and ine icient practices built into systems are a core component. Digital innovation supports this, for example through:

• Telehealth reducing workload / freeing up time to see more patients or spend more time with them.

• Digitally enabled collaborative approaches allowing caregivers to share workload and collaborate on care delivery.

• Instantly available data enabling clinicians to assess outcomes in real time.

Using value-based procurement and contracting to implement these shi s Common between VBHC and digital adoption is the need for stakeholders to work collaboratively and transparently together o en over a long period of time. Both approaches require a clear shared view about what is working and what is not, as well as a joint appetite for innovation, taking risks and shared learning from doing so.

While much about the relationships needed to implement these approaches can only be built through individual interactions and a more nebulous ‘will to succeed’, there are commercial and legal approaches which would underpin these to ensure a better chance of success. We have seen numerous projects flounder without a core binding legal structure to allow them

to navigate disputes and changes in policy.

In VBHC, the procurement process is designed on value, ensuring that all parties involved understand the aims in terms of outcomes from the outset (including during pre-tender engagement), with these having been formulated by a multidisciplinary team of stakeholders. The award process defines value to go beyond financial value, and there is continual development within the relevant marketplace with feedback provided to unsuccessful suppliers, and a contract management focus post-award. Procurement approaches can also be designed around frameworks linking together healthcare products and services, healthcare providers and data providers to produce the kinds of measures needed to drive and demonstrate value.

Value-based contracting prioritises discussion of the ultimate agreement from the outset of negotiations and, importantly, reward based on outcomes not just inputs. It looks to build in terms to enable an incremental approach to achieving outcomes, and transparent risk share, which is also important for digital and medtech innovation and the collaborative approach to developing products to meet needs over time.

HEALTHCARE INNOVATIONS ACROSS BORDERS

Healthcare World Editor Sarah Cartledge finds BeeHealthy’s digital platform can rapidly enhance healthcare provision

Digitisation in healthcare is regularly hailed for its potential to boost e iciency, enhance patient experiences, and drive down costs. However, studies using real patient data to evaluate these outcomes have been limited. Finnish company Mehiläinen’s whollyowned subsidiary, BeeHealthy, has been involved in a recent study conducted as part of the Aalto Executive MBA programme, revealing that leveraging digital health platforms can bring real value to healthcare systems as well as increasing patient satisfaction.

BeeHealthy o ers a cutting-edge patient engagement platform that is revolutionising

social and healthcare service provision.

As a modular, white-label SaaS solution, BeeHealthy equips providers with all the necessary tools to create modern, digitalphysical healthcare services tailored to their brand. Backed by more than 110 years of healthcare experience and 20 years of in-house digital development, BeeHealthy is rapidly emerging as a leading digital healthcare solutions provider in the EMEA region, with an active presence in 10 countries.

The study focussed on data from Päijät-Sote, a Finnish public healthcare region that unites the southern Finland area of Päijät-Häme, organising social

and healthcare for 200,000 Finns. PäijätSote is at the forefront of the digital transformation, utilising the BeeHealthy platform’s whole product suite to provide digital services to its residents. The study, evaluating user experience and coste ectiveness in Päijät-Sote, has revealed a strong demand for digital healthcare services from patients.

Revolutionising patient engagement

The study shows a positive attitude towards digitisation. Patients appreciate digital tools that streamline their patient experience, eliminating the need for queuing. In a region where availability of care has been limited (like in most public healthcare systems), the e icient tools have enabled a dramatic improvement in availability of appointments. The platform’s Digital Clinic module, in particular, has been key in providing easy to access, highly e icient care through features including data-driven

symptom checkers, e-prescriptions, and video consultations. This core module enables professionals to treat patients more e ectively without compromising on quality. As a result, clinicians and service providers have expressed an increase in work e iciency and job satisfaction.

The study highlights that the use of BeeHealthy’s Digital Clinic module leads to savings of €68 per patient visit compared to traditional physical appointments. With widespread adoption of the platform and well-integrated self triage, this could translate into potential annual savings of €20 million for Päijät-Sote.

Teemu Mäkelä, CIO of Päijät-Sote and a member of the research team, emphasises that the transition to a digitally supported healthcare model requires strong leadership and collaboration among various skill sets. To strengthen cooperation between healthcare and digital development professionals, digital solutions should be designed to be as simple and flexible as possible and patients should be steered towards a digital-friendly mindset, making services faster and more accessible.

The study’s finding confirm that BeeHealthy’s platform is well-positioned to help Päijät-Sote meet the Finnish government’s target of handling 35 per cent of patient contacts digitally.

“We

OSKARI ESKOLA CEO Bee Healthy

are impressed with the results Gezond.nl have achieved in their first year, which also validates the BeeHealthy platform’s value proposition in an excellent way”

TRANSFORMING DUTCH HEALTHCARE

In February 2023, Dutch primary care organisation Gezond.nl, part of Arts en Zorg Group, adopted the BeeHealthy platform to enhance its healthcare services. Arts en Zorg Group, the largest general practitioner (GP) group in the Netherlands, o ers healthcare to various patient groups, including military personnel and asylum seekers. Through the BeeHealthy platform, Gezond.nl has successfully established a hybrid care model that blends digital and physical care.

“The results of our first year of collaboration are excellent,” says Sanne van Duin, Director of Gezond. “The service

has been adopted e ortlessly, and 75 per cent of patient contacts are resolved online. The total number of contacts has not changed, only the form. This has led to a 40 per cent decrease in visits at the local practices. This result shows we are succeeding in our ambition to contribute to a more future-proof care model while maintaining quality of care.”

Leveraging the BeeHealthy platform, Gezond patients are treated in a timely manner in the channel best suited for them. The initial contact is made through the patient application, where care questions are directed to the centralised digital practice operated by online GP’s. With an average waiting time of just two minutes, patients can access healthcare professionals directly via the app. They can also view health data, including lab results and health records, along with lifestyle coaching. Equally, they can access in person appointments if needed or preferred, freeing up clinicians to spend more time on pressing cases.

The adoption of BeeHealthy’s digital platform has led to a significant shi towards online patient care, reducing physical appointments and improving overall service e iciency and patient satisfaction in Dutch GP practices. In addition, clinicians report more professional satisfaction as a result of the system, with the online GPs appreciating the flexibility of their work and the surgery GPs reporting better in person visits.

“We are impressed with the results Gezond.nl have achieved in their first year, which also validates the BeeHealthy platform’s value proposition in an excellent way,” says BeeHealthy CEO, Oskari Eskola. “We are looking forward to a long-term relationship going forward.”

Sharing experiences in clinical best practices and healthcare innovations across borders is proving to be key for BeeHealthy as it expands its presence globally. Now with real time studies proving that digitisation is beneficial for both patients and clinicians, there is a genuine opportunity to create valuebased healthcare solutions.

INCREASING TREATMENT ADHERENCE IN CHRONIC DISEASES

Recai Serdar Gemici, co-founder & CEO Albert Health, on the importance of personalised programmes for everyone

As populations become older through the world, chronic diseases are becoming more prevalent. O en they exist in tandem with other co-morbidities, creating a burden on healthcare systems. For Recai Serdar Gemici, co-founder & CEO Albert Health, a solution lies in leveraging Artificial Intelligence (AI) to create accessible and personalised chronic disease treatments for everyone that could decrease the long term complications potentially arising from their illnesses.

Albert is an evidence-based, multichronic disease management platform that has already touched the lives of hundreds of thousands of people since its inception in 2018. The company Albert Health develops chronic disease management programmes and health management programmes in partnership with multinational pharmaceutical companies, insurance companies, hospital groups, and healthcare professionals, and already has a global footprint.

The company has an in-house medical team and currently has 9 clinical trials underway, including MS, haemophilia and growth hormone deficiency with pharma companies Roche, Bayer, Sanofi and Pfizer. By helping individuals access the most appropriate treatment management for their disease, Albert Health o ers proven clinical value and economic benefits to healthcare providers, payors and pharma companies.

Blending AI with science

The Albert Health team design diseasespecific management programmes for patients operated by voice command. Available in English, Turkish and Arabic, there are more than 200,000 users for the multi-condition integrated pathways that include hypertension, oncology, obesity, heart failure, diabetes, asthma, MS and atrial fibrillation. The company is also working on an obesity programme incorporating tactics for behavioural changes including diet and exercise.

In most cases, patients’ disease journey, health data, parties involved in the treatment and monitoring are all scattered and disconnected. This inevitably leads to missed diagnosis opportunities, higher healthcare expenditures and more burden on the patient for managing their chronic diseases. The app enables patients to track and adhere to their medication, track their symptoms and treatment, store their medical documents and give them access to support materials. Telehealth and remote patient monitoring strengthen the relationship between patient and doctor, empowering the su erer and giving them a sense of autonomy over their disease or diseases.

Albert integrates with common health devices such as blood pressure monitors, iOS and Android wearables and epipens, connecting easily to them. But much more than that, it collects and aggregates data, anonymising it for evidence generation that can be used in public health initiatives.

Clinical results show that 62.7 per cent of patients showed an improvement in their blood sugar, 57 per cent showed a decrease in their blood pressure, and 44 per cent had a progression to a lower stage in diabetes. “Diabetes is one of our priority focussed therapeutic areas. For healthcare providers, these improvements o er real value and evidence that prevention can be achieved with the right digital solutions,” says Recai.

The platform also o ers a web panel for doctors to be able to remotely monitor their patients in parallel. “Doctors also

RECAI SERDAR GEMICI Co-Founder / CEO Albert Health

“Diabetes is one of our priority focussed therapeutic areas”

benefit from our products, free of charge, because it’s funded by either the insurance or the pharmaceutical company,” he adds. The more doctors use our product and the more they recommend it to the patient, the more patients use it. But at the same time, the more patients adopt the mobile application alongside their treatment, the more engaged the doctors stay with the product as well.”

Expanding internationally

Many of the diseases managed by the platform resonate in countries in the Middle East that traditionally have high levels of diabetes and obesity. The MENA

region has the second highest expected increase in people with diabetes, reaching 136m in 2045. In the UAE, 68 per cent of adults are overweight and 28 are obese.

In May 2023 Albert Health was accepted on to the TASMU accelerator programme in Qatar and were selected as one of the 8 finalists. In September 2023 the company opened o ices in Dubai and they have also applied for a telehealth licence in the Kingdom of Saudi Arabia, emphasising their commitment to the region. They are also compliant in terms of data security.

“Preventative health is a key focus right now and we have prescribable and reimbursable digital health solutions that

are attractive to payors and providers,” Recai says. “By decreasing long term complications our products deliver real value. We have had discussions with private hospitals in the area and if they already have an application, we can discuss an add-on API integrated chronic disease management module. And thanks to our modular structure and proven trained language model, we can go live in just two weeks.”

Pharma companies have expressed interest in the patient programmes and here Albert can be a patient companion app or be part of a patient support programme (PSP).

As a partner, providers and payors can create their own personalised health management programmes to meet their patients’ unique needs while generating real-world evidence. Building an app from scratch can be challenging but, as Recai says, partnering with a compliant, verified, and secure partner can help streamline the process.

A PAN-ARAB PERSONAL HEALTH RECORD

Dr Mohammah Al-Ubaydli, CEO of Patients Know Best, tells Healthcare World Editor Sarah Cartledge about his recommendations to create a comprehensive record system

In 2020 around 41.4m people moved into or across Arab states . Notably, 35 per cent were from other Arab countries. And of 32.8m moving on, 44 per cent stayed in the region. Moving a person without moving their health record raises the cost of healthcare. Doctors spend time and money recreating the record, and they can make mistakes without it.

For Dr Mohammah Al-Ubaydli, the CEO of Patients Know Best, the company behind Europe’s largest personal health record platform, saving lives saves money. This situation is increasingly urgent as healthcare costs grow faster than economies do. A trained physician and accomplished author, Dr Mohammah has built his reputation as the leading personal health record provider to the world-renowned NHS. Now he has a proposal for a pan-Arab solution.

The current situation

Technology is now su iciently advanced with increasing uptake to aim for a universal long-term solution. In the Gulf, the majority of care by most providers is documented digitally in an electronic health record. Saudi Arabia, Dubai, Abu Dhabi and Qatar already have shared care records between providers, and others in the region are scaling up.

These days, with a few exceptions, patients receive a copy of their data digitally. Gulf countries mandate it, having built national superapps during the Covid pandemic. These superapps include a copy of the record from across providers in a country. Providers also have patient portals as standard for onboarding customers and linking them to clinical care.

Furthermore, Middle East consumers are mobile-first and Middle East countries are global leaders in digital penetration. This local strength means they are ready for universal usage of technologies that have been proven at mass scale.

What is a personal health record (PHR)?

A personal health record (PHR) is a record about the health of a person, organised around that person. It is not tied to an organisation (as in a hospital or primary care portal), nor is it limited to a condition (like a disease app), and it moves with the person (not locked down to a region). Importantly, a personal health record is the only architecture that supports the movement of data with the movement of people. This factor is vital not just for 41m Arab migrants - it is also key for native residents.

In the UK, it’s estimated that 1 in 16 people has a rare disease , so they move to find specialists across regions. In addition, 50 per cent of healthcare spending is from 5 per cent of the population with complex conditions who o en move between providers. The rare disease numbers are likely higher in the Arab region due to consanguineous marriages. As the Arab world’s youthful population ages, the complexity and costs of care will rise.

Supporting the movement of data with people

There are three potential approaches to universal movement of data with people. First is a public sector top-down approach, with governments of the Arab world agreeing to work together. An alternative is a private sector bottom-up approach, but the public sector’s laws and the private sector’s incentives work against scale. The third is the public sector enabling the

MOHAMMAH AL-UBAYDLI CEO Patients Know Best

“A personal health record is the only architecture that supports the movement of data with the movement of people”

private sector, which has had successes in the region, and this solution is my recommendation.

1. Public sector top-down

One path forward is to follow the European Union model, with mutual recognition by Arab states of their neighbours’ infrastructure for storage. In 2022 the EU passed the European Health Data Space legislation. As a citizen moves from one country to another, the departure country’s public infrastructure passes the citizen’s data onto the destination country. The GCC countries could lead the way in this approach through their existing practices of cooperation. At current

speeds this will not be fast. Even with a political union and mature economies with cross-country wealth transfers, the European Union’s progress has been slow. It took years for mutual recognition of data storage across the EU, still more years to agree to the EU Health Data Space legislation, and this in turn will take years to implement.

Elsewhere, ASEAN regional cooperation does not have a political union and does not have any of these elements. The African Continental Free Trade Area has only recently been formed. The Arab world’s only free trade area is the GCC, although Bahrain and Kuwait’s mutual recognition of data storage is the tiny

exception that proves the rule. So at the moment, this route is not a reliable approach for public health.

2. Private sector bottom-up

The private sector has started down this path due to consumer demand. Hospital portals and apps attract paying consumers, and they expect access to data as part of routine care. However, the data is locked to the provider as, commercially, private providers do not like data portability because it allows consumers to shop around and move to other providers. Legally, the GCC countries mandate incountry data storage. It is possible to have apps and portals that cross borders, storing

data in each country and displaying it in one user interface on-demand. However, the behaviour of well-funded hospital chains operating in multiple countries has still been to silo storage and display by country as the providers want to avoid the regulatory risk of joining up care across markets.

3. Public-private cooperation

The model of a multinational personal health record app is definitely workable. Consumer-funded companies already cater to travellers who manually upload their medical records. And government-funded companies such as Patients Know Best already operate across multiple national jurisdictions.

If Arab nations cooperated with the private sector as the UK government has, then it is possible to scale such an option. The UK government opened up identity verification in England via the NHS login to the private sector and it is now reportedly used by 80 per cent of the population. The NHS App incorporates private suppliers to deliver features from electronic consultations to online appointment booking to personal health records.

The current UAE Pass has already shown that Gulf governments can also open up but, as yet, no Gulf country has yet opened up its national data stores to the private sector. Doing so would make their national app o erings dynamic, especially given the competitive marketplaces in the rest of their economies.

Governments do not need to fund these companies - this is simply a policy decision to allow the private sector to better serve their citizens and economies. Furthermore, as GCC countries kick-start this approach

MOHAMMAH AL-UBAYDLI CEO

Patients Know Best

“It is possible to have apps and portals that cross borders, storing data in each country and displaying it in one user interface on-demand”

they can create national champions. The GCC countries are already standardising on FHIR 4, ICD and SNOMED CT for their national data sets. As the personal health records market starts in these countries, the companies will be well developed when other countries join this approach. Such data portability also supports the life sciences industry. Given that 50-80

per cent of their residents are expats, the genetic diversity in the Gulf states’ expatriate workforce makes it globally attractive for clinical trials.

So what next?

This public-private cooperation proposal is put forward as part of global research on personal health records conducted by Dr Mohammah and his colleague, Federica Andreoni. The findings will be shared in a new book “Personal Health Records for Governments” to be published in December 2024.

If you would like to learn more about the research or participate in policy design, please contact book@phr4gov.org

enquiries@patientsknowbest.com

BUILDING THE HEALTH DATA INFRASTRUCTURE

Pedro Ramos, CEO Promptly, explains how to multiply the value of healthcare data

Data is the key to improving healthcare – this fact is a given. But how to harness the vast amount of available data, collected by all organisations, has posed innumerable questions. Now Promptly Health, a global provider of real world data access, has put its finger on the pulse and is building the first patient-centred global evidence network, o ering real world data sharing and monetisation capabilities.

Together with a selected network of partners, Promptly Health generates new knowledge from harmonised datasets, augmented with the collection of longitudinal patient-reported data and patient-generated digital biomarkers

within a secure and privacy-preserving environment. As a result, the organisation delivers valuable insights to leading health systems, payers and life-science companies across multiple therapeutic areas, including cardiometabolic, oncology, and immunology. Operating in 10 countries, it promotes better healthcare at lower costs for thousands of new patients every day through the use of real-world evidence. Importantly, it is helping healthcare organisations to unlock the value of their data assets and capture revenuegenerating opportunities from research and innovation projects at a fraction of the time and cost. This is done by setting up Secure Data Environments where

datasets are harmonised to a common data model (OMOP) which is used by more than 400 organisations worldwide. This solution enables the data to be usable and comparable, including patient-generated health data, clinical data, socio-economic data, and payer’s claims data, all delivered in a research grade format.

Federated evidence network

With more than 20 partners and 25m patient records, Promptly is building a federated data network across the UK, Latin America and Europe to help fast track research and commercial collaboration, while ensuring data stays local. This is done by setting up Secure Health Data Environments where datasets are harmonised to the common data model (OMOP), catalogued, and made accessible for data collaborations, without ever leaving the hospitals’ premises.

Innovation lies in using privacy-enhancing technologies such as tokenisation and federated learning for generating aggregated insights. All data is standardised to OMOPFIHR (used by the FDA, EMA, Oxford, Mayo

Clinic and others), which opens the room for collaborations outside our network in an open-source model.

Promptly partners with leading public and private health systems across Europe, Latin America and Asia Pacific. The company has been vocal in advocating for a new operational model for the use of health data, based on privacy-enhancing technologies that allow data to remain within the healthcare organisation’s infrastructure, using so ware to create secure health data libraries with hospitals and regions.

Promptly Health is a member of the WHO/Europe Strategic Partners’ Initiative for Data and Digital Health (SPI-DDH), which includes a select group of 100 representatives. It is also part of the advisory cabinet of the European Health Data Space (EHDS) and its first pilot led by the French Health Data Hub. In addition, it is part of the European Innovation through Health Data (i-HD), helping advance health systems’ use of high-quality health data to improve the provision of care and accelerate clinical research.

Value-based healthcare

Certified by the European consortium - European Health Data and Evidence Network, to carry out OMOP health data harmonisation initiatives, Promptly Health serves as the technological partner of the World Economic Forum, awarded VBH.CAT project for ophthalmology data collection and analysis. It sets the infrastructure for value-based healthcare models to thrive.

“Being successful in value-based care (VBHC) and scaling programmes requires trust between partners,” says Pedro Ramos. “Our end-to-end suite of solutions helps partners to connect the dots between clinical performance and financial impact to boost payor-provider collaboration and transparency.”

Promptly has been selected as the technological partner of the National Health Service (NHS) organisations in Wales for managing the collection and harmonisation of patient-centred outcomes data. NHS Wales has been at the forefront of high-value care planning in Europe and is highlighted as a Global Innovation Hub by the World Economic Forum and

PEDRO RAMOS CEO Promptly

“Being successful in value-based care (VBHC) and scaling programmes requires trust between partners”

the European Institute of Innovation and Technology (EIT) Health. Since 2019, NHS Wales has been developing pilots for collecting patient-centred outcomes, demonstrating its feasibility in numerous scientific publications, conferences and educational courses. Other clients include Roche, Novartis, Sandoz, Alcon, J&J and health insurers Bradesco, Generali and Ageas.

For healthcare payors, Promptly Health supports claims databases with longitudinal patient-reported outcomes data to assess treatment e ectiveness, manage network performance, and facilitate the implementation of valuebased agreements. Collecting and analysing patient-reported data during the full treatment pathway allows payors to put value at the centre and reward the true care winners, reimbursing healthcare providers according to their care performance.

In just a few years, Promptly has emerged as a global provider of end to end real world evidence solutions. “We have chosen to make a di erence in people’s lives by addressing the biggest problem in healthcare: the lack of real world evidence on the outcomes of care,” Pedro Ramos says. “For us, society denying patients better care due to lack of access to data is unethical, in a world where technology improves so many aspects of our world.”

LOOKING AT THE FULL PICTURE

Brian Niven, Management Consultant at Mott MacDonald, discusses how the KSA clusters should examine the delivery of healthcare services through a strategic whole systems approach

Health clusters across KSA are being implemented to develop an integrated local network of healthcare providers under a single administrative structure. As such, the responsibility of these clusters will extend across primary care centres, general hospitals, and specialised services

ensuring that beneficiaries within that cluster can access the required services through a single integrated administrative system, which is ultimately responsible for the leadership, strategic direction, management and governance of healthcare service design and delivery.

Moreover, these clusters will be responsible for having a focus on holistic, preventive care rather than solely on curative and treatment approaches. The overall aim is to deliver a modern model of care through managing the health needs of their community that achieve the highest levels of outcomes in terms of quality, e iciency, and prevention.

This ambition for the KSA health clusters provides a direction of travel, which is being mirrored across many other jurisdictions globally. It recognises that, within an overall framework for delivering care across the country, there is a need for a local focus on meeting the specific needs of communities and

working with a range of stakeholders to achieve the best health and wellbeing outcomes for that population.

As an example, in 2023, the National Health Service (NHS) in England restructured its governance for delivering healthcare and improving local health outcomes. Integrated Care Systems (ICS) were introduced which have a similar aim to the newly developing KSA health clusters and, whilst serving a catchment population which is typically larger that the KSA health clusters, these ICS’s are now organising themselves into Placed Based approaches which provide a more localised planning for health and care services between di erent parts of the healthcare system and its

BRIAN NIVEN Management Consultant Mott MacDonald

“The focus should be on health outcomes and not solely on healthcare outcomes”

external partners. This integrated systems approach is also well established in other developed nations of the United Kingdom and elsewhere globally.

So, given that this direction of travel for organising, managing and delivering services at a localised level has already been embarked upon by others, what are the key lessons that the KSA health clusters could learn to avoid any potential pitfalls through the implementation of their own journeys?

The need to focus on health outcomes

Findings from studies on ICS programme development over their first year of operation, including The King’s Fund report on the early precursor to ICS development , found that organisations spent the majority of their initial time building the foundations on which to improve health and care for their populations, including governance, leadership and sta ing, and engaging with a wide range of stakeholders. Many also spent much of their time learning about systems working, including the need to lead di erently to deliver their ambitions. Whilst there is service pressure across most healthcare entities within the health and care systems, the report found that there had been a focus on strengthening and integrating primary care and community services, and reviewing how specialist services are delivered in some areas.

The findings of the report are not entirely surprising and, as with the UK, time will be needed to allow the KSA health clusters to find their feet, establish their internal systems and processes, develop their governance structure and reporting mechanisms, and to develop their leadership to work di erently, moving from independent provider organisations to more collaborate work systems.

However, prevention and the focus on achieving health and wellbeing outcomes and reducing health inequalities are

missing through this new localised systems development. Healthcare systems are complex and improving integration and introducing new ways of working takes time, but the focus should be on health outcomes and not solely on healthcare outcomes.

Therefore, from my perspective, it would be important for the KSA health clusters to define early on their strategy and the direction of delivery for both population outcomes and services. This means addressing health inequalities and developing systems which best support individuals and communities. As such, it will be necessary to develop strategies and plans that shi the focus away from bricks and mortar of healthcare infrastructure and towards targeted investments into preventative services and sectors, which will have a more lasting impact on people’s health and wellbeing.

If this process is delayed or prolonged, or if there is an early focus on addressing current healthcare service delivery challenges with shortterm fixes rather than a clear long-term preventative strategy, there is a risk that the KSA health clusters will remain trapped in this cycle. Future decisions and investments will end up being made around fixing existing current infrastructure and delivering incremental performance improvements to existing service models.

It’s like moving home: unless you begin the process to decorate or refurbish within the first few weeks, all your furnishings and fittings now fill the space and it becomes all the more challenging and di icult to be motivated to change.

Whole systems approach

Yet change is needed if the health clusters are going to deliver improved outcomes for the health and wellbeing of its beneficiaries and deliver long term sustainability. There is a need for a more radical shi in how health and care is planned and delivered, recognising the rapid advances in technology and medicines. There is also the shi in how individuals wish to engage and access care services, and their preferences in what works best for them in meeting their health and wellbeing needs. This means that the traditional approach to planning for health and care services needs to be completely rethought.

The health and wellbeing of communities and individuals is wrapped up into a complex system. The social determinants of health clearly show that the impact on individuals’ health and wellbeing is largely driven by the influence of a range of other sectors, including housing, education, employment, social infrastructure, finance and personal behaviours and attitudes. In fact, access to good quality healthcare is responsible for only around 15-20%. So if the KSA health clusters want to deliver outcomes that improve the health and wellbeing of its beneficiaries, it needs to work very di erently and seek to engage more widely than solely across the healthcare system. While this system is important and will need careful planning, it should be seen as a sub-system within a larger system of systems, involving many stakeholders and sectors that are not typically considered in discussions about health and healthcare.

BRIAN NIVEN Management Consultant Mott MacDonald

“The traditional approach to planning for health and care services needs to be completely rethought”

This whole system approach is the key to improving health and wellbeing outcomes and reducing health inequalities between individuals and communities. This means:

• Defining the changing future population demographics and underlying health needs

• Deriving the health and wellbeing outcomes to be achieved and by when

• Identifying those sectors and stakeholders which impact on communities and individual’s health and wellbeing

• Engaging to assess these sectors’ future policy and strategic direction and plans

• Developing a comprehensive map of the levers and impacts within these plans that a ect population health, and assessing how to maximise positive influence or minimise negative impact.

• Using evidence-based literature and observational outcomes to model the potential impact and timeline of these

levers, as well as impacts on health and wellbeing outcomes

• Assessing the subsequent impact over time of these lever impacts on the future profile of demand for healthcare services

• Developing the evolving models of care and service models that will manage this demand and converting this to healthcare capacity requirements

• Mapping this healthcare capacity requirement to infrastructure needs

• Defining the gap in future infrastructure needs and planning for future capital investment.

• Scenario testing of healthcare capacity requirements across this timescale and identifying any short terms pressures.

All this is not easy and should not be under-estimated. Yet globally, if we are ever going to improve health and wellbeing outcomes, it is only through undertaking such detailed exercises that we can truly aim to deliver a whole systems approach that improves health and wellbeing for our populations. It is vital to properly size healthcare

infrastructure to support those whose care needs cannot be met by preventative strategies. This approach is a bold and radical step. But unless we start to plan for health and wellbeing outcomes from the population perspective rather than the traditional route of assuming a ‘le shi ’ from hospital care into alternative

primary healthcare and community care settings, we will never achieve the goal of holistic, preventive care.

An exciting new concept in neurodiverse assessment and care

Rapid progress to superior life experiences through a revolutionary care pathway

Ubiquitous access through appropriate use of telehealth technology

Organisational efficiency reducing the cost of care and improving affordability

Clinical development training on the ADHD 360 Academy promoting neurodiverse expertise across the UK health workforce.

ADHD 360 delivering improved patient outcomes

ADHD 360, a virtual clinic for the assessment, diagnosis, and treatment of neurodiverse conditions. A disruptive business model, highly focussed and motivated team, plus the drive of a determined leadership have created Europe’s largest provider. Harnessing the best of telemedicine and face to face consultations through a combination of video conferencing, bespoke IT platform, and patient portal. Now assessing an average of 1000+ patients each month.

A paradigm improvement in clinician productivity with a bespoke rules-based process and the support of a highly motivated and efficient front office team all trained in the ADHD 360 Academy. A service with quality at its core, rigorously audited by the UK Care Quality Commission, caring for previously under provisioned patients and their families.

PUBLIC PRIVATE PARTNERSHIP IN SAUDI ARABIA HEALTHCARE SECTOR

Talha Maqsood, Head of Development Solutions, Healthcare, Education and PPP at Colliers, on the immense promise PPP’s hold for transforming Saudi Arabia’s healthcare landscape

Saudi Arabia’s healthcare sector stands at a transformative juncture, propelled by ambitious national visions and the increasing demands for sophisticated medical services. The commitment to enhancing healthcare infrastructure through Public-Private Partnerships (PPP) is pivotal in achieving

“PPPs

TALHA MAQSOOD Head of Development Solutions Colliers

the Saudi Vision 2030 objectives of accessibility, quality and e iciency. PPPs merge public oversight with private sector e iciency and innovation, setting new standards in healthcare delivery across the region.

Saudi Arabia has adopted various PPP models to strengthen its healthcare framework. Notable projects such as the expansion of King Faisal Specialist Hospital and the creation of medical cities exemplify ongoing initiatives. Additional significant projects facilitated through PPPs include the Sudair Medical City, which aims to establish a comprehensive medical and research complex and the Dammam Medical Complex, which focuses on expanding and modernising healthcare facilities to international standards. These projects, alongside predominant models such as BuildOperate-Transfer (BOT) and Build-Own-

Operate-Transfer (BOOT), foster long-term collaborations between the government and private sectors. These partnerships not only enhance operational e iciencies but also ensure that facilities are built and maintained according to international standards, demonstrating the tangible benefits of such collaborations.

Looking to the future, Saudi Arabia is poised to explore more innovative PPP frameworks such as Design-BuildFinance-Operate (DBFO) and PublicPrivate-Community Partnerships (PPCPs). These models facilitate the integration of advanced technologies such as digital health solutions, telemedicine and artificial intelligence, further revolutionising healthcare delivery. The adoption of these technologies is expected to improve patient outcomes and align domestic healthcare services with global trends.

PPPs transcend traditional funding roles to become strategic tools that enhance healthcare quality and accessibility while supporting economic diversification—a central goal of Vision 2030. By leveraging private sector expertise and resources, PPPs o er significant economic benefits, including job creation and the attraction of local and foreign investments.

Despite their benefits, PPPs encounter challenges including financial risks, regulatory hurdles and the complexity of managing long-term contracts. There is a need for a robust legal framework that ensures transparency, accountability and equitable risk distribution.

Public-Private Partnerships hold immense promise for transforming Saudi Arabia’s healthcare landscape by e iciently meeting increasing service demands. As the nation progresses towards its Vision 2030 goals, the successful adoption and adaptation of PPP models are increasingly important. Embracing these partnerships and continuously adapting to technological and economic shi s will enable Saudi Arabia to establish a world-class healthcare system, serving as a benchmark for the region and beyond.

OPINIONATED

STEVE GARDNER Managing Director

THE PUBLIC HEALTH PAYOR CONUNDRUM

Incentives are interesting things - they can drive good and bad behaviour. Unsurprisingly, they are at the heart of the debate when it comes to public health because much of public health is about messaging, communication and (of course) incentives.

Make sure you book your screening appointment, check yourself regularly, don’t overeat, make sure you exercise and whatever you do, absolutely, positively don’t smoke! The incentive? To keep yourself fit and healthy of course.

The advent of population health modelling, the use of global healthcare data and the rise of precision medicine has allowed us to target these messages ever more carefully. With su icient information at a population and individual level, we can start to identify the ‘at risk’ elements of our populations. We can tailor our messaging specifically to them and help

them avoid entering the health system, saving massive amounts of time, resources and expense.

We can even create positive incentives that reward potential patients for good behaviours. A er all preventative care is the future. We won’t solve our workforce crisis unless we solve the crisis of healthcare demand, and we need to move from ‘sickcare to healthcare’.

All great ideas but incentives for patients are one thing and the perverse incentive of an insurance led payor model is another. So the question here is (as it so o en is) who pays for all this?

It should be obvious. By screening and creating wellness incentives, and by creating models that allow for preventative interventions rather than waiting for someone to get sick and paying for treatment, the insurer should save themselves a fortune.

However, as a commercial entity the insurer has an issue. It views its member as a customer and that customer (o en paid for by their employer) has maybe 2-3 years with that insurer. Thus, most (if not all) insurers take the view that preventative interventions won’t benefit their profit margin, rather it will benefit their competition, despite evidence that precision population health interventions can pay back in under six months.

So surely the answer is to get all the insurers together and make them pay for public health?

There is a version in the USA with state level ‘super payor’ funds that levy insurers operating in their state to pay into a fund for state level public health. However, the insurers spend their time arguing to pay less and less each year, which means the fund continually has to do more with less and, as a result, there is a lack of imagination and innovation across the system.

An insurer by their very nature is an organisation that exists to collect money to put a thing right when a thing goes wrong. Why would they want to stop it going wrong in the first place it’s not what they were invented for?

Some of this is about value-based healthcare. Creating a model where the payor pays on health outcomes rather than based on volume of activity. Though how do you measure the impact of preventive care and create a payment model against it? More o en, it’s about the evolution of the system. Some of the best public health and preventative care comes in the UK where the NHS is both payor and provider.

For those playing both sides of this game, the natural incentive is to save money on provision by ensuring individuals don’t enter the system in the first place. The UK has one of the best breast cancer screening services in the world and it saves a fortune on treatment costs with early detection and intervention.

There are large payor / providers cropping up in the USA and in Brazil, and much thought being given to the relationship between payor and provider in the Kingdom of Saudi Arabia, but the answer eventually might live with big global corporates who are moving away from their insurers to create their own health packages. These o ers combine healthcare with wellness as an employee benefit, which also drives recruitment and productivity as well as fulfilling the mandate of employee health.

Go global with Bevan Brittan

We are the market-leader in the provision of legal, governance and regulatory advisory services to businesses delivering and providing healthcare services within the UK and internationally.

Our award-winning healthcare teams provide organisations with outstanding corporate, commercial, clinical negligence, litigation, regulatory, property and employment legal advice.

With years of experience and global exposure, our healthcare teams have the expertise to support clients’ endeavours anywhere in the world. Our reputation as a leading healthcare firm has taken us across the globe, working with a wide range of clients (from NHS bodies to independent health and social care providers, operators and developers as well as funders and investors) on a multitude of commercial health projects. Our in-depth practical and commercial knowledge of the challenges and opportunities of expanding overseas are second-to-none and a true benefit to our clients in the increasingly global healthcare market.

Vincent Buscemi Partner and Head of Independent Health & Care vincent.buscemi@bevanbrittan.com

Jodie Sinclair Senior Partner and Head of Employment, Pensions and Immigration jodie.sinclair@bevanbrittan.com

Sarah Skuse Partner and Head of Independent Health & Care Real Estate sarah.skuse@bevanbrittan.com