Health care insights - Middle East

Part
01
of two
Part
01

Health Care Insights - Health Care Providers: Middle East

Recently published sources suggest that both satisfaction and concerns with healthcare providers vary from one Middle Eastern country to another. Compared to people in Turkey, for example, people in Saudi Arabia, appear to be more satisfied with the healthcare services that are offered in their country. Pain points vary as well, with people in Saudi Arabia finding the biggest healthcare problems to be the steep cost of healthcare, the poor quality of treatment, and the long waiting times, and people in Turkey finding the biggest healthcare problems to be the long waiting times, the lack of staff, and the poor quality of treatment. If the behavior of people in the United Arab Emirates is any indication, people in the Middle East choose healthcare providers based mostly on word of mouth and experience. There are several factors that influence their decision, and the condition and cleanliness of the building and waiting area, the specialty and expertise of staff, the quality of interaction time with the doctor, the waiting time, the distance, and the number of patients served are among them.

METHODOLOGY

While information about healthcare consumers in Middle Eastern countries could be readily found in surveys, academic studies, and news articles, we found it necessary to include one source that was published more than two years ago in July 2016. We used this source to supplement the limited information that we found on how people in the Middle East choose healthcare providers. The rest of our sources are all recently published. Details specific to Middle East, as a whole, are not publicly available, so we researched the different Middle Eastern countries separately, along with the Gulf Cooperation Council (GCC) and used insights on the region as a whole and the individual countries specifically to draw conclusions about the Middle East.

WHAT PEOPLE SAY ABOUT HEALTHCARE PROVIDERS

People residing in GCC countries Bahrain, Oman, Kuwait, Qatar, United Arab Emirates (UAE), and Saudi Arabia report satisfaction with the quality of healthcare services they receive. This is despite the fact that a large percentage of Gulf residents would prefer to receive medical treatment overseas. Survey results indicate that 39% of UAE nationals, 47% of Bahrain nationals, and 43% of Qatar and Oman nationals would travel overseas for medical treatment. The cost of healthcare in the GCC is growing, but nationals and expatriates alike have health insurance and can receive health services free of cost.

When it comes to keeping their health data secure, healthcare consumers in Saudi Arabia place a greater deal of trust in government and hospitals than in urgent care clinics, walk-in clinics, and non-medical staff. The government is the most trusted, with 79% of Saudi healthcare consumers saying they trust the government will protect their healthcare data. Non-medical staff at the healthcare provider's office, on the other hand, is the least trusted, with only 52% of the country's healthcare consumers saying they trust non-medical staff. Health data breaches appear to be a pain point, however, and according to the healthcare consumers in the country, these breaches often take place in hospitals, at the physician's office, or the pharmacy. Around 75% of Saudis report that their medical data had been breached before, while 32% report that their personal data had previously been breached. The types of data most commonly breached are electronic medical records, medical record numbers, and health insurance identification numbers. Of Saudis who have experienced a breach, 42% report having less trust in their healthcare provider.

There appear to be stark differences in perceptions of medical care among Middle Eastern countries, with data suggesting higher levels of satisfaction in Saudi Arabia and lower levels of satisfaction in Turkey. Fifty-nine percent of adults in Saudi Arabia agree that they get all the medical care they need, while only 43% of adults in Turkey do so. Fifty-four percent of adults in Saudi Arabia believe the quality of healthcare they have access to is good, while only 46% of adults in Turkey do so. About the same percentage of adults in Saudi Arabia and Turkey (50% versus 51%) agree that wait times to secure an appointment with physicians are too long, and about the same percentage (56% versus 57%) agree as well that many people in their country cannot afford quality healthcare. Personal data security appears to be a cause for worry for adults in Turkey, with 63% of them (versus 46% of adults in Saudi Arabia) agreeing they are concerned their personal data will be shared with other parties without their consent. Forty-one percent of adults in Saudi Arabia and 46% of adults in Turkey believe the healthcare system in their country is overstretched. In Saudi Arabia, the biggest healthcare problems are the steep cost of healthcare, the poor quality of treatment, and the long waiting times. In Turkey, on the other hand, the biggest healthcare problems are the long waiting times, the lack of staff, and the poor quality of treatment.

HOW PEOPLE CHOOSE HEALTHCARE PROVIDERS

If what is happening in the UAE is any indication, consumers in the Middle East select healthcare providers based mostly on word of mouth and experience. These two factors were identified as the most crucial factors consumers in the UAE consider when choosing healthcare providers. In the UAE, most employers pay for health insurance, and individuals can select which hospitals and physicians to access. In some cases, the insurer has a list of hospitals and physicians to choose from. Access to independent medical advice, in cases where consumers are unsure of which provider to use or whether a consultation is needed, is limited, however. Healthcare consumers in the country are advised to "consult their assistance company, which would refer them to assessed and accredited networks." This is especially recommended in Dubai, as most people in the city do not have long-established relationships with local hospitals and physicians. In Saudi Arabia, the top sources of healthcare-related information are online search engines (35%), pharmacists (35%), doctors or healthcare professionals (34%), and family and friends (29%), while in Turkey, the top sources of healthcare-related information are doctors or healthcare professionals (64%), online search engines (55%), pharmacists (46%), and family and friends (41%).

WHY PEOPLE CHOOSE HEALTHCARE PROVIDERS

The factors that motivate consumers in Saudi Arabia to choose a healthcare provider appear to be the condition and cleanliness of the building and waiting area, the specialty and expertise of staff, the quality of interaction time with the doctor, the waiting time, the distance, and the number of patients served. The affordability of fees and the accessibility of the hospital are important considerations too. In Iran, the quality of the physical examination, the cleanliness of the facility, the amount and quality of education offered after discharge, and the level of attention paid by medical staff are the motivating factors for consumers selecting healthcare providers. When it comes to choosing physicians, consumers or patients in Saudi Arabia are influenced by how well-renowned the doctor is and whether they or their relatives had an experience with the physician before. The appearance, the title, and the sub-specialization of the physician matter too.

Part
02
of two
Part
02

Insights and Trends - Digital Use of Platforms and Apps for Health: Middle East

The use of digital platforms and applications for health continues to grow across all regions of the world. Interestingly, different regions of the world identify with different trends and insights regarding the use of these platforms and apps. For instance, in the Middle East, telemedicine, wearable technology, and electronic health records are some popular trends and insights surrounding the digital use of these platforms and apps. Read on for an elaborate research strategy leading to the findings represented after.

RESEARCH STRATEGY

Initial searches focused on retrieving lists and pre-compiled information on trends surrounding the digital use of platforms and apps for health in the Middle East. Unfortunately, we could not find any data on public domains specific to the Middle East. The lack of specific information results from the fact that existing studies and reports found online primarily focus on information about digital use of platforms and apps for health in general or digital health trends in the Middle East. Therefore, we had to aggregate information from different reports to establish trends across the digital use of health platforms and apps for health in the Middle East.

On that note, we scoured the details presented in the various digital health-related websites, platforms (apps), digital health market reports, and health Journals to determine the trends. Extended searches focused on identifying reports on the adoption and application of specific digital health apps in the regions. For instance, a report by Clear State on digital health transformation identified five out of 14 states that have adopted telemedicine technologies. Equally, other reports also identified telemedicine along with wearable technology, and electronic health records as the prevalent trends in the region, specifically regarding the digital use of platforms and apps for health.

These trends were determined based on their repetitive mentioning in multiple digital health trend reports, specifically in more than two sources and their adoption rates across the Middle East. For example, as noted above, for telemedicine we found a report indicating that around five out of 14 countries in the region have adopted the technology. Moreover, the Middle East market for telemedicine technology is expected to grow by 10.8%. Regarding wearable technology, in 2016-17, the Middle East region experienced approximately 56% growth in the wearable device market. Additionally, many major organizations in the area are investing heavily in the wearable technology market. Finally, for electronic health records, we found out that the electronic medical records adaptability in the region is expected to grow by 8.95% by 2024.

We conducted further research to determine the pain points, and usage for each trend concerning the Middle East region and are detailed in the next — 'findings' section. The information uncovered spanned over 24 months since there was very little recent information on the subject across official publications such as Cerner, NCBI, the International Journal of Development Research, Health Care IT News, Accenture, Get app, Research Gate, EHR in Practice, and Health IT government. On that line, we expanded our scope to include reports published beyond the past 24 months to provide a complete and comprehensive overview of the trends and insights. We also found out that some recent reports quoted information from sources published in the past (beyond 24 months).

1. TELEMEDICINE WEBSITES/APPS

The use of telemedicine applications and platforms is regarded as the number one digital health trend in the Middle East according to research. Notable solutions offered via telemedicine include live consultations through devices and patient monitoring via video conferencing on websites on mobile app. Presently, around five out of 14 countries in the Middle East have deployed telemedicine capabilities. The telemedicine market in the region is expected to grow by 10.8% to reach $5.25 billion by 2025.

Influential telemedicine startups in the region include AlemHealth, CareNow, Cardio Diagnostics, Cura, and eTobb. Equally, prominent organizations in the region include a DHCC partnership with GetBEE to promote telemedicine. Prevalent pain points noted by end users in the Middle East regarding telemedicine technologies include delayed responses and interoperability issues. Others also pointed out that the lack of insurance coverage as another pain point in adopting telemedicine in the Middle East.

2. WEARABLE TECHNOLOGY

Wearables are among the most popular and trending digital health applications in the Middle East. Common ones used widely in the region feature biosensors embedded within them to track patients’ health progress via mobile apps. Many residents within the region currently use wearables. A report by DataFloq estimated that during the 2016-17 period, the Middle East region experience approximately 56% growth in the wearable device market. Additionally, research indicates that several organizations are currently investing in this market. The most common pain points identified by users of these technologies include that lack of compatible apps, high pricing, and the security for identification is a significant pain point for adopting wearable technology platforms and apps in the region.

3. ELECTRONIC HEALTH RECORDS

In the Middle East, the use of electronic health records apps and platforms are in the budding stage characterized by relatively steady growth and adoption rate. These apps and platforms are slowly getting adopted in the region since they provide real-time health record data to physicians and patients through mobile apps and websites. The electronics medical records adaptability rate in the Middle East is currently estimated to grow at a rate of 8.95%; however, research indicates that there is an exponential rise in the adoption of electronic health records across most private health care providers. For instance, from 2011-16, the adoption rates for EHR in Dubai increased from 23 – 33 hospitals.

Leading EHR platforms in the region such as Cerner Millennium features records of millions of people and allows instant access to health care providers and information. In this regard, it is possible that the technology is widely adopted in the region and that millions of residents in the Middle East are using some form of EHR technology. Unfortunately, there are some pain points that users experience with the EHR solutions offered. For instance, research shows that doctors get intimidated regarding the use of EHR apps due to lack of technological skills; patients/public doubt the data accuracy/reliability of these technologies due to the lack of secure data integration; and lastly, patients continually express concerns over data privacy of their health records.
Sources
Sources

From Part 01
Quotes
  • "The rising health care costs are largely related to the absence of a specialty, or the quality of the available treatment in the home country. According to a poll, about 39% UAE nationals said they would travel abroad for treatment, 47% in Bahrain and 43% in Qatar and Oman would also prefer to get treated abroad ."
  • "Even though a higher proportion of patients choose to travel abroad, the Gulf residents reported that they are satisfied with the quality of healthcare services provided. Treatment costs incurred abroad are mostly paid by the health care authorities and other government agencies in the Council States. "
  • "The health services in GCC are provided free of cost to all residents and health insurance is available for both the expatriates and nationals. However, to meet the growing demands of the healthcare delivery system in GCC there is a need of a strong and capable health care delivery system."
Quotes
  • "Per an Accenture survey, healthcare consumers believe that healthcare providers are taking measures to protect their digital healthcare data, with half of Saudi consumers believing their healthcare provider has sufficient security and privacy protections."
  • "However, nearly nine out of ten Saudi consumers are worried about a breach of their health information and one-third are worried about a breach of their contact information. When it comes to their health data, consumers in Saudi have more confidence in their government (79 percent) than any other country surveyed. "
  • "A significant majority of consumers (79 percent) trust the government and hospitals (76 percent) to keep their digital healthcare data secure. In fact, 41 percent have “a great deal” of trust in the government with 32 percent trusting hospitals they visit. A high percentage of people trust their physician (75 percent), their pharmacy (74 percent) and labs that process their medical tests (71 percent). Far fewer trust urgent care or walk-in clinics (61 percent) or non-medical staff at their physician’s or healthcare provider’s office (52 percent)."
  • "Of those that experienced a breach over half of the consumers in Saudi Arabia (55 percent) felt the breach was handled very or somewhat well."
  • "The consequence of the breach varied. Overall, Saudis lost more trust in their healthcare organisation than they gained. 42 percent said they had a little less or much less trust in the organisation, 26 percent said their level of trust remained unchanged and 32 percent said they gained additional trust in their healthcare organisations"
Quotes
  • "The most influential factor related to physician personal features was renown, reported by participants as either “very important” (31.7%) or “somewhat important” (23.8%), followed by physician appearance, considered to be “very important” and “somewhat important” by 28.6% and 21.1% of participants respectively. Regarding physician professional features, the most influential factor reported was previous experience of the physician for the patient or relative, considered “very important” by 66.5% of participants, followed by physician title (63.1%) and sub-specialization (57.71%). Regarding hospital factors, the availability of an appointment with a short waiting time was reported as “very important” by 59.2% of participants, followed by affordability of fees (50.0%) and hospital access (46.84)."
  • "Experience of the patient with the physician as well as physician title and sub-specialization significantly influence the choice of physician in the private sector in Saudi Arabia."
Quotes
  • "Word of mouth and previous experience are the most significant factors in how individuals choose healthcare providers in UAE."
Quotes
  • "Out of these, the lack of proper equipment and specialization, the long waiting time and bad condition of waiting area were the main repelling factors for patients. Moreover, other factors such as conditions of building, cleanliness, expertise and specialty of staff, level of health education and interaction time spend with doctor were common attributes which hindered respondents to avail primary health facility at PHCs. In another study, overcrowding and distance were reported as least encouraging factors for attending the PHCs."
Quotes
  • "In total, 167 patients completed the questionnaire. Prioritizing the attributes showed that "physical examination" was the most important attribute. Other key features included "cleanliness," "training after discharging," "medical staff attention," "waiting for admission" and "staff attitude." All attributes were statistically significant ( p<0.05) except staff behavior. "
From Part 02
Quotes
  • "5 out of 14 countries in the Middle East have a well-defined digital transformation plan for healthcare in action."
  • "Telehealth technologies are helping to make collaborative care work to address the challenge of overburdened healthcare systems."
Quotes
  • "The Middle East & Africa telemedicine market value will be $3.48 billion in 2018 and expected to grow at a CAGR of 10.8% to reach $5.25 billion by 2025 during the forecast period 2019-2025. "
  • "However, according to telemedicine industry analysis lack of interoperability between e-health solutions and delayed response time are restricting the growth of the Middle East"
Quotes
  • "DHCC’s telehealth application (telehealth.dhcc.ae) was rolled out in partnership with GetBEE (www.GetBee.com), a technology start-up specialising in business-to-business solution, facilitating live medical consultations and remote patient monitoring, RPM, as well as connecting patients through tools such as video conferencing."
  • "“DHCC facilities providing telehealth services are required to maintain documented policies and procedures to ensure safe practices and adhere to data protection mechanisms. In addition to these, DHCR conducts regular inspections to ensure compliance,"
Quotes
  • "Each HCF site in KSA is likely to have different sets of barriers and challenges in adopting and implementing telemedicine (i.e., enabling their HCFs sites to join the STN) as there are different types of HCFs participating in the KSA healthcare system (e.g., Primary Healthcare Centres (PHCs), hospitals, medical cities, etc.)."
  • "(i) the availability of adequate sustainable financial support to implement, operate, and maintain the telemedicine system, (ii) ensuring conformity of telemedicine services with core mission, vision, needs and constraints of the HCF, and (iii) the reimbursement for telemedicine services"
Quotes
  • "The Middle East’s wearables market is expected to grow significantly over the next few years, working with AI to track NCDs and other vital signs. Biosensors embedded within these devices continuously monitor a patient’s progress, while building a database of information through Big Data that can be analysed in multiple ways, leading to greater population health insights and better patient management."
  • "With one of the highest prevalence of diabetes in the world, Saudi Arabians can realise massive benefits by curbing growth of the disease through wearables and remote patient monitoring."
Quotes
  • "Certain setbacks that wearable devices are facing in MENA are of developing an appropriate app. That is user-friendly and takes care of the security of the identity of the customer."
  • "It is predicted by IDC that during the fiscal year of 2016-2017, the wearable device market is to see a growth of 56% in the MENA region which is rapidly preparing to expand its horizons in this field as well."
  • "Organizations in the Middle Eastern region are widely investing in wearable technology, but there are still many obstacles to overcome before we see a flourishing environment in this enterprise"
Quotes
  • "A lack of apps, security issues, attractive designs and high price points could limit mass adoption of wearables, he said."
Quotes
  • "In the Middle East, EMR purchasing energy is growing. The number of private healthcare groups in the region is expanding, and several public healthcare organizations are evaluating their go-forward EMR plans. "
  • "And while overall digital maturity of hospitals is lower in the Middle East than in some other parts of the world, those organizations who have decided to implement an EMR have very high expectations for deep adoption and need vendor partners who can help them meet their goals"
Quotes
  • "Mubadala Healthcare and Cerner, a global leader in health care technology, have collaborated to implement Cerner’s integrated electronic health record (EHR) at Mubadala Healthcare’s Healthpoint facility."
  • "Our patients will benefit from a seamless experience that starts with their arrival at the check-in desk. The new software will help us access the right information at the right time and supports our physicians in making the appropriate decisions for our patients. Cerner will empower us to provide our community with the health care services they deserve.”"
Quotes
  • "The Cerner Millennium® electronic health record (EHR) platform stores data for millions of people across the region, provisioning a single patient database that can be accessed instantly by participating health care providers."
  • "Cerner is a key driver in the journey toward smarter, consumer-led health care provision in the Middle East. For more than 26 years, we have connected people and systems at health care organizations of all sizes, supporting key clinical, financial and operational needs"
Quotes
  • "Concerns regarding data accuracy and reliability arise when consumers enter and update data."
  • "Data privacy and security protection are critical issues for PHRs. A recent survey found that 75% of adults without PHR would be concerned about the privacy of their health information if it were in a PHR."
Quotes
  • "The market share is valued at $13.45 billion in 2018 and is expected to reach $21.62 billion with a CAGR of 8.95% by 2024."