Healthcare World Magazine | Issue Two 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 Two | Autumn 2021

The Future of Global Healthcare Post Coronavirus What next?

Sponsors of the Healthcare World Festival November 2021

HOW TO DIGITISE YOUR HEATH SYSTEM | UHC AND THE WORKFORCE CRISIS | THE NEED FOR A GLOBAL CLINICAL STANDARD

Dubai: A Destination for Health Investment

Contact:

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

EDITOR’S WELCOME

Welcome to Healthcare World

elcome to Healthcare World 2, or HWF2 as we like to call it. We’ve all come a long way since the last edition, Healthcare World as a Festival and as global nations handling a pandemic. We’ve had to grow and learn daily, taking on board the opinions of those who are dealing with their own version of the COVID reality as it moves into the second year of its allconsuming presence. We’re coming to terms with the fact that there’s a global division between the ‘have-vaxxes’ and the havenots. While we can accept it’s a little like the aircraft safety instructions – make sure you have put on your own lifejacket before you help others – we need to step up to the reality of the situation. And in many ways we have. The plethora of digital innovation and its uptake is on a scale previously inconceivable. We now understand the potential and limits of digital healthcare and we examine this in our first Festival session with esteemed speakers including Dr Nicholas Crisp, Deputy Director General, National Health Insurance, South Africa Department of Health, the Rt Hon Stephen Dorrell, former UK Secretary of State for Health, Jim Campbell, Director of Workforce WHO and Alistair Grenfell, President of Europe, Middle East, Africa and South Asia, IQVIA, who are kindly sponsoring HWF2. Our digital session – How to digitise your health system – brings together a wealth of expertise from this sector, including Nic Fox, Chief Commercial Officer at NHS Digital, Niti Pall, Head of Universal Healthcare at KPMG, Simon Swift of Methods Analytics, Elliott Engers of InfinityHealth, and Dr Anushka Patchava of Vitality Health, Expert Adviser on Artificial Intelligence and Blockchain to the United Nations. In a fascinating article for Healthcare World, Iqvia’s Alistair Grenfell examines how the pandemic has changed the face of healthcare for the good. Healthcare and data will finally be united, underpinned by technology, but public and private bodies will need

Sarah Cartledge Group Editor to communicate effectively to maximise the benefits of digital advancements. We’re looking at opportunities in Dubai with experts including Mawan Abdulaziz Janahi, MD of Dubai Science Park who has played an instrumental role in establishing Dubai Science Park as the region’s leading community for scientific research and innovation, attracting more than 400 companies and strengthening partnerships among corporations, universities, and communities. Also speaking are Andrea Tithecott of lawyers Al Tamimi, based in Dubai, and Isabel Arango from healthcare and infrastructure consultants Mott Macdonald. Our US session with CSSi Life Sciences outlines the routes to market for companies wishing to enter the US. As Ernesto Chanona explains, there are many regulatory and legislative components, and having US partners can really expedite the process. Consultant and former Medicaid Director for New York State Jason Helgerson is a luminary in healthcare solutions. In an fascinating feature for the magazine he outlines his belief that healthcare is going “Back to the Future”, as it bases itself back in the home with the help of digital technology. The economic impact of the pandemic and the restrictions on travel have added to the global workforce scarcity. Our experts will be looking at the reality of the situation and how governments can use new initiatives and technology to overcome the current difficulties. We also looking at the need for global clinical standards that can bring together all the learnings and enhance medical care for the whole global population. By achieving these standards, we could be well on the way to achieving UHC or Universal Health Coverage, giving all citizens equal opportunity to the best solutions and practices in healthcare today. We look forward to welcoming you to our sessions and to hearing your views. We’ll be writing regular updates on the Festival so please contact me if you would like to comment or write an article for the magazine. Email: sarah@thetradeagency.co.uk

The Healthcare World team

Steve Gardner

Sarah Cartledge

Emma Sheldon MBE

Joe Everley

Emma Williams

Fabian SutchDaggett

Ritu Chopra

Managing Director

Campaign Director

CCO & Head of Consultancy

Designer

Operations Manager

Website Editor

Business Development Manager

Contents 3 5 8 12

Healthcare World Magazine | Issue Two

Editor’s Welcome Healthcare World Festival II - Sessions Healthcare World Festival II - Speakers The astonishing speed of pandemic healthcare innovation

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

20 22

Meeting consumer expectations in a hybrid health IT landscape

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

Back to the future?

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

Streamlining hospital processes

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

The International Affiliate Network – a pathway to better patient care

Sarah Cartledge speaks to Alistair Russell, Head of Business Development at Imperial Private Healthcare about their latest venture to ensure better patient experience

Entering the UAE market

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

Meeting the unmet need

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

Developing stronger global health systems post-pandemic

Healthcare World’s Fabian Sutch-Daggett previews Health Education England’s revised strategy

26 4

The urgent need for vaccine parity

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

Emma Sheldon - Time to consult

FESTIVAL SESSIONS

Our Sessions & Speakers Global Healthcare Post Coronavirus – Opening Session Tuesday, Nov 2, 2021 This session will bring together system leaders from across the world to discuss the ways in which the pandemic has changed the delivery of healthcare and how our priorities need to look in 2022 and beyond.

Alistair Grenfell

Jim Campbell

Dr Nicholas Crisp

Ben Furneaux

President, Europe, Middle East, Africa and South Asia, IQVIA

Deputy Director General, National Health Insurance, South Africa Department of Health

Preetha Reddy

Chair, Apollo Hospitals, India / Global

Director of Health Workforce, World Health Organisation

Senior Director and Board Member of CIMS DIFC, Cigna

Stephen Dorrell

Former UK Secretary of State for Health

Vincent Buschemi

Partner and Head of Independent Health and Social Care at Bevan Brittan

How to Digitise your Health System Wednesday, Nov 3, 2021 Launching the Healthcare World Special Edition ‘How to Digitise your Health System’ in association with NHS Digital, HealthTech UK and the Trade Agency. This session looks at the timeline of an individual and the interaction with their health system. It examines where and how many opportunities exist for digital innovation, where the touch points are, what is in development and what is in the future? How do data and digital infrastructure effect and underpin our healthcare, and what are the overarching ideas and systems that make our systems work? Wherever we are in our experience and requirement of healthcare, is there an app for that?

Russell Mayne

Nic Fox

Dr Niti Pall

Dr Anushka Patchava

Dan Cidon

Dan Morris

Healthcare Field Director, Dell Technologies

Head of Universal Healthcare, KPMG

CTO and Co-Founder, NextGate

Simon Swift

Managing Director, Methods Analytics

Chief Commercial Officer, NHS Digital

Deputy Chief Medical Officer, Vitality, Expert Advisor on Artificial Intelligence and Blockchain to the United Nations

Partner and Digital Health Co-Lead, Bevan Brittan

Elliott Engers

CEO and Co-Founder, Infinity Health

Abhi Shekar

Digital Healthcare Lead, Mott MacDonald

The Need for a Global Clinical Standard Wednesday, Nov 10, 2021 How do we compare the standards of healthcare globally? What are the differences in the type, quality and cost of healthcare in different health economies around the world or even within an individual health economy? Where offers the best clinical outcome? The lowest readmission rates? In an increasingly data driven global healthcare economy do we need a way of comparing the data and quality of our healthcare around the world. This session asks, and hopefully answers that question. Brian Niven

Emma Sheldon MBE

Dr Alok Khullar

Jyoti Mehan

Alf Theodoru

Simon Swift

Carly Caton

Josie Winter

Healthcare Advisory Lead, Mott MacDonald

Chief Executive Officer, Gleneagles Global Hospitals

Founder and Chief Executive, NewCourse

Partner, Bevan Brittan

Consultant and Former Specialist Lead of the NHS Export Collaborative Project at Healthcare UK

Chief Executive Officer, Health Care First Partnership

Managing Director, Methods Analytics

Founder and Clinical Director, Advanced Clinical Solutions

Ged Byrne

Director of Global Engagement, Health Education England

International Opportunities in the US Healthcare Market Tuesday, Nov 16, 2021 The USA is one of the world’s biggest healthcare markets and yet it is beset with problems. From the inequities of the current payor system to the massive changes taking place because of the affordable care act. The USA ranks bottom of the Commonwealth Fund report into developed health systems and yet has one of the highest per-capita spends. The global healthcare community is keen to help and the USA is keen to listen.

Ernesto Chanona

Jason Helgerson

Mat Oram

Jennifer Catalano

Shahab Fatheazam

Michael Hanson

Director of Business Development, CSSi LifeSciences

CEO and Co-Founder, AdviseInc

Vice Chairman of the Global Healthcare Group, Lincoln International

Founder, Helgerson Solutions Group, Former Medicaid Director for New York State

International Trade Analyst, US International Trade Commission, & Former Scientific Reviewer at US Food and Drug Administration

Supply Chain Professional, Johns Hopkins Medicine

FESTIVAL SESSIONS

Opportunities in Dubai Wednesday, Nov 17, 2021 Sponsored by the Dubai Health Authority, this session brings together providers investors, suppliers, insurers and regulators from across the Dubai health economy to examine the future of healthcare in the Emirate. Andrea Tithecott

Partner, Head of Regulatory and Head of Healthcare, Al-Tamimi

Marwan Abdulaziz Janahi Managing Director, Dubai Science Park

Isabel Cristina Arango Mott MacDonald

Universal Health Coverage and Workforce Thursday, Nov 18, 2021 Universal Health Coverage and the global healthcare workforce crisis - where has coronavirus left us?

Jim Campbell

Ged Byrne

Charlotte Refsum

Alastair Currie

Alistair Russell

Richard Foty

Director of Health Workforce, World Health Organisation

Associate Director, KPMG

Director of Business Development, Imperial Private Healthcare, Imperial College Healthcare NHS Trust

Director of Global Engagement, Health Education England

Partner, Bevan Brittan

Assistant Professor, Translational Research Program, University of Toronto and CEO of HealthEdge Innovations Inc.

Anthony Huszar

Global Health Security Lead, Mott MacDonald

Healthcare World Festival 2021 - Our Speakers

Abhi Shekar

Alastair Currie

Alf Theodorou

Abhi is passionate about using digital, data and technology to transform health and healthcare service delivery. He has designed digital hospital, digital strategy development and implementation, operating models, business cases and systems implementation, and has worked with a range of healthcare organisations in the UK and Australia.

Alastair is a Partner in the Employment and Pensions Department, advising on a wide range of contentious and non-contentious employment issues. He advises on matters in Tribunals, the EAT, appeal courts and civil courts, usually defending claims for unfair dismissal, discrimination and breach of contract.

An international healthcare specialist with a background in epidemiology, Alf has worked with 210+ hospitals in 40+ countries, developing protocols to benchmark facilities using recognised international standards, key clinical outcomes and patient experience. He is a Fellow of the International Society for Quality in Healthcare (FISQua).

Alistair Grenfell

Alistair Russell

Andrea Tithecott

Alistair Grenfell is responsible for Iqvia’s operations in the UK&I, Northern Europe, France, Spain, Portugal & Turkey, Germany & Austria, Switzerland & Israel, Italy & Greece, East Europe, Russia & CIS and Africa, Middle East & South Asia.

Alistair is passionate about unlocking commercial value from NHS intellectual property. He leads business development for Imperial Private Healthcare (IPH) and the Trusts emerging International Partnerships business in education and consulting services. In 2019/20 IPH generated over £25 million for the NHS.

Andrea Tithecott established Al Tamimi’s regional Regulatory Practice leads the firm’s Healthcare sector group. Her healthcare practice focuses on health sector facilities, healthcare regulation advice, pharmaceuticals, life sciences and biotech advisory services. She is a member of the UAE-UK Business Council Healthcare Working Group.

Anthony Huszar

Dr Anushka Patchava

Ben Furneaux

Anushka has launched new health solutions and propositions across global markets. She holds an advisory position at World Economic Forum as a Healthcare Expert, is Head of Health Technology at the United Nations (CEFACT), and is on the Editorial Board of Blockchain in Healthcare.

Ben Furneaux is responsible for building new strategic opportunities for Cigna International Markets in the ME region. Ben’s experience of developing sustainable joint ventures, partnerships and being seconded into a majority-owned government business as it privatised, brings a unique perspective on making PPPs successful and sustainable.

Dr Anthony Huszar is a public health professional, specialising in health systems strengthening. He previously led the UK Government’s Fleming Fund programme in South East Asia. Anthony has worked on preventative health strategies, task-shifting and digital health initiatives, seeking other ways to circumvent the human resource challenge.

SPEAKER PROFILES

Healthcare World Festival 2021 - Our Speakers

Brian Niven

Carly Caton

Charlotte Refsum

Brian has over 20 years’ experience of working in healthcare consultancy, prior to which he worked within the NHS in information analysis roles. With a background in operation research, Brian has a keen interest in the use of data and metrics to inform policy and decision making.

Carly is a lawyer specialising in commercial and contractual healthcare matters. She leads Bevan Brittan’s international healthcare practice and works with NHS and independent healthcare providers (and suppliers to the healthcare market) on projects both in the UK and globally.

A former GP, Charlotte is Healthcare Executive to the Global Chairman for Healthcare, Government and Infrastructure at KPMG International, during which time she launched KPMGs Global Workforce Proposition for Healthcare and Government, and co-authored a book on the global workforce crisis in healthcare.

Dan Morris

Dr. Dan Ober

Daniel Cidon

Dan is an experienced healthcare litigator with a particular focus on emerging clinical risk and safety issues in digital health and social care, AI and med tech. He advises start-ups, SMEs and established corporate providers on liability exposure, indemnity arrangements and other dispute issues.

Dr. Ober is responsible for the development of innovative, effective and cost-effective clinical strategies, wellness initiatives and quality medical care products and services to enhance the health and well-being of Cigna’s globally mobile population. Dr. Ober also leads the clinical and strategic leadership of Cigna’s Key Global Accounts.

As CTO and co-founder of NextGate, a global leader in enterprise health data integration specialising in patient ID matching, Dan leverages technology to turn problems into opportunities to make a difference. He is responsible for shaping NextGate’s long-term technical vision and turning emerging technologies into leading-edge solutions.

Elliott Engers

Emma Sheldon MBE

Ernesto Chanona

Elliott co-founded Infinity Health in 2014 to make task management safer and more efficient whilst improving clinicians’ experience of their crucial, high-pressure roles. He brings his technical knowledge and skills to deliver a platform to improve the experience of every member of health and care staff.

Emma has built businesses internationally and led cross-functional teams in marketing, sales, operations and research and development and has led M&A activity. She participated in a management buy-out of a global healthcare manufacturing business in 2015. Now she helps business owners to realise their growth ambitions.

Ernesto Chanona focuses on helping national and international companies obtain FDA approval, find venture capital funding and enter the US market. To support international companies, he fosters strategic partnerships with innovation hubs, international trade organisations, academic researchers, NGOs, and entrepreneurs.

Healthcare World Festival 2021 - Our Speakers

Professor Ged Byrne MBE

Dr Ibtesam Al Bastaki

Jason Helgerson

Professor Ged Byrne is responsible for the enhancement of the NHS workforce through engagement with countries within and outside the EEA. A surgical oncologist, he is a Professor of Medical Education at the University of Manchester and an honorary Professor of Health Sciences at the University of Salford.

Dr Ibtesam Al Bastaki is responsible for the development of various health projects within Emirates of Dubai. She leads, advises and guides to ensure a proper holistic expansion in healthcare industries within UAE. She also initiated the healthcare investment strategy, adopting a PPP concept in healthcare.

Jason, a nationally recognized leader in health care & delivery system reform, believes in new, innovative approaches to solving complex problems in health and social care. He leads the firm’s portfolio of venture capital and private equity advising, as well as engaging in international comparative work.

Dr Jennifer Catalano

Jim Campbell

Josie Winter

Dr Catalano is a scientist, international trade analyst, adjunct professor in business and analytics, and non-profit adviser. She was a scientific reviewer at the U.S. Food and Drug Administration (FDA) for 10 years. Currently, she is an analyst at the U.S. International Trade Commission.

Jim Campbell oversees the development and implementation of global public goods, evidence and tools to generate investments in the education, employment and retention of the health and care workforce in pursuit of global health security, universal health coverage and the Sustainable Development Goals.

Josie holds an MSc in Infection Prevention and Control and lectures for the University of Lincoln on Infection Control related issues. She is a Scientific Advisor for BICs (British Institute of Cleaning Science) and has recently worked as an IPC Consultant for Netflix.

Jyoti Mehan

Marwan Abdulaziz Janahi

Dr. Mohamed El Sahili

Jyoti Mehan has 13 years’ experience in healthcare consulting, including working across government organisations to agree system-wide policy and protocols, working with commissioners and providers, designing and delivering complex programmes of work. She is tasked with ensuring that expertise is integrated across the wider system.

Marwan Abdulaziz Janahi has played an instrumental role in establishing Dubai Science Park as the region’s leading community for scientific research and innovation, attracting more than 400 companies and strengthening partnerships among corporations, universities, and communities.

Dr. Mohamed El Sahili is CEO of the SF Group of companies comprising Medland Health Services Zambia, the first hospital in Zambia to use cutting edge techniques and latest equipment in the medical sector. A doctor by profession, he also serves on healthcare, business and sporting Boards for Africa.

SPEAKER PROFILES

Healthcare World Festival 2021 - Our Speakers

Mat Oram

Nic Fox

Dr Nicholas Crisp

Mat is a business intelligence / procurement leader with 16 years public/private and outsourced procurement experience across all levels of business. He works with clients to help solve their commercial, procurement, actionable insight challenges, using stakeholder engagement, strong analytics and industry experience to deliver transformational change.

Nic leads the NHS Digital commercial and legal function which specialises in digital and technology procurements, and commercial and market management. He has led major national digital programmes with a range of technology suppliers, and the programme to establish NHS Digital as a new statutory organisation in 2013.

Dr Crisp is a public health specialist, having worked in several African countries including South Africa, Nigeria, Ghana, Lesotho, Botswana, Namibia and Tanzania. He led the establishment of the National Health Laboratory Service, the South African Health Products Regulatory Authority and the creation of the Forensic Pathology Services.

Niti Pall

Simon Swift

Stephen Dorrell

An expert in primary care, healthcare funding and diabetes, Niti has pioneered a number of major innovations. A leading thinker, she holds senior roles with AXA and KPMG, is the Chair of IDF Europe and sits on a number of clinical and startup Boards.

Simon is focused on improving the use of information so decisions are based on evidence rather than anecdote and whim. His domain knowledge covers healthcare policy, data and the healthcare information landscape together with clinical practice, developing meaningful intelligence to enable understanding, debate and change.

Stephen is Executive Chairman of Public Policy Projects and was Secretary of State for Health from 1995 to 1997. He was the first elected chair of the House of Commons Health Committee, developing the role of the Committee as an authoritative cross-party voice on health and care policy.

Steve Gardner

Suneeta Reddy

Vincent Buscemi

Steve has been a specialist in the development of opportunities in the international healthcare space since 2010. He helped created Healthcare UK’s supplier engagement programme in 2017 and has worked extensively in the Middle East, Indian, South American and African markets.

A member of the founding family, Suneeta Reddy joined the enterprise in 1989. She is a member of Harvard India Advisory Board and a member of the CII National Council and Healthcare Council. She has an honorary doctorate in Life Sciences from Sage University, Indore.

Vincent Buscemi is a highly experienced health and social care lawyer who specialises in commercial, corporate and regulatory law across the independent and NHS sectors; he is recommended by Legal 500 and ranked in Chambers and Partners. Bevan Brittan is a UK Top-100 law firm.

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

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

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

Alistair Grenfell President EMEA, IQVIA

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

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

HEALTH SYSTEMS IQVIA

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

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

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

www.iqvia.com

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

ne-click shopping, locationbased services, and automatic account recognition are the norm in the consumer world, creating frustration among patients who wonder why healthcare seems so far away from catching up. Despite the best efforts of dedicated information management professionals, 14

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

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

HEALTH SYSTEMS NextGate

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

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

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

Royston Adamson-Green Director of Channel Sales NextGate

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

As healthcare becomes consumer-driven, it is equally critical to consider use of other identification mechanisms to ensure that patient demographic information is accurate and up-to-date across systems and institutions. Use of personal smartphones, for example, to streamline registration and allow patients to play an active role in managing and updating their data can help to improve patient matching efforts at key stages where data errors often occur— during enrolment and at registration. The adoption of mobile technology has become part of everyday life. Smartphones have fuelled high expectations for on-the-go, always-connected consumers. Whatever they want, they want it now, so for healthcare organisations aiming to win over customer loyalty and improve the patient experience, harnessing the power of digital identity can be a crucial element of doing business. In broadest terms, an individual’s digital ID will tend to incorporate some aspect of a person’s legal identity, such as a driver’s licence or passport. These IDs tend to focus on uniquely identifying attributes of an individual such as their legal name, date of birth, gender, and physical address. In healthcare, a digital ID, or credential, can also include one’s private healthcare insurance card or state health system identification number. Despite the heightened privacy and security concerns, there are enormous opportunities to better integrate digital identities into the healthcare process using a patient’s own mobile device. Patient registration, for example, is fraught with record look-up and data capture issues. A recent assessment found that one in every 3000 U.S. patient registrations is an exact match to an existing patient with the same first name, last name, and date of birth. Organisations will always have a difficult time knowing that these records should be kept separate, especially without cuttingedge patient identity matching infrastructure in play. 15

Royston Adamson-Green Director of Channel Sales NextGate

“Empowering patients to take control of verifying the accuracy of their own demographic data would result in fewer overall errors” Healthcare can learn from the successes of other industries by creating a digital identification wallet managed by the patient and seamlessly integrated into the provider’s health IT environment. This strategy will let patients take the lead in double-checking their own data for errors and providing informed consent for data access across providers, all from their own personal devices. The ideal digital identification solution merges simple, seamless interfaces with advanced privacy and consent features. Patients could download a digital wallet app 16

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

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

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

HEALTH SYSTEMS DEVELOPMENT Methods Analytics

HELPING COMPANIES NAVIGATE THE INTERNATIONAL HEALTHCARE MARKET Speak to one of our experienced team to see how you can expand your business now Contact Steve Gardner or Emma Sheldon MBE steve@thetradeagency.co.uk / emma.sheldon@thetradeagency.co.uk

C O N S U LTA N C Y | P U B L I S H I N G | M A R K E T I N G | E V E N T S

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

n the 1985 hit science fiction movie – Back to the Future – a high school student played by Michael J. Fox utilised advanced technology to travel back in time. You may ask what possible link there may be between that movie and global healthcare post-pandemic? My answer is, that like the movie, we will utilise technology to go back in time to the era in which healthcare came to us - in our homes - and this change will be far more impactful than many believe. 18

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

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

HEALTH SYSTEMS Helgerson Solutions

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

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

Jason Helgerson Founder Helgerson Solutions

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

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

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

connect@hsg.global www.hsg.global

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

s hospitals and healthcare outlets struggle to manage the after-effects of COVID-19, digital technologies offer many solutions. But it’s an uphill struggle for UK innovators as they try to convince the NHS to implement simple strategies that would make life easier for patients, clinicians and hospital staff. Elliott Engers, CEO of Infinity Health, puts it very clearly. “We just haven’t embraced 20

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

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

HEALTH SYSTEMS Infinity Health

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

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

Elliott Engers CEO Infinity Health

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

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

Contact Information

hello@infinity.health infinity.health

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

nsuring the best patient care is a constant battle for healthcare institutions around the world. It starts from the bottom up – to ensure a quality standard of care, an entire organisation must be operating efficiently throughout, and always striving to improve. For this reason, Imperial Private Healthcare is developing a new collaborative membership, the 22

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

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

HEALTH SYSTEMS Imperial Private Healthcare

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

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

Alistair Russell Director of Business Development Imperial Private Healthcare

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

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

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

he Middle East market is full of opportunity but navigating it can be complex for companies looking to enter it. While the obvious benefit is familiarity through language for English companies, the routes to entry can be varied. For this reason, spending time to research the market is invaluable, especially for SMEs with limited resources. It’s important to scope the market, customise or localise your value proposition and understand the lay of the land for success. Those who do this efficiently can hit the ground running. The British Business Group, based at the British Embassy, is an invaluable resource which can help companies build networks and navigate regulatory requirements. The Department for International Trade in the UK conducts trade missions and makes introductions, supporting partnerships between UK companies and overseas healthcare providers. Once you have done your preliminary research, it’s a good idea to continue it in country. Dubai hosts many conferences and these can be a good place to start. Arab Health at the end of January is the best place to make contacts and begin to understand the requirements for British companies. There are plenty of opportunities for start ups to showcase their innovations and capabilities, particularly in technology, such as GITEX Technology Week, which is one of the biggest conferences we have in October of every year. These are also stepping stones for SMEs and innovators to come in and establish relationships. The UAE health system Dubai has an insurance driven and mandated health system, which means that more than 99.98 per cent of Dubai residents have to have insurance. Most of the insurance comes through employers, so when you set up your own business, you have to cater for the insurance of your employees as part of the visa issuance process. 24

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

Mazin Gadir Government Healthcare Advisor/Director of Partnerships IQVIA

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

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

HEALTH SYSTEMS Mazin Gadir

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

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

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

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

he first half of 2021 has seen more investment into the biotechnology sector than in the entire year of 2019, as reported by the Silicon Valley Bank. It is an excellent time to be in the life sciences sector, and as such, many would like to take the necessary steps to enter the US market by obtaining regulatory approval for medical devices, diagnostics, biologics, vaccines or drugs. As it stands, currently 35 per cent of approved medical devices in the United States, 40 per cent of finished pharmaceutical drugs for the United States, and 80 per cent of APIs (active pharmaceutical ingredients) are manufactured or compounded from foreign entities. While entering the US market can be a tedious and costly task, the great news is success and commercialisation are an attainable goal for those who seek to understand the process. Many companies that are not properly prepared can find themselves having difficulty crossing the all too well-known “valley of death”. Seeing the success of other companies proves, though, that there is a pathway to the other side of the valley. Taking the first step First, companies need to ensure that they are prepared. When entering the US market, foreign companies should spend time on market and revenue research, creating a comprehensive project timeline, and estimating costs. As this process unfolds, there are a few questions to consider: • What unmet public need are we solving with this product? • Are we planning to launch our product in multiple markets? • How much should our product cost in each market? • Are we seeking dilutive capital from US investors to support regulatory approval and commercialisation? • Do I meet all regulations and requirements required by the FDA? • How do I establish a business in the US? 26

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

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

Ernesto Chanona Director of Business Development CSSI Life Sciences

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

HEALTH SYSTEMS CSSI Life Sciences

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

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

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

echanona@cssilifesciences.com www.cssilifesciences.com

Developing stronger global health systems post-pandemic Healthcare World’s Fabian Sutch-Daggett previews Health Education England’s revised strategy

f there was ever a stronger case for health system cohesion and development, it is surely our experiences over the past 18 months. Never before have we seen such collaboration, ingenuity, and rapid development occur. Despite the struggles brought by the global pandemic, we can look back proudly at the momentous changes in healthcare that have occurred as a result. It’s vitally important that healthcare systems should look to carrying on this momentum into the future - which is precisely what Health Education England is aiming to do in their revised global strategy.

“HEE will continue to strengthen the health systems and service in England and across the world through bilateral and multilateral, mutually beneficial, partnerships in order to attract, educate and train an international health workforce.” - HEE Global Strategy Refresh An offer to NHS staff One of the first issues which HEE will tackle is the ever-present issue of the workforce crisis. Without effective and resilient individuals within health systems at home and abroad, no amount of research and development will make a difference to the

way our health systems operate. Clinicians and staff at all levels of the healthcare chain must be provided with the opportunity to develop and learn, as well as share their learnings and skills within a global context. Working and learning in a global context – alongside their peers - not only are individuals better prepared for the issues that they face in their day-to-day routine, but they also have the ability to react to developing situations and provide valuable knowledge to others. In other words, it’s a win-win. “There is significant and mounting evidence that exposure to global clinical environments increases the speed and depth of metacognitive learning. In addition, multiple studies have shown that front-line staff value global experiences including global placement and volunteerism, cross border peer to peer relationships and global educational activity.” - HEE Global Strategy Refresh. “The reason this strategy was developed was because we recognised if we were going to develop the best healthcare, then our workforce had to be exposed to a range of learning environments,” says

EDUCATION & TRAINING Health Education England

seeking more opportunities to undertake global work at points their careers. With the right support and planning, these opportunities can provide personal development for NHS participants as well as benefitting our partners overseas. We support and fund fellowships that use these experiences as a developmental opportunity for NHS staff. Participation in such experiences can also foster innovation in the NHS as they expose NHS staff to new perspectives. Drawing on the insights and lessons learned through working collaboratively with global partners, NHS staff gain experience of solving problems in environments where less resource is available. In addition, a key role of HEE as part of the NHS is ensuring staff who trained overseas are able to thrive as members of our NHS. There is significant activity in supporting international staff in the NHS, including the Widening Access to Specialist Training scheme (WAST), and a focus on tackling differential attainment. Through Supporting NHS staff to take opportunities, such as HEE fellowships, for overseas learning can play a role not just in supporting overseas partners in delivering sustainable change, but will also lead to a stronger NHS over the long-term. Professor Ged Byrne MBE, Director of Global Engagement for HEE. “If we allow our workforce to learn within a global health context, they ultimately improve as individuals and as part of the wider system.” Newly published data from THET highlights a significant number of NHS staff

Ged Byrne MBE Director of Global Engagement HEE

An offer to NHS organisations In addition to enabling individual development in an international context, there must be a focus at the grassroots of our health systems. This is why the second portion of HEE’s new strategy aims to support NHS systems to understand and benefit from a ‘globalised’ approach to education and development. For example, in 2020/21 HEE funded NHS trusts to provide English language training programmes and examinations for nurses trained overseas who, as they are unable to demonstrate the NMCs required level of English language proficiency, are unable to gain registration and so are working in other non-registered roles in the NHS. Working in partnership with 87 NHS Trusts across all seven NHS England regions, more than £1.3m has been provided to fund English language training for 2,046 OTNs currently working in the English NHS. “Adding a global dimension to HEE’s offer to these health systems [ICS] provides new opportunities for system leaders to improve local healthcare delivery.” - HEE Global Strategy Refresh.

“We will work with HEE’s transformation team to integrate global opportunities into existing local workforce transformation programmes,” adds Professor Byrne. The offer to the world The last part of HEE’s refreshed strategy is its offer not to the NHS or the individual, but the global health system at large, centred around the “Triple Win” ethos: • NHS (& HEE) have opportunities to learn and innovate from other healthcare systems • International Governments gain access to a world-leading healthcare workforce and expertise • International benefit from improved Global Health Security, Resilience and Infrastructure As part of this, HEE will continue to work on Technical Collaboration & Consultancy programmes focused on the health workforce and education and training. These projects and programmes provide overseas partners access to NHS expertise for system-to-system knowledge exchange, in-depth strategic analysis and advice, and long-term implementation support for programmes. By increasing and enhancing the quality of global partnerships which include front-line staff and NHS integrated care systems, as well as increasing the number and effectiveness of partnerships between institutions and health economies, HEE’s strategy aims to ensure that the NHS can truly contribute to the UK’s global health objectives – and puts NHS staff at the centre of this. In conclusion HEE’s revised strategy positions the NHS, and by extension, the UK, in a way that enables both overseas individuals and nations to collaborate, learn, and operate in a way which benefits everyone. In today’s still pandemic world, it is vitally important that we continue to develop together as a global health system, not as individual operators. Contact Information

www.hee.nhs.uk

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

he sudden recent emergence of the new Omicron coronavirus variant has led to the unwelcome tightening of restrictions globally. First detected by South African scientists, it appears to affect younger people who have not been vaccinated. The instinctive reaction to ban flights from the country has finally provoked the wider conversation that has been put on hold for more than a year – the urgent need for vaccine parity. South Africa has suffered more than most African countries from the effects of COVID-19. With deaths in excess of 200,000 and the Beta variant identified as originating there, the health department is fighting to vaccinate the population rapidly, despite slow uptake and political obstacles. Heading up the task is Dr Nicholas Crisp, a retired public health official who was originally brought back to set up the new office for the proposed national health insurance programme. On his arrival in June 2021 he was also asked to run the struggling vaccine programme, and he went on to stand in as Director General when the incumbent was placed on precautionary suspension. With a wealth of national and international public health experience, he is fighting many battles and the most important is to contain the anticipated fourth wave. Each wave has been more aggressive than the previous one, but vaccination rates have been good in parts. Around 14.5m people have received both doses, with 22m vaccines administered thus far. Changing the distribution strategy Much of this success has been achieved despite the cuts in the healthcare budget of more than 6 per cent. Many donors have come to their aid and the large private sector has been closely involved. The US and UK government among others have helped with vaccine supplies, while the 30

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

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

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

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

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

HEALTH SYSTEMS South Africa

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

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

shows the important work being done behind the scenes. For South Africa to face renewed economic hardship as a result of closed borders seems harsh to many. However, Dr Crisp is realistic about the situation. “Our allies are the BRICS and not so much the West,” he says. “If the West wants to stay friends with Africa, then they have to be really interested in opening up trade and helping us grow our economies. COVID has taught us that if we don’t stand up for ourselves in Africa, we’re going to end up being the poor kid in the corner with the leftover porridge. And that’s not OK.” 31

Time to consult

’ve spent my whole career working in and around the international healthcare space. With Healthcare UK I helped UK NHS Trusts to make their first steps to sell their services overseas. With Vernacare we exported a UK product to more than 50 countries around the world, for which I was honoured to be awarded an MBE for services to export. Our businesses have been subjected to unprecedented levels of uncertainty over the last year or so, with a lack of clarity and understanding about everything. That uncertainty leads to fear and doubt and there has rarely been such a shared volatile business environment in which to operate. Yet even a volatile business environment offers the potential for significant opportunity, when your offer matches the new needs. Smart businesses have seen opportunities to match their innovations with need, to speed up adoption of their technologies to improve patient care, and to share their successes as widely as they can to help others. To support our entrepreneurs and businesses they need the right advice, the right people, and the right money. This requires a massive investment of time and effort and sometimes we’re running so hard at our goal that we fail to take the time to reflect on the changes that have impacted us. Equally, to understand where our offerings can best fit, we aren’t 32

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

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

HEALTHCARE WORLD MAGAZINE | HEALTHCARE WORLD FESTIVAL

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

GROW YOUR EXPORTS WITH MEDILINK’S SECTOR SPECIALISTS WHAT WE DO

MEDILINK’S INTERNATIONAL ADVISORS

The International Resource Service includes, but is not limited to:

Our team have the sector and overseas market knowledge necessary to accelerate an organisation’s export opportunities and growth. Supplementing industry experience and knowledge with overseas contacts and refined research techniques, the international team offer a unique service within the Life Sciences sector.

• Research and creation of a market entry strategy • Prospect and initiate new relationships internationally • Expedite ongoing negotiations to accelerate the process • Up-skilling of existing staff and support for evolving businesses • Interim resource to cover leave of absences, ensuring your export strategy stay on track • Staffing resource at events locally or internationally

Contact our International Team international@medilink.co.uk 0114 232 9292 @MedilinkINT Medilink International Services

OUR INTERNATIONAL EXHIBITION SCHEDULE Our team of specialist international exhibition and trade mission advisers can assist you throughout the booking, planning and delivery process, providing access to a range of discounted services through our partner organisations, and ensuring the best possible return on your investment. Medilink’s current exhibition schedule for 2021/22 • Rehacare: Düsseldorf, Germany - October 2021 • Medica: Düsseldorf, Germany - November 2021 • Arab Health: Dubai, UAE - January 2022 • Medical Fair Thailand: Bangkok, Thailand - February 2022 • Medical Japan: Osaka, Japan - February 2022 • KIMES: Seoul, South Korea - March 2022 • FIME: Miami, USA - July 2022 • Medical Fair Asia: Singapore - August 2022 • Rehacare: Düsseldorf, Germany - September 2022 • Medical Japan: Tokyo, Japan - October 2022 • Africa Health: Johannesburg, South Africa - October 2022

Healthcare World Magazine | Issue Two

Articles inside

Developing stronger global health systems post-pandemic

Meeting the unmet need

Editor’s Welcome

Streamlining hospital processes

The International Affiliate Network – a pathway to better patient care

Meeting consumer expectations in a hybrid health IT landscape

Entering the UAE market

Healthcare World Festival II - Speakers

The astonishing speed of pandemic healthcare innovation

Back to the future?