February 2018
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TOP 10
Medical Device
manufacturers
Medicare 3D
PRINTING
has arrived
MetroHealth Hospital in a park
Non-invasive
BLOOD GLUCOSE monitoring
WINNING the
WAR
Color’s Co-founder and President, Othman Laraki, on tackling on the world’s most challenging health problems
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FOREWORD HELLO AND WELCOME to the February 2018 edition of Healthcare Global. This month we feature an exclusive interview with Othman Laraki, Co-founder and CEO of Color, who discusses how the business works to blend technology and genetics in order to solve one of the tackle serious hereditary conditions. Technology is impacting every area of the healthcare industry. The emergence of 3D printing within the sector has led to the release of new official guidelines by the FDA, where the technology continues to support the medical industry, transforming traditional procedures and surgical guidelines. We take a look at this rising market, alongside commentary from industry experts, who discuss how the use of 3D printed implants within surgery continues to grow, providing patients with a higher quality of life. Diabetes is also a growing healthcare trend, affecting 370mn people
worldwide. With this growing challenge, Business Chief speaks with Professor Werner Mäntele at German startup DiaMonTech, and its development of a new, non-invasive way for diabetics to manage their glucose levels. The increased need for new settings of acute care has also led to a boom in healthcare construction. We take a look at Ohio’s new Metro Health facility, which is situated amongst 25 acres of green space and is set to completely transform how hospitals are designed in the future. On top of all this, we take a look at ProClinical.com’s 10 favourite medical device companies, as well as a number of key industry events and conferences within healthcare this calendar year. We sincerely hope you enjoy the issue, and as always, please tweet your feedback to @healthcareglbl
Enjoy the issue! www.healthcareglobal.com www.bizclikmedia.com
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F E AT U R E S H E A LT H C A R E S T R AT E G I E S
Solving one of the world’s biggest health problems with technology
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3D PRINTING is no longer the technology of the future – it’s now here to stay MEDICAL DEVICES
DiaMonTech
The development of non-invasive blood glucose monitoring 4
February 2018
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H O S P I TA L S
‘HOSPITAL IN A PARK’, Could it pave the way for a greener future?
C O M PA N Y PROFILES
44 TOP 10
TOP 10 MOST SUCCESSFUL MEDICAL DEVICE COMPANIES
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Service New Brunswick CANADA
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EVENTS
Dr Sulaiman Al-Habib Medical Group MIDDLE EAST
LIST
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Gulf Health Council MIDDLE EAST
56 Events 5
INTERVIEW
Solving one of the world’s biggest health problems with technology By combining state-of-the-art technology and genetics, Color Genomics is helping to solve one of the world’s biggest healthcare problems: cancer Wr i t t e n by LE I L A H AW K I N S
INTERVIEW
COLOR GENOMICS’ INNOVATIVE health service can identify serious hereditary conditions such as cancer and high cholesterol, as well as giving patients a better idea of their chances of falling ill in the future. Prevention and early detection would create huge savings for healthcare services around the world, as well as the clear benefits to people’s lives. As Othman Laraki, Co-founder and CEO of Color Genomics explains: 8
February 2018
“There is no incentive for people to not get genetic counselling.” The tests currently analyse 30 different genes associated with eight common types of hereditary cancer as well as cardiovascular risk. Patients order the testing kits online, provide a blood or saliva sample, and within a couple of weeks the results are emailed back to both them and their doctors. After this, they can discuss the results with Color’s genetic
proved to be wrong,” Laraki says. Color constantly updates its model when new genes are discovered, and when there is a medical consensus to confirm these can lead to serious health problems. Recently it launched Color Prime for people to keep up to date with these latest discoveries. Laraki explains how valuable this is, “because if you go and get tested pretty much anywhere in the world you will get today’s version, but if a new gene gets added to the list you won’t get tested for that by default, and you might be a carrier for that permutation. That’s something we’re unique in doing.”
counsellors and move on to the next steps. With all the initial consultations done online, this is a low overhead process saving doctors valuable time. The technology it employs is extremely precise, and is one that is being used in clinical labs around the world including the UK’s NHS. When a gene mutation is found it is sequenced for a second time to ensure accuracy. “We’ve literally never had one where the first one
The benefits Laraki explains that the benefits of genetic testing to patients can roughly be divided into three categories: prevention, early detection, and treatment. On the prevention side there are lifestyle choices; being overweight and excessive alcohol consumption are traditionally associated with a higher cancer risk, which is exacerbated in people who are mutation carriers. Medication can also have an impact, for instance studies have shown 9
INTERVIEW that a daily dose of aspirin can substantially reduce the likelihood of developing colon cancer. Then there is surgery, a drastic choice - such as the headline-grabbing story of Angelina Jolie who as a BRCA1 carrier underwent a double mastectomy and had her ovaries removed - but one that is increasingly becoming part of the recommendations by US doctors for certain high-risk patients. In terms of early detection, “it’s all about screening,” according to Laraki. “One thing we’re seeing is that almost independent of risk level, the genetics and the awareness you bring to people has a big effect on getting people to comply with their screening guidelines.” He explains that for men in
“Just moving the cancer diagnosis up a stage, from four to three, three to two and so on, you double the survival rate and take out 50% of the cost” OTHMAN LARAKI Co-founder and CEO of Color 10
February 2018
their 50s, only 30% will get screened, however, if they’re aware they are Lynch syndrome carriers for example, which increases the risk of stomach cancer, this figure rises to 90%. The third part is treatment. “If someone has a mutation it has a big effect on how they are treated,” says Laraki. “We just announced a study we’re doing with Fred Hutchinson University in Washington, where we’re testing all metastatic prostate cancer patients in the entire state, because if you have prostate cancer and you have a BRCA2 mutation the type of therapy you should be getting is different, and that has a big impact on outcomes.” The company Getting access to genetic information has traditionally been very expensive, however, since Color launched its BRCA1 and BRCA2 tests for $100 in October 2017 they’ve proven to be very popular. Over time the company is planning to expand testing to other forms of cancer as well as other health areas. The big motivator, as Laraki explains, is to focus on prevention and early detection. “If you look
Color - Genetic Testing for Hereditary Cancer Risk at our healthcare spend, in the US especially but it’s very similar across the world, most of it is on treating disease. The basic model is that we wait for something to break and then we try to fix it. In the US only 3% of healthcare spend is on prevention. Just moving the cancer diagnosis up a stage, from four to three, three to two and so on, you double the survival rate and take out 50% of the cost. “That’s a bigger impact than any cancer therapy that’s ever been invested in its history. It’s
achievable through prevention and early detection. “There’s a massive shortage of genetic counsellors globally,” he continues, “so we built a lot of tools that enable our counsellors to spend the vast majority of their time talking with patients and doctors. We’ve seen a significant increase in of doctors who are not cancer or cardiovascular disease specialists starting to adopt genetic testing as part of general prevention.” This is beneficial to patients, but 11
INTERVIEW
OTHMAN LARAKI Co-founder and CEO of Color 12
February 2018
also helps to educate OB-GYNs and general practitioners who may never had to counsel someone on genetic mutations before. The plan is to roll the scheme out worldwide, but the challenge is to get local doctors fully trained in genetic counselling. “[In the] UK there’s already a lot of genetic counselling availability, but there are definitely countries where there’s a lot to do, where there’s zero local genetic counselling. That’s going be an important aspect of our growth, in terms of how we bridge that gap for different geographies.” Laraki believes that the UK is likely to become one of the world leaders in doing this population level prevention, where he says “there’s definitely a lot of forward thinking.” The future “I do think it is literally the highest ROI investment that is available in healthcare, for both wealthy countries like the UK and the US, as well as developing countries,” Laraki says. “If you look at a country like Nigeria, 180mn people have 40 oncologists, that’s less oncologists than in London. There needs to be a big investment on the treatment side, but I think there
“I do think it is literally the highest ROI investment that is available in healthcare, for both wealthy countries like the UK and the US, as well as developing countries” OTHMAN LARAKI Co-founder and CEO of Color might be an interesting effect where similarly to how a lot of developing countries leapfrogged from landlines directly to cellphones, I wonder whether we might see something similar on the prevention side. “For every late stage cancer you prevent, you can provide genetics and early detection for 1,000 people from the beginning. It’s going be interesting to see the broad adoption in countries like the UK and the US. I think in the next few years there’ll be true population level precision prevention, but it might also happen in developing countries in a similar time frame.” 13
H E A LT H C A R E 4 . 0
3D PRINTING is no longer the technology of the future – it’s here to stay The US Food and Drug Administration has released official guidelines for the use of 3D printing in medical care. Stuart Hodge looks at what that will mean for the industry Writ ten by STUART HODGE
H E A LT H C A R E 4 . 0 THE EMERGENCE OF 3D printing as a viable technology which can be used in the medical industry is nothing new, but it has moved forward in leaps and bounds over the past 12 months. Last year in India, a 32-year-old woman with tuberculosis of the spine who had suffered severe damage to her first, second and third cervical vertebrae and who was facing potential paralysis had her damaged vertebrae wteam of specialist surgeons. Surgery of this type had never been performed in India before but the growing confidence of
medical professionals in 3D printing technology and their keenness to use it as well as the obvious surgical skill allowed that woman to walk again. This is one of a number of examples of how 3D printing is fast becoming a viable option in wider medical practice – and with the United States’ Food and Drug Administration (FDA) choosing to release the first “comprehensive technical framework” to advise manufacturers creating medical products on 3D printers, it seems that the technology is now here to stay. In producing the guidelines, the Building Evidence for 3D Printing. Presented by: Lauralyn McDaniel, SME; James Coburn, FDA; and Fried Vancraen, Materialise May 2016 at Building Evidence for 3D Printing Applications in Medicine colocated with RAPID 2016
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KEY CHALLENGES WITH THE TECHNOLOGY, ACCORDING TO MCDANIEL… •R egulatory environment: “The FDA’s release of the final guidance has made this bit less of a challenge, but some of the underlying needs are still a challenge. When possible, the FDA refers to existing standards. For additive manufacturing (AM), this is an area with much work to do and one to which I volunteer my time through the America Makes/ANSI AM Standardization Collaborative, ASTM F42 Committee, and ASTM/ISO joint groups.” • T echnology and materials: “Faster processes capable of micro and nano-level precision are needed to expand the applications. The number of materials that can be printed needs to expand, whether for strength, biocompatibility, and/or ease of sterilisation. What can be printed today is limited when compared to traditional manufacturing methods.” • Reimbursement: “For some areas like anatomic models and surgical guides, reimbursement is very limited. Most have found a way to justify their use through overall savings or value-add, but being able to include proven 3D-printed models, guides, etc. as those covered by payers will greatly increase their impact on patients.” •Q ualified workforce: “The growth of AM3DP in medicine requires the collaboration of medicine and engineering with AM3DP-trained bioengineers playing a key role.”
FDA reviewed more than 100 devices currently on the market which were manufactured on 3D printers, including a number of patient-matched devices, tailored to fit a patient’s anatomy, such as knee replacements and implants designed to fit like a missing puzzle piece into a patient’s skull for facial reconstruction. “In order to help ensure the safety
and effectiveness of these products, we’re working to establish a regulatory framework for how we plan to apply existing laws and regulations that govern device manufacturing to non-traditional manufacturers like medical facilities and academic institutions that create 3D-printed personalised devices for specific patients they are treating,” said 17
H E A LT H C A R E 4 . 0 FDA Commissioner Scott Gottleib, upon the release of the guidelines. “Overall, it will help manufacturers bring their innovations to market more efficiently by providing a transparent process for future submissions and making sure our regulatory approach is properly tailored to the unique opportunities and challenges posed by this promising new technology.” “Promising new technology” may even be an understatement. It’s estimated that 100,000 knee replacement surgeries are now completed each year using 3D-printed, patient-matched surgical guides – just one specific application within the entirety of the industry. Lauralyn McDaniel is Industry Manager of Medical Device Manufacturing for not-for-profit SME and she is as enthusiastic as anyone about the role 3D printing has to play in medicine moving forward. “I would not be surprised if more than a quarter of hospital patients globally will be directly impacted by the technology in 10 years,” she says. “Medical applications have always been a leader in using the technology for end-use. With the ability to build from medical imaging data 18
February 2018
“With the United States’ Food and Drug Administration choosing to release the first “comprehensive technical framework” to advise manufacturers creating medical products on 3D printers, it seems that the technology is now here to stay” LAURALYN MCDANIEL Industry Manager of Medical Device Manufacturing to create truly personalised tools and devices, AM3DP (Advanced Materials & 3D Printing) is an enabler for precision medicine. “From anatomic models to support patient education to developing patient-matched devices to treat rare diseases like Tuberculous Meningitis, I think the entire healthcare industry is beginning to understand the impact it can have.” No doubt, the ability to match
Medical 3D Printing TEETH
ORGANS
PROSTHESIS
BONES
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H E A LT H C A R E 4 . 0 the construction of devices to an individual patient is one of the leading benefits. For some devices, additive manufacturing and 3D printing offers a method to more effectively create complex structures, more closely matching a person’s anatomy – “such as the porous structures need for osseointegration of orthopedic implants,” suggests McDaniel. The ability to cost-effectively manufacture on a smaller, more precise scale has potential for development of devices for rare conditions. One of the greatest benefits of the technology for any industry is the complexity it enables, which is such that traditional design and engineering approaches often have to be put to the side. With 3D printing in particular, surfaces and structures can be optimised for strength, weight and material use. With this in mind, the FDA has characterised the guidelines not just as a “comprehensive framework” but also as what they are calling “leapfrog guidance” offering the Agency’s “initial thoughts” on medical devices created by additive manufacturing. For McDaniel, this is an important distinction. 20
February 2018
“Essentially, this a manufacturing method,” she says. “It’s not often that a regulatory body would provide guidance on a manufacturing method. “That the FDA has done this indicates an understanding of the possibilities and a willingness to help the industry understand that it can use AM3DP for medical devices with some considerations. They have also dedicated resources to help better understand the technology, conducting research on material properties and other key factors in additive manufacturing. “The key takeaways from the report are that the FDA is anticipating
“More capital needs to be invested developing integrated systems within the 3D printer that monitor the source code that designs the device, and the reliability of the output of the printer” Dr. Robroy MacIver
that even more applications will be developed due to the unique capabilities of AM3DP, and that they want to support the efforts through a regulatory process that supports the next generation of devices. “With the publication of the final guidance, the FDA has indicated the technologies can be used safely and they’ve provided the framework to do that as AM3DP processes get faster and even more precise including to the micro and nano-scale. This can only help.” One of the key goals here for the FDA is to establish a standard process for production of these
devices which ensures they are safe. “More capital needs to be invested developing integrated systems within the 3D printer that monitor the source code that designs the device, and the reliability of the output of the printer,” Dr. Robroy MacIver, a congenital heart surgeon who has pioneered the use of 3D printed models for surgery preparation, told Medical Design and Outsourcing. “Safety, therefore, will depend on adherence to a rigid process, rather than simply the end result.” The requirement to establish a cover-all-bases approach which is safe does not, however, mean that all 21
CURRENT APPLICATIONS OF THE TECHNOLOGY BEING USED IN MEDICINE... • General: Non-personalised instruments or prototypes • Anatomic models: patient education, surgeon review, resident/surgical education and simulation/practice • Surgical planning: guides, templates • Personalized/precision prosthetics • Permanent implants: includes both serialized and patient-matched implants • Active & wearable devices: combines printing of biocompatible materials with printed electronics • Tissue fabrication & bioprinting: Scaffolds for skin and bone are already in some use. Printing of organ tissues for testing of drugs is also already in use. 22
February 2018
H E A LT H C A R E 4 . 0
research into how the technology can be used, adapted and developed will now grind to a halt. In fact, according to a recent report published by Market Research Future, the general global 3D bioprinting market is booming, and is expected to gain prominence by demonstrating spectacular growth over the next decade. Many industry experts actually expect to see major innovation in the space over the coming years. “The access to patient-matched devices will be enhanced greatly by the FDA’s acceptance of this new technology,” Dean Carson, vice president of U.S. operations for medical-device manufacturer Anatomics, told Modern Healthcare. “They’re trying to create a pathway that people can walk along in order to create high quality implants that meet all the standards. “You’ve got two ends of the spectrum: the companies trying to create the products that are going to advance healthcare and then FDA trying to ensure those products are as safe as possible. A guidance document like this is bridging the gap.”
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MEDICAL DEVICES
DiaMonTech
The development of non-invasive blood glucose monitoring
With Diabetes a growing challenge for the healthcare industry, German startup DiaMonTech has developed a non-invasive way for diabetics to manage their glucose levels. We talk to founder Professor Werner Mäntele W r i t t e n b y P E T E R TA B E R N E R
MEDICAL DEVICES PROFESSOR WERNER MÄNTELE has considerable experience as a physicist and a physical chemist, and is now Head of Research and Development for DiaMonTech, which has developed technology to revolutionise monitoring glucose levels for diabetics, using molecular spectroscopy – the study of the absorption of light by molecules. Mäntele has a broad history in analytics and medical issues, in particular molecular analytics. For the past 40 years there has been work on molecular spectroscopy, which he is now using to benefit diabetes
DiaMonTech products
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patients by offering a non-invasive way to keep track of glucose levels. Diabetes is not only becoming a wider issue among the world’s population, but billions every year are being spent on controlling the disease. Diabetes: A growing industry According to a study by BCC Research, the global market for diabetes therapeutics and diagnostics was valued at $110bn in 2011 and was set to reach $118.7bn the following year. 2017’s market value was expected to reach nearly $157bn after increasing at a five-year CAGR
of 5.7%. Grand View Research has also predicted that the global market for devices alone – that is, diagnostic, monitoring and insulin delivery products – will reach $35.5bn by 2024. Grand View cited major drivers of the market as “the growing number of diabetic patients owing to sedentary lifestyles and unhealthy food habits”. The report also stated that the “growing demand for advances and minimally invasive diagnostic, as well as monitoring, devices is expected to propel the market growth”. There’s certainly a demand for a new type of diagnostic product, since Grand View has found that “in 2015, the test-strips sub-segment captured the largest market share in the blood glucose monitoring and diagnostic devices segment” which accounted for around 71% of the total market as it is an area of high repeat purchases. The diagnostic and monitoring segment, according to Grand View, was set to maintain dominance
‘Non-invasive glucose measuring has become more of a holy grail within the market for diabetic products in recent years’ over the next few years “owing to the introduction of technically advanced products coupled with the high adaptation of these products in the near future”. Non-invasive glucose measuring has become more of a holy grail within the market for diabetic products in recent years. Currently, most techniques to evaluate glucose levels are invasive, carrying the risk of infection. They are also considered a detached and impractical method to continually measure glucose levels. The problems for non-invasive glucose measuring are that it remains difficult to accurately test for blood sugar without breaking the skin, as levels of sugar in the blood vary. In addition, according to the Diabetes Control and Complications Trial and Follow-up Study, intensive control 27
MEDICAL DEVICES MEASUREMENT PROCESS
GERMAN ENGINEERING
It’s important that every detail has the highest level of precision in order to get accurate readings. That is why we only work with the best companies worldwide and manufacture our devices locally. DiaMonTech is truly “made in Germany”. 28
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After you place your finger gently on the sensor, a light beam is directed to it. Glucose in your skin transforms that light to heat. This minimal change in temperature (you won’t notice it) is measured by our detection system. Our device then calculates your blood sugar level based on the temperature change.
and management of blood glucose reduced the risk of complications for eye diseased by 76%, kidney diseases by 50%, and nerve diseases by 60%. Replacing needles with light beams That’s where DiaMonTech comes in: the company has now patented technology whereby an invisible infrared light beam is placed into the skin, enabling the beam to calculate glucose molecules non-invasively. An optic lens guides the infrared laser beam to a sensor crystal, burying the laser further into the skin. At the heart of the measurement system is a state-of-the-art quantum cascade laser, which emits the infrared light in a spectral range, which is then absorbed by the glucose. The Berlin-based startup was founded in 2015 by Mäntele and current CEO Thorsten Lubinski, who has vast experience in startups. However, Mäntele, inspired to make game changing progress in molecular spectroscopy, had started out with a fundamental scientific view of this problem 20 years ago. Since then, there has been a gradual evolution in achieving glucose
monitoring without pricking a finger for blood. Mäntele reflects: “We could apply the technologies we had in medicine and we started to investigate blood samples and measured them, and then believed we could use more elaborate methods around 2005, measuring molecules through skin. “I saw the necessity to do this, but it required improvement and cooperation between doctors and scientists. Our biggest challenge is the human skin which varies from person to person and with time. To develop a quantitative molecular measurement system and to discern between molecules is a huge mountain to climb.” Around 2010, molecules in the skin could be measured in laboratories, and it was then decided to move the process from research to the development of a prototype. The funding received from the business angels was imperative, as industry partner support was necessary to build a prototype – even the big players in diabetes were hesitant to take any part in clinical testing. The research and development programme from DiaMonTech will be completed in three stages, with 29
MEDICAL DEVICES the base model taking the form of a shoebox sized contraption providing all optical and electronic components as well as data processing. This element is due to be completed in 2018. Based on what is experienced with this device, miniaturisation will proceed towards a pocket device, which has attracted the sobriquet the ‘muffin’. This portable pocket glucometer is due to be ready in
Prof. Werner Mäntele Head of R&D
Thorsten Lubinski CEO
Otto Hertzberg R&D 30
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2019, and as it can be carried around day and night by the end user, it will make it possible to monitor blood sugar levels frequently. The final piece of the DiaMonTech jigsaw is to create a wrist watch device which will be able to constantly screen blood glucose. It is hoped that this will be ready by 2021. Alarm features will be part of the design, in order to track glucose levels and notify the user if they are too high or too low.
Dr. Rainer Gith Legal Counsel
Alexander Bauer R&D
A German company with global potential DiaMonTech prides itself that all of its technology and devices have so far been completed with German DNA: German engineers have been responsible for the transformation from a research project to a medical project. “We have one engineering partner, Seleon, who supports us with their knowledge in making medical products ready for mass production, and with their expertise in all regulatory affairs,” explains Mäntele. “We outsourced the building of the devices, plus CE and medical device certification. It’s a regulatory challenge to get the CE approval and to optimise the medical device. At DiaMonTech we focus on research and development of a prototype.” Apple, with its spectacular global reach, has been battling it out to delve into molecular spectroscopy technology, which begs the question of whether DiaMonTech would consider any kind of collaboration with the tech giant, or indeed any other organisation of similar size. Even a business the size of Apple would not hold any advantage in terms of the
$35.5 BILLION
The estimated value of the global market for diabetes devices in 2024
$157 BILLION
The estimated value of the overall market for diabetes diagnostics in 2017
71%
The percentage of teststrips accounted for of the total market in 2015
“Non-invasive glucose measuring has become more of a holy grail within the market for diabetic products in recent years” Professor Werner Mäntele 31
MEDICAL DEVICES “Our biggest challenge is the human skin which varies from person to person and with time. To develop a quantitative molecular measurement system and to discern between molecules is a huge mountain to climb” Professor Werner Mäntele
AN AWARD WINNING PROJECT
In June 2017, DiaMonTech won a prestigious award for “most innovative German startup” from German business magazine Bilanz.
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science behind the idea. In fact, this isn’t a privilege held by anyone since DiaMonTech’s technology is patented. Mäntele asserts: “We would take care not to be swallowed up, and we are not selling the idea for a lump of money. If what we achieved was noticed by big players, then we would use investment to increase our employees and so on. The central principle is all ours. However, big corporations like Apple, Samsung and Nokia are very good at building small, often elegant devices for the mass market and selling several
millions of devices. As a startup we don’t have their know-how, so of course we would consider a partnership.” Once all of DiaMonTech’s products have been completed and tested, how then will the devices make in onto the shop floors at the local drugstore, in the same way that blood pressure testing devices have done? Mäntele believes that there is no problem with the technology reaching those who need it most, and maintains that it will be promoted and distributed accordingly. He enthuses: “We get pre-orders, and the diabetic patient community is very well organised with a developed information flow – they have their own journals. The community knows about new products, and due to their marketing of them, micro non-invasive blood measuring products would sell like hotcakes.” With more work by scientists like Mäntele and further success for DiaMonTech, which won the 2017 “most innovative startup” award from German magazine Bilanz, we could soon see test-strips and finger pricking become a thing of the past for this $35.5bn market. 33
‘HOSPITAL IN A PARK’, Could it pave the way for a greener future? The new facility design by Cleveland, Ohio based US healthcare system MetroHealth is set to include 25 acres of greenspace, including a park and wellness garden. Should other companies take note of these groundbreaking plans? Writ ten by STUART HODGE
H O S P I TA L S
The MetroHealth hospital
H O S P I TA L S HEALTHCARE PROFESSIONALS ARE in no doubt about the health benefits provided by having plenty of green spaces, particularly in larger, urban areas. Areas with more accessible green space are associated with better mental and physical health, with research showing the risk of mortality caused by cardiovascular disease is lower in residential areas with higher levels of ‘greenness’. Heartrates can be upwards of 20 beats per minute lower when walking in a park versus in a busy urban environment. There is also evidence that exposure to nature could be used as part of the treatment for some conditions, but until not-for-profit MetroHealth’s revolutionary new county health campus in Cleveland, Ohio, no health facility architects had ever put the provision of acres of green space at the top of their agenda. MetroHealth is a public healthcare system based in Cleveland, and serves the residents of the surrounding area. Its new campus, as part of the MetroHealth Transformation programme, is set to be transformed into an unrecognizable space, serving not only patients but the community 36
February 2018
One of the specialist patient-care rooms at the MetroHealth hospital
as a whole. “We are actually calling this a hospital in a park,” says Dr. Akram Boutros, the hospital system’s President and CEO. He explains the transformation will be conducted using $945.7mn in hospital revenue bonds issued by the MetroHealth last year. About the ‘Hospital in a park’ Overall, the new facility will have 25 acres of green space – a massive increase on what it has currently,
with the existing 52-acre campus incorporating only one or two acres of green space – with construction to be completed between 2019 and 2023. The new campus will include a new hospital bed tower, an Ambulatory Care Center and the expansive new wellness gardens. The northeast corner of the campus is currently dominated by surface parking, but will become a collection of park-like spaces. Jason Dawson, Director of Capital,
Estates and Facilities at The Christie NHS Trust in Manchester, England, one of the most technologically advanced cancer centers in the world, is a big fan of the new design. “The opening of this facility marks a significant step change in hospital design and fully embraces the benefits of green space on both physical and mental health,” says Dawson, who has facilitated capital projects in excess of $500mn in value in nearly a decade 37
H O S P I TA L S
“The links between wellbeing and nature have long been recognised but recent, more sophisticated methods of research into these links is able to demonstrate significant beneficial impacts� JASON DAWSON Director of Capital, Estates and Facilities, Christie NHS Trust 38
February 2018
working for the trust. “The willingness to take down the two circular towers that have been present since 1972 really does mark the beginning of a new era for the site where patients will come first. The proximity of the ambulatory care center and the wellness gardens provide an easily accessible space that will have therapeutic and healing benefits to all patients and their families. “The links between wellbeing and nature have long been recognised but recent, more sophisticated methods of research into these links is able to demonstrate significant beneficial impacts, and not only to those with acute medical needs. It also shows the role green spaces can play in improving health outcomes and reducing health inequalities in a cost-effective way that promotes healthy and active lifestyles on a much wider scale. “The links between access to green space and levels of physical activity are well-established in research, which shows higher levels of physical activity in areas with more green space. Estimates suggest that an inactive person is likely to spend 37% more time in hospital and visit the doctor 5.5% more often than an active person. “Unfortunately, there is often 39
H O S P I TA L S competing demand for space and the commercial values that can be placed upon this space can be prohibitive. However, with an increasingly ageing population, the benefits of green space and lifestyle are obvious.” So, as populations age and priorities shift, could this example be followed across the globe, marking the start of a new era in hospital design? Dawson says that, with this design, MetroHealth has managed to truly integrate health and green space into a seamless landscape that promotes wellbeing, and connects the facility with the local neighborhood and key stakeholders. Upon the release of the new plans in January, a MetroHealth statement said: “Adding all this green to our footprint isn’t just about beautifying our campus. We’ll be able to incorporate therapies and arts in medicine programming into patients’ healing regimens.” That approach has created a synergy which Dawson believes could create a trend for this type of design. “There is a boldness to the plans that firmly place the patient at the center of its design strategy,” he says. “The fact that the executive team have had the vision and courage to challenge the past should be applauded. 40
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“I can see a future where developers and land owners actively seek out healthcare organisations to input and shape the urban landscape. The upstream links to wellbeing also provide an emerging commercial opportunity for redevelopment. The cultural changes to a more active and informed lifestyle creates an opportunity to develop commercial and retail offerings that support these choices.” Challenges beyond green space However, integrating more green space into hospital construction is not without its challenges, and
these projects have much more to consider besides. Pablo Solomon is an award-winning green designer and futurist who has worked with the US Department of Education developing colleges and school systems. He argues there is an issue with air circulation in US hospitals and that this needs to be addressed as a matter of urgency, and that other problems should perhaps be addressed ahead of adding more grassy areas. “While the Cleveland Park project is a step in the right direction, it is still more of a feel good or window dressing approach, rather than meeting the
more pressing challenges to modern hospitals,” Solomon argues. “Patients dying from dirty hospital rooms, dirty air circulation in hospitals and just plain dirty hands in hospitals is one of top causes of death in the US” Solomon currently has a solution in mind: “Some designers and myself are working on surgery room pods that can be sterilised between uses. We are also working on patient rooms that are pods that can be self-contained, easily sterilised and easily removed to prevent in hospital cross infections. “The real advantage of having a park or campus design for future 41
H O S P I TA L S hospitals will be the ease in which ‘pods’ can be exchanged for thorough sterilising and each room can have a separate climate control system that can be sterilised. The days of gigantic hospitals with central air systems are over. Too often these mega hospitals are monuments to incompetence, lack of caring and greed rather than beacons of healing and hope. Once given a choice, the public will prefer hospitals that are safer, cleaner and more focused on healing than billing.” Solomon is quick to express his hope that the new hospital design will address more than just the green space issue. If this is the case, it could indeed become a model for other hospitals appealing to a public that demands increasingly more from its healthcare. Green space in the community Besides the obvious enhancement of inpatient and outpatient facilities which, in facilities elsewhere, have both been shown to enhance patient experience and safety and even, in some reported cases, objective parameters like infection rate, the impact on the surrounding community could be profound in terms of civic pride and recreational space. 42
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Dr Michael Nochomovitz is SVP and Chief Clinical Integration and Network Development Officer at New York Presbyterian Hospital, and was previously the architect and leader of the regional multispecialty physician network and Physician Services Organization which he developed, implemented and managed for University Hospitals in Cleveland. “There is a reconceptualisation of healthcare in recognising that social determinants play a critical role in outcome from a clinical quality, compliance and financial standpoint,” he explains. “Addressing these social determinants are generally critical to public health and economic development in every community and improving the ambience, safety and impression of the area is more likely to promote adjacent community development.” Paying attention to the details and keeping stakeholders happy at each step of the building process will be vital to the eventual success of this facility, but there is no doubt that the ergonomic design has become a major talking point in the hospital construction industry.
“The real advantage of having a park or campus design for future hospitals will be the ease in which ‘pods’ can be exchanged for thorough sterilising and each room can have a separate climate control system that can be sterilised” PABLO SOLOMON An award winning environment designer
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TOP 10 MOST SUCCESSFUL MEDICAL DEVICE COMPANIES
Here is a look at ProClinical.com’s 10 favourite medical device companies, charting which businesses reaped the rewards with recent revenues Written by SHANNON LEWIS
T O P 10
BAXTER
REVENUES: $10.16bn WEBSITE: www.baxter.com
Baxter International, Inc. is a healthcare company which mainly provides products related to renal systems, as well as dialysis and IV solutions. With a sales revenue of $10.16bn, and a market cap of $26.6bn according to Forbes, it provides medical devices for a wide range of markets, from hospitals and kidney dialysis centres to nursing homes and rehabilitation centres. It was launched in 1931 by physicians Dr. Ralph Falk and Dr. Don Baxter, and became the first manufacturer of commercially available IV solutions. Today, it employs 48,000 people, and is 454th on Forbes’ “Global 2000: World’s Best Employers”.
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“ Baxter provides medical devices for a wide range of markets, from hospitals and kidney dialysis centres to nursing homes and rehabilitation centres”
09 STRYKER
REVENUES: $11.3bn WEBSITE: www.stryker.com
Stryker is a medical company which was started in 1941 by Dr. Homer Stryker, with the intention of filling gaps in the market for certain patients’ medical needs. The company provides services and products focused around three main areas: neurotechnology and spine, medical and surgical, and orthopaedics. Reuters reports its annual revenue form 2016 as $11.3bn, the result of a 13.9% increase from the previous year. With 33,000 employees, and 197 work sites, it finally broke the $10bn revenue barrier in 2016. It places 19th on Fortune’s “100 Best: Great Place to Work,” and 58th on Forbes’ “Global 2000: World’s Best Employers”.
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CARDINAL HEALTH
REVENUES: $12.15bn WEBSITE: www.cardinalhealth.com
Cardinal Health is primarily a drug wholesaler, with sales also focused around surgical equipment and gloves. According to Fortune 500, it brings in a revenue of $12.15bn. An American company founded in Dublin, Ohio, it currently employs approximately 50,000 people in almost 60 countries. It places 281st on Forbes’ “The World’s Biggest Public Companies,” with a market cap of $26bn. The company was founded in 1971, and has won awards for environmental sustainability including being named on Newsweek’s “Top Green Companies in the US 2016”.
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07 BECTON DICKINSON
REVENUES: $12.42bn WEBSITE: www.bd.com
Becton Dickinson is a global medical technology company which focuses on advancing the medical world through innovation in diagnostics, medical discoveries, gene and cancer research, and the diagnosis of infectious disease. Forbes sets the company’s sales revenue at $12.42bn, with a market cap of $39.2bn. The company bifurcates into two branches: BD Medical and BD Life Sciences, accruing over 45,000 associates in 50 countries throughout the world. With headquarters in Franklin Lakes, New Jersey, and 50,928 employees, it places 227th on Forbes’ “Global 2000: Growth Champions”. Founded in 1897 by Maxwell Becton and Farleigh Dickinson, Becton Dickinson has spent over a century developing itself, driven by what it describes as “a vision to improve outcomes for patients”.
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SIEMENS HEALTHINEERS
REVENUES: $14.1bn WEBSITE: www.healthcare.siemens.com
Siemens Healthineers is a separately managed branch of multinational conglomerate Siemens. With headquarters in Germany, the conglomerate orients its business around a few key areas areas: power distribution, generation, and transmission, while Siemens Healthineers centers around products and services for diagnostic and therapeutic imaging. On its own, Siemens Healthineers pulls in $14.1bn in revenue, according to ProClinical, for a company that makes, as a conglomerate, $88.35bn in sales revenue, according to Forbes. Siemens Healthineers was previously called Siemens Healthcare; its name was changed in 2016 after the restructuring that led to its corporate independence. It ranks fifth on Fierce BioTech’s “Top Companies in Medtech by 2016 Revenue”.
06 “ On its own, Siemens Healthineers pulls in $14.1bn in revenue… for a company that makes, as a conglomerate, $88.35bn in sales revenue”
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05 PHILIPS HEALTHCARE
REVENUES: $16bn WEBSITE: www.usa.philips.com/healthcare
Philips, a global conglomerate that is the largest lighting manufacturer in the world, has a medical branch, Philips Healthcare, which operates successfully as well. According to ProClinical, its revenue stands at $16bn. It employees 71,000 people, with goods and services in over 100 countries, though its headquarters can be found in Andover, Massachusetts. On Forbes’ “America’s Best Employers,” it places 284th, and second on Forbes’s “The 10 Companies Doing the Most to Make Their Employees Happy”.
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FRESENIUS MEDICAL CARE REVENUES: $18bn WEBSITE: www.fmcna.com
Fresenius Medical Care is a medical device company focused around providing products and services relating to kidney failure, and chronic disease. It makes, according to ProClinical, $18bn in revenue. It provides treatment for upwards of 190,000 patients in the United States, and employs over 60,000 people, becoming North America’s largest provider of renal care, according to Business Wire. With North American headquarters in Waltham, Massachusetts, it originated in Frankfurt, Germany, as a 15th-century pharmacy. It is ranked third on Forbes’ 2015 list of “America’s Best Employers”.
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03 GE HEALTHCARE
REVENUES: $18.3bn WEBSITE: www3.gehealthcare.com
With headquarters in Chicago, Illinois, GE Healthcare is a health segment of a larger conglomerate that operates at global status. According to their 2016 annual report, they brought in a sales revenue of $18.3bn. As a company, it treats patients in over 100 countries and comes in 104th on Forbes’ “America’s Best Employers”. GE Healthcare’s involvement with the medical technology world ranges from drug manufacturing and discovery, to technology for medical diagnostics.
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JOHNSON & JOHNSON REVENUES: $25.1bn WEBSITE: www.jnj.com
Having been founded in 1886, Johnson & Johnson is now a globally-recognised medical device and pharmaceutical company. ProClinical places the medical device sector of the company at $25.1bn of a company that on the whole, according to Forbes, makes $71.94bn in sales revenue. The company makes it onto several of Forbes’s lists. It is 132nd on “America’s Best Employers,”, first on “The Biggest Drug Companies of 2015”, and first on its “Top Brands: Most Trustworthy” lists. With more than 125,000 employees in over 60 countries, Johnson & Johnson professes its mission is to “help people everywhere live longer, healthier, and happier lives”.
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“ Founded in 1949 as a medical equipment repair shop, Medtronic has grown into a global corporation focused on producing technology for life extension, pain relief and health restoration”
01
MEDTRONIC
REVENUES: $29.36bn WEBSITE: www.medtronic.com
Medtronic is, according to its own website, the “world’s largest medical technology company” – and this is backed up by its revenue figures. Founded in 1949 as a medical equipment repair shop, it has grown into a global corporation focused on producing technology for life extension, pain relief and health restoration. According to Forbes, it makes a sales revenue of $29.36bn. Headquartered in Dublin, Ireland, it employs 88,000 people. It is 215th on Forbes’ “America’s Best Employers” and 22nd on the 2015 list of “The 25 Happiest Companies to Work For”. Technologies from Medtronic are used to treat almost 40 different medical conditions.
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E V E N T S & A S S O C I AT I O N S
Events Healthcare Global takes a look at some of the key industry events and conferences for this calendar year Writ te n by STUART H O DG E
E V E N T S & A S S O C I AT I O N S
Global Conference on Integrated Care 2018 Singapore 1-3 February
This year’s Global Conference on Integrated Care will focus on trying to ensure innovative approaches to integrated care, care models, and technology as well as successful disruptions and reforms within the health sector are shared rather than remaining localised.Bringing together health and social care experts, practitioners, professionals and policy makers to present and discuss an array of topics related to integrated care, the conference provides a platform for the sharing of best practices and experiences. The conference theme this year is “Advance! Accelerating the Integration of Care�, emphasising the urgency to transform health and social care. https://gcic2018.sg/ 58
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Phar-East 2018
Singapore 28 February-02 March At the other end of February and staying in Singapore, ‘Asia’s Pharma and Biotech Festival’ festival, Phar-East 2018 takes place. It’s the 10th time the festival will take place, having served over 22,000 attendees over its first nine years. Organisers say: “Asia is more than just a pharma sales and marketing destination, and it’s more than a cheaper manufacturing hub. Now, it leads the way with pharma innovation and R&D. “Across two days, we’ll be exploring 11 of the most exciting pharma areas in Asia: immunotherapy, vaccines, precision medicine, cell & gene therapy, biodata, orphan drugs, partnering, commercialisation and market access, antibodies, biosimilars and biotech innovation.” www.terrapinn.com/exhibition/phar-east
Africa Healthcare Week 2018 London, UK 5–7 March
Billed as Africa’s largest healthcare event in Europe, Africa Healthcare Week comprises of two main set pieces: preevent roundtable discussions at The Royal Institute London and a main conference and exhibition at the Olympia. The summit provides high-level discussion into the future trends and opportunities in Africa’s healthcare industry. Although held in Europe, a high number of African delegates from distributors, government, hospitals, healthcare providers, investors and NGOs are expected to attend. www.africahealthcareweek.com 59
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10th Asia Pacific Global Summit on Healthcare Singapore 12–14 March
‘In Pursuit of High Quality Public Health and Health Care’ is the theme for this event, which sees healthcare professionals from around the world will take part in huge numbers of conferences, workshops symposiums on topics ranging from Business, Engineering, Medical, Pharma, Science, and Technology. Describing the event, Matthew Brice, Coach and Speaker Studer Group Australasia, says: “The challenge before us is to fully integrate our capabilities into a robust culture that is committed to the delivery of seamless, affordable, error free, high quality and highly reliable care.” www.healthcare.global-summit.com
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Future Healthcare Conference 13–14 March London
The Future Healthcare Conference boasts that it is “the only event in the UK dedicated to showcasing products and services in sustainable and affordable healthcare solutions on a global scale”. The conference aims to bring together some of the world’s leading organisations and experts in healthcare, who will address the biggest challenges facing 21st century healthcare and to understand how advances in innovation can spur greater integration and collaboration to better serve future generations of patients. Organisers say: “Aimed at both the public and private sector, this is an opportunity for healthcare policy makers, buyers and practitioners to re-imagine existing systems, learn from international case studies, find new technology and network with those leading the way in cutting-edge healthcare.” www.futurehealthcareuk.com 61
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Australian Healthcare Week Sydney, Australia 21-23 March
This year will see the 8th Annual Australian Healthcare Week celebrated at the International Convention Centre in Sydney. Growth in the healthcare industry in Australia over the last decade means that it now accounts for $1 out of every $10 spent nationally, and is also the country’s biggest employer, employing one in every eight Australians. Organisers say: “The ageing population means that the demand on healthcare services will only increase, and faced with a limited budget, the focus must naturally shift to how we can do more with less. Central to achieving this will be the improved integration of the clinical and non-clinical realms.” This conference brings both of these areas together under one roof to discuss some of the key issues being faced at the moment such as facilities, data, efficiency, change management, patient experience and integrated care. www.austhealthweek.com.au
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Geneva Health Forum 2018 Geneva, Switzerland 10–12 April
Describing itself as ‘the forum of innovative practices in global health’, this year will see the seventh edition of the Geneva Health Forum take place. ‘Precision Global Health in the Digital Age’ is the theme this year, for the summit where attendees can expect to explore the impact of the digital revolution in the health practices, whilst the forum will also look to address emerging global health issues such as future pandemics and health security, antimicrobial resistance, noncommunicable diseases, access and affordability to essential medicine and health equality, chronic diseases, universal health coverage, neglected tropical diseases, and essential diagnostics with a special focus on health initiatives from Central Asian countries. Organisers will once again set up The Global Health Lab, an interactive and dynamic hub where participants will be able to try out new technologies and products, which will be a very welcome return to the event, which is all about creating “meaningful connections that could lead to new ideas, new opportunities and partnerships”. http://ghf2018.g2hp.net/ 63
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Patient Experience Conference 2018 Chicago, USA 16–18 April
The Patient Experience Conference 2018, hosted by The Beryl Institute, brings together the collective voices of healthcare professionals across the globe to convene, engage and expand the dialogue on improving patient experience. The conference is hosted in an interactive format which organisers say will allow attendees to “identify strategies and discover solutions”. Organisers say: “Come prepared to network and build professional relationships, and leave inspired to further your commitment to building the field of patient experience.” http://ghf2018.g2hp.net/
International Forum on Quality and Safety in Healthcare – Spring Edition Amsterdam, Netherlands 2–4 May
Over 3,000 attendees are expected in Amsterdam at one of the world’s largest conferences for healthcare professionals to meet, learn and share knowledge at the event which focuses on improving the quality and safety of care for patients and medical communities across the world. The focus this year will be on overcoming the challenges, restrictions and bureaucracy, which prevent meaningful change and to discover that quality in healthcare can be ‘reclaimed’ by making the best use of available resources, promoting innovation and working together to provide exceptional patient care. www.internationalforum.bmj.com/amsterdam
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World Health Care Congress 2018 Washington DC 29 April–2 May
The 15th Annual World Health Care Congress will see decision makers from payer, provider, pharmaceutical, government, and solutions organisations come together with the aim of inspiring partnerships and defragmenting the current health care system by sharing strategic initiatives, results, and steps to overcome access and affordability issues while delivering high-value care. Speakers will include executives from Lockheed Martin, BlueCross, New York-Presbyterian, UPMC Health Plan, and Essential Health. The event is designed to “help participants form partnerships and become catalysts for change” as they seek to transform the delivery of healthcare. www.worldcongress.com/events/HR18000
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e-Health Conference 2018 Vancouver, Canada 27–30 May
The annual e-Health Conference and Tradeshow is the largest digital health event of its type in Canada and brings together key industry professionals together to network, connect, and learn from one another. Keynote presenters, expert panelists and leading-edge vendors serve to ensure that e-Health is always a popular event, which consistently delivers great education and networking opportunities. Delegates will engage with current and future leaders at the Conference, Showcase, and Hackathon, and network with old and new colleagues at the Tradeshow and social events such as the Canadian Health Informatics Awards Gala, and sponsor receptions. www.e-healthconference.com
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International Forum on Quality and Safety in Healthcare – Autumn Edition
Melbourne, Australia 10–12 September
This event follows on from the success of last year’s event at Kuala Lumpur, where 1,000 healthcare practitioners and leaders from over 35 countries were “united by the vision” to improve quality of healthcare provision and act together across professions and with service users to achieve real success in improving care worldwide. The focus at the spring conference in Amsterdam this year will be on overcoming the challenges, restrictions and bureaucracy which stifle the improvement of care, and although an agenda has still to be confirmed for the autumn, discussions could centre on a similar theme. www.internationalforum.bmj.com/melbourne
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VALUE-BASED HEALTHCARE THROUGH STRATEGIC PROCUREMENT By driving efficiency in its supply chain, utilising data analytics, and truly understanding its services, Service New Brunswick is delivering value-based, high-quality goods and services to the healthcare system for the province of New Brunswick, Canada Written by Laura Mullan Produced by Denitra Price
SERVICE NEW BRUNSWICK
Ann Dolan Executive Director of Strategic Procurement, for Service New Brunswick Health services
Ann is an experienced healthcare supply chain leader, an executive with over 27 years health procurement experience across shared services and group purchasing sectors. Ann has a deep understanding and knowledge of public procurement. She is known for her integrity, dedication and energy she brings to every project
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rocurement can be a challenging discipline. There’s an increasing pressure to reduce costs and achieve savings, the continuous challenge of sustaining supplier relationships, and the need to keep up-to-date, accurate data. However, when tasked with purchasing the goods and services for an entire province’s healthcare services, the pressure increases tenfold. With more than 27 years of experience in the sector under her belt, this is the job that’s in the capable hands of Ann Dolan, Executive Director of Strategic Procurement for Service New Brunswick Health Services. Providing the procurement of goods and services within healthcare for the Canadian province, Service New Brunswick is a crown corporation that has transformed its strategic procurement function in recent years. Value-based procurement The corporation (previously FacilicorpNB) was instructed by the government to achieve savings of $20 million. Of this amount, between CA$14 and CA$16mn was to come from supply chain initiatives in the healthcare sector. “It was a real challenge,” admits Dolan. “For us, it was important to understand the needs of the client - the clinician or physician – and so we asked them ‘what is it that you need in your practice to treat a patient?’” Dolan says. “We asked them ‘what are some of the things you’re doing now that you don’t want to lose sight of? What are some of the improvements you’d like to see?’
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NBHC MEDIAN CARDIAC O.R. WAIT TIMES DOWN
44%
*
WORKING WITH HEALTH SYSTEMS TO REDUCE WAIT TIMES WITHOUT SACRIFICING COST OR QUALITY Like many health systems, Horizon Health Network was faced with a challenge: A growing number of patients with heart conditions was leading to longer wait times to get treatment. Horizon Health Network partnered with Medtronic Integrated Health Solutions to tackle wait times and improve some other key services at the New Brunswick Heart Centre (NBHC). After the first year, the results already exceed expectations. NBHC improved its cardiac surgery internal processes, providing the capacity to be more productive and see more patients. Learn more at www.medtronic.ca/NBHC. * Data on file © 2017 Medtronic. All Rights Reserved.
“Only when you understand the business of the client, can you start to understand their needs, their wants, and why they ask for certain things,” she adds. “Our category management methodology really helped us with this but, more importantly, I think in procurement you have to be curious. You have to ask a lot of questions, understand what the product or service does, and you have to know if it provides value to the clients or not.”
“SOMETIMES IT CAN BE HARD BUT ONE OF THE MAIN THINGS THAT KEEP US MOTIVATED IS THAT WE KNOW THAT FOR EVERYTHING THAT WE DO, THERE’S A PATIENT AT THE END OF THAT TRANSACTION”
Data analytics Like many organisations, Service New Brunswick tapped into the potential of data analytics to help with its cost-saving measures. The shared services group creatively used Microsoft Excel, its Access database, and its current financial systems, to extract and analyse data about its procurement strategy. To this end, Service New Brunswick could then clearly see what its clients were buying, which regions had the best contracts, and whether it
– Ann Dolan, Executive Director of Strategic Procurement for Service New Brunswick Health Services
could get products at the same price province-wide. “When you have the data, the story tells itself,” notes Dolan. “You don’t have to be the persuader. Then we essentially looked at the low hanging fruit and asked ourselves ‘can we extend this cost-effective contract? Can we commit a certain volume to get a better deal from our suppliers?’ “Then we brought in a consultant to help us make further savings,” she says. “This helped us move towards a competitive procurement process that we hoped would show not only savings, but efficiencies, changes
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in practice that would have a better value for the patients of the province.” Providing meaningful healthcare Although it was a mammoth task, Dolan and her team successfully achieved these savings by taking a market-driven approach to procurement. But when Service New Brunswick is responsible for the goods and services needed to support the healthcare of around 750,000 people, how did the group balance the need to drive efficiency
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with the need to provide meaningful, high-quality products and services? “That’s the million-dollar-question,” Dolan says. “I think the way we achieve that is through our market research. It’s important that we’re aware of our operations from a public accountability perspective, from the perspective of the client, from the perspective of the supplier, and from the perspective of the patient.” Operational transformation In 2015, the government announced that it would merge four shared service
“WHEN YOU HAVE THE DATA, THE STORY TELLS ITSELF” – Ann Dolan, Executive Director of Strategic Procurement for Service New Brunswick Health Services.
entities to create one larger shared services organization that would provide high quality, safe, and efficient services throughout the province. This meant that non-health related shared services such as accounts payable, payroll, copying services, procurement, information technology, human resources for internal government, shared services for healthcare, laundry, supply chain, clinical engineering, and the provincial entity that manages customer services centres to the public would be merged. However, despite this
transformation, the corporation’s meaningful ethos remains to this day. Over the past three years, Service New Brunswick has seen further changes to how it does business. It implemented a category management methodology, separating the strategic part of procurement from the transactional part. “The reason for that move was that it allowed us to align ourselves with how the clients are organised. That way, we could have people dedicated to that portfolio, where they could really get to understand the business and
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needs of the client,” explains Dolan. “We’ve just conducted our strategic planning session as an organisation and our 2022 vision is ‘excellence in service delivery,’” notes Dolan. “Essentially, this means that our mission is to provide high quality, innovative services for customers with a focus on value for all New Brunswickers.” Developing supplier relationships To achieve its ambitious aim, Service New Brunswick has worked diligently to sustain its supplier relationships. The group has migrated from the traditional yet restricted request for proposal (RFP) process to the more flexible negotiated request for proposal process. Through this system, suppliers may put forward Best and Final Offers (known as BAFO) whereby suppliers can bounce ideas back and forth. This provides suppliers the chance to present what could be a forwardthinking proposal to the corporation. “We are moving towards another evolution of procurement, whereby it
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Full team training day on Strategic Procurement
is more value-based and less focused on price,” observes Dolan. “We have developed strong relationships with our suppliers - companies such as Medtronic, Johnson & Johnson and Baxter. These are global, international companies and they really benefit from working with us because we’re able to pilot things and we can do this fairly quickly. Then our suppliers can use that template and apply it to other customers and clients in other provinces or countries. In that way,
I think we’re progressive because sometimes the relationships that we’ve built allow us to be on the leading edge of new technology and healthcare practices.” Adapting to challenges Working closely with suppliers is not only about forging long-lasting relationships, it’s also about preparing for potential crises. In today’s everchanging climate, natural disasters are increasing in devastation and
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frequency and this can play havoc with governmental supply chains. “The last one that affected our supply chain was Hurricane Maria which devastated Puerto Rico,” remembers Dolan. “Four or five of our large suppliers had manufacturing plants there and so suddenly this posed a major issue to the supply chain. Therefore, we have to be ready
to address any natural disasters that may happen and which, I think, are going to become more and more frequent. We have to be able to utilise the data and analytics effectively. We need team members who have good interpersonal skills who can talk to people, get to the heart of the problem very quickly, and who can find a solution.”
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“WE ARE MOVING TOWARDS ANOTHER EVOLUTION OF PROCUREMENT, WHEREBY IT IS MORE VALUE-BASED AND LESS FOCUSED ON PRICE” – Ann Dolan, Executive Director of Strategic Procurement for Service New Brunswick Health Services. By driving efficiency in its supply chain, utilising data analytics, and truly understanding the meaning behind its products and services, Service New Brunswick has dealt with its supply chain transformation in its stride. In doing so, it continues to deliver value-based, high-quality healthcare goods and services for the province of New Brunswick. “In all this change, we have to find balance,” reflects Dolan. “Sometimes it can be hard but one of the main
things that keeps us motivated is that we know that for everything that we do, there’s a patient at the end of that transaction. That patient could be one of our family members or one of our friends. Our core mission is to provide high quality, innovative services for customers with a focus on value for all New Brunswickers. So, when someone says, ‘thank you very much’, that’s what keeps us going during the hard times – knowing that we’re helping New Brunswickers.”
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MIDDLE EAST MEDICINE MAKES ITS MARK FOR THE FUTURE Written by Fran Roberts Produced by Stuart Shirra
A TARGET OF SAUDI ARABIA’S VISION 2030 IS GREATER PARTICIPATION OF THE PRIVATE SECTOR WITHIN THE ECONOMY, AND THIS IS ESPECIALLY THE CASE IN HEALTHCARE. AS THE COUNTRY’S LARGEST PRIVATE COMPREHENSIVE HEALTHCARE PROVIDER, DR. SULAIMAN AL-HABIB MEDICAL GROUP IS SET TO LEVERAGE SIGNIFICANTLY ON THIS
T
he GCC healthcare market is projected to grow at a 12.1% compound annual growth rate (CAGR) from an estimated $40.3bn in 2015 to $71.3bn in 2020, according to Alpen Capital. The GCC healthcare environment is rapidly changing and flourishing with unprecedented demand in healthcare services as more patients choose to receive care in their home country rather than abroad as standards improve. There is no doubt that the healthcare sector in the region would have never reached this point without adopting up-to-date innovative strategies, and of course technologies. Dr. Sulaiman Al-Habib Medical Group (HMG), is one local provider that has keenly embraced innovation and new technology
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Dräger is an international leader in the fields of medical and safety technology. The family-owned company was founded in Lübeck, Germany, in 1889. It’s guiding philosophy is “Technology for Life” through which Dräger empowers hospitals to continuously improve results in acute care – to protect, support and save lives. From advanced anaesthesia workstations for the operating room, to sophisticated ventilation and monitoring systems for intensive care, from pioneering devices in neonatal care to holistic gas management systems for the hospital – Dräger brings to life its passion as being “Your Specialist in Acute Care”. PLEASE VISIT OUR WEBSITE: WWW.DRAEGER.COM/EN_SA/HOSPITAL
H E A LT H C A R E
HMG is the largest private provider of comprehensive healthcare services in the Middle East, currently operating 14 medical facilities across Saudi Arabia, the United Arab Emirates (UAE) and Bahrain. This encompasses seven hospitals, six medical centres, and one of the largest private medical cities in Saudi Arabia.
Digital healthcare Founded in 1995 and based in Riyadh, HMG has achieved much over the last two decades. 2016 marked a major milestone for the
Group with the opening of Al-Habib Hospital in Al Sweidi. Dr. Sulaiman Al-Habib Hospital in Al Sweidi is the first digital facility in the Saudi Arabia that uses electronic systems at all stages of the provision of healthcare services; from patient admission until their departure from the hospital. The hospital combines about 300 beds and 240 clinics, in addition to the 32 isolation rooms in all departments of the hospital, in order to control the spread of infectious diseases. The hospital has 88 rooms on each floor, characterised by spacious areas that
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provide greater comfort for patients. well as one of the largest hospitals in To accommodate the next Riyadh, with a capacity in excess of generation, the hospital has 100 350 beds. Built on an estimated area rooms for vaginal delivery, two rooms of about more than 900,000 sq ft, the for caesarean delivery, alongside hospital consists of more than 240 an intensive care unit for newborns, clinics covering 35 medical specialties. which accommodates approximately Arryan Hospital gained the Joint 58 incubators, 10 quarantine rooms, Commission International accreditation and 31 postpartum rooms. (JCI) just seven months after opening – There are also 10 operation an unprecedented achievement. rooms of 56 sqm – larger Reflecting these high than the internationallystandards, dozens of adopted standard successful accurate HMG is the largest of 45 sqm – as well surgeries are private provider as two cardiac performed daily of comprehensive catheterisation inside the hospital, healthcare services rooms, and about 50 especially in the in the Middle East intensive care rooms. fields of neurosurgery, In addition, the hospital paediatrics, heart includes an emergency surgery, spine surgery department with a capacity and tumour surgery. of 45 beds and quarantine rooms Of course, such high standards are equipped with automated systems to not confined to one hospital. In recent quickly deal with infectious cases. years, HMG has received the Arab Health Award 2011 for Best Radiology International accreditation Department in the Middle East, The HMG’s other facilities are equally Arab Health Award 2012 for Excellence impressive. Dr. Sulaiman Al-Habib in Human Resource Development, Hospital in Arryan is one of the largest and The Arab Health Award 2013 for existing investments of the Group, as Excellence in Surgery Services.
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DR SULAIMAN AL-HABIB MEDICAL GROUP
Major challenges A major challenge for HMG, as well as the wider region is the rise in mortality and disability due to noncommunicable diseases. According to the World Bank, four GCC countries are in the global top 20 for obesity: Bahrain, Kuwait, Saudi Arabia and United Arab Emirates. As a result, diseases like diabetes affect almost one in five people in the GCC which is almost three times the average of other high-income countries. The World Health Organization (WHO) reported that 70% of men and 75% of women in Saudi Arabia are overweight or obese. HMG prides itself as being a pioneer in establishing obesity treatment centres within the private sector. The Group operates its Obesity Centres in Riyadh and Qassim (Saudi Arabia), Dubai (UAE) and Manama (Bahrain). The centres adopt integral solutions: diet and behavioural therapy, and sport remedy, in addition to surgical options in order to eliminate weight increase and obesity. The centres are always eager to keep up with the latest released technologies in obesity treatment,
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such as Obalon, which is considered to be the latest technology in eliminating obesity without surgical intervention. The Obalon Balloon System is an intragastric balloon system designed to be swallowed and indicated for temporary use to facilitate weight loss in adults with obesity who have failed to lose weight through diet and exercise.
Vision 2030 In just under a quarter of a century, HMG has achieved a tremendous amount, establishing itself as a pioneering healthcare provider and a leading adopter of state-of-the-art innovation and technologies. 2016 saw Saudi Arabia unveil an ambitious plan called Saudi Vision 2030 to transform its economy and diversify the country’s sources of income away from its current dependence on oil. Healthcare is one of the main focus areas of Vision 2030 and HMG will surely play a central role as the country works towards this.
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Narrowing thegulf in healthcare procurement Written by Fran Roberts Produced by Heykel Ouni
2016 marked the 40th anniversary of the first meeting of the Gulf Health Council, in Riyadh, Saudi Arabia. Today, regular meetings are held to discuss the health issues of concern in the states. Part of the Council is Gulf Joint Procurement programme, which ensures the standardisation of the medicines directory and medical supplies of all specialities across the GCC
T
he Gulf Health Council is a regional technical specialised organisation with its membership restricted only to the Cooperation Council States, plus Yemen. Within this organisation sits Gulf Joint Procurement programme. “The Council enjoys a legal impartiality and financial and administrative independence,” advises Fatthi Alkathiry, Director at Gulf Joint Procurement. The Health Council of the GCC aims to develop cooperation and coordination among member states in the preventive, curative and rehabilitative health fields, as well as other mutually beneficial activities. The idea of the joint procurement for medicine began in February
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1976, when the Ministers of Health of the GCC states requested that the Council form a technical committee among the states. The committee’s main objective was to study the possibility of member states benefiting from direct control, like the processes in Saudi Arabia and Kuwait. A second key objective was to standardise the purchase of certain medicines. “The set objective at that time was to study the development of a unified system for the registration and control of medicines and the development of a guide for medicines in the GCC states,” Alkathiry explains. “The Gulf Health Council for Joint Procurement seeks to standardise the directory
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Fatthi Alkathiry Director
A leading Procurement Director, currently working with in Gulf Joint Procurement for Gulf Health Council, Mr Fatthi AlKathiry focuses on developing the vision, mission and operational plans for Gulf Joint Procurement. Providing leadership, strategic planning and assurance for procurement administration, AlKathiry acts as the vendor management partner for all the business units, ensuring all relationships are strategically, culturally, and ethically aligned with GHC’s mission and values. Throughout his career with GHC, AlKathiry has continuously enhanced the organisation’s sourcing, procurement and performance management capabilities by attracting public and private hospitals to become participants in Joint Procurement. With a proven ability to develop, maintain and execute procurement policies, Al Kathiry consistently supports the Joint Procurement mission and meets the stakeholder requirements, facilitating a seamless implementation and adoption of solutions.
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“The Gulf Health Council for Joint Procurement seeks to standardise the directory of pharmaceutical devices and medical supplies throughout the Gulf Joint Procurement programme” –Fatthi Alkathiry, Director, Gulf Joint Procurement
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of pharmaceutical devices and medical supplies throughout the Gulf Joint Procurement programme, with the controls in place across the GCC member states.”
High-quality medicines With vast potential to impact the lives of others, the Gulf Health Council takes very seriously putting the interests of citizens in the Gulf countries above all considerations. With a growing population in the region, healthcare is set to become even more important. The GCC healthcare market is projected to grow at a 12.1% compound annual growth rate (CAGR) from an estimated US$40.3bn in 2015 to US$71.3bn in 2020, according to Alpen Capital. “The mission of the Gulf Joint Procurement programme is the development of a unified directory for medicines and medical supplies for all specialities, and the provision of high-quality medicines, medical supplies and devices to member states and participating hospitals, to the right location, at the right
time, and from the manufacturers registered with the Central Registration Programme, at fair prices. The ambition of Gulf Joint Procurement programme is to be the benchmark in the provision of standardised procurement services, based on global procurement standards,” reveals Alkathiry. In order to adhere to global procurement standards, Gulf Joint Procurement programme coordinates the process of selection, standards specification, and quantity of pharmaceuticals, medical supplies, and equipment required by Ministers of Health in member states, as well as standardising the preparation of tenders.
Ensuring safety The most prominent services that indicate the extent of progress and modernisation in a country are those services that concentrate on sustained health welfare and safety of the people. To this end, Gulf Joint Procurement programme ensures that all of the medicines it procures meet the highest safety
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FURTHER, TOGETHER 60% OF ALL DEATHS AROUND THE WORLD ARE CAUSED BY CHRONIC DISEASE.1
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THROUGH MUTUAL PARTNERSHIP AND HONEST DIALOGUE, WE CAN FIND SOLUTIONS THAT BETTER SERVE PATIENTS. Learn more at medtronic.com/furthertogether 1. World Health Organization. 10 facts on ageing and the life course. http://www.who.int/features/factfiles/ageing/en/. Accessed September 17, 2015. *Organisation for Economic Co-operation and Development 2. World Health Organization. Tracking universal health coverage. http://apps.who.int/iris/bitstream/10665/174536/1/9789241564977_eng.pdf?ua=1. Accessed September 17, 2015. 3. Porter E. A world of rising health care costs. New York Times: Economix blog. http://economix.blogs.nytimes.com/2013/06/27/a-world-of-rising-health-care-costs/?_r=0. Accessed September 17, 2015.
Rising costs, an aging population, chronic disease, and barriers to healthcare access impact us all. 600M
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standards. “We supervise the process of receiving samples and ensure the safety of their use, storage and preparation during the tender stage,” states Alkathiry. The tendering services offered by Gulf Joint Procurement programme are possibly the most integral ones to the success of achieving its mission. “We receive tender documents, and source and prepare schedules of comparison between tenders. Also, we plan, coordinate and prepare meetings of the joint procurement committees,” reveals Alkathiry. “We follow-up on the recommendations of the executive committee and decisions issued by these committees and coordinate with the member states as to the combined quantities required. Finally, we announce the results of the purchase decision and recommendations, and we receive, verify and study complaints and objections concerning tenders, and refer to the supplementary commentaries.”
The factor of time Many may not know that time is
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“THE AMBITION OF GULF JOINT PROCUREMENT PROGRAMME IS TO BE THE BENCHMARK IN THE PROVISION OF STANDARDISED PROCUREMENT SERVICES, BASED ON GLOBAL PROCUREMENT STANDARDS” –Fatthi Alkathiry, Director, Gulf Joint Procurement middleeast.businesschief.com
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Fatthi Alkathiry, Director, Gulf Joint Procurement, taking part on a discussion panel for a healthcare forum the most important factor in the procurement process. “The most important reasons for the success of Gulf Joint Procurement programme is committing to the time of tendering over the next 40 years. The whole tendering process takes around four months, starting from the directory updating meeting and preparation for tender until the tentative notice of award,” explains Alkathiry. “This attracted several bodies, other than the health ministries in the member states, to apply for participation in the Gulf Joint Procurement programme.”
Upgrading the health sector In order to achieve such success, Gulf Joint Procurement programme collaborates with a number of other key players. “Our partners are the ministries of health in the GCC. We have six countries there – Saudi Arabia, Kuwait, United Arab Emirates, Oman, Bahrain, and Qatar. They are members of the Gulf Health Council. Also, we have more than 20 public hospitals like King Fahad Medical City, King Faisal Specialist Hospital in Riyadh, and King Abdullah Medical City in Mecca,” states Alkathiry.
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Fatthi Alkathiry, Director, Gulf Joint Procurement “All suppliers from our programme are our partners also. We have about 18 categories of materials. “The mission of the Health Council is to promote and upgrade the health sector in member states by providing constructive initiatives and responding to the regional and global health issues. We challenge and support the decision-making process, and the health policies with the aim to strengthen the cooperation and integration between the member states, the health sector and among
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that, achieve the Council objectives. Its values are accountability, professional leadership, continuous development, evidencebased decisions, creativity and innovations, quality, cooperation and coordination, integrity and ethics.” Such partnerships and values have been key to the success of Gulf Joint Procurement programme. “I think we’re not successful without three main key factors – coordination, collaboration and integration,” Alkathiry comments. “Without these
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three main factors, the 40-year old Gulf Joint Procurement programme would not be successful.”
Encouraging innovation Out of 50 employees within the Health Council, seven employees are serving in the Gulf Joint Procurement programme. Alkathiry strives hard to attract and retain the best staff to ensure the continued success of Gulf Joint Procurement programme. “I create a workspace where every employee is engaged by the work they do and inspired by who they work for. Without good staff you will not achieve your goal. The management structure achieves this by encouraging everyone to innovate. “It doesn’t have to be earthshattering. It can be a small change, but innovation equals improvement. Innovation must streamline, must enhance, must endure. Innovating our business by looking for ways to reduce expense, speeding up or streamlining processes, improving customer interactions and experience, making our products or services better. Innovation drives business, so if you don’t encourage middleeast.businesschief.com
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Stay ahead with Sysmex
Stay ahead with Sysmex 5 – 8 February 2018 Dubai International Convention & Exhibition Centre Za’abeel Hall No. 5, booth Z5.H10
Sysmex is greatly looking forward to seeing you at this year’s MedLab 2018 in Dubai. Why? Because we believe we have yet again found ways to help you solve challenges and to ‘Stay ahead with Sysmex’. Each year we make further progress in living our mission of ‘Shaping the advancement of healthcare’. At this year’s MedLab, we will again be presenting some of our latest advances. We have brand new solutions in human and veterinary haematology, in urinalysis, in flow cytometry and in oncology. Our specialists will be delighted to answer any questions and together see how we can help you to stay ahead with Sysmex in the future. We are looking forward to seeing you on our booth Z5.H10.
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your people to innovate, you are wasting your resources, I believe.”
Automation for the people Such innovation is central to Gulf Joint Procurement’s future plans. “I’m working now with my team to automate our processes. There are plans in the future, to implement a new system for the Gulf Joint Procurement programme. Currently we have requirement to automate our process, and link with the GCC countries and the suppliers to make quotations align, and to organise everything historically. The second thing - there are plans for expansion of the service procurement to market our services to the private hospitals to join in our programme,” Alkathiry concludes.
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