Telehealth: Is it the Future of Healthcare in the MENA Region?

Various advancements in the healthcare sector have been made due to a compelling blend of technology and the health profession. In this current era of communication and information technology, Telehealth is not only being used for long-distance consultations but has also led to the emergence of various health-related educational resources that aid in the advancement of medical education around the world, equipping professionals with the necessary knowledge and skills. Due to the benefits that Telehealth has to offer in a variety of communities, there has been a decrease seen in commuting for healthcare, an increase in remote admissions, a further decrease observed in the operational costs and support for healthcare providers. The Arab countries, sharing common culture and language, tend to have a broad spectrum of differences in terms of the availability of healthcare amenities in their regions.

At one end of the pole, there are oil-rich and natural resources-rich countries, including Saudi Arabia, Qatar, Kuwait, and the United Arab Emirates (UAE), whereas on the other there are countries such as Yemen, Palestine, and Syria that suffer from conflicts, famines and poverty. The considerable discrimination in between their quality of life is a major setback for poverty-stricken countries to access healthcare facilities for all. Telehealth or advancing digital solutions have the potential to drive these regions to achieve a sustainable development goal. It has been largely witnessed that the GCC countries have made substantial investments in both healthcare and Telehealth. Countries such as Bahrain have invested in developing the Dilmunia Health District on a manmade island, and Oman, which is currently constructing the International Medical City, is working continuously towards building the best-in-class infrastructure and state-of-the-art technologies

Steps that have been taken to increase prospectively related to Telehealth

Tele-health solutions were not in vogue for MENA hospitals and clinics before the eruption of the pandemic. Before the rising of the pandemic situation, the service providers and recipients did not incorporate digital platforms in their everyday activities, however post-pandemic, there became a dire need to do so, considering patient reluctance to visit the hospitals due to the increased risk of getting COVID. Before the advent of the COVID 19 outbreak, there were many hurdles in the way of telehealth adoption, like the lack of digital infrastructure, business incentives, regulatory frameworks and policies and cyber security threats to both the system and the data.

In the year 2019, the federal medical liability law of 2016 (‘Medical Liability Law’) was issued, setting out amongst the other things, the terms and conditions for offering Telehealth services in UAE, thereby solidifying the level of permissibility and parameters for providing such services at the federal level. Earlier, federal laws related to the practice of human medicine and the medical liability law of 2008 had included a mandatory protocol for the physicians to check the patients face-to-face and to conduct a physical, in-person examination. The Medical Liability Law generated a way for the health authorities in UAE to start a system that permitted the provision of distance health services.

Although in the year 2017, the Dubai Health Authority had passed Administrative Decision Number 30 of 2017 for regulating the practice of telehealth services in the Emirates of Dubai, there was no such progression observed in the telehealth scenario immediately after that. However, after the outbreak of the Covid-19 pandemic, Dubai has witnessed a rise in the provision of telehealth services. Since the year 2020, the telehealth service providers in medical centers and hospitals had started to offer a 360-degree solution using the help of a regulation-compliant health information system (HIS), supporting patients living in remotely built areas. Also, in 2019, Vice President and Prime Minister of the UAE and Ruler of Dubai, H. H. Sheikh Mohammed bin Rashid Al Maktoum, had listed around nine articles, further transforming the shape of Telehealth in Dubai, amongst which Article 5 is titled as the “A Doctor of every citizen” is the most famous. It constantly aims to provide the citizens with medical consultations 24/7 via a myriad of doctors, specialists and other medical consultants around the globe. It will be aided by the smart government application. The goal of the government enlists the transformation of the medical system in order to bring doctors closer to individuals, thereby improving awareness and utilizing the top doctors that help to assist the citizens on a continued basis. When launched, the services were available for Emirates only; however, after the spread of Covid-19, it was extended for all the residents of the emirates of Dubai and consultations related to coronavirus were also a part of the programme.

The UAE Ministry Of Health And Prevention (MoHaP) had also started the international telemedicine services in the year 2020, wherein they helped both the doctors and patients receive second opinion consultations remotely in case of critical health scenarios. The services were found to be available in 16 public hospitals under the ministry’s Visiting Consultants Programme, spanning across all medical specialties such as the Al Qasimi Hospital, Kuwait Hospital (Sharjah), KhorFakkan Hosptial, among others. The patients have the permission to connect with adequate consultants abroad via the video calling services when visiting the hospital. It had also initiated a chatbot service called Virtual Doctor for Covid-19, where people can readily access if their symptoms could be associated with novel Coronavirus-19. The patients can thereby be connected to the concerned doctors via this facility. Other recently launched options by MoHAP, in collaboration with the telecom company Du, include the first virtual hospitals in the Middle East for offering remote care facilities to the patients. It had also upgraded all its hospitals’ outpatient clinics into virtual such as Aster DM Virtual Outpatient Department (OPD) and TruDoc 24×7’s Health & Wellness Virtual Clinic. The UAE’s Mulk Healthcare had also launched the first” e-hospital” as a downloadable app for providing global medical services.

Speaking of remote care apps, such as the DOH remote care app launched by the Department of Health-Abu Dhabi, via which patients were free to receive the needed healthcare at their homes, without the requirement of visiting hospitals/clinics physically. The app comprises tools for the purpose of examining symptoms, diagnosing non-emergency cases, registering for appointments and getting consultations from doctors using telecommunication options.

In the previous year, in the COVID -19 therapy market, six telemedicine solutions were approved for their use in UAE by the Telecommunications Regulatory Authority (TRA). The new telehealth providers and facilitators that came out with telehealth solutions were NextGen Healthcare, VSee, OKADOC, Doxy.me, GetBEE, as well as Mind Mina Telemedicine. It is as a result of the Telecommunication Regulatory Authority that has made continued efforts in ramping up the hospitals and clinics for providing remote healthcare facilities. The Department of Health and the National Emergency Crisis and Disasters Management Authority’s Weqaya had also launched an app called TraceCovid, for the purpose of tracking cases. The solution uses Bluetooth in order to pick nearby signals from smartphones and allows the identification of a person who had probably come in contact with someone who tested positive for COVID-19.

Another solution launched by GE Healthcare, also known as the “CT in a container,” comprises advanced Computed Tomography (CT) equipment, which would help in diagnosing viral pneumonia attributable to COVID-19. They were released in association with SEHA and Abu Dhabi International Medical Services; the product is fully-insulated and self-contained containers that were both built and assembled in UAE and were allowed in temporary tactical areas wherein people suspected of COVID-19 were tested without the need of them to enter into hospitals.

The National Health Information Centre linked to Saudi Health Council and connected to an automatic network of health information with MOH and other government agencies have launched the Saudi Telehealth Network initiative for connecting different specialized health care facilities with the primary health care centers and hospitals in remotely situated areas utilizing telemedicine systems. The Ministry of Health has also launched smartphone applications for promoting Telehealth. These include Seha, Seha for Doctors, Tetamman, Tabaud, Tawakkalna, and others.

Current Scenario, Challenges and Proposals for Implementing Telehealth across MENA

Telehealth is a door via which healthcare will be delivered to patients in the future. The current need for social distancing in a safe environment due to COVID-19 is clearly encouraging Telehealth and how it has allowed the transition to consumer-centric care paradigms. Technology has aligned with more than 50% of the hospitals in UAE, wherein they are using various IoT-based solutions and almost 90% of the doctors are currently using medical apps for providing healthcare facilities to patients. The government is making continued efforts to support the rise of telematics infrastructure and the advancement of telemedicine application, thereby providing country-wide provision of healthcare services in the future with various initiatives. An array of companies are also providing teleconsultations, from independent telemedicine companies to health insurers. Further, access to Telehealth has also ended barriers such as adoption due to an increase in reimbursement facilities because of the pandemic. However, certain challenges in terms of the lack of federal guidelines in the UAE will be restraining the Telehealth players from expanding their services to all the emirates due to different regulatory requirements. As a result of this, a significant concentration is seen in major cities like Dubai and Abu Dhabi. Similarly, there are barriers with respect to acceptance, standardization, technological, cultural/ethical, legal issues at both ends, including physicians and patients. COVID-19 effect on pharmaceutical industry can be witnessed as it has driven a lot of physicians towards the acceptance of telemedicine. The current use of Telehealth has experienced a predominant surge due to COVID-19 and the government, along with the telehealth providers, need to continue this trend in order to make healthcare accessible for all. The current need is to improve maximum patient engagement for Telehealth and related services along with the creation of adequate infrastructure and platforms which allow smooth and holistic care across different healthcare settings.

Source: DelveInsight – www.delveinsight.com