Healthcare World Magazine | Issue Four by TheTradeAgency

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

Issue Four | Spring 2022

Saudi Arabia

The new healthcare opportunity

ARAB HEALTH 2022 OVERVIEW | THE RISE OF WELLNESS | VIRTUAL WARDS | UK MARKET ENTRY

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17/01/2022 20:27 1/14/22 5:03 PM

EDITOR’S WELCOME

Welcome to Healthcare World

elcome to the our latest edition of Healthcare World. We are delighted to be focussing on healthcare in the Kingdom of Saudi Arabia, which is the rapidly growing destination for innovation and technology within the sector. We are honoured that Dr Ahmed Al-Musaed, MD, MMM, FRCPC, CPE, Assistant to CEO for Clinical Affairs Eastern Health Cluster will be answering questions from our panel about the opportunities that exist within the pioneering first cluster of the reorganised Saudi health system. Christina Sochaki, Senior Associate at legal firm Al Tamimi & Co in the Kingdom gives us a comprehensive overview of the healthcare environment and the changes underway. This is the first in a series of Healthcare World special series on Saudi Arabia healthcare, so do look out for them in the next few months. We were delighted to take part in Arab Health at the Dubai World Trade Centre at the end of January. It was an absolute pleasure to be back with colleagues to see the enormous advances in healthcare that has resulted from the pandemic. We were privileged to see the wealth of development which has occurred all throughout the world, such as operations conducted by AI, healthcare initiatives in outer space from an astronaut, huge leaps in prosthetics; and many were ecstatic just to have a coffee and a chat with colleagues that they hadn’t seen in years. So, this issue is a recap of the latest insights into Middle East healthcare. We talk to Jyoti Mehan, CEO of Health Care First Partnership, about importance of primary care on a global scale. We also speak to Mona Hayat about her wellness platform Nexus Digital Technology, and her partnership with the Greek prehab and rehab clinic Palladion which is breaking new barriers in the push towards patient-driven care. Bevan Brittan hosted a webinar after Arab Health to elucidate upon the insights gained at the event. At the forefront of the conversation was the importance

Sarah Cartledge Group Editor of integration between healthcare operators and nontraditional players within the sector. It was the future of healthcare as a result of the pandemic that played most on people’s minds. ACS are focussed on the importance of regulation within clinical settings, and are experts in providing enhanced patient safety, particularly after the unexpected onset of the new pandemic. As everyone becomes more accustomed to sharing their healthcare data, Methods Analytics discussed the evolution of population health and how data can influence critical decisions within healthcare. And as we become increasingly aware of the urgent need for cooperation and truly global operation at an international level, Snomed’s clinical language, designed to promote interoperability between practitioners enables clinical and healthcare operators to achieve greater cohesion, will have greater visibility in Europe thanks to funding via the European Health and Digital Executive Agency (HaDEA). On a more practical level, BuzzStreet’s Joe Fernandes explains how wayfinding reduces patient stress via an app that helps them navigate perhaps intimidating settings such as large hospitals and clinical environments, enabling them to get to where they need to be in the quickest manner possible. But what is becoming increasingly evident is that every one of us has to take responsibility for our own health, not least because it can provide economic benefits. Romano Toscano has come up with the concept of LifeScore, a measure for insurance companies to evaluate risk not only for healthcare but also as a general assessment of how we live our lives. LifeScore will allow each one of us to achieve a numerical value for our lives that can be applied to our health and other insurances to evaluate our risk, rather than placing patients in cohorts that do not fit their health profile accurately. So do delve into our pages to discover the latest insights in the world of healthcare. sarah@healthcareworld.com

The Healthcare World team

Steve Gardner

Sarah Cartledge

Emma Sheldon MBE

Joe Everley

Emma Williams

Fabian SutchDaggett

Ritu Chopra

Managing Director

Group Editor

CCO & Head of Consultancy

Art Director

Operations Manager

Features Editor

Business Development Manager

Contents 3 6

Healthcare World Magazine | Issue Four

Editor’s Welcome Creating a sustainable future for the medical laboratory industry

In the last two years, the pandemic has shone a light on the incredible job of those working in laboratories and the work they have carried out to address the challenges COVID-19 has created, says Rejoy Penacerrada, Conference Director – Healthcare, Informa Markets

10 11

Arab Health 2022: Jumeriah Beach Hotel Dinner Arab Health 2022: Healthcare World Drinks Reception

Christina Sochacki provides a brief overview of the healthcare provision in KSA and the proposed reforms

Emerging trends from Arab Health 2022

A Bevan Brittan webinar finds global healthcare has entered a new and exciting era, reports Fabian SutchDaggett

The privatisation of Saudi Arabia’s healthcare system

Is Population Health Management past its sell by date?

Simon Swift, MD Methods Analytics, and Richard Oakley, Director of Data Science & AI at Methods Analytics, discuss the importance of including citizens in the data conversation

Providing holistic healthcare

Sarah Cartledge discusses Nexus Digital Technologies and Palladion Rehabilitation Center’s new partnership with CEOs Mona Hayat and Katerina Karniadaki.

Internationalising primary healthcare

Sarah Cartledge discusses the importance of primary healthcare with Jyoti Mehan, CEO Health Care First Partnership

Sharing health data with ease

SNOMED’s standardised terminology allows for greater interoperability by achieving a single global language for health, says SNOMED International CEO Don Sweete

CONTENTS

12 38

38 43 44

Expo 2020 Dubai

The world’s greatest show comes to Dubai in October this year, discovers WHJ Editor Sarah Cartledge

Patrick Wynn - Notes from a Modern GP Accessing teenage mental health support on demand MeeToo enables young people with mental health issues to help themselves and help others, co-founder Suzi Godson tells Healthcare World Editor Sarah Cartledge

46 48 50

32 32

What’s your score?

Romano Toscano, CEO and Founder of MyLifeKit discusses the launch of LifeScore

Stemming the tide of infection

Josie Winter, Clinical Operations Director at Advanced Clinical Solutions, discusses the importance of compliance in patient safety

Taking the path to savings with indoor wayfinding

Chelsea and Westminster Hospital in London has found that digital wayfinding has improved both the patient and visitor experience, says Joe Fernandes, founder and CEO, BuzzStreets

Streamlining patient referrals

Queensland Health is implementing a revolutionary referral system to support General Practitioners (GPs) with the most accurate, up-todate provider information for streamlined referral management

Entering the UK healthcare market

Sarah Cartledge speaks to Mat Oram, CEO of AdviseInc, about the challenges in entering the UK Healthcare market

Collaboration and opportunity in the Emirates

The UAE is the ideal location for launching into global markets says Mazin Gadir, healthcare adviser and digital health expert

Treating cancer effectively with precision medicine

COVID has caused a global backlog in cancer care, but CanCertain can help select effective treatments, Dr Himanshu Kataria, Founder and CEO, tells Sarah Cartledge

Conrad Hotel on the first night, as well as local healthcare leaders from the UAE. The main topic of conversation was digital health, telemedicine and the rapid deployment of new technologies within the sector. And indeed, the effect of the pandemic was clearly evident in the amount of innovation on display at Arab Health. From robotics to the metaverse, digital hospitals to AI diagnosis, there has been a huge leap forward in the way the healthcare sector has embraced the future. The event showcased healthtech solutions such as medical drones and cloud technology, mobile temperature machines and even robots to guide patients, entertain them and enhance their overall hospital experience. The power of AI and the Metaverse

Return to Arab Health The return of the conference at the Dubai World Trade Centre was a huge success, says HW Editor Sarah Cartledge

ore than 56,000 delegates and exhibitors from across 60 countries arrived in Dubai in late January for Arab Health 2022, which last year was held virtually. Although visitors had to undergo COVID screening to enter the emirate, it didn’t seem to affect the amount of people who were determined to meet once again face to face. Suffering from Zoom and Teams fatigue, delegates enjoyed every opportunity to chat over coffee and lunch at the Dubai World Trade Centre to see how the healthcare sector has moved on apace. Healthcare World took its largest ever delegation to this year’s event, including companies such as Nexus, AdviseInc, Methods Analytics, Health Care First 6

Partnership and ACS. We were joined by Mott Macdonald, Dell, Iqvia, Al Tamimi and Huma who, among others, kindly sponsored our networking drinks at the

Global clinicians made ‘exhibition history’ by attending a lecture in the Metaverse with the launch of The Metaversity. “In the future, maybe we will see benefits such as remote collaboration with patients and dissemination of information among clinicians at different centres,” said Professor Shafi Ahmed, multi awardwinning cancer surgeon at the Royal London Hospital and Chief Medical Officer of Medical Realities. “Virtual reality and augmented reality are already making a difference in patients’ lives, and Metaverse allows us to take this to the next level.” AI Body demonstrated its Digital Human Organism capable of producing true to life responses and simulations. Built up from the sub-cellular level, this unique approach makes it possible for all interrelated biophysical, physiological and biochemical processes to occur concurrently in a simulation, in real-time. By simulating virtually any condition, treatment options can be examined and deployed, supporting clinical decisions. It is also widely used in medical schools as a training method.

EVENTS Arab Health 2022

World-renowned surgeons also demonstrated a Right RATS (RoboticAssisted Thoracic Surgery) Lower Lobectomy and Lymph Node Dissection procedure via Proximie, a software platform connecting clinicians to the operating room from anywhere in the world. The technology can be used for consultations allowing clinicians to remotely ‘scrub-in’ to the operating room and educational purposes. Every Proximie-assisted procedure can be recorded, analysed and leveraged for future use. Many companies who are harnessing the power of blockchain to create new ways to underpin technology and innovation were

also present, showing how far healthcare has come in the light of the recent pandemic. Harnessing knowledge from outer space Professor Ahmed also hosted an expert panel on day three of the exhibition that saw renowned American physician and former NASA astronaut Dr Scott Parazynski in conversation with CEO of UK-based 3D LifePrints, Henry Pinchbeck. Together, the panel explored the lessons that can be derived from working in the harshest of environments to solve

some of the modern health challenges facing mankind. These include ways in which health technologies are providing solutions, the latest innovations and their transformative impact, as well as how stateof-the-art technologies can be transitioned from use in space into wider public use. Giving the audiences a glimpse into additive manufacturing and how it can be applied in healthcare, the session addressed the potential for 3D-printed patient-specific devices to enhance patient care. “When we press the boundaries of exploration to make it possible to deliver care in space, wonderful things happen,” said Scott Parazynski. 7

“For example, we have a 3D printer abroad the International Space Station and when they needed to deliver a splint for a type of finger fracture, we were able to send out a CAD file and print it out just in time for that particular patient. One can leverage the unmet needs of space flight with new technologies and then end up with solutions that can then be deployed in remote locations here on earth.” Benefitting from Arab Health For many clinicians and healthcare professionals, Arab Health offers the chance to see different ideas and technology in action, giving them the ability to broaden their own goals and link their ideas with others. The UAE healthcare sector is renowned for its openness to innovation and, for companies wishing to consider exporting to Dubai, there were plenty of people around to help them with their 8

queries from Dubai Health Authority, Dubai Science Park to Dubai Free Zone. For the Healthcare World delegation, many new partnerships and relationships were formed. “It’s been a huge success for our SMEs,” said MD Steve Gardner. “We supported them with a full Healthcare World team and we look forward to their success stories throughout 2022 and beyond.”

Nexus Digital Technology We are the international experts in health and wellbeing connectivity. We create the tools to give everyone the best chance of optimising their personal health and wellbeing. We partner with organisations and healthcare providers, creating bespoke digital solutions to help engage their people to transform the quality of their lifestyle.

Our Nexus solutions provide actionable data for organisations, so they can measure engagement and effectiveness. The end result is a tangible reduction in the personal, social, and financial costs associated with disease and ill health. To find out more about how Nexus can support your business or organisation, please contact Emily Nicholls, Chief Operating Officer on enicholls@nexus-dt.com

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20:27 17/01/2022 20:23

Arab Health 2022: Jumeriah Beach Hotel Dinner Arab Health kicked off with a fabulous dinner at the Jumeirah Beach Hotel in the shadow of the Burj al Arab.

uests with trade missions led by Healthcare World, Medilink and Northern Powerhouse were treated to a gourmet offering, showcasing some of the best cuisine in the city. Delegates were able to mix at leisure and get to know other UK companies in the sector before heading up to the rooftop bar to see spectacular night time views over Dubai. 10

EVENTS Arab Health 2022

Arab Health 2022: Healthcare World Drinks Reception Arab Health kicked off with a fabulous dinner at the Jumeirah Beach Hotel in the shadow of the Burj al Arab.

he Yoga Terrace at the Conrad Hotel near the Dubai World Trade Centre was packed with HW clients and friends from across the globe. The red lighting gave everyone a healthy glow as they reconnected with colleagues not seen since Arab Health 2020. “Coming back to an in-person Arab Health for the first time in two years meant renewing a lot of old relationships, creating many new ones and saying hello face to face for the first time in a very long time,” said MD Steve Gardner. “With more than 200 people present, it reminds me what a great set of friends and colleagues Healthcare World has in Dubai.”

The Healthcare World Drinks Reception, Arab Health 2022

www.healthcareworldmagazine.com

Location:

CONRAD DUBAI

P.O. Box 115143, Sheikh Zayed Road Dubai, United Arab Emirates Date & Time:

24/01/2022 at 7.30pm

drinks reception24/01/22

Sponsored by:

The privatisation of Saudi Arabia’s healthcare system Christina Sochacki provides a brief overview of the healthcare provision in KSA and the proposed reforms

he healthcare and life sciences sector is one of the most significant sectors for the Kingdom of Saudi Arabia. The first formal public health department was established in Mecca in 1925. Since then, significant progress has been made in improving population health and expanding healthcare access, yet hurdles remain. Current reforms target decentralisation of the public sector and increasing private sector participation. 12

Opening the doors to the private sector Saudi Arabia’s national healthcare system, where the government is responsible for both the financing of health care and its delivery, is largely publicly financed. The Saudi Ministry of Health (‘MOH’) is the largest provider of healthcare in the Kingdom, accounting for approximately 60 per cent of healthcare services, delivered at three levels: primary, secondary and

tertiary. The other governmental healthcare providers (such as the Saudi Arabian National Guard and the Ministry of Defence and Aviation) provide comprehensive health services to their targeted population, usually employees and their dependants, and represent around 20 per cent of health services. The private sector provides the final 20 per cent of the healthcare services in Saudi Arabia, but we expect this to increase due to a variety of factors. The health insurance market has also grown significantly in recent years, as a result of the introduction of mandatory insurance regulations. The Council of Cooperative Health Insurance (‘CCHI’) mandatory unified health insurance scheme makes it compulsory for private companies to provide insurance for both their Saudi and expatriate employees, and their dependants. Since September 2019, tourists must also purchase a Saudi government health insurance policy when submitting their visit visa application.

HEALTH SYSTEMS DEVELOPMENT Al-Tamimi

The Saudi government views healthcare as the sector with the best privatisation potential; consequently a restructure of the public sector is underway, through decentralisation and digitalisation initiatives, with the goals of increasing efficiency and reducing costs. Simultaneously, privatisation of public health services is ongoing, aiming to create a more competitive health care environment to attract investment and improve service delivery and outcomes. Saudi is seeking to make increased use of private healthcare provision and develop third sector organisations (such as charities and nongovernmental organisations) to cover gaps in the healthcare system. We have also seen a shift towards publicprivate partnerships (‘PPP’) and buildoperate-transfer (‘BOT’) contracts. An array of regulatory and legal reforms have been made in recent years to accommodate more foreign investment and PPPs. Of particular highlight is the 2019 Private Health Institutions Law, which newly permits foreign investors to own, operate, and manage hospitals and health centres in the Kingdom through PPPs and BOT models. While private sector contribution to publicly funded projects is not new within Saudi, it had traditionally been largely restricted to certain sectors, and not permitted in healthcare. Further, the MOH now permits foreign ownership of hospitals and medical centres, if certain foreign investment requirements are met. Additionally, in March 2021 the National Center for Privatization & PPP (‘NCP’) issued the regulatory base for private sector participation and PPPs in KSA - the Private Sector Participation Law and its implementing regulations (‘PSP Law’). The PSP Law aims to increase private sector participation in infrastructure projects and in the provision of public services to citizens and residents, through PPPs and the privatisation of public sector assets. All contractual relationships between the public and private sector that relate to infrastructure or the delivery of public services are covered by the PSP Law, if they meet the following parameters: 1. a term of five years or more; 2. the private sector’s obligations include two or more of the following types of work: design, construction, management, operation, maintenance or finance of the assets, whether those assets are government-owned, or owned by the

private sector party, or both; 3. there is quantitative or qualitative distribution of risks between the parties; and 4. payments owed by or to the private sector party are primarily performancebased. Another highlight of the PSP Law is that it permits international arbitration as a dispute resolution forum. One of the challenges to foreign direct investment in Saudi Arabia was typically that foreign parties were unable to subject their government contract disputes to binding international arbitration. The PSP Law allows PPP contracts to specify that disputes arising out of such contracts will be referred to arbitration. The Board of Directors of the NCP is specifically provided authority to: approve the inclusion of an arbitration clause in the PPP contract; enter into an arbitration agreement to settle an existing dispute arising from the PPP project; or approve the inclusion of an arbitration agreement or clause specifying a foreign law to be the governing law for the subject matter of the dispute. Vision 2030 & Healthcare Clusters At the backbone of all this reform activity is Vision 2030. In 2016, Saudi Arabia announced Vision 2030, which is an ambitious plan for reform across the Kingdom and seeks to create a more diverse and sustainable economy. The Vision 2030 strategic objectives include a

Christina Sochacki Senior Associate Al-Tamimi & Co

“Under these new models of care, it is anticipated that privatisation initiatives will be accelerated” number that are dedicated to healthcare, including targeting the privatisation of 290 hospitals and 2,300 primary health centres by 2030. Through the various Vision 2030 programmes, the Kingdom seeks to introduce new strategies to fulfill public health needs through insurance-based financing and increasing private sector participation. It is considered that there are a number of significant challenges in the Saudi health care system. The result has been an increasing healthcare budget and investment into the sector, including significant reform, following both regional and global trends. As part of Vision 2030 and the MOH’s Healthcare Transformation Strategy, the MOH is migrating all existing MOH providers into healthcare clusters, which will amount to approximately 20 - 30 geographically defined, vertically integrated, “Accountable Care Organisations”, serving around 1-2m people each. These clusters will be established as “corporatised” public bodies, with substantial and defined decision rights. This strategy was drawn widely from the NHS experience in corporatising public healthcare providers. Healthcare clusters have already begun issuing tenders and contracts for private companies to provide consulting services to assist the formation, management, and operation of these clusters and their facilities. The goals of decentralisation and clustering public health service delivery is to increase competition, transparency, and efficiency as health clusters compete with each other as well as the private sector for clients and health care professionals. Under these new models of care, it is anticipated that privatisation initiatives will be accelerated as the clusters will be encouraged to transfer the ownership, management and operations of their facilities to private companies, in due course. 13

Healthcare Regulatory Landscape Taking a step back, Saudi’s healthcare institutional infrastructure consists mainly of: 1. Ministry of Health – provides healthcare; promotes public health and disease prevention; develops laws and legislations concerning both the government and private sectors; regulates the industry, including monitoring the performance of health institutions; supports and conducts research; and operates healthcare academies 2. Saudi Food & Drug Authority – develops and enforces health standards to regulate the food and drug sectors, including the review, registration, classification, pricing, and monitoring of drugs, foods, herbal products, supplements, and medical devices 3. Saudi Commission for Health Specialties – ensures effectiveness of health practitioners’ registration and classification; sets controls and standards for the practice of health professions; promotes medical research and education; and supervises and develops professional development programs through coordination and partnerships with local and international institutions 4. Council of Cooperative Health Insurance (‘CCHI’) – oversees the implementation of comprehensive health insurance coverage, while supervising and controlling both insurance companies, and service providers 5. Saudi Health Council – liaises between the multiple health sector stakeholders in the Kingdom to: prepare and oversee the healthcare strategy in the Kingdom; issue relevant regulations to ensure that hospitals run by the Ministry of Health and other governmental agencies operate appropriately; and seeks to provide health services efficiently by eliminating duplication and waste, amongst other powers. Privitization Program Falling under Vision 2030, Saudi’s Privatization Program was launched in 2018 in order to identify government assets and services that can be privatised in a number of sectors, including healthcare. At the launch of the Privatization Program, the 14

Christina Sochacki Senior Associate Al-Tamimi & Co

“Already, we have seen the implementation of digitisation in the health sector and launching of a package of applications, spurred forward by the pandemic” Privatization Supervisory Committee performed a full scale study of the health sector, identifying nine different areas that would benefit from privatisation and/ or a public-private-partnership (‘PPP’). The areas include the development of: health centres; hospital operations; new medical cities; radiology services; rehabilitation and extended care; home care; laboratories; pharmacies; and health care logistics. The NCP was also established and is responsible for enabling the Privatization Program, including issuing regulations, creating the strategic framework for privatisation, and advancing the government assets and services earmarked for privatisation. As discussed above, the NCP issued the regulatory base for private sector participation and PPPs in KSA - the PSP Law. Other responsibilities of the NCP include tendering various privatisation initiatives including those for: the Saudi MOH; the Saudi Health Council; and the

King Faisal Specialist Hospital and Research Center. Below we highlight some of the recent tenders. Ministry of Health PPP’s PPP’s are one of the main pillars for driving reform in the Kingdom. The MOH has issued a number of opportunities through its PPP programme, charged with increasing private sector involvement in eight strategic areas: primary care; hospital commissioning; the construction of medical cities; rehabilitation; radiology; long-term care; home care; and laboratories. Ministry of Health Vision Realisation Office Through the MOH’s Vision Realization Office (‘VRO’), the following key programmes are underway: 1. Corporatisation of healthcare facilities – the transformation process intends to separate the service provider from the regulator. The vision is to provide healthcare services through a group of independent integrated healthcare enterprises. Each enterprise will provide comprehensive and integrated health services to certain population (Health Communities), against certain prices, and accountable based on specific indicators. Under the new system, independent state-owned enterprises would provide healthcare services, with the goal of then allowing MOH to focus on its core role of supervising, monitoring, and designing health policies

HEALTH SYSTEMS DEVELOPMENT Al-Tamimi

2. Private sector participation – this initiative aims to establish partnerships with the private sector for the financing of capital and operational projects and increase the role it plays in the development and management of health units. Current projects include one related to medical cities and another to radiology, as elaborated below 3. Health insurance and purchasing of healthcare services – with the primary objective of achieving universal health coverage, this new strategy for the health financing system in the KSA aims to introduce a Health Insurance and Health Service Procurement Program for: 1) strategic purchase of health care services; 2) evaluation of health cost-based risks; and 3) facilitating a restructuring of KSA’s network of healthcare providers 4. Health sector governance – as a result of these transformation programmes, MoH will have a redefined role as the sole policymaking / regulatory body in KSA and an opportunity to review the current governance arrangements across the healthcare system and design the future model. The initiative aims to develop a comprehensive healthcare governance system that would in turn improve sustainability, accountability, and transparency within the health sector 5. Workforce – the strategic planning under this initiative focuses on building the capacity and capability of the healthcare manpower and service providers in the Kingdom 6. E-health – the strategy aims to improve the efficiency and effectiveness of healthcare sector through information technology and digital transformation. Plans include setting up an e-health governance framework, a national health IT infrastructure, a Saudi network of telemedicine, adopting modern digital technologies to improve healthcare services, expand use of the Saudi e-Health Information Exchange, and others.

Health Sector Transformation Program: Launched in 2021 and established under the Kingdom’s Vision 2030, the Health Sector Transformation Program (‘HSTP’) was originally under the VRO of the MOH. Now, it has been established as a national programme with the goals of restructuring the Saudi health sector, ensuring continued development of healthcare services in the Kingdom, founded on the principle of value-based care. The programme also aims to facilitate the citizen’s access to free health and healthcare services and insurance by guaranteeing fair and comprehensive geographical coverage across all regions of the Kingdom, expanding e-health services and digital solutions, and improving the quality of healthcare delivery. Under its priority initiatives built upon the lessons learned from the pandemic is the national e-health initiative. Already, we have seen the implementation of digitisation in the health sector and launching of a package of applications, spurred forward by the pandemic. The National Platform for Healthcare Information Exchange Services (‘NPHIES’) was launched in January 2021 by the CCHI for a phased adoption by health insurers. NPHIES is set to become the only means of communication between payers and providers in respect of health insurance transactions. Further, the ‘Sehha’ app launched in 2017 to provide remote medical and preventive care to users; remote medical services were made available in 2019 for COVID-19 vaccinations, testing, and information through the ‘Sehhaty’ app; and the appointment booking application ‘Mawid’, launched in 2018, acts as the Central Appointment System for the MOH. Further, the ‘Wasfaty’ service was launched in 20201 and links hospitals and primary healthcare centers with community pharmacies, to provide electronic prescriptions. The HSTP will work on enabling comprehensive transformation in the sector

and its restructuring, adopting the principle of value-based care aimed at ensuring transparency and improving health services. The programme will focus on boosting public health and disease prevention, in addition to improving access to health services through optimal coverage, comprehensive and equitable geographical distribution, and expanding the provision of e-health services. Not-for-Profit Privatisation: Under the above-mentioned Privatization Program’s study, it was concluded that King Faisal Specialist Hospital & Research Centre (‘KFSHRC’) should be turned into a notfor-profit organisation working to advance specialised healthcare and medical research as well as enhance patient experience. In 2021 by Royal Decree, the centre was turned into an independent, non-profit institution, establishing it as a wholly independent financially sustainable and professionally governed entity, in line with Vision 2030 objectives. The road to completion of this transformation included corporatisation (completed in December 2021), operational transformation (ongoing, but expected to be completed in December 2023), and establishment of an investment arm to maintain revenue generation in the longterm. With the introduction of the concept on non-profit companies into the law in 2020, permitting them to operate as joint-stock or limited liability companies, and the inclusion of an enhanced §1. Concluding thoughts These reforms have opened the door to privatisation across the sector and we expect a rapid increase in private sector investment in Saudi Arabia. In the short term, PPP opportunities are likely to be focused on consultancies, construction, and operation of new facilities, with the privatisation of existing public facilities following later in the coming decade. Joint ventures in the private sector are also on the rise, with a number setting their sights on acquiring and developing facilities. Contact Information

www.tamimi.com

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Leading the debate in international healthcare

As the healthcare sector around the world evolves and adjusts to a ‘new normal’ post Covid, Healthcare World creates a new kind of business to support the international healthcare sector, international collaboration and the business of healthcare. To find out more contact Steve Gardner or Emma Sheldon MBE steve@thetradeagency.co.uk emma.sheldon@thetradeagency.co.uk Healthcare World is a brand name of The Trade Agency Ltd

HEALTH SYSTEMS Bevan Brittan

Emerging trends from Arab Health 2022 A Bevan Brittan webinar finds global healthcare has entered a new and exciting era, reports Fabian Sutch-Daggett

t is a relief that we are beginning to return to a sense of ‘normality’ after spending so long apart. Nevertheless, there is a palpable sense that things have changed and that the world has evolved without us. And this begs the

question, what has changed for the international healthcare market? After two years Arab Health returned as an in person event at the Dubai World Trade Centre, and the fast pace of innovation in the healthcare space was

clearly evident. As is often the way with such large exhibitions, there is always too much to take in at the time, so Bevan Brittan organised a panel with Healthcare World to discuss the main takeaways from Arab Health 2022. Hosted by Carly Caton, Partner at Bevan Brittan, with Andrea Tithecott, Senior Partner at Al-Tamimi, Isabel Arango, Regional Healthcare Principal Advisor in the Middle East for Mott Macdonald, Ahmed Faiyaz, Partner and Head of Healthcare for KPMG in the Lower Gulf, and Jyoti Mehan of Health Care First, the panel discussed their principal findings. 17

Main discoveries from Arab Health 2022 Despite the COVID regulations still in force, huge numbers of visitors arrived in Dubai for the biggest event in the healthcare sector. For lawyer Andrea Tithecott, it was a welcome change after the restrictions of the previous months. “We’ve been here throughout the whole process of lockdown, and what we’ve seen throughout the last year ahead of Arab Health, is a comprehensive opening up of the UAE to visitors, such as for Expo and Arab Health, and a huge number of international visitors who took the plunge. The government was also out in force, actively looking for international collaboration partners which is key to their strategy,” she said. Ahmed Faiyaz, Partner and Head of Healthcare for KPMG in the Lower Gulf, agreed that it was almost as if COVID had not happened at all. “I think COVID has really pushed forward the digital agenda,” he commented. “We saw a huge focus on digital, which isn’t new, on AI, and particularly so from the public sector. Many of the providers were focusing on coordinated care, changes in patient pathways, and using AI.” 18

It was clear that everyone had enjoyed meeting up again with colleagues and discussing the new era in person. “I took away a few things - for one, that Arab Health was open for business. The dialogue was much more welcoming than I had thought - very much about how we can work together, how we can bring different parts of the sector together, and how do we think about integration of care in a new way? That was very refreshing for me,” observed Jyoti Mehan of Health Care First. “It was wonderful to see so many familiar faces, and new faces too, some of them reuniting for the first time in years, and a great representation of the governmental entities, willing to entertain conversations on collaboration with the private sector,” Isabel Arango added. “One thing came up many times - efficiency, as a driver of healthcare, and the view of healthcare as an ecosystem as a whole, not just in silos of services and products. These were conversations which were very encouraging to hear.” Clearly, there are key factors here which have been widely recognised as emerging within healthcare - the push

towards digital healthcare, the broadening of different sectors within healthcare itself, the desire to get involved, and the interlinks which these different sectors can develop and share. However, what has actually changed within the international healthcare dialogue? “My reflection and what I’ve heard is again around integration, and it’s really interesting to see how learning in this area can be shared between providers and nations, and how this can be built upon in focus areas,” host Carly Caton reflected.

Carly Caton Partner Bevan Brittan

“There has been a firm realisation that not so much care needs to occur in acute settings, and that spaces can serve more than one purpose”

HEALTH SYSTEMS Bevan Brittan

Digital health driving change One thing is certain - digital is once again at the very forefront of the conversation within healthcare, perhaps exacerbated by the urgent need for digital solutions during the pandemic as it was often impossible, or at the very least highly risky, for patients to access their care in conventional ways. However, while we are now hopefully seeing the beginning of the end of the pandemic, the energy and drive surrounding digital innovation is not showing any signs of slowing down. “There’s a convergence of many of different industries, some not necessarily involved within healthcare directly, looking to see how they can improve the healthcare sphere, said Ahmed Faiyaz. “Globally, Amazon is a great example but, over time, we’re seeing a large uptake from non-healthcare organisations and the technology sector investing in startups and developing tools specifically for healthcare.” Ahmed noted that this drive towards digital healthcare is also being influenced by three main factors:

• Traditional public and private sector investment in solutions and apps for patient cohorts • Non-traditional organisations investing in healthcare • The start-up ecosystem and incubators The third point, he feels, is crucial, and developing in many areas of the world, not only the UAE. Firms operating within this start up ecosystem are either looking to access a target population, or harbour their business in a specific locale which is conducive to development growth for healthcare start up firms. Development of infrastructure Yet, with the enormous potential of digital health, what impacts does this have for physical healthcare infrastructure? For many years infrastructure existed as the predominant solution for fixing issues which arose within healthcare and healthcare populations, but again, the pandemic has forced a rethink. Now, we are seeing infrastructure itself become part of a larger pivot, and rather than existing as

a standalone fixture within the healthcare debate, it is becoming an integral part of a system of healthcare solutions for the modern age. “We are absolutely seeing a shift towards a more comprehensive integrated health system throughout all sectors, such as within education and research to actually make a difference within outcomes. We are also seeing a filling of gaps within healthcare systems, where before the pandemic it wasn’t necessarily evident before,” said Isabel. “Within the new ecosystem, and looking at healthcare as a whole, we’re beginning to ask the question of what are the right services to provide, not only what infrastructure do we need to develop.” “In terms of how the infrastructure will change, I think there are spaces which are new which have the capability to be more flexible. COVID came from nowhere and changed everything, and I think there has been a firm realisation that not so much care needs to occur in acute settings, and that spaces can serve more than one purpose,” commented Carly. Andrea outlined the many changes over the last 12 months within Dubai in regards to how the whole continuity and delivery of healthcare will work, First of all, the Dubai Academic Health Corporation, established last year, have already begun to outline their strategy. “The Chairman is Sheikh Ahmed bin Saeed Al Maktoum, and the Vice-Chairman is Sheikh Mansoor bin Mohammed bin Rashid Al Maktoum, so you have two senior Sheikhs of the Maktoum family heading up this initiative, which demonstrates just how important this is going to be,” she said. In conclusion, the pandemic has pushed the global healthcare sphere into a new and exciting era - with a strong focus on digital health, development of infrastructure, integration of systems and providers alike, and perhaps most importantly, improving patient outcomes. Detailing all of the knowledge and learning which occurred at Arab Health is an impossible task, but one thing is certain - international healthcare is in a stronger position than ever before. Contact Information

www.bevanbrittan.com

Is Population Health Management past its sell by date? Simon Swift, MD Methods Analytics, and Richard Oakley, Director of Data Science & AI at Methods Analytics, discuss the importance of including citizens in the data conversation

T 20

here are many fashions around healthcare at the moment. Many of them focus on smart services to provide personalised care, whether

they are clinical devices informing long term condition management or smart devices to provide health information for individuals. And as healthcare moves

out of formal settings and into homes, we need to look at how we identify individual health risks and how best to deliver this information to both citizens and health care professionals. There are hundreds of apps and services out there collecting data, but it’s often only used for the purposes of the app itself, rather than for a collective good. If the data is collated and aggregated then the bigger picture emerges, one that can be used for the benefit of individuals and systems. To a certain extent, I’m talking about what we call population health, because all roads seem to lead there. In my world of data analytics, we can aggregate

DIGITAL SYSTEMS Methods Analytics

Richard Oakley Director of Data Science & AI Methods Analytics

“Data from users can improve engagement and activation, and help people become proactive about their care”

the data from individuals to a group level (a geography or condition for example) so we can do the maths to understand factors that are predictive of good and bad outcomes,; then our data driven services can predict individual risk. Then at the individual level, identifying the predictive factors and advising, enabling, ‘activating’ people to engage in activities that will decrease the impact of a negative predictive factor and increase the impact of a positive predictive factor, changing the prediction. Understanding what interventions make a difference, and to whom – ‘impactibility’ is key here.

Accessing the data Through the pandemic, the general public have become more used to the idea of providing their data for the greater good. Whether it is logging a positive result on a COVID app or checking a box on a form to allow your information to be used, there is a sense that we all know how important it is. But again, this is where the problem can lie. How does the healthcare sector encourage more people to provide their data? The insurance market is testing this at the moment, offering devices such as Apple watches to incentivise individuals to monitor their health and also hand over their results. Some people are suspicious

of the motives, so the conversation we need to have is about the purpose of using their data. Is that purpose benign or malignant? If an insurance company is using that data to improve its service to you, to improve your health, that might be considered a benign purposes. If they use it to understand your risk profile, including your response to suggested beneficial interventions (exercise more, eat better, stop smoking….) so they can price your insurance accurately, you may think it is benign if your fee goes down. If their purpose is to understand who might be really expensive and deny them cover because they’re looking at the bottom line, then that purpose can rightly be seen as malignant. This kind of cherry-picking behaviour breaks the concept of risk pooling that underpins insurance. At Methods Analytics, we look at it from the data ethics angle. We have a fairly simple approach when anybody asks us to come and do something with data. First ask why? Why are you trying to do this? What is it going to achieve? What impact is it going to deliver to your organisation or the users? And the next question: is this technically feasible? Is the data available and can it be used in this manner? Once you’ve understood the intent and feasibility, the next question is the ethical one – “should you?” Is this specific purpose an appropriate use of the data? If we can’t answer those three questions satisfactorily, the work is not going to go anywhere. So what does a ‘healthy’ population look like? Data from users can improve engagement and activation, and help people become proactive about their care. We are currently working with an ICS to help them understand how to 21

link together data across disparate NHS and local authority entities so that they can build person-centric data models in order to understand the population at risk, to identify which interventions will mitigate that risk and to enable better targeted services to improve the health of individuals. We’re also working with a local authority looking at vulnerable children, understanding the risk to individual children and what interventions can be put in place to mitigate that risk and improve their chances of a successful placement or adoption. Again, it’s a population health approach by any definition, but not within the normal sphere of ‘healthcare’, more ‘care’. What about bringing these data together, adding in more data around small areas such as police data education data, benefits data in order to understand vulnerable adults, risk of violence, antisocial behaviour and so on. I would say this is all the same - mathematically it s. The purpose is to improve peoples’ lives and experience day to day just as much as a healthcare purpose is. It’s about improving an individual’s health and broader circumstance by using the data to create a personal risk profile, and identifying which mitigating actions can be taken to reduce the risk of a negative outcome. It’s driven by an understanding of data at group level: populations and geographies, then understanding that within any group there are cohorts of individuals with similar patterns, similar shapes, and they are likely to respond to similar types of interventions. I’ve always talked about population health management as a specific healthcare commissioning concept, but thinking about it more carefully, it is a general concept

about using data to predict risk and the impact of interventions for groups and individuals. The implications are clear for anyone looking after a group of people, whether it is an insurer, central or local government, a health organisation, a buyer or provider of health care, even the police, all of whom are in the business of gauging risk. The basic principle is using data to predict a specific risk and understand the impact of interventions on that specific risk, then to engage people, to activate them, and adopt those interventions. It’s by using data in this manner we can create not just population health but broad improvement in life circumstance and social value.

Engaging the public So everything boils down to a common concept: understanding factors about an individual and how they will respond to an intervention. This concept is not a special one that only works in the context of health. It works for understanding early years education, anti-social behaviour, anything where we can use data to predict. In health, the changes are ones that are largely down to individual. Outside of health the changes may well not be, but interventions at a group or geography level such as creation of green space or restriction of the density of fast food shops. Discussing these ideas and bringing people into the conversation about the use of data to improve our lives, individually and collectively is necessary if we are going to achieve meaningful change. The scope for benefit is enormous but we won’t achieve this if people are not bought into the way their data is a vital part of the approach.

Contact Information

www.methodsanalytics.co.uk

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Providing hollistic healthcare Sarah Cartledge discusses Nexus Digital Technologies and Palladion Rehabilitation Center’s new partnership with CEOs Mona Hayat and Katerina Karniadaki.

olistic practices and preventative treatments, is the future of healthcare rooted in millennium old practices? In a bid to promote wellness as a pretreatment to sickness, award winning Nexus Digital Technologies have partnered with Palladion Rehabilitation Center in Tripolis, Greece. The groundbreaking combination of these services provides a comprehensive, patient led service from prehabilition to rehabilitation with ongoing support to maintain a healthy society. Until now, many have not considered their health a priority, as it proves easier for people to be concerned if they get sick, rather than taking measures to maintain a sustained level of wellness. COVID-19 24

has given us the perfect opportunity to reflect on this standard, and Nexus and Palladion’s partnership offers an ideal solution to introduce complete support to patients throughout their wellness journey. Through a series of education, communication and accessibility, Nexus and Palladion aim to change the way we view our own health. The importance of wellness Mona Hayat created Nexus as a digital solution to the growing need for prevention treatments, and to empower patients to forge their own path to health via a personalised wellness journey through their app. “We don’t acknowledge enough that

we are burning out.” says Mona. A holistic approach to wellness is key to maintaining a healthy society, and accessibility to these services are vital. Through the Greek government’s healthcare support schemes, many locals are taking steps to better understand how to sustain their wellness with Palladion’s support. Companies based in Greece are also realising the benefits of sustained wellness, and are offering their employees access to these services too, promoting an ongoing focus on society’s wellbeing. Combining traditional Greek and Chinese

Mona Hayat CEO Nexus Digital Technologies

“We are completely equipping the patient to best understand the experience they are about to have”

HEALTH SYSTEMS Nexus & Palladion

in which patients are treated. It is utterly patient centred. So we’ve come together to do something that we feel is going to be very trailblazing.” Alongside their rehabilitation services, Palladion provides a head to toe overview of how to maintain wellness. Be it through acupuncture, hydrotherapy, reflexology or clinical intervention, teams of psychiatrists, psychologists and physical therapists work alongside clinicians to offer a full, human-centred approach. “We take into consideration the whole person and their lifestyles to find prevention,” says Katerina. Supporting the patient journey

medicines with state of the art Artificial Intelligence and scientific technologies, Palladion’s Preventative Rehabilitation Program - PreHab - model is exceptional. Katerina has designed a multilayered solution to multilevel illnesses, tackling mental and physical health simultaneously. “I was genuinely taken aback when I went to visit the Palladion centre in Tripolis,” she continues. “It is the best rehabilitation centre I’ve ever seen in my career. The thing that made it state of the art to me is it was less about the facilities and the way

Mona’s vision is to extend patient support by including Greek GP practices in the model so they can help their patients focus on wellbeing too. By pointing them to the Nexus platform, GPs can give people access to online health coaches and the whole Nexus community. By partnering with Nexus, Palladion are able to gain a picture of their next patient before they arrive. Surveys and remote patient monitoring help to tailor the services each patient will receive. Nexus also gives the incoming patient an opportunity to be socialised before their arrival, through access to services and by providing additional information to the patient. This does a great deal in tackling any anxieties. As Mona says, “We are completely equipping the patient to best understand the experience they are about to have.” Upon arrival, patients are treated to comfortable, styled rooms, exquisite menus and extraordinary views of the surrounding countryside. The intuitive therapeutic approach includes education about the history of wellbeing and teaches

Katerina Karniadaki CEO Palladion

“We take into consideration the whole person and their lifestyles to find prevention” patients to sustain their health, instead of waiting to be sick to become healthy. “What I love about the model Palladion has brought together is the seamless patient pathway it creates,” says Mona. Not only does Nexus support the patient journey, it also provides a peer platform to encourage trust and support in treatments throughout a wellness focused community. Recommendations are made and patients are able to safely discuss how effective certain treatments have been before pursuing them. Evidence-based data analytics provide Palladion with the tools to encourage other practices around to try a wellness -centred prevention model. “It’s the value system of really looking at the whole person,” Mona adds. Education and accessibility are critical for Palladion’s goals too. Being centred in a disparate country, mobile apps are essential to allowing all citizens access to a range of complete services wherever they are. Not only do apps increase accessibility, they also provide accurate information to patients through their journey to wellness, and reviews of available treatments. Katerina Karniadaki, is looking to further digitalise around the current offering to provide “fast, safe and global” services in light of patient needs following the COVID-19 pandemic. “Medicines cannot be outside of globalisation; we must combine our services for the good of society,” she says. As the cost of being unwell rises, it is essential we focus our attention on maintaining wellness before having to call on invasive medicines and expensive interventions. Contact Information

www.palladion-rehab.gr/en www.nexus-dt.com

Internationalising primary healthcare Sarah Cartledge discusses the importance of primary healthcare with Jyoti Mehan, CEO Health Care First Partnership

he UK’s National Health Service or NHS has often been a conundrum for international healthcare providers. They admire the concept of free healthcare at the point of delivery, but can misunderstand this complex organisation which is divided into 223 hospital trusts, 135 clinical 26

commissioning groups, 1300 primary care networks (PCNs) with around 10,000 general physicians known as GPs, and several other groups that oversee its work in different ways. So it’s not a model that is easily replicable, but it has more than 70 years of learning that can be adapted on a global level.

The first port of call in the UK is the general practice service, offering a care navigation system that can resolve varied issues without involving secondary intervention. But in many countries across the world, the cultural norm is to take any medical problem to a hospital where it can be dealt with, regardless of urgency. So in these countries, introducing the GP system could meet resistance through lack of understanding and a mismatch of system incentives. This is where Jyoti Mehan and her colleagues at Health Care First come in, offering a consultancy package for overseas providers that embraces the ethos of general practice while ensuring it aligns to cultural nuances and demographic requirements to enhance the provision of healthcare.

HEALTH SYSTEMS Health Care First

Jyoti Mehan CEO Health Care First

“Utilising digital integration, but not digital first, will enable a complete patient journey”

Patients and providers can understand the concept of family medicine, but it’s not always easy for onlookers to understand the concept of general practice and what it can deliver. “However, if you take it out of the prism of the NHS you can easily align it to an in-country structure to maximise its benefit,” says Jyoti. “If, for example, the first point of contact within a hospital looks like and feels like a hospital service to a patient but is in fact is what we call General Practice, then in this way it would integrate GPs without impacting people’s perceptions. So the learning is not to put the GP service where you think it should be, rather to allow people to follow their path and then build the pavement.” Digital integration

Sharing expertise Health Care First is an award-winning atscale provider of general practice, serving more than 32,000 patients across 7 sites in the north east of England. “We feel we can value by sharing our learnings, many of which have been achieved through trial and error and through circumvention,” says Jyoti. “As a result we can help create something fit for purpose, rather than copying and pasting the NHS model.” The organisation has a large team with a diverse background of clinicians and MDTs, along with skilled professionals in change management, operational model design expertise and digital transformation. “We bring industry expertise, international

expertise and first rate clinical expertise we can share,” Jyoti stresses. “Many of us have worked at all levels of the system commissioner, investor, provider, operator and regulator – so we understand how it works and where the challenges lie.” At the heart of their work lies the culture of putting the patient first. It may seem an obvious focus, but in such complicated systems the patient may not always be at the forefront of decision-making. “The core elements of patient care are agnostic. Other decisions need to be nuanced to country culture and region. Given our diverse UK population we are skilled to be able to unpick this and understand these very specific requirements and help shape something that’s fit for purpose.”

In regions or countries where healthcare organisation is in its infancy, there exists the unprecedented opportunity of building a system for current purpose and need which includes embracing digital through a complete digital healthcare system. “I would advocate a fully integrated digital model of primary care in the first instance, delivered in the hub and spoke model, because access is incredibly important,” she continues. “Facilities would need to be in key areas, enabling people to access them relatively quickly and linking into other providers including acute care and community services. This enables patients to access a service in the way they need to use it so they are not bouncing between systems or having to wait weeks when all they wanted was a blood test. “We need to integrate this concept into a bricks and mortar structure to provide a seamless user journey - either through walk-ins or as digitally-enabled rooms providing a cost effective service by accessing a wider workforce,” she 27

continues. “A patient could walk in and use a digital facility and if they need their bloods done they can walk out of that room and see a haematology assistant immediately.” In remote or large geographical areas, digital integration is the key. “Here the hub and spoke model works incredibly well alongside outreach programmes,” she says. “Even some of the most deprived areas have access to mobile phones, if nothing else. Utilising digital integration, but not digital first, will enable a complete patient journey. Some will have a phone in their community, others won’t, so bricks and mortar, supported by outreach teams becomes incredibly important to provide that journey.” Creating a care navigation system via digital integration can be a seamless option to streamline healthcare provision for all citizens. By providing it in a way that dovetails with other services, it can be integrated effortlessly into both new and existing systems. 28

Challenges and solutions However, there are outlying challenges that will inevitably impact any system. In healthcare, there is a workforce shortage and an increasingly transient workforce is looking to other countries for a better work/life balance. “But if that workforce challenge can be addressed through a combination of increased remuneration and integrated, digitally enhanced services, one could use a follow the sun type model,” Jyoti considers. “A workforce based in the UK could deliver UAE services, for example, if it can be financed and become operationalised. So there is a requirement to be creative with solutions and consider other professionals in end to end care.” Other key solutions include investing in prevention aligned to ease of access that will reap long term benefits even if they are not apparent now. In addition she feel pharma and

providers have to be better integrated with lower barriers without impacting the care/ cost dynamic. Leveraging learning from the best international experience will lead to the best systems for implementation in each scenario, and will shorten the time required for this implementation. Importantly, modelling access around patients will ensure uptake and use. “Where people use bricks and mortar, put the facility there,” she says. “If mobile works best, then use mobiles, but when you need both then implement both. Follow the patient path for success.” In this way the concept of family medicine delivered via primary care benefits everyone, from the patient themselves, to secondary care, the provider and the payor. Contact Information

www.healthcarefirst.co.uk

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

• • • • • • • • • • •

Design of new models of care Data simulation, analysis and evidence led consulting Clinical pathway design Operating model design Capacity planning and modelling Operational excellence and efficiency improvements Digital innovation in both services and facilities Business case and feasibility study development Estate masterplanning Impact assessments Infrastructure delivery

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

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Sharing health data with ease SNOMED’s standardised terminology allows for greater interoperability by achieving a single global language for health, says SNOMED International CEO Don Sweete

t the end of 2021, the European Health and Digital Executive Agency took a firm step towards increasing the semantic interoperability, re-use and the cross border exchange of health data. The European Union will provide its Member States with 60 per cent funding towards SNOMED International membership until 2027, via the European Health and Digital Executive 30

Agency (HaDEA). The goal of this initiative is to allow the residents of participating member states to easily access and share their own health data in their own language with healthcare providers as they travel in the European Union. According to the European Commission, the objective of the agreement is to facilitate the use of a standardised terminology to express clinical meanings

for clinicians and to benefit the citizens of the European Union. Founded in 2007 by nine charter nations, which has now grown to serve 42 members globally, SNOMED International is a notfor-profit organisation that owns and maintains SNOMED CT, the world’s most comprehensive clinical terminology. With more than 350,000 concepts, SNOMED CT is not just a coding system of diagnosis. It also covers clinical findings like signs and symptoms and tens of thousands of surgical, therapeutic and diagnostic procedures. Also within the scope of SNOMED CT are observables and those concepts representing body structures, organisms, substances, pharmaceutical products, physical objects, physical forces, specimens and more that are required to be recorded in or around the health record.

HEALTH SYSTEMS SNOMED

Don Sweete International CEO SNOMED

“It significantly contributes to our goal of a single global language of health and supporting patients and citizens to better manage their own health”

A common health terminology An important step toward building stronger, more resilient and accessible health systems, SNOMED CT also attempts to better manage the fragmentation and vulnerabilities of disparate health systems revealed throughout the COVID-19 crisis, according to SNOMED CT Expo 2021 Keynote Speaker Dr Andrzej Ryś, Director responsible for Health Systems, Medical Products and Innovation at the DirectorateGeneral for Health and Food Safety, European Commission. “There is currently a fragmentation of standards used to express clinical concepts, which hampers the semantic interoperability of health data sharing and the ability of the European health data space from reaching its full potential.”

One of the benefits cited in the agreement is SNOMED International’s approach to translation. Currently, entire or part translations of SNOMED CT are available in a number of languages and dialects, including United States English, United Kingdom English, Australian English, Spanish, Danish, Dutch, Lithuanian, Swedish and French. Translations in other SNOMED International Member countries and elsewhere are also in progress. Germany, which also became a member in 2021, has formed a working group that includes Austria, Switzerland and Luxembourg to launch a joint Germanlanguage reference translation of SNOMED CT. SNOMED International’s translation tooling can also be used to support

additional translations of SNOMED CT by member countries/territories or groups of members that share a common language. Ahead of formal membership by France, a collaborative group formed of representatives from France, Belgium, Switzerland, Luxembourg and Canada are working to develop a global French translation of SNOMED CT. SNOMED International CEO Don Sweete hails the agreement as a creative and effective approach to encouraging the adoption of a common health terminology across a diverse group of countries, each with its own language and degree of digital health readiness. To bridge implementation, countries adopting SNOMED CT are supported by SNOMED International’s implementation services and resources, easing the process of adopting the clinical terminology and optimising the benefits it offers. “This agreement falls in line with the SNOMED CT Case for Investment, which outlines why countries invest resources in the clinical terminology and how SNOMED CT meets the clinical terminology suitability requirements of the EU community,” he says. “Partnering with an organisation such as the European Health and Digital Executive Agency facilitates the adoption and implementation of SNOMED CT across Europe and it significantly contributes to our goal of a single global language of health and supporting patients and citizens to better manage their own health.” Contact Information

info@snomed.org www.snomed.org

Streamlining patient referrals Queensland Health is implementing a revolutionary referral system to support General Practitioners (GPs) with the most accurate, up-todate provider information for streamlined referral management

atient referrals are always a tricky issue to manage, even in the most developed health systems. It is all too easy for a patient to fall through the cracks, or for vital appointments to end up at the door of the wrong practitioner, or never at all. This is why Queensland Health, in partnership with NextGate and Alcidion, is developing a brand new referral system, known as iRMS (integrated Referral 32

Management Solution) to ensure the proper management of referrals, and streamline the process so that patients have access to the right care at the right time. Queensland is the third largest State in Australia with a population of just under 4.6m, while Queensland Health is comprised of 16 Hospital and Health Services (HHS). Under the Hospital and Health Boards Act of 2011, Queensland

Health is responsible for the overall management of the Queensland public health system. There are approximately 6,500 GPs working across Queensland as well as seven Primary Health Networks. Annually, Queensland Health providers receive nearly 2m referrals for outpatient services. However, ensuring that high-quality information was available in the delivery of care throughout the referral process was a continuous challenge for many years. NextGate’s market-leading technology in patient and provider identification connects the healthcare ecosystem to provide a complete and accurate record of care across the enterprise. Involved in managing 250m lives across the globe, NextGate’s Enterprise Master Patient Index (EMPI) is deployed by the most

HEALTH SYSTEMS DEVELOPMENT NextGate

healthcare for seamless data exchange, enhanced clinical decision-making, and better care collaboration. The Referral Service Directory In 2016, the then Minister for Health and Ambulances Services for the State of Queensland in Australia convened two summits with a focus of solving the challenges they were facing around patient waiting lists. The challenge was not only within the acute sector, but rather, the entire patient journey, all the way from General Practitioner (GP) referrals to outpatient appointments, and diagnostic procedures or any surgery and recovery. A strategy was developed in order to pinpoint the target areas which required attention, and they were found to be: • •

•

successful health systems, hospitals and HIEs. It helps organisations overcome the clinical, operational and financial challenges that result from duplicate records and fragmented information in

Andy Aroditis CEO NextGate

“We are delighted to support Queensland with an accurate, up-to-date RSD to give GPs and other providers timely, reliable access to referral information”

•

Funding for Hospital and Health Services (HHS) to provide more specialist outpatient appointments Empowering GPs to easily manage and track a patient’s referral with consistent referral standards and electronic referral management systems Providing GPs with a greater understanding of the specialties and services available to their patients from the local health service Providing patients with greater control over their healthcare through online booking systems Establishing or enhancing alternative models of care, such as allied health and telehealth, to provide patients in rural and remote parts of the state with access to services closer to home Enabling Queensland GPs to have access to real-time hospital information about their patient’s health and treatment needs

The programme was split into five projects and, as part of it, Queensland Health tried to find a solution which would not only be scalable at the state level, but also delivered in local care. Known as the Referral Service Directory or RSD, it provides accurate, timely information to GPs while allowing them reliable, up-to-date access to referral information for more informed decision making with enhanced workflows and increased patient and clinician satisfaction.

The solution is hosted in the AWS cloud environment. Integration was established with several national, statewide and GP systems to ensure data was available to be shared as part of the electronic referral process. At a state level, the partnership has seen NextGate’s Provider Registry software established as a centralised authoritative regional registry / index that is a source of truth for services, providers and systems that deliver health care across participating Queensland Health care providers, for example, specialists and non-specialist outpatient services. Creating a modern connected health system Queensland Health has confirmed it is committed to implementing Smart Referrals as an important step in digital healthcare and creating a connected, modern health system for Queenslanders. Now, NextGate and Alcidion are working in partnership with Queensland Health in order to deliver and develop this project, which has already seen great success. At present, 2m referrals are put through annually on the RSD, with more than 330 GP practices using the system, along with 9 hospitals and health services. Crucially, this system provides the link between the referral system at the GP practice and the speciality service provided by hospitals and acute services. The RSD harbours detailed information about each hospital and health service (disciplines, conditions treated, services offered and capabilities, location, etc.) to help GPs and their systems identify the most appropriate HHS to direct their patients. “Made possible through our partnership with Alcidion, we are delighted to support Queensland with an accurate, up-to-date RSD to give GPs and other providers timely, reliable access to referral information for improved clinical effectiveness and workflow efficiencies,” says NextGate’s CEO, Andy Aroditis. We believe this foundational capability will continue to deliver benefits to the delivery of healthcare in Queensland well into the future.” Contact Information

www.nextgate.com

Collaboration and opportunity in the Emirates The UAE is the ideal location for launching into global markets says Mazin Gadir, healthcare adviser and digital health expert

hanks to the impetus of the global pandemic, healthcare innovation is on a fast trajectory. The recent Arab Health exhibition in Dubai delivered concrete evidence of this swift rise, from health economics to the Metaverse to new ways of clinical care using AI. But one thing that is becoming clear is the need to link the best ideas together in a comprehensive solution that delivers integrated healthcare at a government level. For providers, the inherent problem with siloed solutions, even those that are interoperable, is the difficulty of choosing from so many ideas and taking a bet that they will work seamlessly from the start. And interestingly enough, I have observed a great deal of collaboration and consolidation. The Department of Health Abu Dhabi is focussed strongly on optimising and merging solutions such as personalised medicine solutions and technologies, digital twin AI, virtual metaverse, extended reality solutions, but they are focusing on big players within both the public and private sectors. So it seems that the market could be led by what the departments of health and the regulators feel is the best fit. This will give providers confidence that these solutions are fit for purpose and are backed by reputable industry leaders. Opportunities in the Middle East So where does this leave the smaller innovators who have created solutions to ongoing problems in healthcare services? It’s true that the Dubai health system is congested. But even so, there are opportunities for SMEs to fill in the gaps beyond the big players and find a niche for themselves. The most obvious one is that the Emirates is a perfect location to launch into global markets. Right now we’re seeing the Saudi health market opening up – this has huge potential and there is plenty of room for everyone. It’s an attractive market, especially now that they are trying 34

to push for more headquarters and regional head offices to locate there. The UAE itself is investing into Saudi, so there’s a huge amount of allowance for UAE-based companies to come in. Following on from Expo 2020 here in Dubai, it’s very probable that Expo 2030 will be in Riyadh, so the next eight years will be crucial in establishing in a presence in the Saudi market. The UAE is also becoming the gateway for the Egypt market which is growing very quickly. They have an enormous population and an increasingly wealthy middle class, so the opportunities here are potentially large. Many of these will be outside the principal cities so it’s very interesting indeed.

Mazin Gadir Healthcare adviser and digital health expert

“There are opportunities for SMEs to fill in the gaps beyond the big players and find a niche for themselves” And then of course there is Ethiopia, which has not been on the radar so far. It has a population of 100m and there is huge potential to scale up a lot of infrastructure and other investments. The UAE is also investing heavily in Ethiopia at the moment and many companies are following suit, so it’s one to keep an eye on. It’s an ancient kingdom and one that has always been connected to the Middle East by virtue of its location, so it has potential to be the gateway for Africa for this region. The UAE as a location Dubai has currently relaxed its visa rules for overseas nationalities as it becomes more business-focussed, so now is a good time to look at basing your company here. The health system is restructuring again and

the Dubai health portfolio is going to spin off into a new organisation called the Dubai Academic Health Care Corporation which will be the operator arm for its five hospitals and 20 plus clinics. They will also focus on academia by boosting the Mohammed bin Rashid University of Medicine and Health Sciences into a more active role as it focuses on medical education within the whole healthcare setting.

HEALTH SYSTEMS Mazin Gadir

The Department of Health Abu Dhabi is leading the way with a lot of initiatives and research, particularly focussing on AI and clinical trials with pharma companies. This year it had a huge presence at Arab Health and is taking the lead in many areas, despite the fact that the population is not as big as that of Dubai. But their funds are endless and they have more physical space so

they are becoming more business-friendly and allowing more people to settle. This openness will lead the way to new specialities taking root, such as elderly care and end of life care. Finally, the Emirates can also open up routes into India’s healthcare sector, given its proximity. In my opinion, India is the country to take digitisation to the next level. They have a successful tech industry

and they have been driving many digital solutions and initiatives in the past few years. So keep an eye out for the new unicorns coming out of India because there will be quite a few of them. Contact Information mazingadir@gmail.com

Treating cancer effectively with precision medicine COVID has caused a global backlog in cancer care, but CanCertain can help select effective treatments, Dr Himanshu Kataria, Founder and CEO, tells Sarah Cartledge

here are substantial amount of patients globally who have been unable to access cancer diagnosis or care since the start of the pandemic. As clinicians work to make up the backlog, they are being aided by huge advances by science thanks to personalised treatments and precision medicine. 36

Cancer testing such as that offered by CanCertain will soon deliver results based on drug sensitivity, immunity and drug resistance. Developed by Dr Himanshu Kataria in the north west of England, a test using 3D cell culture enables drugs to be tested for efficacy on a tumour sample taken via biopsy. By mimicking the natural

human body in a laboratory setting, cells grow and act as they do in the body and can be tested for their response to chemotherapy, immunotherapy and targeted therapy drugs. As cancer is a disease characterised by both a patient’s genetic makeup and that of the cancer cells within their tumour, it generally becomes more heterogeneous as it progresses. As a result, the tumour can include collections of cells with distinct molecular signatures and differential levels of sensitivity to treatment. Despite the development of newer targeted therapies, most cancer patients receive a ‘one-size fits all’ treatment plan because of systematic constraints in cancer treatment.

CLINICAL SERVICES CanCertain

Targeting the right treatment Currently observational trials are running at three UK hospitals in the north west: Wirral University Teaching Hospitals, Liverpool Heart and Chest Hospital and St Helens and Knowsley Teaching Hospitals. Interim results show CanCertain tests can significantly improve treatment response rates in lung cancer patients. Compared to the standard clinical pathway treatment response rate of 55 per cent, if patients had had a CanCertain test to determine optimal therapy, the response rate would have been 90 per cent. “CanCertain is not about finding a new cancer treatment; it’s about trying to match the cancer patients to the right treatment

based on a 3D cell culture of their own cells,” says Dr Kataria who conceived the idea when he was leading research for a clinical research network across 23 NHS organisations. “We are experimenting on the patient, but not the body.” For patients in an advanced stage of cancer, blood samples are taken to access the tumour cells circulating in the blood. “With our technology we find them in more abundance, so we take those circulating tumour cells and we treat them in 3D with different cancer treatments, which are all approved for that particular cancer, and discover which treatment is more effective.” The CanCertain tests also determine the patient’s immunity and drug resistance, which helps to understand how the tumour will react to a particular drug and whether some cells will be more sensitive than others. With a turnaround time of just 8 working days, the CanCertain personalised plan helps the patient begin the most effective cancer treatment quickly, thus increasing the chances of an early recovery. Currently it is only available to self-pay patients, but Dr Kataria’s vision is for every cancer patient globally to have the CanCertain test done before they start treatment. “Currently, 45 per cent of patients will not get a response to their treatment, and they’re at risk of side effects. And there is some early evidence that there might be a risk of the cancer worsening,” he says. “CanCertain removes the uncertainty surrounding the effectiveness of the therapy, reducing the need for multiple rounds of different drugs while safeguarding the patient’s immune system. It also reduces debilitating side effects and improves patient quality of life.” Cutting the cost Board member Dr Dorai Ramanathan, an oncologist based in Dubai, was one of the early investors in CanCertain. “It is very exciting as you are dealing with a real life situation in a 3D cell culture,” he says. “Instead of giving patients a cocktail of medicines we’ll be giving them the right medication and the chances of a better outcome will be much higher, rather than the current 30-40 per cent. We are waiting for it to become available in the UAE as currently the samples have to be flown back to the UK for analysis.” The company has a footprint in the UAE and also offices in India where there is

Dr Himanshu Kataria Founder & CEO CanCertain

“CanCertain removes the uncertainty surrounding the effectiveness of the therapy” considerable interest for different reasons. While cost saving is the main focus, in India the tests will enable more people from all levels of society to access effective care within a tightly controlled budget, and in the UAE it will reduce the number of patients sent abroad for specialised treatment. By eliminating the number of ineffective drugs that patients take before identifying the best course, the potential to reduce costs is clear. Insurance companies and payors are showing great interest in CanCertain, but more trials are needed before they can agree to include the treatment in their schedules. “We have spoken to one American insurance company and shown them how they will lose more than $8m just by standing still,” Dr Kataria says. “The cost of a failed first line treatment is around $49,500, so it is in the interests of the payors to have a better shot at success from the start. “CanCertain is a promising early stage technology, which requires further clinical validation for reimbursement,” he continues. “We are collaborating with the University of Manchester for developing that strong, robust validation. It needs to be proven within the structures, and those structures require a large amount of funding to actually deliver. “Currently, we are working on the basis that there would be patient recruitment for one year and there would be a fall off of one year. I should be able to deliver results within the span of two and half years to get to a stage where it is available to all patients.” Contact Information

dharmesh@cancertain.com www.cancertain.com

Expo 2020 Dubai The world’s greatest show comes to Dubai in October this year, discovers HW Editor Sarah Cartledge

xpo 2020 Dubai. Dubbed the World’s Greatest Show, 192 countries have confirmed their attendance at the first World Expo to be held in the Gulf, bringing the best of their region to celebrate with the best of the GCC. Open seven days a week for 173 days from 20 October to 10 April 2021, Expo 2020 Dubai will be an extravaganza of innovation, music, invention, food and drink from all around the world. Art, culture 38

and architecture will play an important part in this celebration of our differences, inviting us to know one another and our future aspirations as we move into the next decade of the 21st century. The World Expos are the oldest and largest international events, taking place every five years and lasting six months. The first World Expo was London’s Great Exhibition of 1851, devised by Queen Victoria’s husband Prince Albert and Henry Cole as a showcase for the emerging

inventions of the mid-century. The 1889 Paris show revealed the Eiffel Tower for the first time, while other landmark inventions on display at subsequent shows included talking movies in 1900 and in 1939 the television, along with Seattle’s famous Space Needle in 1962 and even Heinz’s tomato ketchup. Connecting Minds, Creating the Future Like these other great shows, Expo 2020 Dubai promises to deliver similar innovations under the theme Connecting Minds, Creating the Future. Held in one of the world’s most exciting cities, Arab-style vistas will feature throughout Expo 2020, including palm groves, jasmine trees, wadi

EVENTS Expo 2022

figs and desert scenery with shade provided by the canopies of the national tree of the UAE, the Ghaf tree. Underpinning the theme is the belief that innovation and progress are the result of people and ideas coming together in new and unique ways. For the first time in World Expo history, each nation will present its own pavilion in a unique way and elaborating on the subthemes of Opportunity, Mobility and Sustainability. The epicentre of Expo 2020 is Al Wasl Plaza with its shimeric dome. In September 2019, Al Wasl Plaza’s 550-tonne steel crown was positioned at the top of the jewel of the Expo 2020 Dubai site in a feat of precision engineering involving hundreds of onsite technicians. Named after the Arabic word for ‘connection’, Al Wasl Plaza is the iconic centrepiece of Expo 2020, hosting major ceremonies and celebrations during and after Expo. It will also be one of three venues able to accommodate up to 8000 people, alongside Forsan Park(2,500 people) and Jubilee Park (15,000 people). Healthcare will have its own arena in the Dubai Exhibition Centre, with a series of conferences, medical talks and events over the six months of Expo. The programme includes a Virtual Reality (VR) and Robotics Expo alongside paediatric, orthopaedic and surgery conferences, as well as events focusing on technological advances such artificial intelligence (AI), 3D Printing and wearable technology. Celebrating diversity The country pavilions promise innovation and imagination in their designs. Each centring around a plaza or town square, the pavilions will showcase issues such as the quest for sustainability in Brazil which has recreated the Amazon basin and highlighting the country’s rich diversity. The UAE pavilion, designed in the shape of a falcon in flight, will tell the history of the nation as a connected global hub. Inspired by a project by the late scientist Stephen Hawking, the UK pavilion highlights artificial intelligence and the space sector, featuring a continuously changing poem on its exterior generated by AI and visitor contributions. As part of the Opportunity section, the theme is Innovating For A Shared Future. Building on India’s heritage, the India pavilion will focus on the ‘new’ India and show the strength of its human resources and youthful aspiration. define the 39

country’s potential to become a global power through its ‘Five Ts’ – Talent, Trade, Tradition, Tourism and Technology. Food and culture will be the highlights of the pavilion, where the flavours and sounds of India will be bound to draw huge crowds to taste some of the region’s most famous dishes. Spain’s pavilion showcases the strengths of its ties with the Arab world, focusing on 800 years of Islamic rule in Spain during which architecture, education and literature flourished. Bahrain’s pavilion explores how its close ties with the sea has formed its culture and economy, encouraging trade, innovation and entrepreneurship. 40

Sarah Cartledge Group Editor Healthcare World

“Expo 2020 Dubai will be an extravaganza of innovation, music, invention, food and drink from all around the world. Art, culture and architecture will play an important part in this celebration of our differences”

EVENTS Expo 2022

The United Nations will have its own dedicated pavilion, providing the organisation with a unique platform to highlight to millions of visitors the value of working together to tackle global challenges and build a peaceful, sustainable and just future for all under the theme “We the Peoples: Shaping Our Future Together”. Its dedicated pavilion also forms part of its 75th anniversary celebrations, with UN

Day – held annually on 24 October – to focus on commemorating 75 years since the adoption of the UN Charter in 1945. District 2020 More than 80 per cent of the Expo-built structures will live on in the future city of District 2020. It will comprise 65,000 sqm of residential space and 135,000 sqm

of commercial space in a location that will be home to world-class innovation, educational, cultural and entertainment facilities. The Sustainability Pavilion will become a Children and Science Centre post-Expo. Many other major structures, including Al Wasl Plaza and the Mobility Pavilion, will remain as permanent fixtures in District 2020.

COLUMN Dr Patrick Wynn

Notes from a Modern GP

’ve been a GP for 22 years and involved in medicine for much longer. In fact, I always knew I wanted to become a doctor, but it’s true to say that the reality is very different from the dream. As students we knew about the long hours and the reams of paperwork, but the satisfaction of resolving a patient’s clinical conundrum was always the ultimate goal. As I get longer in the tooth, the healthcare sphere is changing. We’ve never stopped seeing patients at home or in the practice, but the consultation process is transitioning to a digital front end. With an increasingly ageing population living with noncommunicable diseases, primary care professionals are seeing more and more people, and this is where digital and telehealth comes in. Years ago you might queue outside the clinic from 8am and eventually see someone, but that queue is now a digital queue. You can text, email or consult online and wait for a call back - these are all new ways of queuing. What this system allows general practitioners to do is implement care navigation to get patients to the right person. This might not be a doctor but another health professional instead. I’m always glad to see my regular patients, but this way they receive a higher level of care. I’m a firm believer that you don’t need to see the same patient each time, as we can all add something to the medical knowledge of each individual. Having said that, we know that people feel reassured to see the same doctor when their issues are troublesome or worrying. So what exactly is a GP? In the UK NHS (National Health Service), a general practitioner is just that – someone who knows a lot about many things. We’re good all-rounders, where a specialist or consultant is an expert in their own subject. Yet there’s a tendency for some of the population to think that a specialist in hospital would be more knowledgeable. What they fail to realise is that

Dr Patrick Wynn

at a GP surgery we undertake front line assessment and management to deal with most conditions most of the time, and if needed we refer the patient to the right consultant. In this way, the specialist can concentrate on those who need their specialist knowledge the most. So GPs are actually are navigators and can direct care more efficiently. Our services deal with most other issues immediately closer to home. We have nurses and physiotherapists, phlebotomists, pharmacists and mental health practitioners – we can be a one stop shop without the hassle. In response to COVID our patients have adapted to the new digital front end very quickly and have confidence that our diagnoses are as good as they were fact to face. We still have the option to see people face to face if the patient wants it or if the doctor thinks it’s necessary. As people live longer and have more comorbidities, continuity of care is key. The role of GPs is to keep patients out of hospital by identifying their issues and keeping a close eye on them so they can live fulfilling lives without endless hospital visits. Clearly this isn’t always the case, but it’s a well-documented fact that humans respond to human kindness, which is what we always try to provide. It will take a while for everyone to understand fully the transition to digital and telehealth. But it will soon become clear that the adoption of the digital front end means that everybody can see the right professional at the right time in the right place. Dr Patrick Wynn is GP Partner at the Health Care First Partnership in West Yorkshire. Contact Information

www.healthcarefirst.co.uk

Accessing teenage mental health support on demand MeeToo enables young people with mental health issues to help themselves and help others, co-founder Suzi Godson tells Healthcare World Editor Sarah Cartledge

ince the start of the pandemic, mental health issues have become increasingly talked about. Recently there have been news stories about young people developing nervous tics since the advent of COVID, adding to the stress around their education problems as a result of school closures. Fortunately there is help at hand in the form of an app called MeeToo, developed by Suzi Godson and her business partner 44

Dr Kerstyn Comley. Suzi, the sex and relationships columnist for the Times newspaper, found her inbox increasingly filled with questions from teenagers who were either embarrassed or who wanted some form of distance while searching for answers to typical adolescent problems. “Young people tend to have all sorts of anxieties and we felt the best way to descale them was through interacting with peers in a safe environment,” Suzi says.

“I realised a long time ago that the best solution was a digital one where they can safely get advice, not from experts but from each other.” The MeeToo app allows them to talk anonymously about difficult things with other people of a similar age or experience. They can access help with their problems or use their experiences to support others. The app is a safe space where all posts and replies are checked before going live, so there is no harassment, bullying or grooming. Understanding the teenage brain Providing 365 day support, the app is beginning to remove the stigma around mental health issues that still prevents those suffering from seeking reassurance. “Teenagers use it anonymously so they

DIGITAL HEALTH MeeToo

feel safe yet in touch,” says Suzi. “All posts are moderated and if we feel there is a real issue we can intervene and ascertain what the situation is. Teenagers can tend to exaggerate, and it may be that a post which says the author is considering self-harming or suicide is just an way of expressing emotion rather than anything more serious.” Most importantly, it helps young people understand that their feelings and emotions are common in their age group. “There’s this sense that you’re the only one out there feeling this way and everybody else is different to you. And the great thing about support is that it normalises all sorts of stuff and helps them process what they are going through. It’s a way of deescalating their anxieties.” During lockdown Suzi and Kerstyn spent their time refining the app for its users.

They then decided to promote it via social media, as they realised that teenagers prefer to find their own solutions. “They want to remain anonymous so we have to reach them directly,” Suzi says. “By finding us in their social media feeds they can reach out to us with confidence. We also want to the app to be free at the point of use so that any young person can access it, particularly as we are trying to reach the most disadvantaged in society.” MeeToo has a team of trained moderators, counsellors and super-peers who provide psychological support. In addition, each new user becomes a new counsellor so the service is eminently scalable and instantly accessible in the hour of need. There are now 54 schools in the UK paying for the service, but according to Suzi, UK universities have proved more difficult to penetrate because they don’t actively engage with the students. Exeter University and York University are providing the service although it’s still hard to get the word out to the students that it’s available. “Every four days a university student dies by suicide, so it’s really important to let students know that help is easily accessible,” she stresses. At Exeter and Reading Universities a peer programme is in place where MeeToo trains psychology undergraduates and in return the students provide support to users for around four and a half hours. It gives the students hands-on training and they also receive course credits. Suzi is currently part of the Times Education Commission, looking at ways to improve schools and education. “The Times has been incredibly supportive and have done a great deal to promote us,” she says. Building the evidence base MeeToo was independently evaluated in 2021 by the Evidence Based Practice Unit. Founded in 2006 as a collaboration between UCL Faculty of Brain Sciences and Anna Freud National Centre for Children and Families, EBPU bridges cuttingedge research and innovative practice in children’s mental health. They conducted a study with 876 young people, and Suzi says they found statistically significant evidence that using MeeToo improves mental health, increases confidence and connectedness and decreases feelings of loneliness. “It also

Suzi Godson Co-Founder MeeToo

“Our insights are feeding into research we are undertaking with Bristol University and Sussex University, the aim of which is to build a state of the art suicide support system for young people” improves mental health self-management, so basically kids equip kids with the tools they need to manage their own mental health, making them feel more confident in their day to day life. “It’s really unusual to have that evidence base, particularly as there are so many apps out there and it’s difficult for people to differentiate between them,” she adds. “So we’re constantly building our evidence base and our data is what makes us really extraordinary because obviously we can see what’s going on with young people. “Our insights are feeding into research we are undertaking with Bristol University and Sussex University, the aim of which is to build a state of the art suicide support system for young people.” Suzi and her team have spent several weeks at Expo 2020, where MeeToo was supported by Expo Live with a grant of $100,000. “MeeToo has generated a huge amount of interest as peer to peer support is scalable, where individual counselling is just not financially possible for the amount of young people who need help,” says Suzi. “And we don’t have time to educate the educators about the importance of having automated mental health support. We run surveys and we know that 31 percent of our users have some form of disability - 16 per cent with autism and 18 per cent with ADD and many of them are in social care. So we’re reaching the really hard to reach kids which is our aim.” Contact Information

www.meetoo.help

Entering the UK healthcare market Sarah Cartledge speaks to Mat Oram, CEO of AdviseInc, about the challenges in entering the UK Healthcare market

he NHS or National Health Service is a daunting entity to approach within the healthcare market, especially for new businesses and organisations looking to enter the UK. As one of the highest civilian employers in the world with more than 1.7m staff, the NHS is truly a gargantuan organisation. The structure of the NHS makes it very difficult to understand for overseas organisations who often think it is one entity, whereas in fact it comprises 223 Trusts with their own individual procurement teams. Yet, getting into the market is not as difficult as it may first seem. Having the right people to guide you through the process is incredibly beneficial, and knowing where to start is the first hurdle. So where do you begin with the NHS? Do you approach a Trust, or do you approach individuals? Is it best to start outside the country and then move in, or get a foothold here first? According to Mat Oram, CEO of AdviseInc, the NHS has become simpler over the past few years. As a former NHS procurement expert, his company AdviseInc analyses data to benchmark pricing and is independent of both buyer and supplier, providing a clear understanding of how data can help everyone involved in the buying process and benefit from the healthcare system. Getting your foot in the door “If you’re a brand new entrant, it’s difficult for an organisation to break into a wellestablished market, so the approach has to be different, which is where we come in,” says Mat. “We would recommend having conversations with individual hospitals themselves to gauge the appetite for your product.” And it’s here that AdviseInc can help. Through their extensive procurement relationships they can identify the NHS Trusts that could be interested in a new product, picking up the phone to speak to the procurement team directly. Conversely, if there is little appetite in the UK for such a 46

product, AdviseInc can accurately identify this at an early stage, enabling businesses to either change their models for the UK market before too many costs are sunk. “By working through us, you may find that there is no opportunity for your product. That isn’t great news, but it would save you far more money by going through us to hear that than approaching the market through other channels,” says Mat. Like most things in life, it’s not what you know, it’s who you know. Unfortunately, this is all too often a killer for businesses looking to operate in every sector around the world. Thankfully, AdviseInc maintains strong partnerships with many procurement leads throughout the NHS, who are only too willing to discover new, exciting products and find ways of cutting unnecessary cost. “We know many Heads of Procurement very well, and if you’re looking to promote your product to a specific sector, we can easily broker a conversation between you and them,” says Mat. “Most of them are either looking for savings or for innovation, and in actuality, would be open to conversations with new suppliers. We can get suppliers to the people who will be able to make the buying decisions, or who can advise them on who to talk to next. “For more complex devices, we can identify the markets for them, ascertain the buyers, and locate the variations between products. For example, we can identify the different levels of technology

Mat Oram CEO AdviseInc

“We know many Heads of Procurement very well, and if you’re looking to promote your product to a specific sector, we can easily broker a conversation”

in a pacemaker, and the requirements for patients that need them - not all patients require the same products, which can be really beneficial for new entrants. “We can also identify through data which surgeons are fitting which devices, and in some situations, a ‘lesser’ product, may be perfectly adequate or even more beneficial than one which will cost the provider far more money.” Value-based procurement Then again, not every supplier is looking to sell the same product for a cheaper rate, or produce lesser products. As we are seeing now, and have been for many

HEALTH SYSTEMS AdviseInc

years, new methods of treatment, new pharmaceuticals, and new devices have been revolutionising patient care and patient outcomes. However, these breakthroughs, whilst medically fantastic, are often not easy on the wallet. Yet, if these treatments can deliver a higher standard of care, lower recovery times, or better patient outcomes, that is the ideal selling point for these products within the NHS. “Say, for instance, there is a long-standing procedure that needs to be performed on a patient, which requires a highly invasive surgery and a long hospital stay for recovery and monitoring. In addition to that, the patient will probably require a period of

convalescence after that. But what if a supplier has developed a new way of doing this procedure and the patient no longer has to go through a highly-invasive and potentially risky surgery, or even undergo general anaesthetic. However, this product costs 5 times more than the cost of doing it the old fashioned way, which produces just as good results, so why would procurers switch to this? “The answer is that now, the hospital can treat this patient as a day case without a week’s recovery in the hospital. The patient feels immediately better, and there is less risk of complication. At a patient level, they only end up with a small scar that can heal on its own, as opposed to a larger scar that

requires stitches. All these little things add up, and it can be far cheaper in total costs for the procurer to take the more expensive option.” Overall, targeting the UK market requires only a few things - the right product, the right target, and the right people. AdviseInc can help to identify all of those for suppliers who are looking to sink their teeth into the UK market. Contact Information

www.adviseinc.co.uk

What’s your score?

and therefore leads to disadvantageous insurance policies and biased financial restrictions.

Romano Toscano, CEO and Founder of MyLifeKit discusses the launch of LifeScore

A comprehensive score

s the world takes stock following the devastating impact of COVID-19, MyLifeKit Founder Romano Toscano believes a holistic overview of a person’s lifestyle wellbeing is essential. MyLifeKit’s new venture LifeScore hopes to provide just that via a numerical expression to identify risk. “Our vision is to use accessible information and technology to create a ‘LifeScore’ Society, leading to better lives for everyone,” says Toscano. 48

LifeScore has been created to provide individuals with an overview of, notably, their insurability derived from information gathered about their lifestyle choices. Since 1979, financial decisions have been based upon a credit score that in Toscano’s view doesn’t reflect the full reality. “This limited view on a person’s insurability is unfair, and often based on only partial information of an individual’s life,” he says. He feels that the current system is unable to provide a comprehensive risk profile of one’s lifestyle

LifeScore will merge health-related data and credit-related data to offer users a numerical expression of their life based on their physiological needs, health, and financial wellbeing. Consumers will use the MyLifeKit platform, LifeScore, to evaluate potential risks posed by unhealthy lifestyles and be presented with solutions to improve it. The service also has applications within the healthcare sector by providing healthcare professionals deeper insight into a patient’s lifestyle. It can also be applied in the insurance and banking sector, to help consumers with better

HEALTH SYSTEMS MyLifeKit

other factors, supported by data inputs and artificial intelligence. The result will allow people to take control of their life situation by comparing their score to benchmarks and by providing individual advice on how to improve the score and henceforth improve their lives. Collaboration with general practitioners will allow seamless LifeScore sharing between patients and healthcare providers, leading to greater insight into patients’ lives allowing general practitioners to provide better health care, early issue identification, and preventative medicine recommendations. It will lead to an improvement in job satisfaction by enabling general practitioners to practise at the top of their licence. It will also create an improvement in the economics, efficiency, and effectiveness of medical care processes, leading to a healthier patient base and increasing patient retention. LifeScore can help reduce the imbalance between the demand for, and capacity in, general practice. Working with inhouse experienced counsel to provide the best GDPR and data protection, “LifeScore will revolutionise the decision-making process for insurance firms,” states Toscano. “For example, in the USA it is not allowed to take medical data into a credit decision. We provide the indicators but for the USA we wouldn’t want to give that data away. The control should always be with the client- they should be the ultimate controller of their data. We call it ‘giving AI back to the people’.” So, what’s the score? access to credit and insurance coverage, as enabled by a positive LifeScore, similar to the way in which traditional Credit Scores usually work. More than 5m UK citizens have ‘thin’ or non-existent credit scores and almost a third of them are under 30. Those who have little to no history of handling credit are classed as unscorable or rejectable. Having a sparse record is no reflection of a consumer’s financial situation or risk. Furthermore, a bad credit score can impact an individual’s insurability indefinitely. LifeScore for healthcare LifeScore regularly calculates an individual’s score based on many aspects such as health, credit, surrounding factors, environmental aspects, global trends and

With the rise in popularity of monitoring services such as fitness apps and smart technologies, enriched data can be accessed to create a complete overview of an individual’s lifestyle. A recent report by IQVIA has found that there are more than 350,000 digital health apps available, with over 90,000 being introduced in 2021 alone. Across the pond, the US predicts there will be over 86 million users of health and fitness apps this year, and more than 100 million active Apple Watch users. These statistics show the willingness of people to keep track of their wellness through health, fitness, and financial monitoring. “Numerical signifiers have surged in popularity in recent years, and yet there is no offering which combines credit and health analysis into one simple score, LifeScore will answer that need” says Toscano.

Romano Toscano CEO & Founder MyLifeKIt

“Numerical signifiers have surged in popularity in recent years, and yet there is no offering which combines credit and health analysis into one simple score” The level of data available through a combination of these mobile apps will allow LifeScore to create a profile of a user’s lifestyle, based upon their behaviours. This user profile will be translated into a number, which will replace the credit score with a more fair, reliable, and well-rounded risk analysis of an individual’s habits. This number, in turn, will provide banks, insurance companies, mortgage brokers and comparison sites a ‘smart’ and accurate dataset reflective of multidimensional variables which are not currently considered. By using LifeScore, individuals will be able to check in on their lifestyle wellness as easily as they do their daily step count or sleep patterns. Essentially, users will receive benefits such as insurance premiums and financial deals, and the way an individual’s financial risk profile is calculated will be reformed. LifeScore is set to launch in June of this year, following a significant investment led by Egalify and its partnership with credit score provider TransUnion. “Our product will bring multiple benefits. Not only it will boost personal health awareness, but also flag potentially unhealthy lifestyles; thus bringing a revolutionary approach to medical prevention, by spotting diseases and life-threatening illnesses ahead” says Toscano. “Credit score starts when you apply for credit. Life score starts when you are born. It should be a holistic overview of someone’s life.” Contact Information

info@mylifescore.com www.mylifescore.com

Stemming the tide of infection Josie Winter, Clinical Operations Director at Advanced Clinical Solutions, discusses the importance of compliance in patient safety

egardless of the recent pandemic it has never been clearer that worldwide changes in terms of international healthcare standards should and need to be addressed. Whether it’s starting with infection prevention control or 50

health and social care, it’s never been more important. Advanced Clinical Solutions (ACS) is a team of highly trained health care professionals who are experts in patient safety, regulatory compliance and quality improvements. I’ve worked for the NHS

and for private healthcare organisations including a large corporate med-tech organisation. I’ve developed and delivered hundreds of clinical audits and quality improvement plans and trained thousands of healthcare staff in various clinical skills. We apply our extensive knowledge across a number of services, adopting a ‘seek first to understand’ approach to best serve our clients different demands, needs, wants and desires. Since attending Arab Health 2022 in Dubai, the impact of technology has become apparent to me, and I can see how shared resources could be achieved with an international guidance system in place.

HEALTH SYSTEMS ACS

Josie Winter Clinical Operations Director Advanced Clinical Solutions

“The key is always to review risk dynamically and make sure your standards are not just up to code but even better”

connecting on a social platform (visit us on LinkedIn). This will help us all progress as a community and effect global change. Sharing knowledge internationally

Achieving enhanced patient safety Our customers include nursing and care homes, private acute care and private clinics, universities and educational institutions, GP services, and legal and insurance providers. ACS strives to meet a level of competency across a multiple of services in any country. These include: • Preparing and suggesting audit levels (regulatory compliance) • Exceed standards for infection prevention and control • Training to enable you to retrain new

employees (train the trainer) • Leadership and coaching (as required) • FREE updates and our latest information I’m proud to say we’ve worked on several projects to ensure this goal, from film studios to local health authorities and beyond. In our experience the key is always to review risk dynamically and make sure your standards are not just up to code but even better. One of the best ways to do this is by sharing our networks - it can be sharing a business card at an event or even

Our goal is to further develop compliance at an international level, and we can achieve this collectively by learning and indeed improving from our global partners. As part of our brand ethos, it is vital that the patient should be and always is our number one priority. Following the impact of the pandemic and borders across many countries being reopened we’ve also learnt that the value of global reach is incredibly important. Being based in the UK with the ability to travel, we have learned the reach of the digital landscape, and we know by collaborating effectively there is a real opportunity to affect change. While face-to-face meetings are always constructive and important, as an international service provider we realise that virtual sessions can also achieve similar results in tandem with face-to-face interaction. Not only does this collectively reduce our carbon footprint but it has also proved to have higher engagement with an international audience. The most important piece in the jigsaw puzzle is the patient, who is at the heart of our work. By adopting compliant practices through clinical governance, education, learning and quality improvement, we can enhance patient outcome and ensure better environments for everyone. Contact Information

www.advancedclinicalsolutions.co.uk

Taking the path to savings with indoor wayfinding Chelsea and Westminster Hospital in London has found that digital wayfinding has improved both the patient and visitor experience, says Joe Fernandes, founder and CEO, BuzzStreets

ayfinding is the communication of information that helps people navigate from one part of a physical space to another part. Poor wayfinding can be a drain on hospitals. The hospital managers I have spoken to, in both the UK and Portugal, estimate the cost each year, for each hospital, to be more than a million euros, and the time lost, in aggregate, to be months of person-hours. When Wayfinding is working well it means: • • • • •

you know where you are you know where you want to be you have an effective route to your destination you easily recognise your destination when you reach it and you know how to find your way back.

When visiting hospital, patients and their families are often in a raised state of anxiety, leading many to misjudge journey times and struggle with signage and on-wall maps. More than 85 per cent of patients ask for directions when they go to a hospital or other public health facility, and 30 per cent of first-time visitors get lost. (Source: Deloitte Digital) Wayfinding systems can ease stress by providing easy-to-follow signage and legible

Joe Fernandes Founder / CEO BuzzStreets

“The advantage of indoor navigation apps is that the system can be much more than a reliable way of moving around”

directions. Currently, the navigational challenges presented by hospital sites are considerable as hospitals are often made up of multiple buildings that have usually been added to the original environment over time. Thus, moving among buildings can be tricky, and even the best static wayfinding systems can become undone by future decisions and actions (or inactions). How technology is changing wayfinding Global positioning systems are part of everyday life. Millions of people and vehicles are guided down roads and pavements every day by reliable digital navigation. It is an obvious next step to take this digital navigation indoors, enabling patients and other visitors to navigate from outside the hospital all the way to the specific location —whether that is a bed on a ward, a consulting room, the café, or the pharmacy. Essentially, technology can create a sat-nav for indoors, but unlike car sat-nav, the system is accurate to 1-2 metres as the ‘sensors’ are within the hospital (not 12,000 miles away in space). One example is the BuzzStreets Wayfinding system, already being trialled in a number of hospitals including Chelsea and Westminster in London. It is part of the CW Innovation programme (a joint initiative between Chelsea and Westminster Hospital NHS Foundation Trust and its charity CW+) to test and scale innovations and digital systems that improve patient care and experience. Chelsea and Westminster Hospital is a complex building with more than 6000 daily visitors, all with different needs at different times with different end locations. The app uses a system of Bluetooth low energy beacons, wi-fi signals, and the earth’s magnetic field to pinpoint the person’s location, giving them real-time directions, both spoken and visual, to allow them to navigate through the hospital, both horizontally and vertically. The app can personalise the route by choosing

the fastest or the least busy route, and avoiding stairs if required. The app also includes points of interest such as offices, cafeterias and, uniquely, more information about the Trust’s collection of more than 2000 works of art and digital installations that transform the hospital environment for patients, families, volunteers and staff. “The BuzzStreets pilot project has already shown that the app reduces frustration for staff and visitors alike. It helps reduce the anxiety of patients and visitors trying to find their way in the hospital, which previously required contact with multiple different staff. Overall, we’ve seen that the app helps save resources, improves patient outcomes, and enhances the entire hospital experience for patients and their families,” says Vanessa Sloane, Deputy Chief Nurse at Chelsea and Westminster Hospital NHS Foundation Trust. Wayfinding helps staff too Digital indoor navigation could also be a boon to staff. Research involving UK teaching hospitals looking at doctors’ expectations and experiences noted that many participants mentioned getting lost, with more than 50 per cent reporting becoming lost on the way to a crash call. These emergency situations mean staff are under time pressure and may be called to an unfamiliar ward. Thus when working on large sites, route optimisation should be a vital part of task prioritisation. Similarly, one of a hospital’s many responsibilities is the daily safety management of patients with mental health problems and diseases (Parkinson, circumstantial or profound amnesia, Alzheimer’s, etc.) who may become lost within healthcare buildings during hospitalisation. A digital navigation system that allows these patients to be tracked, and assists staff who encounter them to aid them back to their ward, can help ensure these patients do not miss out on the care they need. More than just A to B The advantage of indoor navigation apps is that the system can be much more than a reliable way of moving around. Other services—such as appointments, examination results, general hospital information, spaces available in the

DIGITAL SYSTEMS Wayfinding

parking areas—can also be incorporated into a single mobile application. BuzzStreets includes features such as a communication system between patient and doctor, the possibility of scheduling appointments, receiving medical scans and prescriptions in the app, heat maps, contextual notification, updated and edited locations, appointment reminders, and multilingual voice guidance. Additionally, the app allows for the collection of information to adapt the hospital to the flow of people who attend it, thus avoiding crowds of people in the same area. This data is also beneficial for facilities management: if a route is consistently busy or over-crowded, but another is always empty, steps can be taken to help change this either permanently or at specific times of day. According to a 2019 survey, 97 per cent of respondents felt that their NHS

room or ward (in England) was either very clean (69 per cent) or fairly clean (28 per cent) [Source: Statista]. A digital navigation system that gathers information about routes and traffic of patients and professionals can assist with a hospital’s cleaning and disinfection routines. This is achieved by identifying the areas of the hospital experiencing the highest levels of traffic, the type of traffic, and the dayparts where traffic is heaviest. Such information allows managers to organise cleaning staff efficiently and target areas requiring more frequent attention. Digital wayfinding systems can also allow staff to trace equipment that is regularly moved around a hospital (e.g. wheelchairs) thus avoiding time wasted searching for them, or considering an item lost so a new one is ordered. With this knowledge, it is much easier to ensure that the experience for everyone

(staff, patients and visitors) is smoother, easier and more efficient. In turn, this information results in financial savings. Conclusion Many times each day, doctors, nurses and assistants are stopped (and therefore delayed) by visitors asking for directions, and patients are often late for appointments as they are lost within the hospital. With financial and resource management implications, digital indoor navigation is an important step forward in saving hospitals time and money. Contact Information

www.buzzstreets.com

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Healthcare World Magazine | Issue Four

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Emerging trends from Arab Health 2022

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Arab Health 2022: Jumeriah Beach Hotel Dinner

The privatisation of Saudi Arabia’s healthcare system

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