Healthcare Digitalization in the Middle East: Ambition as a Trait (Michele Tarnow, Ziad Tabet)
“UAE has really positioned itself to become a global leader in healthcare. The UAE in general is a great visionary country. The leadership has a very strong, traditional practice of setting 50 year goals, and then breaking them down into five-year strategic initiatives,” says the CEO of Alliance Care Technologies Michele Tarnow, who has been living in the Middle East since 2016.
Ziad Tabet is another US expat, who has been in the region for a decade, working with government and private organizations to advance healthcare operations, processes, policies and regulations to promote digital healthcare adoption and use. One of the main strengths in the digital transformation he observes is the interest of the policy and government leaders to work with stakeholders and the industry.
Outline of the region
Healthcare in Saudi Arabia is in the middle of a transformation with the Vision 2030 program, which aims to “restructure the health sector in the Kingdom to be a comprehensive, effective and integrated health system that is based on the health of the individual and society (including the citizen, the resident, and the visitor).”
Talking specifically about the UAE, Michele Tarnow observes a strong national desire of UAE leaders to make the country a global leader in digital health. “Every medical institution is digital from the standpoint of hospital and operations,” she illustrates.
Because the technology is modern, the integrations are also well defined. Many established players, such as Siemens, GE Healthcare, Epic, etc. are present in the area, because of the traditional reputation. 80% of the EHR space in Qatar is covered by Cerner. The current challenge therefore is determining if what the big brands provide are really the best solutions on the market. “More work needs to be done in breaking those barriers and saying, yes, smaller players can be really contributory to long-term success. In healthcare, you don't marry yourself anymore to one brand. Today you have to put together the best combination and work collaboratively to create integration teams,” says Michele Tarnow.
So how can smaller players enter the market? With strong enough use cases. “One of the things that the government here is really open to is proof of concepts. That can help us get our foot in the door and then it's up to us to prove ourselves through a proof of concept. And I think that it's more of a ‘try before you buy’ type environment, which also fits very well with a SaaS model, which is the way most of our solutions are sold,” says Tarnow.
Cultures create innovation
Another strong point of the region is the welcoming culture. “If you have a good concept, if you have an innovation that you want to develop, it's fairly easy to get doors open here. Obviously, to keep the doors open, you have to deliver what you're promising and it has to make business sense at the end of the day,” says Tarnow.
85% of the population in Dubai is being composed of expatriates, which creates cultural diversity that has positive effects on innovation, says Michele Tarnow, describing her team. “We have individuals from Iran, India, two first-generation Americans who have come here. We have a lot of people with multiple passports and of course all around us, everyone is from somewhere different, which just enhances that ability for creativity and innovation because you bring people together with different perspectives and you come up with solutions that you wouldn't otherwise come up with if you were in a very homogeneous environment.”
What makes UAE better positioned for digital health transformation
Strong insurance framework. “10 years ago leaders of UAE made the decision to move to an insurance market and everyone in the UAE has healthcare insurance. It's a requirement for employment. You can't get a residency visa if you don't have health insurance. Saudi Arabia has about 25% of its population covered by health insurance. Other countries in the region are rolling out mandatory health insurance. That really helps shape up the payer market and reimbursement and it sets some normality in the entire financial end of the market as well as inequality,” explains Michele Tarnow.
The remaining problem not just here but globally is workforce shortages.
While many factors make the Middle East a prosperous digital health region, it did not escape the global healthcare challenges such as the rising workforce shortages. “We can't train ourselves out of the healthcare workforce shortage problem that we have. That bus has already left. There's not enough time to usher into educational practices, enough people to train to be doctors, nurses, allied health care professionals. At the same time, COVID has made the employment situation even more acute. So there's a lot of pressure and need for that. I think the UAE has that right vision two years ago, they brought KPMG in to really educate all of us in the healthcare development industry about how acute the workforce problems are. In 2019, just before COVID, KPMG predicted that by 2030 the world would be short of 80 million healthcare providers. And we see in the news daily that people are leaving the healthcare profession because they're burnt out,” warns Michelle Tarnow.
On the technical side of challenges in the region, the transition to the cloud is a little bit complicated, because of the localization requirements. Due to privacy and protection laws, patient data cannot leave the country of the UAE and Saudi Arabia. “We do fortunately have companies like AWS setting up data centers. So this is a short-term problem,” Michele Tarnow adds.
Barriers to successful healthcare digitalization in the Middle East
Asked about barriers to successful national digitalization projects in the Middle East, Ziad Tabet, an industry veteran originally from the US, points to budgetary constraints and the general setting of priorities about healthcare improvements. “The immediate needs of some parts of the region are basic human needs, such as hygiene, clean water, things like that. So nobody in that region is looking for a Cerner because it simply doesn't resonate. Then you've got locales where the fundamental need is primary care. I think some other factors are more human and emotional type factors such as the desire for recognition and achievement to be acknowledged as a member of tier one world-class healthcare adopting, internationally accepted clinical standards and other types of operational standards.”
As Ziad Tabet further emphasizes, digitization is a multi-layer process, that has to have a clear purpose. “If the purpose is anything other than creating healthy communities, then it's probably a misplaced objective. So if you work backward how do you use technology and digital healthcare to drive better outcomes? You need data and the data needs to be in some way, shape or form structured. It doesn't need to be standardized necessarily. You can normalize that data. So you can use it and leverage it, but unstructured data is difficult to manage, difficult to derive consistent and reliable conclusions and pure conclusions from it. And so if you think about all of the infrastructures you need that a health information exchange is a prerequisite to being able to perform sound and beneficial population health management,” comments Ziad Tabet.
Tune in to the full episodes with Michelle Tarnow and Tabet:
Healthcare Digitalization in the Middle East 1/2: What Contributes to Rapid Development? (Ziad Tabet) iTunes, Spotify
Healthcare Digitalization in the Middle East 2/2: Ambition and the and Leadership Aspirations (Michele Tarnow) iTunes Spotify