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Sat 2 Jun 2007 09:03 PM

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Healthcare revamp

Billions of dollars for the region's health system have developed state-of-the-art technologies and revitalised the sector.

With the likes of Dubai Healthcare City (DHCC), King Fahd Medical City (KFMC) - and many more healthcare facilities just like them springing up throughout the region - being ill has never before been so appealing. And, of course, technology is proving to be a major driving force behind these super health centres According to industry experts, IT is going to make the Middle East's healthcare the best in the world.

In 2006, Peggy Farley, general partner in the US$100 million Ascent Medical Technology Fund II, a private equity vehicle to promote the development of the medical technology industry in the Middle East, stated it was going to happen sooner rather than later.

While there are the grass-roots of medical technology here, this is principally the manufacturing of basic supplies in Oman and generic drugs in Jordan.

Farley is confident that intellectual property and advances in medical technology can originate in the Middle East, and be kept here, if funds are diverted into developing clinical research facilities and medical technology manufacturing facilities The injection of $100 million, likely to be from American firms in the first instance, will catapult the value of the regional medical technology investments sector to levels that will surpass any non-oil sector in the region, according to Farley.

"The Middle East has the capacity to provide competition to a fat, lazy and complacent American healthcare sector that is stifling innovation through its bureaucracy."

Karl Groth, Farley's Partner in the Fund, says: "While there are the grass-roots of a medical technology industry in the Middle East, this is principally the manufacturing of basic supplies in Oman and generic drugs in Jordan.

But the real money is to be made in new patents, and the Middle East can be supported and nurtured to the extent that localised discovery of new drugs, new medical devices such as therapeutic products that enable heart function, new cell therapies, and new cures will follow."

Ascent medical technology investments are exceptional, having had an average return on investment of 824% year on year.

"One principal reason for the high returns, beyond selecting outstanding technologies, is a history of successful IPOs from the US medical technology sector," explains Farley.

As certain sections of the vertical come on in leaps and bounds, there is a very real danger that some smaller health centres could be left in their wake. According to Oracle, a major player in healthcare back-end systems, this is highly unlikely to be the case.

"Let me just be very blunt," says Ammar Mamlook ,Oracle's healthcare accounts manager for the region. "What we're seeing in the Middle East are islands of excellence - some hospitals and health centres are fantastic but the rest of them are far from advanced.

With the islands of excellence, there are hospitals that I would say are even better and much more advanced than those in the USA or Europe. But there are still just a handful of facilities up to similarly advanced standards.

"Fortunately, I think the sector as a whole is advancing rapidly and I can see plenty of change taking place. Soon, these smaller and more ‘dated' hospitals could soon be up to the same excellent standards that we see with the likes of King Fahd Medical City. Mamlook feels that one thing this region's healthcare sector needs to further develop is the back-end applications. "Most hospitals have their front-end systems fully in place but less attention seems to be given to the back-end," he says.

"Although the front-end systems are obviously very important in delivering care, it's important to remember that it's the back-end applications that are used to actually run the businesses and keep the facilities ticking over."

ITQAN, a local systems integrator that specialises in healthcare informatics, has seen vast changes in the sector since it began working in it ten years ago.In 1997, Feras Al Jabi, general manager at ITQAN, felt that although many vendors had started talking to end users about the need to start digitising, the solutions in Middle Eastern healthcare needed more attention from system integrators.

"I still believe that it needs more support from pure IT vendors - those who develop programming languages, databases or platforms," explains Jabi. "They need to support the implementation providers to make the technology more applicable to the end users in the industry - doctors and nurses.

"The IT has been there for a while, maybe 15-20 years, but it's not necessarily exactly what is needed. For example, we all use Microsoft XL. The one you use in the Middle East is the same one you can use in America or anywhere else in the world, apart from maybe a difference in the language.

"But HIS is very much related to the local business rules and industry-specific procedures applied in a country, other business requirements within the hospital and requirements within the country's health authority.

"From that point of view, I wouldn't recommend that hospitals look around the world and just pick what they consider to be the best application," Jabi adds.

This is the kind of thing Healthcare Solutions Middle East (HCS) is helping CIO's with. The healthcare information consulting firm specialises in supporting healthcare system integration, implementation, reporting, billing/insurance, and operating managed healthcare organisations.

Recently, the company was helping the Department of Health and Medical Services in Dubai. The project was extensive, involving a number of implementations in a variety of locations - four hospitals and more than 16 primary health centres in the United Arab Emirates.

A core system supplied by Siemens Medical System and pharmacy system supplied by IBA Health with full clinical and inventory functionality coverage to reduce medication errors and full inventory and cost tracking.

A laboratory & Copath system was also supplied by Misys Healthcare Systems interfacing more than 50 instruments in the hospitals.

On top of this, a billing system was tailored by HCS consultants to suit the government requirements, an e-service portal was developed by HCS consultants outsourced in DOHMS and there was full integration with GRP systems. All of the systems procurement and integrations were done by HCS, meeting the specific needs of the hospitals with greater adaptability in mind.

"The main challenge with this was in adapting to the international systems standards and government standards," explains Adel Eid, operations manager at HCS. That required a full study and requirement analysis prior to commencing the implementation.

There are plenty of other companies looking to make an impact on the region's technology. The Cleveland Clinic, one of the USA's largest medical centres and a pioneer in healthcare technology - with the likes of its new Virtual Visit teleconsultation service - has its sights fixed firmly on Abu Dhabi.

The Clinic, along with Abu Dhabi's Mubadala Development, announced at the Arab Health 2007 exhibition that it is in the process of to creating Cleveland Clinic Abu Dhabi.

The hospital, expected to be ready by 2010, will incorporate Cleveland Clinic's medical group model, providing an impressive spectrum of specialty services.

The hospital, scheduled to be operational in three years, scheduled to be operational in three years will benefit greatly from the Cleveland Clinic's state-of-the-art technology.

The region has the capacity to provide competition to a fat, lazy and complacent American healthcare sector that is stifling innovation through its bureaucracy.

"We are thrilled to be partnering with Mubadala Development and Abu Dhabi to advance the delivery of health care to the citizens in the region," says Dr Cosgrove. "The Cleveland Clinic has a longstanding history of excellence in clinical care, research, and education. We are truly proud to be a part of this unique and exciting opportunity and to continue our longstanding relationship in the Middle East."

Dubai, not one to be outdone, has been forging ahead with its own Healthcare City (DHCC). Owned and developed by Dubai Holding, the $1.8 billion development consists of a collection of medical teaching institutions, private hospitals and clinics, pharmaceutical offices and research centres, and spas and rehabilitation centres. It is currently partially functional, with a staff of more than 760, including more than 130 physicians.

There are 17 hospitals planned for DHCC, with a total of 780 beds to be available by the end of 2008. I and II are under construction, and it is expected that it will be fully operational by 2010.

The first phase, located behind Wafi City, Dubai, is approximately 4.1 million square feet in size. The second phase, dedicated to wellness facilities, will be announced soon.

The structure of DHCC is highly integrated with the Academic Medical Centre forming the core and, unsurprisingly, technology plays a massive part in the 2010 vision.

This vision includes a unique example of an integrated health network, as well as a Health Information Reporting and Analysis System (HIRAS).

The Centre for Healthcare Planning & Quality (CPQ) announced in 2006 its plan to set up the HIRAS - the implementation of which was completed in early 2007 - as part of its role of planning and managing Healthcare City.

"The HIRAS is a unique healthcare information integration platform that enables DHCC to create electronic medical records," says Dr Ivo Janecka, CEO of CPQ.

HIRAS`s uniqueness comes from connecting various healthcare operators in DHCC who use different healthcare systems.

The system makes patient records available at the touch of a button and enables experts to make a quick diagnosis and plan early treatment.

According to the CEO of DHCC, Dr Muhadditha Al Hashimi, a patient's personal details are a sensitive issue and one that involves great responsibility on the part of the healthcare providers. "All patient data will be completely secure with only authorised personnel being privy to the information," Dr Hashimi says. "The degree of risk is controllable through the implementation and enforcement of strict regulation, rules and policies."

The rapid advancement of such healthcare providers in the Middle East is of course aided by the constant push from IT vendors to constantly develop improved products and get involved in major projects.

In April 2007, Intel chairman Craig Barrett dedicated new projects to improve education and healthcare for Lebanon's citizens as part of a reconstruction process.

When visiting Beirut, he announced that Intel is increasing technical and doctor training support for a telemedicine programme at one of Lebanon's top hospitals, American University of Beirut Medical Centre (AUBMC) and the Nabatiyeh Governmental Hospital in Nabatiyeh. The telemedicine systems provide the hospitals with real-time video consultation between physicians miles apart, the ability to share data and to diagnose patients from afar.

Without Telemedicine, Nabatiyeh citizens needing a specialist would have to travel to Beirut, a trip that can be long and arduous.

"The Nabatiyeh-Beirut Telemedicine Program could not come at a better time," says Dr Nadim Cortas, Vice President for Medical Affairs and Dean of the faculty of medicine and the American University of Beirut Medical Centre.

There are islands of excellence – some hospitals and health centres are fantastic but the rest of them are far from advanced.

"Since last summer, there has been an increase in eye and skin problems due mainly to crowding, particularly among the residents of South Lebanon. Now we can bring medical expertise to more people, and faster than before." The innovation gives local doctors the ability to access the latest medical data and get second opinions from specialists and medical centres hundreds of kilometres away.

"We've been in the region for one and a half year and have approached a number of hospitals and healthcare organisations here," says Iyad Malaeb, Intel strategic relations manager for the GCC region.

"We're working very closely with King Fahd Medical City in Saudi, which wants to be fully digital and wireless, and we're trying to help King Fahd and many other hospitals improve their care through state-of-the-art technology," he adds.

"The healthcare sector needs a lot of investment from the application point of view and also in the technology infrastructure. Small hospitals, as well as the large healthcare developments, need technology.

"It does require some investment many small hospitals have come to us asking us to help them improve their IT. It's vital if they want to offer a high quality service."

An example of Intel's latest technology is the mobile clinical assistant to help enhance patient safety and ease clinician workloads. Intel says eventual products based on the mobile clinical assistant platform could offer a variety of technologies including radio frequency identification technology for rapid user and patient identification, barcode scanning to help reduce medication-dispensing errors and wireless connectivity to electronic medical records systems.

Xerox and Siemens are just two of the other vendors leading the way in the Middle East's healthcare vertical.

According to Xerox, for every hour of skilled nursing care, nursing staff spend 30 minutes managing documents - and more than 90% of a medical centre's communications is in the form of documents.

In conjunction with their business partner, Aycan, a leading provider in plain paper imaging solutions for radiology, Xerox is bundling the Aycan X-ray print solution with the Xerox WorkCentre M24. This bundle offers healthcare providers in the GCC with a complete solution, which allows them to print radiological and other medical images on plain paper at near film quality, saving them money.

This solution fits into both traditional and PACS (picture archiving and communication system) workflows to provide a low-cost solution for sharing images with referral physicians.

Ayman Mattar, regional marketing manager, Middle East, Xerox, says: "I would bet that not many people associate Xerox with the medical profession. In fact, we have many years of experience in providing the healthcare sector globally with cutting-edge technology helping to cut significant costs and enhance their workflow and operational standards."

Meanwhile, at Arab Health 2007 Siemens announced that the Near and Middle East region would be the first region to experience its Soarian Medsuite 4.0 technology.

Soarian MedSuite offers healthcare organisations an integrated HIS (Hospital Information System) that helps users manage administrative, clinical, and financial processes and drive towards increased efficiency, productivity, and quality of care across the healthcare continuum.

"The integration of clinical, financial performance and operations information through a single unified platform makes Soarian MedSuite essential for assisting with improved patient care and overall hospital efficiency," says Maurice Faber director of Siemens Medical Solutions, Near and Middle East. "Siemens has accumulated vast experience in deploying new healthcare technologies in more than 30 countries. Leveraging this knowledge, Soarian MedSuite offers a critical tool for healthcare organisations in the Near and Middle East and beyond."

With state-of-the-art technologies such as these, the outlook for the region's medical services has never been in better health. And with the market in the Middle East worth more than $74 billion per year, the development is unlikely to lose any momentum in the near future.

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