This document discusses the future of healthcare in the Middle East and opportunities for investors. It notes that healthcare systems are struggling to keep up with increasing demand and costs of chronic diseases. New technologies like artificial intelligence, robotics, and digital healthcare delivery could help address workforce shortages and improve productivity. These changes may significantly alter the roles of clinicians over the next 5 years. The document suggests investors should consider companies applying these new technologies to reinvent healthcare models.

1. GUIDE 2016 HEALTHCARE EXPERT OPINION
T
oday’s health challenges are simply be-
yond the control of health systems that
were built to solve a completely differ-
ent set of needs. There is an ever-increasing gap
between demand for health services and the re-
sources necessary to fulfil that demand—glob-
ally as well as across the Middle East. People
are living longer and governments are facing
the growing burden of long-term chronic dis-
ease combined with ever-increasing costs for
treatment. In addition, lifestyle-related diseases
are escalating. Heart disease is the number one
cause of death across the Middle East, obesity is
prevalent across all demographics, and there is
an alarming increase in type-2 diabetes among
the young. Finally, the resource gap is not just
about tighter finances given lower oil prices. The
Middle East has a large clinical workforce gap.
Investing in highly trained professionals
has been the traditional approach to closing the
clinical workforce gap. But is this the right ap-
proach? For example, to gain the full benefits
of precision medicine, clinicians need to know
what is relevant in a mushrooming evidence
base. The number of new studies published each
year doubles every nine years and this is com-
pounded by enormous amounts of data being
generated for each individual patient. Staying
current with this explosion of data is completely
beyond the capabilities of a human being.
At the same time as health systems are facing
this demand/resource gap, citizens in the Middle
East are ready to receive Care Anywhere; in our
recent report, 67% of those surveyed across the
Middle East are willing to access healthcare digi-
tally, outside the established clinical environment.
Digitally enabled care is no longer a nice-
to-have, but a fundamental business imperative
for reinventing how healthcare is accessed and
delivered. This is creating unprecedented oppor-
tunities to leapfrog western healthcare systems
that have been traditionally focused on the clini-
cian, the hospital, their legacy infrastructure and
incentives to maintain the status quo.
Capacity and capability are in short
supply; what should we invest in today?
There simply aren’t enough doctors and clini-
cians with enough of the right skills to treat the
growing demand. Arab Health data highlights
that 30,000 doctors, 8,000 pharmacists and
over 37,000 specialist staff will be needed in the
Middle East by 2020 to maintain its current (un-
dermanned) staffing ratios. However, there is a
lot that can and is being done very differently
today. Three areas on which Middle East health
investors can be focusing to get greater returns
in the short term are leading edge HR practices,
increasing productivity through technology and
behaviour change.
HR analytics is being used by many health-
care employers to retain staff, spotting those at
the highest risk of leaving, and using technolo-
gy to mitigate those risks. They are also invest-
ing in technology to increase the well being of
clinicians and other staff, which increases the
likelihood of becoming the employer of choice.
A greater sense of wellbeing is also linked to in-
creased productivity.
Productivity can further be improved by
investing in technology that reduces wastage of
valuable clinician time, for example by reducing
Would You Invest In A
Digital Doctor?
1
http://www.wired.co.uk/article/kyu-rhee-ibm-watson-ai-doctor
IMAGEFROMSOURCE
BY HAMISH CLARK,
PWC MIDDLE EAST
PARTNER, MIDDLE
EAST HEALTH
INDUSTRIES
16 FORBES MIDDLE EAST I GUIDE 2016

2. RAJA/FORBESMIDDLEEAST
the time expended in searching for test results and patient re-
cords, or in completing necessary documentation. We’ve esti-
mated that such an investment can provide savings of up to 4%
of total healthcare spent.
Many of the greatest productivity gains that could be made
come from investing in changing the behaviour of clinicians.
Typical gains from coaching and culture change increase the
productivity of clinicians by around 20% in almost all areas of
healthcare provision—with direct benefits in patient experi-
ence, quality of care, increased capacity and reduced cost.
Are AI and robotics the future for Middle East
investors?
Most investments in healthcare are made over the very long
term. The cost of land and building a new hospital might only
begin to generate a positive return after 10 years; and those
buildings are all designed with the assumption that the way
clinicians work in 10 years’ time will be the same as today.
But dynamic new models of care are already emerging.
A hospital without patients—effectively a command centre
monitoring (some very sick) patients at home—is currently
being built in the U.S. This model of care should make Middle
East health investors think. The organisations that will emerge
as winners in this new marketplace will be those that can artic-
ulate how technology can add value, align incentives, strategi-
cally share and analyse data, and redeploy, extend and expand
their workforce to embrace digital enablers. Given that 61%
of Care Anywhere survey respondents are in favour of home
monitoring, these changes are not in the future or somewhere
else, they are now and in the Middle East. The first investor
in a patient-less hospital will have first-mover advantage in a
dynamic and expanding market.
But there are other ways the pattern of clinical practice
may change, and change radically.
Will AI replace the stethoscope?
The human ‘face-to-face’ element of healthcare is tradition-
ally cited as vital. And yet most doctors probably spend more
time going over medical records and interpreting data from
tests and other medical interventions than actually spend
time with their patients. In addition, the majority of that vast
amount of health data is invisible to current systems because
it is unstructured.
According to IBM’s Kyu Rhee, it is a problem that “AI
doctors” can help address, with supercomputers processing
information faster and far more efficiently than human doc-
tors. Using AI systems such as IBM’s Watson—a technology
platform that uses natural language processing and machine
learning to reveal insights from large amounts of unstructured
data—data can be translated at the point of care into usable,
relevant insight. In fact, Watson has the ability to answer ques-
tions, extract key information from documents and reveal in-
sights, patterns and relationships across data.1
This may well evolve into a human-like interface for pa-
tients and consumers of healthcare services—either remotely
or in a clinical environment—where the experience will feel
Digital technology is
now fundamental to
reinventing healthcare.
GUIDE 2016 I FORBES MIDDLE EAST 17

3. like an interaction with a ‘real’ doctor. Already virtual health-
care providers like Babylon Health are combining their inno-
vative means of accessing the doctor with AI technologies that
enhance the power of diagnosis. And given that two-thirds of
Middle East Care Anywhere survey respondents are interested
in a virtual consultation by smart phone, this technology is
likely to catch on in the Middle East very quickly.
Will robots replace surgeons in the operating
theatre?
In the three decades since robots first began performing sur-
gery, the exponential advances in robotic technology are en-
hancing a surgeon’s ability to see, feel and do. Autonomous
surgery performed by robots, replacing the surgeon, is likely
to further the efficacy, safety, consistency and accessibility of
surgical techniques. Some experimental studies have already
shown autonomous robots to perform higher quality suturing
than surgeons.
Deakin University in Australia has developed a robot with
haptic technology—human touch and feel that functions as an
extension of the doctor’s arm. In other words, what the robot
feels and does is felt and done by the doctor, and can be con-
trolled from hundreds of miles away from the patient. While
this technology is currently undergoing trials and is not being
used in the context of surgery, the potential is enormous.
What’s next?
The next five years will be critical in making the leap from
using these technologies as add-ons to making them fully
integrated tools that allow for lower cost care alternatives and
create data-rich insights into real-time care delivery.
So far, we are only beginning to see AI, robotics and Care
Anywhere as a means of accessing healthcare. As each of these
three areas develop, and more importantly as each combines
and integrates, as in the case of Babylon Health, the potential
for change and the impact it will have on the role of clinicians
is staggering.
But healthcare is personal. As you read this, you will not
only be thinking about your business opportunities, you will
be thinking about your own personal experience of healthcare,
which raises a whole series of questions:
How would I feel if my doctor wasn’t human? What if my
doctor was a robotic technology platform capable of learning,
diagnosis and treatment that was outperforming my specialist
or family doctor? What if that doctor was a robot performing
surgery on my mother?
For now, the role of an AI doctor or surgical robot isn’t
intended to replace the human component of medicine, but
to complement it by augmenting the precision skills and data
analysis necessary for the diagnosis and treatment of a broad
range of healthcare needs. In addition, the uniquely human
capabilities for compassion, common sense, and morality—as
well as the ability to abstract or generalise—remain of utmost
importance to health outcomes.
One day though, AI and robots may attain these funda-
mentally ‘human’ capabilities. So for investors looking towards
the future, you may well invest in a doctor, just not one you
presently recognise.
ROKASTENYS/SHUTTERSTOCK.COM
EXPERT OPINION
Studies have
shown that robots
can outperform
surgeons.
18 FORBES MIDDLE EAST I GUIDE 2016