Imagine waking up in the morning and checking your watch to see how many hours of deep, restful sleep you obtained, your caloric intake from the day before, and your body temperature.
You head to the fridge to grab some food and it assesses the ingredients present and recommends recipes that meet your dietary requirements, with complete calorie and nutritional information. It can also warn you that you’re running low on milk and fruits.
Just as you’re about to step out the front door, your watch beeps, reminding you that it’s time for your daily vitamin supplement and displays your BMI and blood pressure.
Health and wellness, often the purview of medical practitioners, is now no longer shielded from the digital age. With a device like FitBit becoming a ubiquitous accessory, experts at the world's first interactive digital health event - Digital Health Live - assert that it won’t be long before an array of similar technologies permeate our lives, radically changing the way we perceive and monitor our health.
The power of tech and health
Digital health spans wearables (such as monitoring vests), mobile wellness apps, portable electronic medical records and DNA sequencing. “There’s an important distinction to be made between digital health and health IT,” said Jack Young, Senior Director of Qualcomm Ventures, overseers of a $100 million fund for digital health (their best known investment is FitBit).
“Digital health utilizes technology to improve health and wellness outcomes, not just taking technology to automate a process. Digital health encourages a seamless connection between different technologies, drives continuity of care, reduces care gaps and ensures the early initiation of preventative care.”
Accomplished business veteran John Sculley, former CEO of Apple and Pepsi and once the boss of tech legend Steve Jobs, was there. He worked with Jobs in “pursuing the noble cause” of changing the lives of consumers. His new mantra? Focus and investment towards healthcare innovation, or as he puts it “the Uber-ization of healthcare.”
Health industry innovators predict a shift towards virtual tools. These include sensors and biomarkers that automatically notify both the wearer and their medical practitioner, and insurance company, in the event key health indicators deteriorate and need attention.
MENA’s potential for digital health leadership
Healthcare proves both a critical and rapidly growing sector in the Middle East and North Africa, with demand far outpacing supply owing to the growing population and shifting disease demographics, the latter largely prompted by sedentary lifestyle habits resulting in the rising prevalence of obesity, diabetes and cardiovascular diseases. In 2011, approximately 27 million people in the region had diabetes according to the International Diabetes Federation. In barely four years, that number has already risen to 37 million, and IDF estimates nearly 68 million diabetes sufferers by 2035.
While both the public and private health sectors are meeting the challenge by increasing healthcare spendingwith this year’s MENA healthcare spend projected as US$125 billion aloneseveral experts at the conference deliberated that significant efforts are still needed to leverage digital health at the primary care level.
The general consensus was the rethinking of healthcare outside of the “doctor-hospital model.” In the words of Cleveland Clinic's Executive Director of Innovation, Gary Fingerhut, it is “dated and ineffectual.” Fingerhut also said that “until today, the crux of healthcare provision is still the doctor in a hospital. The fact is, hospitals are to healthcare what Blockbuster is to movies today...irrelevant.”
Brian de Francesca, founder and CEO of Dubai-based Ver2 Digital Medicine speculated that the tremendous regional spending on hospital and healthcare projects, often operated in partnership with leading Western medical institutions, are not necessarily the recipe for improving health outcomes.
“Healthcare needs innovation, not architectural creations,” said de Francesca, adding: “Digitization is far more important than building massive hospitals. Imagine if every one of us had an intelligent automated weighing scale at home that would monitor our BMI and blood pressure and make suggestions for potential interventions very early on, much before someone becomes obese and develops a roster of chronic complicated ailments.”
Several speakers remarked that region’s “greenfield” status allows for ample opportunity to build the healthcare model of the future. “Dubai can become the international center of excellence for digitizing medicine,” ventured Fingerhut, adding: “In fact, the traditional healthcare model needs an overhaul and the Middle East might very well be the region that shows us how.”
De Francesa added that the region’s thirst for advancement should be tempered with discernment so as not to replicate copies of Western healthcare models, already riddled with fragmentation, dense regulatory frameworks and stakeholder politics.
Self-professed “health hooligan” Dr. Gautam Gulati, Adjunct Professor of Medical Innovation and Entrepreneurship at the Johns Hopkins University reinforced this position: “As a ‘greenfield’ the Middle East presents an opportunity to establish a sophisticated and seamless healthcare system from the ground up, versus replicating Western models.”
Gulati added that there needs to be a move towards 21st century thinking, “where holistic experiences are designed for people and take into account people’s perceptions and empathy. Look at what Dementiaville is doing for dementia sufferers.”
Healthcare: Still in tech slumber
While clear that engaging consumers through everyday smartphone technology proves the most effective method of adapting health behaviors, why has the medical establishment been so slow to embrace technological change? An answer could be the response from Dr. Aaron Han, Chief of Pathology at the American Hospital in Dubai: “At the risk of affronting my doctor colleagues, let’s face it, we doctors are terrified that digital health technologies will make us redundant. So much of the healthcare infrastructure policies and institutions are governed by doctors or former doctors who wish to maintain this fraternity. This is perhaps one of the main reasons why technology is yet to be utilised in a widespread manner.”
This systemic inertia towards digital health is clearly impeding the progress of healthcare across a number of fronts, including drug development. “50 percent of all drugs prescribed to patients in the US do not work. Medication that works at discrete molecular processes levels only works effectively on a very small portion of the population,” shared Daniel Kraft, Faculty Chair of Medicine at Singularity University. Kraft noted: “This is where genomics and pharmacogenetics plays a role. The pharmaceutical industry is aware of the positive clinical impact for several years now and including genomics as part of a clinical trial is a foregone conclusion that has yet to materialize in practice.”
The lack of uniform regulatory and quality standards across the region when it comes to health technology also proves a hindrance towards digital health adoption,rendering these technologies as “consumer products” as opposed to “medical products.” Medicine relies on a burden of irrefutable evidence regarding the efficacy of a medical product or device in treating or alleviating a health condition. Since the current regulatory landscape overwhelmingly applies only to pharmaceuticals and certain medical devices/accessories, the establishment of special regulatory councils that pertain to digital health technology would improve its acceptance by the medical establishment and consequently uptake by patients.
The diagnosis for digital health entrepreneurs
The landscape for digital health entrepreneurs in the region appears promising. Two smartphone applications will be launched in Dubai later this month. Designed by Oubai Abbasi, Same’e is a visual app that loads patient information through a video call with sign language so emergency responders can communicate with deaf patients, while Olem is tailored for blind patients and is voice activated through a smartphone.
“You need techies and medical professionals to work together,” said Young. “If you start out in a new therapeutic area, for which no decisive clinical studies or medical research has been conducted, the burden rests on you to prove efficacy and outcomes.” He pointed out that many digital health aspirants develop technologies based on respected study findings, thus eliminating the need for extensive evidentiary proof.
“Investors typically do not have the patience or the foresight to appreciate that the dynamics of digital health are different,” quipped Aschkan Abdul-Malek, founder and CEO of AlemHealth. He added: “Digital health has a different pace when it comes to pivoting your idea, a slower one compared to other sectors. It can take up to a decade before you can even go to market, precisely because the burden of proof required to validate a health technology is immense.”
The future of healthcare is shifting from one of reactive care to proactive care, no longer focussed on treating people when they are sick but inspiring them to lead a healthier lifestyle right from the start. Digital health methods and applications are at the forefront of addressing a myriad of current healthcare challenges across many countries, including the increasing battle against chronic diseases and the pressure to reduce healthcare spend. As Sculley stated: “The consumerization of healthcare will be bigger than the PC revolution...mark my words.”