Healthy returns

By Julian Rogers, Deputy Editor

The healthcare sector in the UAE is forecast to swell at an annual rate of more than 13 percent by 2012, according to research. Meeting this growing demand will be the role of Dubai Healthcare City (DHCC) as Business Management’s Julian Rogers discovered when he books an appointment with Dr Ayesha Mohammed Abdullah, SVP of the DHCC.

“We looked at other countries and very early on we realised that if we were to make DHCC a magnet for healthcare, and really compete in the global arena, it was very important to work with partners who have a lot of experience”
-Ayesha Mohammed Abdullah

Lying in the heart of the city, Dubai Healthcare City (DHCC) is the world’s first healthcare free zone with 92 clinical outlets. Launched in 2002, the concept of the city was to curtail the flow of UAE residents travelling abroad for operations and treatment. The long-term vision is for it to become an internationally recognised location for quality healthcare, as well as integrated centre of excellence for clinical and wellness services, medical education and research. Dr Ayesha Mohammed Abdullah, who has 18 years’ healthcare and engineering experience, says the DHCC is forging strong partnerships with international pharma companies and universities to turn Dubai into a healthcare hub.

How does DHCC fit in with Dubai’s strategic plan for 2015?
Ayesha Abdullah. Dubai Healthcare City is the brainchild of His Highness Sheikh Mohammed Bin Rashid Al Maktoum and the goal was to contribute to Dubai’s strategic plan, which establishes Dubai as a global city. And one of the key infrastructures of any global city requires that it includes education on healthcare. The DHCC also came about primarily because there was a major gap in the region when it came to tertiary healthcare and higher education. In healthcare we are providing a platform for international and regional operators to come and set up shop in DHCC where we have a very stringent regulatory function. And we are building a university teaching hospital, as well as several hospitals that are currently under construction and two that are already operational. We have nearly 100 clinics and the goal is that DHCC will contribute to the GDP of Dubai, and we build a healthcare destination.

What are the key benefits of operating within the DHCC?
AA. We like to position DHCC as the quality destination for healthcare. So what’s currently happening is a lot of people from the region are going abroad to get medical treatment, as well as going abroad to get higher education in medicine. For example, if you’re a medical doctor, you go to one of the medical schools in the region but if you wanted to specialise you would have to go abroad. But what we’re doing is providing the higher education in medicine in DHCC, either through our strategic partner, Harvard Medical School, or through some of our other medical education partners. We also have dental education through a collaboration that we have with Boston University. We also have some of our other providers, such as the Royal College of Surgeons in Ireland, which are offering medical education here. We have a diverse group of providers.

The other key benefit is that this is a free zone, so there is 100 percent foreign ownership. So if you were an international provider and you wanted to set up shop in DHCC, you wouldn’t need a local partner. We have a one-stop shop for clearing visas and all government-related matters. The other benefit, of course, is as a free zone you can get customs exemptions, if you were to import, say for example, equipment. And more importantly, we make sure that every provider that comes into DHCC meets very stringent international requirements – the same that you would if you were to go to the United States or any European country. There same type of rules would apply. And, of course, having all these policy operators coming together, operating in a cluster, also creates synergy. They can work together, there are networking opportunities and cross-fertilisation of ideas. So you’re working in an environment of like-minded people.

What role does the Center for Healthcare Planning and Quality play in regulating the city?
AA. When we first conceptualised the idea about a healthcare city it was very important that we would be a quality provider. In order to lay the groundwork for this, we set up the Center for Healthcare Planning and Quality to have an independent regulatory function that serves purely the DHCC. So if we were to bring physicians to DHCC, what would be the licensing requirements? What kind of board certifications would they need? We go back to where they went to school to make sure that they actually graduated or they don’t have fraudulent degrees, to see the quality of their training, to see whether they have any malpractice lawsuits, or whether they’ve had any ethical or professional gaps. We also look at how many patients they’ve seen, their success rate and how many operations they have carried out. And we make sure that there is ongoing quality overview once the clinic is awarded a licence. If you look at patient satisfaction you will see that we’ve had a very high satisfaction rate of 89 percent for several years. This is a good indication that not only is the patient getting quality healthcare, but also that patient experience is important here, everything from the waiting room to the ambulance is about the feel-good factor that the patient will experience.

We do clinical planning to make sure that the entire value chain of healthcare is available in DHCC. So if you needed plastic surgery, dental care, tertiary surgery, cardiac care, fertility treatment or whatever it may be, it is all available. We have a thorough network so we are using very sophisticated IT networks and IT systems that will monitor the quality of care offered at DHCC. So for every physician we could actually go and audit his electronic health record and see whether is he working outside his practice. What’s the success rate? Are there medication errors? That way, we work very closely with our providers so that we make sure that they actually increase the bar in terms of quality. The Center for Healthcare Planning and Quality then benefits the consumers – the patients – in that they know that the units core function is patient safety and prioritising their safety and the quality of care that they get.

DHCC has partnerships with the likes of Harvard University, as well the pharma giants Novartis Astra and Zeneca. How does this aid DHCC in its efforts to be a world-renowned medical facility, and also make Dubai the healthcare capital of the Middle East and, perhaps, even the world?
AA. When we started working on the concept of DHCC we looked at other countries and very early on we realised that if we were to make DHCC a magnet for healthcare, and really compete in the global arena, it was very important to work with partners who have a lot of experience. Hence, the collaboration with Harvard Medical School. We also understood that in order for us to build a sustainable ecosystem for healthcare, it’s not enough to just provide quality healthcare, but it’s also important to have education, where you train the future physicians and nurses who are going to work in the system. They need to be of a very high calibre so it is important to build that human capital.

Also, this education has to be gained in a research environment, so you have to build a research platform. Initially, of course, we cannot create the work labs that you would find in America. But I think you can bottle what you call ‘translational research’, which is research that benefits the patients directly. Through Harvard University and Harvard Medical School we set up a research foundation, which is called the Dubai Harvard Foundation for Medical Research (DHFMR), which is a US$100 million endowment, whereby we train the future primary researchers from the region. This foundation is not only for Dubai, but it’s actually for the entire Arab region.

Our researchers are awarded fellowships and they go and work in labs at Harvard University and we fund them for the duration of their postgraduate period. But one of the criteria is that the research that they’re working on has to be relevant to the region. So when they come back, they can actually set up labs, and we assist them with this. The goal is that these kinds of researchers come to DHCC or anywhere in the region, and then we work very closely with them. And, in parallel, we’re setting up a research programme where we’re doing epidemiology studies. Eventually, when most of the hospital is open in DHCC, then we’re going to get to a stage where we could start clinical trials for some new drugs, which is where the pharmaceutical companies come in. We will be in a position then to work with five or six pharmaceutical companies that we have already attracted on clinical trials. So we believe the future of healthcare is going be customised care, which is where the clinical trials and specialised medicine will come in. We are in a position then to benefit from the presence of these pharmaceutical companies.

The alternative medicine market has mushroomed in recent years. Do you see this developing in the city?
AA. Definitely. At DHCC there is an opportunity not only to work on traditional medicine or Western medicine because there’s a big movement, specifically in the West, to go for complimentary and alternative medicines, which is what we call integrated medicine. This is another area that we’re pioneering in DHCC. Through the Center for Healthcare Planning and Quality we have developed very comprehensive standards and regulations for regulating what is offered in complimentary and alternative medicine. Although there are hundreds of complimentary and alternative medicine disciplines, we’re only concentrating on those that have a track record of safety and efficacy.

We also give our patients a variety of choices. If you need a painkiller, you don’t necessarily have to take the traditional, perhaps you could take herbal remedies that will be equally as effective minus the side effects. Just like how we’ve worked with Harvard on the research and education, we set up a high profile council, where we have the likes of Dr Andrew Weil, a guru in complimentary medicine and integrated medicine. We also have Teresa Hale from the London Hale Clinic and others so these are experts who are there to advise for us in the area of complimentary and alternative medicine. This is an industry that will grow because it’s driven by patient need.

Demand for healthcare in the GCC is expected to soar by as much as 240 percent in the next 20 years, with the bulk of this being in the UAE and Saudi Arabia. Do you think the UAE is in a position to cope with this rise and how will DHCC play its part?
AA. The statistics, of course, are driven by a lot of factors such as lifestyle and an ageing population. If you look at the population of the GCC you will find it is a fairly young population but with the life expectancy extended to around 70, we’ll have an elderly population. There are different ways of looking at this: there will always be demand for healthcare and it will keep increasing but I think what’s very fortunate is that we take a strategic approach to how we meet these healthcare demands. It’s also about creating public awareness and public health campaigns where we push a lot of these responsibilities back to the patients and educate them about self-help, educate them about the importance of preventive medicine, rather than being reactive and looking after them after they are very sick, which becomes a very costly affair.
So what we’re trying to do, as part of social responsibility, is to create awareness. If you have a history of something like diabetes or blood pressure or whatever it may be, because some people are genetically inclined this way, you will be screened way before the disease manifests. We’d help to change your lifestyle, such as nutrition and so on. So we have an entire cluster engaged in working on prevention and this is where the complimentary and alternative medicine are both going to be. I think Dubai and the UAE are very well positioned, not only to meet the demands of its local population, but also to attract people to get medical services in DHCC.

How important is medical tourism is to DHCC?
AA. Medical tourism is an important component for DHCC. But any healthcare institution has to cater first to its local population because healthcare is very local. It’s only when people can’t find the services close to home, or it’s very expensive, that people go abroad. Most of these will likely be cosmetic or dental surgeries, where people can actually go as tourists and then go home. There are people who will also go for a bypass surgery or a hip replacement and this requires an extended stay in a hospital because you need time to recover and go through some rehab before you can go home. The UAE spends billions of dirhams sending people for medical tourism. The patient travels with their families and this means a lot of expenses and a lot of money leaves the country. Our first emphasis is to encourage those people that currently go abroad from the region and from the UAE, to stay and come to DHCC.

People don’t need to go to Europe or America, mainly because of our partnerships. If you wanted to do a cardiac assessment, then you could come to the Mayo Clinic. A lot of people go to Moorfields Eye Hospital in London for eye operations but Moorfields is here too. For plastic surgery we have the American Cosmetic Surgery Hospital and people can get the same work done as they would in the United States. So the same surgeries are available in the UAE and the same thing applies for city hospitals and general hospitals that have centres of excellence in cardiology. So with all these brands, and with all these specialised services, we are in a position then to attract a lot of medical tourism. We also have niche services, like mental health, that are very difficult to find in the region, so people will come automatically. And we hope once everything is open we will be in an even better position to attract more and more medical tourism. I would say maybe anywhere between seven to 10 percent come from overseas at the moment so we’re already seeing the medical tourism. But it will take time for it to become a major component.