Telehealth in the Middle East

Appdragon's business development director, Saadi Hussain, has been flying in and out of the middle east region on a regular basis and has developed a good understanding of the Telehealth opportunity there.  

With a penchant for running marathons in the Sahara Desert, he understands the challenges and ideologies of the region and the benefits that Telehealth could bring if implemented well.

It's by far from a complete view as the cultural, political, geographical and socioeconomic mix is broad and varied, but its conclusion is fairly similar to that reached in other geographies - Telehealth is going to be major.

If you look at Bahrain for example, the population is relatively small at 1.3m people (smaller than Greater Manchester) and close to 89% live in urban areas.  Kuwait has a population of 3.2m and 98% of those live in urban areas.  Oman however, has a less urban society with just 73% living in urban areas.  The geography and social history of the region explains why there's a penchant for urban living, but what affect might this have on health provision and in particular Telehealth services.

Well one of the usually cited USPs of Telehealth is somewhat negated by such a large urbanite population - that Telehealth brings quality healthcare to the remote, generally poorer rural communities.  If most people live in the cities, where hospitals and clinics also tend to be located, then the inconvenience of travelling to a healthcare provider is less prevalent. 

Kuwait has some state of the art health facilities but faces challenges like anywhere else

However, city living also has its health related drawbacks. Both the ability to afford and the availability of rich, luxury foods makes diet a big concern and the high, growing occurrences of diabetes and obesity as well as the knock-on heart conditions, are testament to this.  Also, more of the population undertake "city" jobs, often based in offices   or factories, with less fresh air and exercise that their rural counterparts.

Let's consider obesity and males in particular.  In the UAE 30% are considered obese. In Saudi Arabia it's just shy of 29%. Over 31% in Qatar are considered obese and almost 38% in Kuwait. Bahrain and Oman have the lowest rates at 24% and 19% respectively.

So we've established that city living could cause more health problems, but how can Telehealth help in the urban setting?  Well, getting around in the city isn't as easy as you might think because of traffic and transport issues. Busy, hectic lifestyles leave little time to visit clinics for checkups and the high pace of life has a telling effect on blood pressure - especially for those individuals with poor diet and exercise regimes.

Telehealth allows the busy city slicker to keep tabs on their health and vital signs at a time that's convenient for them, without having to take time out of their day.  Spotting symptoms early can enable more effective intervention and potentially improved health outcomes as a consequence.

Telehealth also, importantly, provides healthcare providers, governments and employers with a wealth of important health trend data that can be used to spot and deal with trouble spots or high risk jobs or areas.

Also, with some many people in one small space, waiting rooms and hospital wards become overcrowded.  This is especially the case in countries like Kuwait where a large part of the healthcare provision is funded by the state, so budget is limited.  Telehealth can help manage this by reducing the need for in- and out-patient appointments for checkups and also to reduce the number of interventions requiring clinic or hospital attendance.

Setting up a patient to use SmartMed to monitor their own health in the home

Telehealth also allows those undergoing treatment to be discharged sooner, in the knowledge that they can monitor their recovery from the comfort of their own home using Telehealth services such as SmartMed's HomeCare solution.

This is just a snippet of the opportunities for improved healthcare that Telehealth can bring in the Middle East.  For further information and to find out more about SmartMed speak to our agents in the region Harrington Consultants.

Saadi Hussain
Business Development Director
SmartMed mHealthcare Solutions

Telehealth Can Make a Difference in Bangladesh

Appdragon is about to launch its SmartMed HomeCare telehealth service into Bangladesh after several month's of successful piloting.  Telehealth services can make a real difference in developing countries like Bangladesh, where mobile networks are typically much better than fixed telephony networks, with greater reach and data rates.  This is generally because of foreign and local government investment in what is regarded as one of the key infrastructure components, but also because there are relatively fewer and smaller copper wire networks to maintain, so funding can be directed straight at the newest mobile technologies.  Also, mobile network infrastructure is less costly and quicker to deploy, requiring less below ground work and cable laying.

The availability of mobile technology isn't the only factor that makes Bangladesh the perfect place to deploy telehealth solutions though.  You only need to look at the demographics of the country to realise that the provision of suitable healthcare, to all, is problematic.  There is a total population of 156.6m with an annual growth rate of over 6%.  However, life expectancy isn't on a par with other developing nations at 69 years for females and 71 for males.  This means a larger middle and old-aged population, a group of society who are traditionally heavy users of health care services.

Then consider the geography.  There are several major cities, with Dhaka the largest of the all counting for about 7m people, with a total of 29% living in urban areas. This is low compared to the region where the average is 34% and globally the average if 54%. This all means a large majority of the population are spread out across the rural lands, with relatively poor transport connections and challenging terrain including mountains, rivers and jungle.  Getting to and from hospitals which are entered around the big four cities is therefore challenging, time consuming and expensive.

If we look at the availability of health care professionals in Bangladesh, again the stats suggests a very strained infrastructure with only 3.6 physicians per 10,000 people (the regional average is 5.9 per 10,000).  Nurses and midwives are even more scarce at 2.2 per 10,000 (15.3 regional average).

High blood pressure affects 27% of those aged 25 and over, higher than the 25% regional average.  9.9% of females (9.8% of males) have diabetes, again higher than the regional average. In real terms, that means that over 42m people have blood pressure issues and around 30m have diabetes related health issues.  Obesity, though relatively low compared to the West (just 1% of the population are affected) is growing at an alarming rate and 1% still means 1.6m are overweight to an extent where it can affect their health (source: WHO website).

So we have the factors that lay the foundations for the need for telehealth: 1) good technological infrastructure, 2) poor transport infrastructure, 3) a large, dispersed rural population and 4) significant health problems and 5) very low availability of health services and qualified clinical personnel.

SmartMed HomeCare will start to address this by enabling patients, initially in the suburbs of the major cities, to monitor their own conditions from home whilst SmartMed's qualified physicians monitor the patient's progress remotely from the Dhaka based SmartMed Telehealth Centre.

This not only means the patient doesn't need to struggle across the busy, traffic choked city to attend a clinic thereby improving their quality of life and reducing the strain on busy clinics and hospitals, but it also means more regular checks and timelier interventions.  Ultimately this will result in fewer escalations and complications of the illness, requiring less in- or out-patient attendances.  

In Bangladesh we have teamed up with local, well-respected doctors who were trained in the NHS in the UK but have practiced in Dhaka and Bangladesh for many years.  Our intention is to use local knowledge and expertise to deliver services usually reserved for the wealthier end of Western society to as many people as possible across Bangladesh.

Our next launch will be the HealthWorker proposition, which addresses the needs of the 300,000 or so community based healthcare workers across the country.  Providing them with SmartMed's Android based apps and Bluetooth medical peripherals will allow them to see more patients in a shorter space of time, have qualified, experienced clinicians analyse the results and advise them on any interventions and it will enable them to deliver a broader level of services, addressing a greater number of illnesses and conditions.

It's clear that telehealth isn't the ultimate solution to healthcare problems in the developing world but in Bangladesh, we sincerely believe that telehealth and SmartMed in particular will make a big difference to the quality of care many thousands (and hopefully millions) of people can receive. Wherever they are...

For more information on our Bangladesh offerings, please visit our localised web-site at www.smartmedbd.com or check out or video of how SmartMed HomeCare works in the UK market .

Healthcare providers. Do you want to reduce your waiting lists?

Dumb question. Of course you do. Healthcare providers everywhere face the enormous challenge of providing quality health outcomes for the millions of patients suffering with chronic illnesses.  Escalating pressure on medical resources mean hospitals, clinics and GPs are looking to alternative ways of dealing with the problem, without the need for significant capital investment.

Achieving better healthcare for everyone. Everywhere.

The answer could be tele-health, such as Appdragon's SmartMed (TM) offering.  Tele health is the provision of health care away from the hospital, clinic or surgery.  This could be in the patient's own home, at their place of work or, virtually, anywhere. With modern lifestyles, it's frustrating and stressful for patients to be tied to clinic appointments for routine testing, and it's also expensive for health care providers to provide frequent assessments.

Is Tele Health the Answer?

Tele health, if correctly implemented, can address this conundrum by using mobile broadband, smart phones and app technology to empower and enable the patient to take control of their own condition.  This can lead to better engagement of the patient in managing their own progression of their pathway.  Patients may become much more aware of the symptoms and ways of minimising the affects of their condition.  For example, studies show that patients regularly testing vital signs relevant to a chronic illness, are more likely to stick to diets, prescriptions and exercise regimes.  Of course, it's not the ultimate solution and it won't work in every instance, but for those patients and health care providers that do buy into this new approach, the potential gains are clear.  Reduced health care costs due to fewer in- or out-patient admissions, sooner discharge after minor operations or procedures and fewer re-admissions to hospital. For the health care provider then, a reduction in costs and the ability to divert scarce resources to primary care and emergency treatments (or even research and development) are the main benefits.  For the patient and society at large, an empowered patient could mean less stress and better motivation to take control and manage their condition. This could mean slower progression of chronic conditions and fewer episodes requiring treatment or time off work or absence from loved ones.

SmartMed's Article in Global Health Opportunities 2015

In a future blog I'll talk a little more about what tele health actually is and how it could work in certain scenarios, but for now, take a look at our web site for more information, or read our article on page 101 (or our ad on page 60) of the latest edition of Global Opportunity Healthcare Journal 2015.