GCC Healthcare 2017

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DOSSIER

GCC HEALTHCARE Taking the pulse of the region's health industry Overview | Comment | Interviews

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OVERVIEW

MECOMED

AVIVO

The health care industry in the Gulf: A bird’s eye view as the region catches up to the world

Collaborative leadership is the key to success for health care in the region

AVIVO Group has a strong presence in the health care ecosystem

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Vice President Ravi Raman

EDITORIAL Editor Sudeep Guha

ART Art Director

Steven Castelluccia

MARKETING AND SALES Assistant General Manager Poonam Chawla Executive Research & Marketing Blossom Menezes Circulation Executive Rex Emmanuel Exclusive intelligence report complimentary for subscribers of Bloomberg Businessweek Middle East edition. Not to be sold separately.

UMS International FZ LLC, PO Box 503048, Building no 5, Office 206, Dubai Media City, Dubai, UAE. General enquiries: Tel: +971 4 432 9467 Fax: +971 4 432 9534

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GCC HEALTHCARE

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PHILIPS

ROYAL PHILIPS

Combining human insights and clinical expertise, Philips innovates for patients

The company has concentrated on health care since branching out in 2016

CONTENTS

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OV E RV I E W

Health Care Industry in the Gulf:

A BIRD'S EYE VIEW AN INDUSTRY IN ASCENT, THE GULF'S HEALTH CARE SECTOR FACES A SERIES OF CHALLENGES TO REALISE THE GOAL OF DELIVERING THE HIGHEST HEALTH CARE STANDARDS IN THE WORLD

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n light of shifting market conditions and oil market turbulence, GCC nations have been looking beyond the oil sector for some time now and have been making proactive efforts to diversify their economies. To that end, they are now focusing on sectors that were not traditionally a priority during the oil era. One such sector is health care, where Gulf nations have been concentrating their efforts over the course of the last decade. As a result, the health care sector in the Gulf has shown impressive growth and the projections are very optimistic. According to a February 2016 report published by Alpen Capital, the health care market in the Gulf is projected to grow to $71.3 billion in 2020 from $40.3 billion in 2015, which is a CAGR of 12.1 per cent in the same period. The individual health care markets in each GCC nation in the same period are also expected to show growth of anything between 11 and 13 per cent. On this growth, Dr KP Raman, Founder and Senior Cardiologist at Al Hayat International Hospital says: “Health care in GCC nations is in the midst of a positive transformation. We are seeing significant investments from both government and private entities towards the improvement of infrastructure and recruitment of talent.� The governments of all Gulf nations are today investing heavily in health care, and are also encouraging private sector investment and participation primarily for setting up and running clinics and hospitals. This is in line with the global trend of GCC HEALTHCARE

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public-private partnerships (PPP) in health care. According to a Frost & Sullivan study, PPP in health care has enabled governments worldwide to cut their costs by as much as 25 per cent. Significant investments made by GCC member nations in acquiring the latest and the best medical technologies available, and mandatory health insurance schemes in various stages of implementation. GCC members have acted as major drivers in the Gulf health care industry. Meanwhile, the significant funds injected into this sector have gone a long way in upgrading the health care infrastructure as health care standards in the Gulf are on their way to matching global standards. But much remains to be done because, according to an Ardent Advisory report, health care spending in GCC nations is still much lower than global trends. According to the Alpen Capital report, health care spending in the Gulf as a percentage of GDP in 2013 was just 3 per cent ($49.9 billion) and it rose to 3.3 per cent ($55 billion) in the following year. According to Frost and Sullivan, there are major changes ahead in how health care is dispensed in GCC nations. By 2018, GCC citizens will have access to: selective and customised care; customised individual insurance plans; presymptomatic diagnostics and treatment; rise in the number of companies willing to invest in treatment and services; improved regional and intra-country connectivity; medical professionals keeping up with the latest knowledge; and, services to allow citizens to monitor themselves. 2

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The Alpen Capital GCC Health Care Report says the GCC population, which is more than 50 million at present, is expected to grow at an annual average rate of 2.4 per cent from 2015 to 2020. This will be a major driver for the healthcare sector in the Gulf. Some other significant growth drivers for the health care sector include a rise in the spending capacity of GCC citizens, strong demographic transition and improved life spans and mortality rates. Also creating a need for better health care services are the sedentary lifestyles and changes in dietary habits that have led to an increase in cardiovascular diseases, diabetes, anxiety, depression, nutritional disorders and other ailments related to obesity. According to Ernst and Young, within GCC countries, integrated technology enabled primary health care centres are needed most. The lag in delivering care expected from health care centres and the growing concern over their ability to survive in the current health care system has led to concerns and spurred a search for alternatives. WHO in a 2013 report said Saudi Arabia, which accounted for 47.9 per cent of the total health care spending in the Gulf, and the UAE with its corresponding share of 26 per cent collectively accounted for almost threefourths of the region's spending on healthcare. Following the two major spenders were Kuwait, Qatar, Oman, and Bahrain, in that order. The Alpen Capital report ranked Qatar at the top of the in per capita health care

2.4% expected population growth in the GCC from 2015 to 2020

13%

maximum growth predicted in individual health care markets in the GCC from 2015 to 2020

GCC HEALTHCARE

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spending list in the region, at $2,043. But the total expenditure per capita in the GCC is still substantially lower than that in North America which was at $8,803 in 2013. Primary health care indicators in the Gulf are almost on par with other developed countries around the world. According to a report by Ernst & Young ‘Investment big bets: health care and life sciences,’ life expectancy at birth is 77 years in the GCC (UK 81 years) whereas infant mortality, the primary health indicator of a country, is 6 deaths per 1,000 live births as compared to 3.8 per 1,000 live births in UK. Striving to improve standards in healthcare has put tremendous pressure on government finances presenting hurdles that are slowing down the development of health care in the region. One of the primary impediments to the development of the health care segment in the Gulf is the shortage of local medical talent and the inadequacy of existing talent to meet the present demand. Alpen Capital estimates the average across the Gulf at just 26 physicians and 49 nurses for every 10,000 citizens. This shortage exists firstly because the Gulf region produces limited number of medical graduates to serve its growing population, and secondly because nursing is often seen as a woman’s profession, thus cutting down on the available workforce. As a result, health care institutions are largely dependent on expatriate workers. To fill this huge gap, GCC governments plan to increase the number of medical schools

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GCC government budgets are coming under increasing pressure to find funds for an improved health care system

and provide residency programmes to increase the number of medical professionals. However, the results of such strategies will only be visible in the long run. The Alpen Capital report also states that construction of a hospital in the UAE using conventional method requires a capital outlay of about $0.3 million per bed. This evidences the fact that private players in the GCC health sector face multiple barriers to entry, including high costs of setting up hospitals, and long gestation and payback periods. Volatility of financial markets, low oil prices and economic uncertainty have made potential investors more cautious. This has affected the fund-raising ability of companies in the Gulf to adequately finance their healthcare projects. Healthcare providers in the Gulf region are therefore considering measures to cut short their operating costs in constructing hospitals. When it comes to allocating health care spending, the budgets of GCC nations are

GCC HEALTHCARE

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majorly impacted by the persistently low price of oil. Oman and Bahrain are particularly expected to reduce their spending because of widened fiscal deficits. According to Alpen Capital analysts, the Saudi government announced a cut in December 2015 on public spending in 2016, which was a result of an annual budget deficit of about $98 billion and the overall health care spending of the nation was impacted as the budget for health and social development was slashed by more than 30 per cent to $27.9 billion. Although considerable improvement has been made to the GCC healthcare system over the last 20 years, the quality and accessibility of care at clinics and public hospitals is yet to meet citizens’ expectations. The expansion of the infrastructure projects over the years in the Gulf has increased the requirement for associated resources, pushing up the cost of construction. At present, GCC citizens tend to travel abroad seeking treatment because of prevailing high medical costs and a lack of specialised care, especially for heart, heart-related, and cancer and tumour treatments. This outbound medical tourism is also one of the key factors that is negatively impacting the health care industry in the Gulf. Patients are being forced to seek treatment abroad as high

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costs and a shortage of skills impact medical service provision across the GCC. Finally, GCC government budgets are coming under increasing pressure to find funds for an improved health care system, amid falling oil prices, as per Alpen Capital’s GCC Healthcare Industry Report. With the governments of GCC nations designing and implementing plans to upgrade and expand their health care systems, visa regulations in the Gulf are also being relaxed to encourage intra-GCC medical tourism. The entry process for patients has been simplified by introducing visas for multiple entries for patients and their escorts. The Alpen Capital report ranks Dubai as a popular medical tourism destination in the Gulf with 260,000 inbound medical tourists in the first half of 2015. Dubai now has also plans to attract half a million foreign patients annually by 2020, which is likely to bring in revenue of $0.7 billion. The plan, to be implemented in two phases, involves the

construction of 18 private and four public hospitals with a workforce of more than 3,800. Bahrain has planned the construction of Dilmunia Health District at an estimated cost of $1.6 billion spread over 165,000 square meters of land on the man-made Dilmunia Island. In order to promote itself as a medical tourism destination, Oman is also planning to construct International Medical City at an estimated cost of $1 billion. Such large-scale projects are likely to attract patients not just from neighbouring nations, but from all over the world, ideally also resulting in a substantial reduction in the outbound visits of local citizens when seeking specialised treatment. Penetration of mandatory health insurance is another favourable strategy of governments to reduce health care costs. Suadi Arabia was the First GCC nation to implement such health insurance for expatriates and Kuwait, Bahrain, Abu Dhabi Qatar, and Dubai are expected to follow suit. This expansion of medical insurance coverage across the Gulf nations is expected to encourage overall healthcare spending. Given the current trends of the health care sector in the Gulf and keeping in mind the growth drivers, key challenges, and persistent efforts of member nations, 2020 looks appealing in terms of profitability and financial valuation and stability. Going forward, the journey ahead for the health care sector in the region is summed up in a McKinsey report that says: “As GCC policymakers prepare to grapple with the challenges of this substantial rise in overall healthcare demand and costs, as well as with the challenges presented by patients seeking better care, they are increasingly turning to private sector for help with both provision and financing.”

A considerable improvement has been made to the GCC healthcare system over the last 20 years GCC HEALTHCARE

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MECOMED

COLLABORATIVE LEADERSHIP IS THE KEY TO SUCCESS FOR THE REGION’S CHANGING HEALTH CARE INDUSTRY BY RAMI RAJAB, CHAIRMAN, MECOMED

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he MENA region is currently witnessing a major socio-economic transformation. The growing investment in education and the increase and attraction of talent in health care is helping to position the region as a world-renowned hub for innovation. The MENA health care industry is an excellent example of how the region has developed with innovation and new technologies, clearly contributing to saving lives and in improving the well-being of patients. The region’s medical technology market is advancing at a rapid rate. With the value of the industry projected to reach $12 billion by 2021, it is no surprise 27 of the world’s top medical technology companies are regionally based in the UAE and consider MENA a fertile ground to grow and prosper while bringing in high-quality solutions. Despite the growth, higher life expectancy coupled with an increase in obesity and associated illnesses, including heart disease, diabetes, stroke, and kidney failure is putting a burden on health services, and as a result, increased demand for high quality products and more hospitals capacity and efficiency. The long-term solution lies in better planning and increased role of the private sector through building stronger Private Public Partnerships. Local Health Authorities and Medical Device companies need to join forces and have an open dialogue on how to co-operate to improve outcomes. At Mecomed we are building strong ties with authorities including, the UAE MOHAP, and the Saudi Food and Drug Authority, amongst others, to help ensure health care professionals have access to the latest technologies available while

also ensuring these technologies used to diagnose, treat and cure patients meet safety and quality requirements. Mecomed serves as the voice of the industry for 21 countries across the Middle East and North Africa, with the aim of bringing all stakeholders together to help shape the healthcare industry, Mecomed seeks to also raise industry standards when it comes to ethical business behaviour. An example of this is the introduction of the region’s first Conference Vetting System (CVS) two years ago. CVS is an independently managed system for the practical implementation of the Mecomed Code of Business Practice (the Code). CVS reviews the compliance of third-party educational events with the Code to determine the appropriateness for companies which are members of Mecomed to sponsor Health care Professionals to participate in such events. More than 500 educational events are held across the MENA region each year and it is critical that the sponsoring of these events by MedTech companies are conducted in the most ethical, consistent and transparent manner. Another focus for Mecomed is to help address the gender gap between male and female leaders in the sector. As doctors, nurses and administrators, women make up more than half of the workforce but only constitute 20 per cent of executive and board member positions. There is a potential for women to pave the way forward, provide new insights and ideas. For example, we have seen here in the UAE, Her Royal Highness Princess Haya bint al Hussein leading the development of Dubai Health care City and the work she has done to establish it as a globally recognised centre of health care excellence. Mecomed’s 2017 MENA MedTech Forum, taking place on March 8-9, will address pressing industry topics such as the global and regional economic outlook and impact on health care spending in MENA, solutions for sustainable quality health care in the region and worldwide trends towards outcome-based health care. It will also include a focus on the role of women in health care, and how valuable their contribution is at a senior level. For more information on The Mena MedTech Forum 2017, visit: www.menamedtechforum.com For more information on Mecomed and its initiatives, visit: www.mecomed.com For more information on Conference Vetting System, contact: Arwa.Asiri@ethicalmedtech.com

GCC HEALTHCARE

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ZIMMER BIOMET

Your progress. Our promise.

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AVIVO GROUP

AMITAVA GHOSAL CEO AVIVO What are your thoughts on, and how is your growth plan synced with, the GCC health care market which is projected to grow up to $71.3 billion in 2020 from an estimated $40.3 billion in 2015, which is a CAGR of 12.1 per cent? We are very positive about the prospects of the healthcare industry in the GCC. Our ambition is to be one of the largest providers of integrated healthcare services in the region with global standards of quality. We are focused mostly on building the primary care network. Today, we have 47 facilities with over 1,200 employees and 200 physicians, serving nearly 1 million patients every year. We are expanding our network further, not only in the UAE but also in Kuwait and Qatar. We have strong operations in IVF and Dental and have a network of aesthetic clinics. We also offer high-end orthopedic and urology services through our German Medical Center in DHCC. Alongside our sub-brands, such as PrimaCare and National Hospital, we provide almost all types of healthcare services to different segments in the region. All of these facilities are being scaled up across the region as we speak. Several patients in the region travel abroad for treatment due to lack of specialised care or high cost, what steps can be taken to reverse this trend? We need to encourage private sector investment in the region by in turn, building the confidence to invest and bring the latest technologies to the local population. The current efforts of the Dubai government to promote medical tourism form part of an excellent initiative to enhance the healthcare infrastructure and improve the quality of delivery to reach global standards. GCC governments should take initiatives to build a standard of care focused on quality and accreditation, safety, continuity of care, patient satisfaction, and confidentiality. They should also start promoting investment in building training institutions to create a strong healthcare workforce in the region across all categories. Creating a

How is Avivo group overcoming challenges, such as the acute shortage of trained health care staff and the high cost of medical treatment? The healthcare industry is highly skill-driven, and it is still challenging to hire people with the right skill set, as the Middle East does not produce enough healthcare professionals to meet the needs of the growing population. We always keep a pipeline of highly trained healthcare staff to mitigate the risk of a talent shortage. We encourage our medical fraternities to practice evidence-based medicine to help patients with better diagnosis and outcomes, reducing the duplication of medical processes and consequent billing. We welcome the insurance regulatory changes that were implemented recently by HAAD as such initiatives will help address the higher costs of medical treatment. GCC HEALTHCARE

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“Prevention has become an integral component of primary health care. Delivery of clinical preventive services such as immunisations, mammograms, and cholesterol screening has risen steadily over the past two decades.� operational, and financial environment for all the potential investors in the healthcare space. What are your thoughts on the gradual shift that is happening from curative to preventive care? With digitalisation, patients are well informed about all aspects of diseases and prevention. Many of the leading causes of death and disability in the GCC can be haulted through preventive care. Prevention has become indispensable in the primary health care space, and medical practitioners play a major role in both primary and secondary prevention. Delivery of clinical preventive services, including mammograms, immunisations, and cholesterol screening, have steadily been increasing over the past two decades. Primary prevention can stop the disease process in its most initial stage by encouraging healthy lifestyles and vaccination against infectious diseases. Secondary prevention significantly reduces morbidity or mortality by detecting and treating asymptomatic risk factors or early asymptomatic disease. Moreover, health plans and individual clinicians are progressively being held accountable for the quality of the preventive care provided to patients. How is Avivo group incorporating the new technology that is changing patient care? We feel that digitalisation and consumerisation will be the important trends to watch out for in the healthcare system and they are already changing conventional healthcare practices. The old concept of patient-doctor relationship has been revamped to a data analysing, treatment management system. People’s accountability for spending on new digital healthcare technologies, such as health-tracking apps and wearables, has increased, allowing them to take full control over their healthcare choices. Smart technological solutions in healthcare are evolving at a rapid pace, with some important shifts in the medical sector opening opportunities for med-tech companies. We are getting ourselves equipped to embrace the digital revolution, emphasising patient empowerment and patient engagement.

specific 'Medical Tourism Visa' category would also help draw health care seekers from across the globe. Is there a lack of standardised regulations in the GCC? How can this hurdle be overcome? Yes, there is a lack of standardised regulations in the GCC, and that is indeed quite a challenge to be addressed for a regional player like AVIVO. I think that at least the regulations in each country should be similar. The real problem is that even in a single country like the UAE, regulations vary between different emirates and it would be helpful if that was addressed. The lack of standardised regulations across the region makes it difficult for potential big players to participate and invest. GCC governments should try to remove institutional hurdles and create an enabling regulatory, GCC HEALTHCARE

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PHILIPS

OZLEM FIDANCI SENIOR VICE PRESIDENT & GENERAL MANAGER HEALTH SYSTEMS MET AT PHILIPS

What are your thoughts on, and how is your growth plan synced with, the GCC health care market which is projected to grow up to $71.3 billion in 2020 from an estimated $40.3 billion in 2015 The rising demand for health care services paired with its restricted supply has resulted in GCC government implementing new technologies, systems of care, and considering further partnerships. Governments continue to invest in modernisation and reformation of their health care systems. The UAE, along with other countries in the region, must look at more innovative approaches. These involve non-traditional participants in the health care system. At Philips, by combining human insights and clinical expertise, we aim to improve patient outcomes while lowering the burden on the healthcare system. Advanced healthcare solutions are a fundamental part of the portfolio for both HCPs and consumers, to meet the needs of patients in hospitals and at home. Our mandate is to grow our leadership position across the health-tech industry. By doing so, we strive to make the world healthier and more sustainable through innovation. Our goal is to improve the lives of 3 billion people a year by 2025. Over the next 3 to 4 years we aim to achieve a comparable sales growth of 4 to 6 per cent annually for our health-tech businesses globally. Philips is focused on expanding its core business to address the opportunities in the fast-growing health technology market around the world, including the Middle East. In an increasingly connected world, where people are wanting to live healthier lives and societies are looking for more effective and lower-cost solutions across the health continuum, our businesses – with their combined clinical and consumer capabilities and cloud-based digital health platform – are excellently positioned to capture growth.

GCC HEALTHCARE

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GCC Governments are recognising the role of the private sector in health care, will this lead to public private partnership (PPP) initiatives in the near future? At Philips we believe that through successful partnerships we can co-create the future of healthcare by collaboration and leveraging the strengths of different stakeholders and risk sharing models. In today’s world, health delivery is a complex matter and no one institution or government can improve/change the existing systems alone. PPPs are proven to be successful in transforming and renovating the health care delivery in different parts of the world and as Philips we believe we have the right strengths and the global experience to create successful PPP models in the GCC. We can bring the most advanced technology and innovation to create efficient health delivery through the improved patient outcomes in the form of a strong PPP. Our unique differentiation is that we are able to address the entire health continuum including the preventive strategies and home healthcare. How is technology changing patient care? How is Philips adapting to this? We have a growing and aging world population and we are experiencing a dramatic rise of chronic and lifestyle-related diseases, global resource constraints, and a digital revolution. These trends are driving demand and creating opportunities for a new approach to health care. Philips is focusing on health-tech, where we see an opportunity to leverage advanced technology and deep clinical and consumer insights, to deliver integrated solutions that improve people’s health and enable better outcomes across the health continuum. Four most profound market trends are: a shift to value-based healthcare to reduce cost, increase access and

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“Philips is focusing on health-tech, where we see an opportunity to leverage advanced technology and deep clinical and consumer insights, to deliver integrated solutions”

improve outcomes; care is shifting to lower cost settings and homes; consumers are increasingly engaged in their health, creating more opportunities to focus on prevention; digitalisation has reached a turning point in healthcare, shifting value from devices to software and services; and, there is a clear need to enable better health and better care at lower cost, also known as Triple Aim. Health Continuum phases: Healthy Living • • Help people to live a healthy life in a healthy home environment Prevention • Enable people to manage their own health • Diagnosis • • First-time-right diagnosis with personalised and adaptive care pathways Treatment • Enable more effective therapies, faster recovery • and better outcomes Home care • Support recovery and chronic care at home • Connected care & health informatics •

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• What new innovations do you foresee in the Healthcare industry? Philips is actually making history with its innovative • solutions. Our most recent launch Auzrion is a great example Azurion is a next generation image guided therapy • platform that allows physicians to provide superior care for patients, easily and confidently perform procedures, whilst optimising lab productivity • Developed in close collaboration with clinicians, a range of procedures can be performed via the platform from PCI (percutaneous coronary intervention) procedures to complex vascular perfusion exams

Healthy living

Prevention

Image guided therapies, also known as minimally invasive therapies Interventions, are usually performed by delivering a local treatment via catheters, navigated through a small opening in the blood vessels, or needles through the skin. Medical imaging technologies involving X-rays, ultrasound, CT and MRI are used to enable and guide these procedures The images produced provide the visual maps that allow the clinician to guide these instruments through the body to perform the therapy. The ongoing growth of image guided therapy procedures is being driven by the significant benefits it offers healthcare systems and patients: • enhanced procedural outcome • reduced patient risk • shorter recovery times and hospital stays • lower health system costs Azurion can be used to diagnose and treat patients in hospitals or specialist clinics, providing image guidance in diagnostic, interventional and minimally invasive surgery across vascular, non-vascular, cardiovascular, and neuro procedures.

Diagnosis

Treatment

Home care

Connected care and health informatics

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ROYAL PHILIPS want for our loved ones and then to get to minimally invasive therapy that enable patients to return home faster after which they can receive support for their diseases at home. We have just introduced, for example, a technology that allows minimally invasive spine surgery through augmented reality, whereas in the past you would have had to open the skin and lay bare the spine which was very dangerous. This augmented technology, which kids might already know about very well, is what we are applying to the world of health care. Could you tell me more about future health index and its objectives, and what you aim to achieve through it? At Philips, we have a holistic approach to health care in which the patient is at the centre. We look at the preparedness of a population to find new ways of health and health care. Here in the Emirates, we see very high willingness to embrace technology as the means to achieve better health. Of course the occurence of diabetes, and heart and cardiovascular diseases is high here and I think people are realising that a change in lifestyle may be required, but I also see a willingness to adopt healthier lifestyles and achieve better health through technology.

FRANS VAN HOUTEN CEO , ROYAL PHILIPS ELECTRONICS

How do you see the UAE in relation to other GCC nations and North Africa overall? What are the market trends? People in the Emirates are very forward looking in their thinking and preparing for the World Expo in 2020 has set a goal for them, to be the heart and health city of the world. This is breakthrough thinking, and I think this is great. We are supporting Dubai in developing a network in which, through crowd sourcing, if someone has a heart attack on the street health providers around this person will be instantly notified to provide recussitation and necessary help. Similarly, if there are any cases of hard labour, health care providers in the proximity will be immediately notified. Through pathology, radiology, big data, etc., we will be able to diagnose a patient first time right, and have a tailored treatment pathway for that patient so that we can get that person to recover faster, and return home. That is trend number one. The next trend is leveraging the cloud to be able to provide access to care remotely. At Philips we believe that tele-health care will connect doctors with people. This is very beneficial for remote areas where maybe there are no doctors, and the problem of access to health care still persists. We are sure that tele-health care using mobile technologies can allow that to happen. We know that some countries confuse health care costs as a percentage of GDP and they struggle to pay for it. But by incorporating health care technology, treatment can be made first time right and there is less waste, which makes everyone happy.

How has the bifurcation of Royal Philips into health care and lighting affected business in terms of performance and innovation? 2016 was the year in which we brought our lighting business to the stock market, and since then Philips is focusing on health-tech. Health care is a fantastically exciting market in which there's a very wide scope for innovation. The global population is growing and many people do not have access to health care yet, moreover we see a lot of diseases, especially chronic diseases like cardiovascular diseases, cancer, etc., where technology can create breakthroughs. By focusing in this area, Philips can innovate faster, I already see the benefits because last year Philips was growing by 5 per cent throughout the year in health care, and we are concentrating on health care as an integrated patient-centric solution. From preventive care, diagnosis, minimal invasive treatment, to supporting chronic patients at home through the cloud, and this technology is reaping dividends for us. Coming to cloud and IoT, what are the major disruptors you see in the next five years which will affect the health care industry and patient care? The use of artificial intelligence and machine learning, and using big data is helping doctors in becoming far more productive, and helping them to see and detect diseases earlier that helps in diagnosis, which, I think, we would all GCC HEALTHCARE

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