How The UAE Healthcare Sector May Look In 2027 And What You Need To Prepare For Taking the time to consider the future can be a very useful strategy when it comes to managing employees and the benefits packages put on offer.
By Simon Stirzaker •
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Thanks to technology, the rate of change in all industries is gathering pace– and the healthcare system and how it affects your company in the UAE is no exception. So, when making key decisions, it is good business sense to anticipate coming healthcare trends. This will give you an upper hand when designing benefits packages, helping to keep your insurance premiums low.
While one day we may have a Star Trek-style device capable of offering instant diagnosis and treatment –or even hospitals staffed by robot doctors– this is still very much the stuff of science fiction. So, for now let's stick to the medium-term and fast-forward to how UAE healthcare may look in 2027.
To do so, we need to start by assessing current trends.
Right here, right now
Gulf Cooperation Council (GCC) countries rely heavily on government funding to make ends meet and it is becoming more and more expensive. A 2017 report predicted that in the Middle East and Africa, expenditure would rise by 4.2% a year until 2020, meaning a jump in spending from US$ 113bn to US$ 139bn. Results from the Willis Towers Watson 2017 Global Medical Trends Survey Report suggest that this may even be a conservative estimate. Either way, there is no doubt that the UAE's medical trend is considerably higher than the 2.7% figure for general inflation, which the World Bank attributed to the Middle East and North Africa (MENA) region in 2016.
The trends
There is, therefore, a clear need to get spending under control and this will be the primary driver of any change over the next decade. But it won't be the only one. From shifting demographics to empowered patients, there are many reasons why healthcare will evolve over the coming 10 years, and they can all be summed up in one word: more.
1. More patients
The population in the Middle East is undergoing a boom. More economic wealth means more people are living longer, and more migrants are being attracted to the area. Indeed, the Population Reference Bureau cites the MENA region as having experienced the highest rate of population growth in the world during the 20th century– and this trend shows no sign of abating. But more people means more strain on services, especially in the UAE where people have direct access to specialty care.
2. More chronic disease
Wealth brings survival, but not without the cost of long-term disease. In 2014, research in prestigious medical journal The Lancet into health in the Arab world found that while communicable diseases have started to wane, they are being replaced by non-communicable ones, such as high blood pressure, heart disease and diabetes.
3. More technology
Wealth also brings many wonderful benefits such as the development of, and access to, new technologies and treatments. In the past decade alone, we've seen the birth of the smartphone, which has fast become a device most of us now consider a necessity. Yet while technology is improving healthcare by allowing more accurate diagnostics, better data collection and more integrated care, it comes at a cost. Turning back to the Willis Towers Watson 2017 Global Medical Trends Survey Report, we find that 63% of insurers attribute rising medical costs to new technologies. When funding new technologies, the mantra is generally "pay now, save later'.
4. More knowledge
The internet has upended how people learn and access information. It means that patients are far more informed about their health and treatment options than ever before.
5. More investment
The shift to a mandatory health insurance system is bringing a new era of private and government investment. Data from the Health Authority – Abu Dhabi (HAAD) from 2015 reveals that there has been a 17% increase in doctors and 12% increase in licensed facilities since 2010. However, the health system overall still lags behind international standards- for example, the UAE has just over one bed per 1,000 people compared with nearly three in the US and UK.
The year 2027
What could this translate into in 10 years' time? Let's start by stepping into a UAE hospital in 2027.
In hospitals: Expect personalized care. As the cost of genetic sequencing becomes cheaper and cheaper, physicians of 2027 will diagnose and decide on treatment, not just by signs and symptoms but by the patient's unique genetic make-up. The benefits are many, including improved outcomes, as well as less waste and expense. For example, the Oncotype DX test is capable of predicting how a patient will respond to chemotherapy. By reducing unnecessary use of treatment, it can offer considerable savings. The only issue is that right now the test is expensive – that's likely to have changed by 2027.
You will also notice more automated care. Hospitals are incredibly inefficient, with nurses in particular often overworked. One 2013 study of around 2,900 British nurses published in the British Medical Journal found that 86% of nurses had had to leave out one or more of their care activities during their last shift due to lack of time. Part of the problem is that nurses have a wide range of duties such as drug searches and taking samples to labs. With pizza deliveries by robot undergoing tests in some parts of the world, it's unlikely to be long before similar machines deliver bloods, find medications, and even schedule food or linen.
Also, be prepared for more accessible care. We have become increasingly accustomed to accessing information as and when we need it, and this demand for quick answers will cause the hospitals and clinics of 2027 to oblige. The most modern of new hospitals could offer bedside machines with AI, which are capable of answering routine questions and letting patients access their own records. Medical centres in the US are already offering a secure online equivalent. Ohio State University Wexner Medical Center offers its MyChart platform, for example. This allows patients to make appointments, view test results, ask questions and renew prescriptions at any time and without speaking to a member of staff.
In clinics: The MyChart example highlights that we may not even make it as far as the hospital in 2027. In fact, even those requiring surgery should expect to experience more outpatient care. In a system looking to cut costs, day surgery is a key target. At the start of 2017, a study in the Canadian Journal of Surgery compared knee replacement surgery for outpatient and inpatient settings. It found that outpatients cost the hospital 30% less, and that after one year there was no difference in rates of complications or returns to hospital. HAAD statistics suggest the UAE is already well set up for this, with over 71% of insurance claims being for outpatient procedures compared with 45% in Switzerland and 58% in Spain.
At home and work: With some surgery shifting to clinics, don't be surprised if even more of us access care from home or work. This will be made possible by virtual care, such as telemedicine, where doctors or nurses are available to offer advice or diagnosis online via video calls. According to the Willis Towers Watson 2015-2016 Staying at Work Survey for Europe, the Middle East and Africa this is already a reality for 5% of employees in the Gulf.
As people become more engaged and knowledgeable in the management of their own health, we should expect a rise in connected and preventive care. Employers will find themselves at the centre of this burgeoning revolution through wellness programmes. Connected care sees the divergence of digital technology and human interaction. The ability to track our fitness and vital signs via smartphone apps, wearable devices and bio-sensors will allow healthcare professionals to monitor our health better and prevent illness before it becomes both serious and costly.
The impact
I'm not going to tell you that in 2027 healthcare spend will be reduced. Maybe that will be the case. But a more likely scenario is that health spending will be better targeted, more efficient and brought under control. Two areas in particular that are likely to be impacted are insurance policies and benefits.
As healthcare shifts closer and closer to home, the best and most cost-effective insurance polices will take advantage of this. Employees may even catalyse a demand for access to virtual doctors and outpatient surgery, further helping to keep insurance premiums low.
With personalized medicine enabling unique treatments, this may also mean that benefits plans, such as wellness programmes, will start to be defined by the employee's own genetic profile. If a young worker is shown to be a high risk of heart disease, their wellness programme could be geared to helping them reduce cholesterol and stay fit.
