Telemedicine in the Middle East, the time is now

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FVC and Du demo the capabilities of telemedicine at GITEX
The time is now. (Image via CommsMEA)

In 2001, a team of French and American physicians in New York made history by remotely conducting surgery on a patient in Strasbourg, France, relying on broadband transmission and a surgical robot named Zeus.

This landmark trans-oceanic operation, referred to as
the Lindbergh operation, catapulted telemedicine from the realm of science-fiction into reality.

According to the American Telemedicine Association, telemedicine constitutes the use of medical information exchanged from one site to another via electronic communications to improve a patient’s clinical health status.

Often interchangeably referred to as telehealth, the practice includes a growing variety of applications and services using two-way video, email, smart phones, wearable devices, wireless tools and other forms of telecommunications technology.

John Nosta. 

“Telemedicine is nothing new,” suggests John Nosta, a global digital health evangelist and Google Health advisory board member.

He continues: “When the telephone became a common household device, patients started using the phone to speak to their doctors instead of going to a clinic or getting him/her to make a house call. The telephone is technology, that conversation is care. Together, that’s telemedicine.”

The applications can involve two modes of communication: real-time (synchronous) - such as when consulting a remote specialist or conducting continuing medical education - or store-and-forward (asynchronous), where digital data is transmitted to a practitioner in order to acquire additional input for a diagnosis.

A new era in medicine?

The momentum behind the growing global adoption of telemedicine only gained strength earlier this decade.

Recent research indicates that the global telemedicine market is poised to reach $27 billion in value in 2016 with an annual growth rate of 18.5 percent and projected patient acquisition of seven million by 2018.

Research firm Kalorama Information named telemedicine as one of the top five health trends for the year while IDC Health Insights projected that 65 percent of transactions with healthcare organizations will be mobile by 2018.

These startling stats seem a by-product of increasing public insistence for innovative healthcare delivery models, spiralling healthcare costs, rapid developments in web and mobile connectivity and digital technology coupled with a modern-day hyperconnected on-demand culture.  

“Doctors spend a lot of time with patients who don’t need to be in their clinic,” explains Nosta, adding: “A quick video consultation to diagnose a common cold or asynchronous messaging frees up that doctor’s time to see several more patients for routine issues or dedicate their attention in-person on trickier cases.”

Talk of telemedicine is heating up hospital corridors and investor circles in North America, with some of its largest health insurers readily coming on board, ex-Apple CEO John Sculley backing MDLive and even Google launching a telehealth pilot.  

Today, neurologists can “beam in” on stroke victims to provide instant life-saving assessments and patients recovering from surgery at home can request an electronic house call via video with their surgeon.

Regional impact of telehealth

In the Middle East, and especially in the oil economies of the Arabian Gulf, telemedicine has garnered pockets of support both across the governmental and private sectors and few, yet promising, success stories have emerged.

Brian de Francesca.

“We’re going through an exciting transition in medicine thanks to the phenomenal growth of cognitive computing, analytics and ubiquitous broadband connectivity,” says Brian de Francesca, founder of Dubai-based  Ver2 Digital Medicine which offers integrated digital medicine services.

The American, a former chief officer with Johns Hopkins Medicine International, adds: “Twenty years from now we won’t be having this discussion. There won’t be this moniker of digital medicine, telemedicine, m-health etcetera. It’ll just be the norm, just medicine.”

Caring for critically underserved populations

A fundamental tenet behind telemedicine has been to bring better care to underserved and remote areas.

“We want to bring healthcare to the next billion, people in some of the most impoverished parts of the world,” declares former healthcare investment banker Aschkan Abdul Malek.

As founder of the Dubai-based and Startup Health-backed AlemHeath, Malek believes the young enterprise will address the growing chasm in provision of quality healthcare in developing nations and war-torn areas: “In Iraq and Afghanistan, the ratio of doctors to patients is one-one hundredth of that in developed countries, maybe even worse in some areas. Many Afghans travel to India just to get routine medical care. The market need and basic humanitarian call to serve is undeniable,” he contends.

AlemHealth creates a low-cost, low bandwidth approach to diagnostic telemedicine that is ideally suited to resource limited areas or rural areas in semi-developed countries.

The AlemHealth model for getting patients to doctors. 

The service, which connects healthcare practitioners and institutions in resource-challenged economies to a global network of accredited specialists, has amassed increasing number of subscribers, bringing in revenues fairly quickly.

“We’ve established telemedicine services in hospitals and clinics in Kabul and we’re looking to scale, expand our reach to sub-Saharan Africa, MENA and Southeast Asia. Wherever there is dire human need for quality healthcare, we want to be there,” says Malek.

A tool for democratizing medical education

The speed with which telemedicine allows world class education and diagnosis to be imparted across borders renders it a brilliant tool in the promotion of international health, believes de Francesca.

Having spearheaded distance medical education programs in the past, he explains: “The production of qualified medical staff is a constant requirement for healthcare systems across the globe, however access to continuing medical education about the latest research and practices is prohibitive due to cost.”

His solution? A simple video conferencing program virtually connecting students to medical professionals.

Monitoring health information to save lives

Telemedicine can also reduce costs and improve outcomes by remotely monitoring people with chronic conditions.

Sankari with Obama at the White House this year. (Image via CardioDiagnostics)
Ziad Sankari meeting President Obama.
(Image via White House press office)

Lebanese entrepreneur Ziad Sankari established CardioDiagnostics following the untimely death of his father due to his inability to receive critical care during a heart attack.

Sankari pursued his engineering education in the US and returned to Lebanon to launch the cardiac technology startup, subsequently winning the first place award at the 2011 Global Innovation through Science and Technology (GIST) led by the US State Department.

We are the first commercial cardiac telemetry technology developer,” says Joana el Khoury, their business development manager. “Our niche focus is on mobile cardiotelemetry and we’re now moving from the diagnostic space into the wearables arena, to allow preventive care as well.”

CardioDiagnostics appears to be the cynosure of the global and regional medical technology fraternity. With Sankari recently in the White House to receive commendation from President Obama, a number of projects in the R&D pipeline and its recent entry into Saudi Arabia and Kuwait, the company setting the tone.

The future of telemedicine

For telehealth to grow in the region, there need to be a number of factors in place:

An agile and advanced regulatory infrastructure. Ragy Khairy, founder of telehealth platform Eshraq explains: “Medical regulation in this part of the world is still evolving. When it comes to regulation pertaining to telemedicine, it’s entirely uncharted waters.”

The 'lifesense' device for tracking heart arrhythmias.

Investing in outcome-based health practices and technology versus expensive hospital construction. de Francesca affirmed his longstanding view that “healthcare needs innovation, not architectural creations.” He adds: “Creating a world-class healthcare system of the future relies on harnessing technology that takes both physicians and patients into account.”

Policies and practices to encourage a rich ecosystem for medical innovation. “As a greenfield, the Middle East is in prime position to learn from the mistakes of mature healthcare ecosystems,” says Nosta. “A collaborative national or even regional platform that involves medical practitioners, students, researchers and healthcare investors could set the tone for the future.”

More investors with a solid understanding of impact investing and the unique forces affecting healthcare startups. Both Khairy and Malek rue the general investor appetite for healthcare startups in the region. “Locally, one of our investors is WOMENA, and while there are some visionary and pioneering investors, by and large it seems most regional investors veer towards startups in the food delivery, retail and fashion sectors versus fledgling healthcare enterprises that save lives.” 

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