an Economist Intelligence Unit business Healthcare A report by The Economist Intelligence Unit Digital Health: Digital Transformation in the Middle East Integrating technology to solve the regions healthcare challengesThe world leader in global business intelligence The Economist Intelligence Unit (The EIU) is the research and analysis division of The Economist Group, the sister company to The Economist newspaper. Created in 1946, we have over 70 years experience in helping businesses, financial firms and governments to understand how the world is changing and how that creates opportunities to be seized and risks to be managed. Given that many of the issues facing the world have an international (if not global) dimension, The EIU is ideally positioned to be commentator, interpreter and forecaster on the phenomenon of globalisation as it gathers pace and impact. 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We specialise in these key sectors: E IU C onsumer : We help consumer-facing companies to enter new markets as well as deliver greater success in current markets. We work globally, supporting senior management with strategic initiatives, M for others it begins earlier by figuring out the way digital health is relevant to them, what they can shape and influence in healthcare, and where they need to adapt. In this report, explore how digital technologies are shaping the Middle Easts healthcare ecosystems, activities and stakeholders in significant ways. It is also on this deepened understanding that we examine the opportunities and challenges that lie ahead in the realities of finding digital health solutions for this region. Ivy Teh Global Managing Director, Economist Intelligence Unit, Healthcare Managing Director, Clearstate 1 Worldwide searches on digital health, Google Trends, 2017DIGITAL HEAL TH: DIGITAL TRANSFORMATION IN THE MIDDLE EAST INTEGRATING TECHNOLOGY TO SOLVE THE REGIONS HEAL THCARE CHALLENGES © The Economist Intelligence Unit Limited 2018 2 Acknowledgements T his report engaged healthcare stakeholders in follow-up discussions and interviews to present a comprehensive and integrated picture of the digital health ecosystem. We would like to thank all contributors and interviewees for their time and insights. Contributors in alphabetical order: Rajat Karol, General Manager - Healthcare Digital, Eastern Growth Markets (Saudi Arabia, Turkey, Middle East) and Africa, GE Healthcare Jim Massey, Innovator, Middle East, Cerner Sondos Samara, Chief Executive Officer and Founder, SanadyMe Dr. Rakesh Suri, Chief Executive Officer, Cleveland Clinic Abu DhabiDIGITAL HEAL TH: DIGITAL TRANSFORMATION IN THE MIDDLE EAST INTEGRATING TECHNOLOGY TO SOLVE THE REGIONS HEAL THCARE CHALLENGES © The Economist Intelligence Unit Limited 2018 3 Scaling up digital health solutions in the Middle East: The seeds of digital transformation 5 Locating technologys value proposition in different markets 8 - Collaborative care anywhere: Reaching patients with multiple care points with telehealth 8 - The big data vantage point: Artificial intelligence 10 Future care models for the Middle East: Keeping people healthy 13 Digital health: Not a question of if, but when and how 15 ContentsDIGITAL HEAL TH: DIGITAL TRANSFORMATION IN THE MIDDLE EAST INTEGRATING TECHNOLOGY TO SOLVE THE REGIONS HEAL THCARE CHALLENGES © The Economist Intelligence Unit Limited 2018 4 Executive Summary 5 out of 14 countries in the Middle East have a well-defined digital transformation plan for healthcare in action. Governments, healthcare providers and companies will have to figure out how to initiate entire healthcare ecosystems to adopt new technology-enabled ways of solving challenges in healthcare. Scaling up digital health solutions in the Middle East: The seeds of digital transformation Government-led digital transformation efforts in several parts in the Middle East are reshaping how individuals and organisations in the healthcare ecosystem are interacting with each other. There is a stronger need for collaboration and companies will need to engage with other players on new terms. Locating technologys value proposition in different markets Digital health instantiates itself uniquely in different countries and markets faced with an exclusive set of healthcare challenges. We examine how quality care can be extended across distances by growing telehealth use in different settings and geographies. We also look at data-driven solutions that are used to create smarter, more efficient and more precise healthcare delivery and patient experiences. Future care models for the Middle East: Keeping people healthy Digital technology is making new care experiences possible by reshuffling delivery nodes of different medical services that will bring opportunities in decentralised and near-patient products and services. DIGITAL HEAL TH: DIGITAL TRANSFORMATION IN THE MIDDLE EAST INTEGRATING TECHNOLOGY TO SOLVE THE REGIONS HEAL THCARE CHALLENGES © The Economist Intelligence Unit Limited 2018 5 Scaling up digital health solutions in the Middle East: The seeds of digital transformation A ccess to digital health innovations does not depend solely on technologies, but on the broader environment where government-led digital transformation efforts are critical in enabling the use of technology to address healthcare challenges at scale. Often, deep-seated institutional and regulatory barriers, rather than technical challenges, are what stand in the way of innovations reaching providers and patients. In the Middle East, a wave of digital transformation is taking place in healthcare. Economic calculations and policies are paving the way for digital transformation in the regions healthcare. Governments are now exploring the enormous potential of technology to improve the efficiency of healthcare as they seek to moderate and manage healthcare spending. 5 out of 14 countries in the region have a well-defined digital transformation plan for healthcare in action. Saudi Arabias National Transformation Program 2020 was launched to realise Saudi Arabias Vision 2030, aims to improve healthcare using information technology and through digital transformation. By 2020, 70% of Saudi citizens will have a unified digital medical record 2 that will support the digitisation of health services and care models. The entire healthcare landscape is shifting. Fast-growing digital health ecosystems have emerged as a result of national drives to diversify the economy. In Israel where the government identifies digital health as a national economic growth engine, start-ups and extensive innovation networks via digital Figure 1: Countries with dened healthcare strategy for digital transformation Source: EIU, MOH, Clearstate analysis. Israel Fast-growing digital health ecosystem with digital health identied as a national growth engine. Digital technologies integrated into public healthcare delivery. UAE High-tech medical cities forming out of Dubai Health Strategy 2021 and Abu Dhabi Healthcare Strategic Plan 2015-2020 Saudi Arabia Digital transformation initiative under NTP 2020 and Vision 2030 to improve healthcare Qatar National Health Strategy 2018-2022 to optimize digital health solutions. Qatar Genome Project to sequence and integrate individual genetic data into national electronic medical records. Oman Building a connected healthcare environment for its population and healthcare businesses 18 41 20 N/A 45 Business environment rank (2018-2022, out of 82 countries across the world) Key: 2 National Transformation Program 2020, Government of Saudi Arabia, 2016DIGITAL HEAL TH: DIGITAL TRANSFORMATION IN THE MIDDLE EAST INTEGRATING TECHNOLOGY TO SOLVE THE REGIONS HEAL THCARE CHALLENGES © The Economist Intelligence Unit Limited 2018 6 health incubators and accelerators backed by multinational companies have since blossomed in the country. Governments are proving to be the key catalyst connecting organisations to establish collaborative centres to co-create digital solutions for healthcare. The co-creation of solutions is happening across industry domains with the increasing participation of technology companies in healthcare innovation; and together with users and customers with companies interacting with local hospitals and governments to test and build innovations to meet unique challenges. MindUP , the first digital health incubator in Israel, was founded as a joint venture of Medtronic, IBM and Rambam Medical Centre, a leading hospital in the country, and two other venture capital companies. MindUP was established with the support of Israel Innovation Authority. Not only has digital technology brought new value to the users of healthcare products and services, it is also reshaping how individuals and organisations in the healthcare ecosystem are interacting with each other. From smaller tweaks in patient behaviour related to seeking care, to large-scale transformation of providers who have digital business models to deliver healthcare services, the evolution of individuals and organisations in the ecosystem means they must each engage other players on new terms. In the next section, we look at key areas where technologies are harnessed to create value for patients and the healthcare system. Figure 2: How the healthcare ecosystem gets redened? Source: Clearstate analysis. Start-ups new professions introduced to managing emerging product categories Healthcare Providers Locus of delivery of medical services reshues; new types of providers emerge e.g. virtual clinics, internet hospitals Payers Leverage big data analytics to lower healthcare cost while improving care outcomes EcosystemDIGITAL HEAL TH: DIGITAL TRANSFORMATION IN THE MIDDLE EAST INTEGRATING TECHNOLOGY TO SOLVE THE REGIONS HEAL THCARE CHALLENGES © The Economist Intelligence Unit Limited 2018 7 Key implications: l For digital health to take off, there must be a fundamental shift in how stakeholders collaborate. Achieving a vibrant digital health ecosystem often requires government action. l Governments and organisations need a strategy not just for itself, but for the entire digital health ecosystem. l To scale digital health use, companies need to understand and respond to local challenges and varying levels of readiness for technology adoption in different markets. l Companies can seed change in different markets more effectively and quickly by setting up centres for digital health in strategic locations with high digital density, leading to the formation of digital hubs.