middle east hospital magazine february 2010

The definitive

guide to

Hospitals and

Healthcare

in the

Middle East

THE ARAB HOSPITAL

www.middleeasthospital.com

MIDDLE EAST HOSPITALincluding

Special feature:

Specialist article on home dialysis by Dr. R N Greenwood

Philips Healthcare

Outstanding Contributionto Healthcare in the

Middle East

THE

ARAB HOSPITTHE

ARAB HOSPIT

AL PIT TAL

The definitive

guide to

MIDDLE EAST

THE including

MIDDLE EAST

ARAB HOSPITTHE uding

MIDDLE EAST

ARAB HOSPIT

HOSPIT

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AL PIT TAL

SPITTAL

guide to

Hospitals and

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in the

Middle East

www

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osp ta coospital.com

Sales Office +44 (0)114 240 4400

Fax +44 (0)114 257 6555

Email [email protected]

www.boltons.co.uk

Bolton Surgical Ltd, Churchill House, 16 Churchill Way, Chapeltown, Sheffield. S35 2PY

February 2010 | 3

The Arab Hospital Middle East Hospital

February 2010 contents:

MEH Health and InnovationAwards winnerspg. 4-10

Healthcare industry newspg. 12-13

Special feature: Medical Edu-cation and Training in the Gulf

Imperial College London Dia-betes Centre Abu Dhabi pg. 14-16

Cleveland Clinic and IIRpg. 18-19

Philips Continuous MedicalEducation academy Dubaipg. 20-21

Weill Cornell Medical CollegeQatarpg. 22-24

Specialist article: the rejuvina-tion of home dialysis- clinicaland financial considerations,by Dr RN Greenwoodpg. 26-29

Editor’s introduction

For exporters to the Gulf andwider Middle East markets ArabHealth is the key trade show ofthe year, and early reports sug-gest it was a great success formany companies. Despite theglobal economic crisis finallybeing felt in the Gulf, and particu-larly in Dubai, the healthcare mar-ket here remains robust.Spending of around $100billionhas already been allocated acrossthe region, as new hospitals andhealthcare projects flourish.

At Arab Health 2010 MEH held itsinaugural Health and InnovationAwards ceremony, recognisingcompanies that have contributedto healthcare in the Middle Eastregion, and rewarding the intro-duction of innovative new prod-ucts to the market. We at MEHwere particularly honoured thatthe internationally renowned sur-geon and UK business ambassa-dor Lord Darzi agreed to presentour awards, which made the oc-casion even more special for thewinners. In this issue there is ex-tensive coverage of the awardswinners and their products.

The magazine has a special re-port on some of the institutionsand companies that are contribut-ing to medical education andtraining in the Gulf. We look at the

Continuous Medical Educationschemes being implementedby important healthcare organ-isations such as Philips,Cleveland Clinic, and WeillCornell. We also have a lookat the rise of home dialysis inan article by Dr Greenwood ofthe Renal Unit at Lister Hospi-tal, Stevenage.

In next month’s issue we will havean in depth review of Arab Health2010, hearing from the compa-nies that attended both large andsmall. British companies domi-nated the MEH awards and wewill shine a light on British health-care excellence on display at theshow, and in the Gulf region.

Guy Rowland, Editor

Lord Darzi

Students at WCMC-Q

The Arab Hospital

The Arab region’s leading health-

care monthly, Middle East Hospi-

tal magazine (MEH), presented

their inaugural Health and Innova-

tion Awards at an awards cere-

mony today at Arab Health 2010

in Dubai. The awards, for suppli-

ers of medical equipment to the

Middle East region, were pre-

sented by the renowned surgeon

and UK Government healthcare

ambassador Lord Darzi.

The editor of MEH, Guy Rowland,

said, “these awards recognise the

contribution of companies from

across the globe to healthcare

services in the Middle East, and

the benefits their products have

provided for hospitals, clinicians

and patients in the region. The

Arab countries import the vast

majority of their medical devices

and healthcare products, and the

introduction of high quality, inno-

vative new technologies by med-

ical equipment manufacturers has

played a major role in the ongoing

revolution in healthcare provision

taking place in the Middle East.”

Commenting on the UK-based

award winners Lord Darzi said,

“These firms represent the very

best of UK innova-tion and excel-lence. Their workwill save lives andimprove the qualityof life for peoplearound the world. Icongratulate thesepioneering firmson the recognitionthey haveachieved.”

British success

story

Kimal won an in-novation award forthe NxStage Sys-tem One homehaemodialysis ma-chine, which wasunveiled at ArabHealth by LordDarzi, and alsobagged the presti-gious prize ofBritish Middle EastExporter of theYear for 2009 fortheir impressive recent growth inthe region.

Kimal plc has been operating inthe Middle East region for 30years, initially developing busi-ness from its UK base and thenopening dedicated regional of-fices in the UAE during 2001.

Corporate Marketing Manager,Ken Findlay, said, “The MiddleEast operation has gone fromstrength to strength in the pasttwo years with total sales at theend of March 2009 increasing by

MEH Health and Innovation Awards

Middle East Hospital

February 2010 | 4

an amazing 42% to over £6.5m. Itwas during this year that also sawsales manager Brian Deane be-coming the first Kimal sales per-son to achieve the £5m personalsales milestone.

“Most notably for the ME opera-tion is the level of new businesscreated in the region. Based onan excellent order book the com-pany expects new business to hitover half a million pounds by 31stMarch 2010. This is an amazing460% increase from the same pe-riod in the previous year. Not only

Lord Darzi of Denham

NxStage One from Kimal

Middle East HospitalThe Arab Hospital

February 2010 | 5

Award winners

Most innovative product for export category

Kimal for the NxStage System One home haemodialysis machine

Surgins for range of stainless steel and titanium surgical instruments

Medibord Limited for the Medibord MRI, CT and radiotherapy compatible material

Mirage Health Group for the Propulse NG Ear Irrigator

Bedfont Scientific for their range of exhaled breath carbon monoxide monitors

NuTec Medical Ltd/A-Z Innovations for the Paraskate cylinder trolley safety range

Bolton Surgical for their colo-rectal range

Sanitas for healthcare innovation in the field of hygiene promotion

Outstanding contribution to healthcare in the Middle East category

Gene Profiling for MammaPrint

Adam, Rouilly for the Venepuncture and Infusion Arm

Malem Medical for their range of enuresis alarms

American Middle East exporter of the year

Welch Allyn

British Middle East exporter of the year

Kimal

German Middle East exporter of the year

Karl Storz

Special award for outstanding contribution and commitment to healthcare

in the Middle East

Philips Healthcare

International award for outstanding Middle East export achievement of the year

Steve Spurgin of Downs Surgical/B-Braun

Special Award for outstanding contribution to British Healthcare Exports

Theresa Ashford (ABHI ) for the International e-newswire

Award for outstanding International contribution to pediatric healthcare

Children's Hospital Boston

that but it is also a mind blowing3614% increase on the new busi-ness figure as at 31st March2008. Actual new business salesin the region at the end of Decem-ber showed a brilliant 227% in-crease on the same period in2008-09.”It is fitting that in this, their 30th

year operating in the Middle Eastthat Kimal are leading from thefront in developing UK healthcarebusiness and are reaping the re-wards of the continued effort andexpertise in supporting and devel-oping this ever important marketfor UK companies.

L-R: Dr Hilal Malem (Malem Medical), Peter Bolton (Bolton Surgical), Steve Spurgin (Downs Surgical),Dr Peter Briggs (Health Audit International), Jenny White (Adam, Rouilly), Theresa Ashford (ABHI), DrRizwan Qureshi (Surgins), Lord Darzi, Alan Press (Kimal), Jonathon Richards (Medibord), Samir Zreik(Gene Profiling/Agendia), Mike Tanousis (MEH)

Ken Findlay, Brian Deane and Alan Press of Best UK Middle EastExporter winner Kimal, wih Lord Darzi

February 2010 | 6


Bolton Surgical- Sheffield steel surgical instruments

Bolton manufacture theatre quality surgical instruments covering all disciplinesof surgery and are the market leaders in the development of instruments forColo Rectal surgery. This range has been developed in conjunction with Eu-ropes leading Colorectal surgeons over the last 10 years. Peter Bolton toldMEH, «We have over the last decade designed and developed an extensiverange of instruments for the Colorectal surgeon. Our Colo Kraft range is nowrecognised worldwide and to receive an award was a wonderful accolade. Theteam at Bolton Surgical will all take pleasure at the recognition and we wouldlike to thank all responsible for the nomination.»

Medibord CEO Jonathan Richards

Medibord Limited- Innovation in medical composites

Medibord Ltd, from Nottingham in the UK, have launched theworld’s first fully x-ray translucent and non-conductive material fora range of couch tops and patient positioning devices. Medibord™is a unique and innovative MRI, CT and radiotherapy compatiblematerial. Unlike carbon fibre alternatives, Medibord has been de-signed to be fully x-ray translucent and non-conductive ensuringno heating occurs with MRI giving no artefacts and enabling ac-curate software image overlay.«For a new business such as Medibord, it is a great honour to beacknowledged for our innovative range of products and we are de-lighted to receive such a prestigious award from the highly es-teemed Middle East Hospital Award Panel», said CEO JonathanRichards, «Medibord is yet another step closer to developing a sig-nificant market share in the MRI/CT scanner accessory productfield».

MEH Health and Innovation Awards: A closer look at the winning products and companies

Adam, Rouilly- medical training tools

Adam, Rouilly produce a range of medical training tools from brainmodels and heart models to skeletons and anatomical charts; fromvenipuncture training tools and instruments to resuscitation simula-tors. Sales and Marketing Manager GrahamFowler says, “The suc-cess of Adam,Rouilly’s export sales is due to the hard work of ourdedicated sales team. In 2009 we achieved 50% of our total sales inexport markets with significant sales in the Middle East. The adventof clinical skills training in hospitals in the Middle East is a major fac-tor in these achievements. Attending Arab Health since 2004 has en-abled us to regularly meet many of our customers, and the salesreflect the confidence our dealers have in the products, quality andservice that Adam,Rouilly offers to Healthcare Education.”


February 2010 | 8

Malem Medical- Enuresis alarms

For 30 years Malem Medical have been manufac-turing the world’s best and largest range of EnuresisAlarms and Vibrating Watches for the treatment andpermanent cure of Nocturnal as well as DiurnalEnuresis.Malem Enuresis Alarms (bedwetting alarms) aredesigned to maximize success in the treatment andcure of bedwetting and provide a safe, efficient,economical and permanent cure for bedwetting incontrast to the short term relief offered by expensiveand potentially dangerous drugs. Dr HiIal Malem said, “I wish to express our prideand appreciation in being awarded the Health & In-novation Award. We will treasure and value it for-ever. It is good to be acknowledged for the workover the last 30 years. We are continuously workingon new products to fulfill the needs and improve thequality of life of people.”

Mike Tanousis of MEH presentsthe award to Dr Hilal Malem

Sanitas Healthcare plc- unique swine flu hygiene pack

CEO Rob Gros said: “Building on our recent success in the UK weare increasing our efforts in the Middle East where the response fromSaudi Arabian, Libyan and Kuwaiti distributors in particular has beenhighly encouraging. At Arab Health we launched a new addition tothe FluPak family - TravelPak the hygiene kit which has been devel-

oped for people on the move by air, by sea or on land.

“The complete range of Sanitas products empowers people to ac-tively protect themselves against viruses such as swine flu and avianflu, and pathogens such as MRSA, Norvirus and E.coli etc by sani-

tising their environment and reducing the risk of infection.”

Surgins- a surgeon’s vision

Surgins is one of the fastest growing stainless-steel and titanium sur-gical instruments companies based in the United Kingdom. It aimsto develop a global reputation for surgical Instrumentation of out-standing quality, precision and cost-effectiveness- on basis of pro-found surgical knowledge.Dr Qureshi explains, “Surgins philosophy is to provide such a “Sur-geons’ Platform” where surgical instruments should be manufactured,developed, customized and innovated as per surgeons’ wisdom & vi-sion. Surgins believe that providing surgeons with the surgical instru-ments that surgeons want is the key to successful surgery, which willfacilitate the treatment of diseases across the globe.”

Dr Rizwan Qureshi of Surgins


February 2010 | 9

Bedfont Scentific- exhaled breath monitors

Bedfont Scientific Limited specialises in the manufacture of exhaledbreath and gas monitoring instruments for medical, scientific and in-dustrial markets throughout the world. Andrew Shephard, Export Sales Executive, says, “Airway inflamma-tion is a central process in asthma and other lung diseases. Beingable to measure this inflammation and monitor the patient’s reactionto medication is regarded as a gold standard in the management ofrespiratory diseases. It is increasingly recognised that the measure-ment of Fractional Exhaled Nitric Oxide (FENO) in particular consti-tutes a novel way to monitor separate aspects of diseases. Theseinclude asthma, COPD and interstitial lung diseases,that are not as-sessed by other means, such as lung function.”

NuTech Medical/A-Z Innovations- the Paraskate range

An elegantly simple mechanical clip that exploits the force ofgravity to safeguard tall, heavy gas bottles from the danger oftoppling over is capturing avid attention from prospective health-care customers across the UK and around the world. Thisunique clipping system, named Paragrip is the invention of RobinMore, Managing Director of NuTec Medical Ltd, a Southend-based research and development company. «Gas bottles are inwidespread use in the healthcare industry and they are tall, thinand heavy. The dangers their instability poses while they arebeing moved and in use are considerable, and this is a world-wide problem. Previous systems to keep gas bottles in placesimply do not work effectively. But by using Paragrip and itscounterpart Paraskate, a simple mini-trolley, stability of bottlesis greatly increased both in use and in transit.»

The Paragrip

COmpact smokerlyser

Mirage- ear care specialists

Mirage Health Group specialises in the provision of earcare products which allow clinicians to carry out safe andeffective ear care in accordance with today's guidelines.The unique Propulse ear irrigation range has been sup-plied to the UK primary care market since 1997.David Caldwell, General Manager – Sales and Operations,told MEH, “Mirage is committed to working with cliniciansto provide the tools they need to carry out safe and suc-cesful ear care for patients.The Propulse Ear Irrigator hasbeen the clinicians favourite for over 10 years. Over thattime, the Propulse range of products has developed to in-clude good value, high quality instruments designed specif-ically for ear care.

Propulse NG Ear Irrigator

February 2010 | 10


medibord.com

World First Technology Medibord™

The Medibord™ has been designed to enable the development of innovativesolutions for radiotherapy and MRI compatible medical devices and clinical use.

• Lightweight – less than 4.5kg/m²

• Rigid – impressive strength to weight ratio

• Robust – high impact resistance offers superb durability

• Ecological – 100% recyclable

• MRI Compatible – uniquely magneto-radio translucent

• Modular – ability to form and offer 2D for shaping cost effective ancillaries

Successful clinical trials carried out by Nottingham University Hospitals have provedthe Medibord™ to be a revolutionary material for the use in radiotherapy and MRI scans

eliminating heat and the resultant image artefacts.

• Oncology couch tops

• Patient positioning boards and devices

• Patient transfer systems

• Emergency and temporary partitioning

• Clinical waste applications

For more information and to arrange for a clinical trial please contact us.

• • [email protected]

Most InnovativeProduct for Export


February 2010 | 12

Healthcare Industry News

Medical tourism industry growing in KSA

Hospital, Ibn Rushd Hospital,

Saudi German Hospital, Qari

Medical Center for Blood Dis-

eases and Tumors, Dr Abdul Rah-

man Baksh Hospitals, and Eid

Clinic.

There are several other clinics

springing up in various regions of

the Kingdom. Abdul Rahman Al-

Jassas, SCTA’s executive director

for tourism development in the

Riyadh region, said that Saudi

Arabia is also making giant strides

in business and conference

tourism.

“Riyadh hosted more than 50 per-

cent of these types of tourism ac-

tivities Kingdom-wide during the

last year,” he said.

Health tourism accounted for overSR800 million out of the totalspending by both citizens and ex-patriates for domestic tourism in2007, a recent report from theSupreme Commission for Tourismand Antiquities (SCTA) said, alsonoting that foreign tourists spentover SR400 million to undergotreatment in the Kingdom during

this period.

The SCTA report showed thatthere are several medical firmsand centers to promote medicaltourism in the main cities of theKingdom. These include PrinceSultan City for Humanitarian Serv-ices, Dr. Sulaiman Al-HabeebCenter, Kingdom Hospital, Dallah

Samsung Medical Cen-

tre opens in Dubai

Dubai Health Authority has an-nounced the opening of the firstSamsung Medical Centre in theMiddle East in Dubai next Marchunder the patronage of DubaiHealth Authority and in collabora-tion with INDEX Holding as thefirst center of its kind outsideKorea. The centre will have highly spe-cialised medical and nursing per-sonnel in addition to the medicalvisits by consultants from Sam-sung Medical Centres and Hospi-tals in Korea. Samsung MedicalCentre Dubai provides special-ized medical services in the treat-ment of Cancer, Cardiology,Nephrology, Urology, Gastroen-terology, Women Health andFamily Medicine. The centre aimsat attracting medical tourism tothe region and to facilitate the ex-change of knowledge and experi-ences.“We are pleased that a world-class center like Samsung Med-ical Center has decided to openits first medical center in the re-gion in Dubai. The decision re-flects the investors’ trust in Dubai,the United Arab Emirates and inthe vision of the wise leadershipof His Highness Sheikh Mo-hammed Bin Rashid Al MaktoumVice President, Prime Minister ofUAE and Ruler of Dubai” said HisExcellency Qadhi Saeed AlMurooshid, Director General,Dubai Health Authority.

DHA hospitals get accreditation from the Arab

Board of Medical Specializations

The Arab Board of Medical Spe-cializations has granted accredi-tation to two DHA hospitals totrain newly qualified graduates(residents) in general surgery. Thetwo hospitals are Dubai Hospitaland Rashid Hospital. Dr Khalil Qayed, Director of theMedical Education Department atthe DHA said, “This is a significantstep for us and this accreditationreflects the high-level of qualityservices we provide in our hospi-tals. The medical field is ever-evolving and at the DHA it is ourendeavour to provide our doctorswith opportunities where they can

receive training in the latest ad-vances in medicine.“This accreditation means that ourdoctors can now receive trainingin general surgery within the DHAhospitals itself and since the train-ing is recognised by the board,our doctors will be eligible to givetheir Arab Board examinationsonce they have completed theirfive-year training with us. Thisprovides a tremendous boost forour doctors and makes it moreconvenient for them to undertakethe examinations and receivetheir certification in general sur-gery.”


February 2010 | 13

New ProPlus Digital Wheel-

chair Scales 1600KL and

2610KL added to the Health

o meter Professional Line

The maker of the world's mostrecognized brand in clinicalweighing, Health o meter Profes-sional scales, announced lastmonth the addition of new 1600KL(700 lb/ 310 kg capacity) and2610KL (dual ramp, folding, 1000lb / 454 kg capacity) models to theProPlus® digital wheelchair scaleline. Both models include EMR con-nectivity through USB and serialports and swivel display indicatorsthat are easy to use and easy toread. Each scale is manufacturedto ISO13485:2003 standards of

quality and includes 270 Patientmemory, multiple data ports, ex-clusive tare functionality, cus-tomizable display options,user-friendly data screens, mo-tion-sensing technology to com-pensate for patient movementand troubleshooting diagnos-tics. These scales are the latest ad-dition to the ProPlus wheelchairline--all factory calibrated withpatented features that allow fora low cost of ownership. Com-mitment to dependability, dedi-cation to customers and eightdecades of technical expertiseallows Health o meter Profes-sional weighing instruments tocontinually provide innovation toa greater scale.”

Seward sees 7500th Stom-

acher® 400 Circulator Pad-

dle Blender sale

Seward Limited, manufacturerand developer of the world lead-ing, patented Stomacher PaddleBlender range for over 40 years,has recently achieved its 7500thglobal sale of its Stomacher 400Circulator. This success can beattributed to its growing US-basedsales and technical support office,opened in Long Island, New Yorkin September 2008, backed up bySeward’s global Headquarters inthe UK, where all Stomacherblender systems are manufac-

tured.

Over 8 million food samples a dayare now reproducibly ho-mogenised using Stomacher®400 paddle blender units and as-

sociated Stomacher bags world-wide. Sample preparation is a crit-ical step in all microbiologicalanalyses and Stomacher paddleblenders guarantee reliable andconsistent homogenising perform-ance through industrial strength,power and build quality. Theglobal success of the Stom-acher® range of paddle blenders

and bags is also demonstrated bythe fact that Stomacher is themost highly referenced brandname in food safety and life sci-ence sample preparation. “We areextremely proud of the long his-tory and excellent reputation ofour Stomacher trademarked prod-ucts, some of which are still in re-liable routine use after 25 years,”said Stuart Ray, Technical Direc-tor, Seward Ltd. “The 7500thglobal sale of our Stomacher 400Circulator system further high-lights the world leading status ofour Stomacher brand.

«Due to its unique patented pad-dle design the Stomacher 400 Cir-culator blender enhancesmicroorganism recovery oversquare paddle designed labora-tory blenders.»

MEH Special feature:

Medical Education and Training in the Gulf

February 2010 | 14


Imperial CollegeLondon DiabetesCentre Abu Dhabi

In 2004, Mubadala DevelopmentCompany signed a frameworkagreement with the UK’s ImperialCollege London for mutual coop-eration in the fields of education,healthcare, research & develop-ment and industrial development.The first initiative to come out ofthis partnership is the establish-ment of the Imperial College Lon-don Diabetes Centre in AbuDhabi. This state-of-the-art spe-cialized Centre was opened inmid August 2006 next to the city’sZayed Military Hospital.

The treatment at the Centre al-lows the highest level of special-ized patient care from firstdiagnosis to the management ofall the complications associatedwith diabetes. This is achieved byin-house comprehensive diagnos-tic facilities including digital retinalphotography, retinal laser ma-chines, and the latest in cardiacechocardiographic imaging andstress testing to detect the earliestsigns of heart disease.

Research conducted at the Cen-tre encompasses epidemiological,basic, clinical and genetic ©Woods Bagot - Imperial College London

February 2010 | 15


research focusing on diabetes inthe UAE. One of the Centre’sleading priorities will be to providecontinuing education for healthprofessionals and the generalpublic.

Imperial College London’s historyand expertise in the study of dia-betes brings one of the leadingmedical academic institutions inthe world to Abu Dhabi as a coreworking partner.

Imperial College London DiabetesCentre (ICLDC) was one of thefirst facilities to be established aspart of Mubadala Healthcare’s vi-sion to create a world-classhealthcare network in Abu Dhabi.The Centre is a prime example ofhow this vision is being realised -addressing one of the most press-

ing healthcare issues in the re-gion by harnessing the world-renowned medical expertise ofImperial College London andcreating a centre of excellencefor Abu Dhabi.

Since it opened in 2006,ICLDC has treated over20,000 patients and reachedout to countless othersthrough its cutting-edge re-search, awareness cam-paigns, and communityoutreach programs. By raisingknowledge and awarenessabout the condition andthrough ongoing research,ICLDC is paving the way bothto improve the quality of lifefor those living with diabetesand ultimately to reduce itsprevalence in the region.

ICLDC recognised as a quality

medical provider

In December 2009 ICLDC wasawarded an accreditation with com-mendation by the Joint CommissionInternational (JCI). Dr Maha Taysir Barakat, ICLDC’sMedical & Research Director andConsultant Endocrinologist, said,“The Centre is dedicated to theworld-class treatment and re-search of diabetes in the UAE,and the greater region. The inter-nationally-recognised JCI accred-itation provides quantifiablebenchmarks that focus on thequality of patient care and patientsafety.” She added that theseguidelines mirror the criteria set byICLDC from the outset, with many ofthe elements encouraging the efficientuse of information technology.

©Woods Bagot - Imperial College London

”The Centre is equipped with special-ist equipment that directly interfaceswith each patient’s medical record andminimizes transcription errors, avoidslost reports and delayed receipt of re-sults.

“At every consultation, our patients areprovided with a printout that shows re-sults in full, and shares the doctors’recommendations,” Dr Maha advised.In tandem, an automated internalcheck on the individual doctor’s per-formance is initiated, and is mergedwith an on-going audit that continu-ously drives quality at ICLDC.

Dr Maha also said that there is a pop-up signal that prompts the doctor’s at-tention when results appear to be offtarget, and she stressed that patientconfidentiality is at the core of all doc-

tor-patient communication. ICLDC’s ITsystem operates by a strict access-controlled, patient-centric mechanism,that also ensures a seamless patientinterface, right through to the manage-ment of appointment times to mini-mize waiting.

“Our processes are fully automatedand paperless. One of our aims hasbeen to lessen the administration bur-den of the doctor, ensuring that maxi-mum time is dedicated to patientinteraction, conversation and counsel.Dr Maha added, “Our successful ac-creditation by JCI sends a clear signalto the region’s community that ICLDCis committed to quality in patient care.We will continue to deliver superiortreatment to patients, as well as offeron-going medical training to health-

care professionals through our Con-tinuing Medical Education pro-gramme (CME).”

The Joint Commission Interna-tional (JCI) works with healthcare organisations, ministriesof health, and global organisa-tions in more than 80 coun-tries. Since 1994, theorganisation has focused onimproving the safety of patientcare through the provision ofaccreditation and certificationservices as well as throughadvisory and educational serv-ices aimed at helping organi-sations implement practicaland sustainable solutions.(www.icldc.ae)

February 2010 | 16


©Woods Bagot - Imperial College London

MEH Special feature: Medical Education and Training in the Gulf


February 2010 | 18

To remain certified, doctors mustregularly update their skills,knowledge and practical know-how to provide the best service totheir patients and to ensure theirlicense to practise does not lapse.For many in the GCC this repre-sents a significant financial invest-ment and time cost as only limitedCME (Continuing Medical Educa-tion) accredited courses are avail-able in the region forcingpractitioners to travel abroad.

At Arab Health 2010, IIR MiddleEast and the Cleveland Clinic’sCenter for Continuing Educationcollaborated to significantly ex-pand continuing medical educa-tion activities in the Middle Eastby giving medical professionalsan opportunity to gain CME ac-creditation by attending the multi-track conference and exhibition,reducing travel costs and timespent away from their practice.Delegates who attended receivedan accreditation certificate thatcan be used towards maintainingtheir annual quota of continuingmedical education credits, whichare now necessary to renew med-ical practicing licenses in theUAE.

“By ensuring that our conferencesare accredited and our speakersare leading experts in their fields,

Cleveland Clinic and IIR Middle East enable delegates to gainCME accreditation at Arab Health Conference and Exhibition

IIR Middle East iscommitted to pro-viding the bestpossible medicaleducation avail-able in the re-g i o n , ”c o m m e n t e dSimon Page,Group Director ofLife Sciences Di-vision, IIR MiddleEast. “Our part-nership withCleveland Clinic sets an unprece-dented standard and we continueour work as an internationalprovider of specialist informationand services for the academicand scientific, professional andcommercial business communi-ties.”

Cleveland Clinic, located in Cleve-land, Ohio, is a not-for-profit mul-tispecialty academic medicalcenter that integrates clinical andhospital care with research andeducation. Cleveland Clinic wasfounded in 1921 by four renownedphysicians with a vision of provid-ing outstanding patient carebased upon the principles of co-operation, compassion and inno-vation. U.S. News & World Reportconsistently names ClevelandClinic as one of the nation’s besthospitals in its annual “America’s

Best Hospitals” survey.

Approximately 1,800 full-timesalaried physicians and re-searchers at Cleveland Clinic andCleveland Clinic Florida representmore than 100 medical specialtiesand subspecialties. In 2008, therewere 3.6 million outpatient visits toCleveland Clinic and 48,300 hos-pital admissions. Patients camefor treatment from every state andfrom more than 80 countries.

Its Lerner Research Institute isone of the country's leaders inNIH-funded research. Its Educa-tion Institute sponsors one of thelargest physician graduate train-ing programs. The ClevelandClinic Lerner College of Medicineaccepted its first class in 2004. Itcombines education and research


February 2010 | 19

in an innovative program that willgraduate 32 medical studentseach year who are mentored tobecome physician-scientists.

At Arab Health, the ClevelandClinic will sponsor medical educa-tion meetings and certify them forAMA PRA Category 1 Credit™which will broaden accreditedpost-graduate education in theMiddle East. The American Med-ical Association (AMA) Physi-cian’s Recognition Award (PRA)has recognised physician partici-pation in continuing medical edu-cation (CME) for more than 35years. AMA only authorises or-ganisations that are accredited bythe Accreditation Council for Con-tinuing Medical Education(ACCME) to designate and awardAMA PRA Category 1 Credit™ tophysicians.

As an accredited provider, Cleve-land Clinic ensures all educationalactivities complete a rigorous cer-tification process to comply withguidelines and policies developedby AMA and ACCME. These ac-tivities maintain, develop, or in-crease the knowledge, skills, andprofessional performance ofhealthcare professional in a bias-free, evidence-based manner.Activities certified for AMA PRACategory 1 Credit are ensured in-tegrity of the content.

The Cleveland Clinic’s relation-ship with IIR Middle East ensuresthat over 20 medical meetings an-nually, such as Arab Health, theAbu Dhabi Medical Congress andSight 2009 will be accredited andsponsored by the Cleveland

Clinic. For Arab Health, there willbe substantial incorporation of theCleveland Clinic faculty andCleveland Clinic directed contentwill feature at the medical con-gress. The congress will be ableto utilise the Cleveland ClinicCME infrastructure and there willalso be significant integration withthe Cleveland Clinic Abu Dhabiand the Sheikh Khalifa MedicalCentre.

William Carey, MD, Director of theCleveland Clinic Centre for Con-tinuing Education believes the on-going relationship with IIR MiddleEast and the Cleveland Clinic willensure qualityeducation formedical profes-sionals in theregion.

“The collabo-ration betweenthe ClevelandClinic Centerfor ContinuingEducation andthe Interna-tional Instituteof Research(IIR) MiddleEast allows usto broadenquality continu-ing medical ed-u c a t i o nactivities bene-fiting the localmedical com-munity as wellas the regionand beyond,”said Dr Carey.“ P r o v i d i n g

AMA PRA Category 1 Credit™ willsignificantly expand accreditedpost-graduate education in theMiddle East and we are pleasedto provide CME credits for 14 con-ferences during Arab Health Con-gress.”

Continuous Medical Education academyof excellence to open in Dubai


Dubai Healthcare Authority(DHA), Active-M Group and RoyalPhilips Electronics have an-nounced a joint venture to de-velop a strategic framework fordelivering and marketing a world-class Continuous Medical Educa-tion (CME) academy ofexcellence. The academy, basedin Dubai, will offer both interna-tional and local accreditedcourses for all medical practition-ers in the United Arab Emirates(UAE) and the States of the GulfCooperating Counsel (GCC). Allthe parties of the joint venture arevery keen to make sure that theDubai Academy for ContinuousMedical Education opens itsdoors in maximum six months.

The academy’s mission is to en-hance the quality and effective-ness of patient care throughinnovative delivery and support ofcontinuing professional develop-ment programs for health careprofessionals. The Academy part-ners with medical education andcommunication companies andother organizations to provide cer-tified continuing education forhealth care professionals.

The academy will deliver first-class accredited medical educa-tion to ensure up-to dateknowledge and skill development

for the community of regionalmedical practitioners at large. Theacademy is an answer to the in-creasing demand for continuousmedical education in the GCC re-gion due to permanent influx ofexpat personnel requiring calibra-tion of knowledge and training.

The Dubai Healthcare Authority,being a pioneer in introducingbest practices in healthcare in theregion, will provide the joint ven-ture their premises to conduct themedical courses, define the topicsof the courses and workshops

Seated from left to right: Dr. Khalil Qayed - Director of Medical Education,Dubai Health Authority, Ms. Salam Saadeh - CEO, Active-M Group, Mr.Louis Hakim – VP of Royal Philips Electronics and CEO of Philips MiddleEast. Standing from left to right: His Excellency Qadhi Saeed Al Murooshid– Director General, Dubai Health Authority, Dr. Gottfried Dutine – ExecutiveVP, Global Head of Markets & Innovation, Royal Philips Electronics,Mr. Tony El Zoghbi – Project Manager, Dubai Health Authority

February 2010 | 20


that are fully in line with the de-

mand in the UAE and the GCC

arena at large, and grant accredi-

tation to participants according to

the rules and regulations applica-

ble in the UAE.Dr. Khalil Qayed,

Director of Medical Education at

the Dubai Health Authority said,

“This is a great opportunity for the

medical community to upgrade

their knowledge and skills and to

get in touch with high caliber sci-

entists and experts to exchange

their expertise. Such a platform

whereby the private and the pub-

lic sector work together for the

benefit of the medical community

is part of the DHA’s strategy as we

believe that the private sector is

one of our key stakeholders.”

Active-M, a venture capital invest-

ment and advisory company with

a special focus on the healthcare

services segment in the region will

finance and fully manage the joint

venture. Active-M will coordinate

between the different parties toensure delivery on the agreedstrategy. “We live in a highly de-manding healthcare servicescommunity due to the high popu-lation growth, rapid ageing of thepopulation, fast growth in chronicdiseases, and chronic lack ofmedical personnel; among otherthings. As such we, at Active-M,are very pleased to work along-side DHA and Philips on this ex-citing project that will aim tomaintain and increase the qualityof individual healthcare servicethrough providing continuing edu-cation for the medical body”, saidMs. Salam Saadeh, Founder andCEO of the Active-M Group.

“Philips, being a global leader inhealthcare services and solutionswill leverage its world-wide net-work with academic bodies for thebenefit of the joint venture”, com-mented Louis Hakim, VP of Royal

Philips Electronics and CEO ofPhilips Middle East. “Philips willalso provide curriculum for topicsthat need regional development,in line with topics identified by theDHA clinical expertise”, addedLouis.

Dubai Health Authority

The Dubai Health Authority (DHA)is the strategic health authority forthe Emirate of Dubai. It has beenempowered to set policy andstrategy for health, and to assurethe application of that health pol-icy and strategy. The DHA leadsan integrated approach across thespectrum of health, anticipatingour future needs and being re-sponsive to users. It will stimulategrowth and innovation in thehealth market, ensuring value formoney and quality of servicesthrough effective regulation.

About Active M-Group

Active- M Investments LLC is aVenture Capital Investments andAdvisory firm with the key objec-tive of helping entrepreneursacross the region start new andsuccessful business ventures. Ac-tive-M’s strength lies in providingback office support, funding andguidance for entrepreneurs inorder for them to focus on what isimportant and materialize theirdreams. Active-M has a portfolioof projects underway particularlywithin the healthcare and educa-tion services sectors. Active-Malso offers management, financialadvisory and consultancy serv-ices to early stage companies andsmall to medium enterprises(SME).

February 2010 | 21


Established in 2001 as a partner-ship between Cornell Universityand Qatar Foundation, WCMC-Qis part of Weill Cornell MedicalCollege in New York and sharesits mission of dedication to excel-lence in education, patient careand research. The first medical school in Qatarand a pioneer of co-education atuniversity level, WCMC-Q offersan integrated program of pre-medical and medical studies lead-ing to the Cornell University M.D.degree. Teaching is by Cornelland Weill Cornell faculty, includingphysicians at Hamad MedicalCorporation (HMC) who hold WeillCornell appointments. Enrollmenthas grown rapidly from 25 firstyear pre-medical students in fall2002 to over 200 students frommore than 30 countries by Sep-tember 2007.In the clinical arena, WCMC-Q isalready making a contribution tothe community in Qatar. Medicalfaculty members licensed andcredentialed to practice see pa-tients as part of their teaching as-signments in HMC facilities. Thereare exchanges of expertise withfaculty-physicians from New York- Presbyterian/Weill Cornell Med-ical Center, particularly in the


planning phase of Qatar Founda-tion’s Sidra Medical and ResearchCenter.Collaborative biomedical researchprojects are underway betweenWeill Cornell in the U.S. andQatar, and HMC, and a major re-search program is now on theanvil. WCMC-Q students haveopportunities to take part in bio-medical investigations: The Sum-mer Research Program enablesselected students to travel to theU.S. and work under the mentor-ship of leading investigators atCornell and Weill Cornell. Mean-while, a growing number are par-

ticipating in projects in Qatar,guided by WCMC-Q faculty andfunded by the Undergraduate Re-search Experience Program ofQatar National Research Fund.Following the landmark year ofthe graduation of the Class of2008, Qatar's first 'home-grown'doctors, Javaid I. Sheikh [MD,MBA] Interim Dean said, “Exciting future developments in-clude the role WCMC-Q will playas part of a world-class academicmedical center on completion ofQatar Foundation’s Sidra Medicaland Research Center, currently

Dr. Mohamud Verjee and class of

2010 in Clinical Skills Centre

February 2010 | 22


under construction on the Educa-tion City campus. Working to-gether, WCMC-Q, Sidra and HMCwill implement "one program inmultiple institutions," achievingstrength through collaborative ef-fort.”

WCMC-Q Takes Part in Qatar’s

First Health Congress

Around 200 health care profes-sionals from more than 20 coun-tries gathered at Doha’s exhibitioncenter recently to speak about ad-vances in medicine. Among themwere five physicians from WCMC-Q. Their lectures were part of thefirst of its kind, five-day “QatarHealth 2009” congress, which fea-tured 13 tracks of medical presen-tations and workshops.“This event, with its number oftracks and eminent internationaland local speakers, provided richmaterial for the ongoing educationof all health professionals in Qatarand the region,” said Dr. Marcel-lina Mian, adjunct professor of pe-diatrics at WCMC-Q. “I commendthe organizing committee for put-ting together such an ambitiousproject.”

The event, organized by HamadMedical Corporation and theSupreme Council of Health, wasdesigned to showcase advancesin the Qatar’s health care systemand drew a large number of dele-gates from the medical sector andthe general public. Further, localprofessionals and internationalspeakers had a chance to meet,Dr. Mian said, making the week apleasant and gratifying experi-ence for those in the health carefield. Overall, Qatar Health 2009

was a chance for the country tohost multi-track presentations atthe leading edge of health care’sglobal evolution.Contributing to the obstetrics andgynecology track, Dr. Arash RafiiTabrizi, assistant professor of ge-netic medicine in obstetrics andgynecology at WCMC-Q, spokeabout “Laparoscopy in Gyneco-

logic Oncology.” Dr. Nady E.Nady-Mohamed, assistant profes-sor of obstetrics and gynecologyat WCMC-Q. spoke along thesame track about “LaparoscopicManagement of Large OvarianCysts During the SecondTrimester of Pregnancy.”Along the pediatrics track, Dr.Mian spoke about “Child Protec-

Dr. Kevin Smith

February 2010 | 23


tion in Western Cultures: Difficul-ties and Challenges.” And Dr.Ahmed Teebi, professor of pedi-atrics and genetic medicine atWCMC-Q, spoke about “InheritedDisorders: Proposed Strategy forPrevention.”In addition, WCMC-Q hosted twopediatrics-track workshops—onthe “Art of Pediatric Medical Edu-cation” and “Sharing the Light:Simple Strategies for Success inTeaching”—overseen by Dr. Mianand Dr. Amal Khidir, assistant pro-fessor of pediatrics at WCMC-Q.Dr. Khidir also provided final rec-ommendations at a pediatricsworkshop entitled “Promoting

Family-Centered Care,” whichtook place at the IntercontinentalHotel.Contributing to the Rehabilitationand Physical Medicine track, Dr.Leopold Streletz, associate pro-fessor of neurology at WCMC-Q,spoke about “Physical Activity andBrain Plasticity.” Within the sametrack, Dr. Basim Uthman, profes-sor of neurology at WCMC-Q,spoke on “Management of Spas-ticity in Complex Neuro Disability.”Additionally, WCMC-Q increasedits local presence as it joined 100exhibitors of the latest medicalequipment, technology and serv-

ices—the medical school’sbooth—shared with health careand research partner Sidra Med-ical and Research Center—pro-vided attendants with informationabout the curriculum and entrancerequirements.

Dr Verjee in the Clinical Skills Centre

February 2010 | 24


www.royalbucks.co.uk

Telephone: +44 (0) 1296 678800Fax: +44 (0) 1296 399875

The Royal Buckinghamshire Hospital, Buckingham Road, Aylesbury, Bucks, HP19 9AB, U.K.

The Royal Buckinghamshire Hospital

World Class Rehabilitation Centre

Haemodialysis has been es-tablished as a successful lifesustaining treatment in patientswith renal failure for over 40years. Through a mix of finan-cial pressures and conven-ience for patients, the numberof hours patients spentdialysing has fallen gradually.Thrice weekly treatment for ap-proximately 4 hours carried outin renal centres has now be-come the normal experiencefor the vast majority.

It is increasingly recognised, how-ever, that thrice weeklyhaemodialysis, which most oftentotals 12 hours per week, ‘re-places’ only approximately 10-15% lost kidney function, and haslimited impact on quality of lifeand survival in people with kidneyfailure. Essentially patients con-tinue to live with chronic kidneydisease equivalent to CKD 4/5.More frequent treatment, particu-larly if the 2-day ‘long break’ isavoided, not only allows for a re-laxation of dietary and fluid restric-tions it can also deliver muchmore dialysis. Impressive im-provements in wellbeing andmeasurable clinical outcomes arebeing reported with enhanced,frequent haemodialysis. In prac-tice, this therapy is best carriedout in the home or in a communitysetting by patients trained in self-care. After many years of declinethe number of patients opting for

self care haemodialysis is nowgrowing in some countries, withmost patients who have opted forself-care choosing to dialyse morefrequently than thrice weekly.

In the UK, the National Institute ofClinical Excellence (NICE), abody charged with advising theNHS about the efficacy and af-fordability of new therapies, pro-duced a guideline (2002) whichenvisaged up to 15% haemodial-ysis patients self-caring at home.While in the 1960s and 70s, closeto 100% UK patients were selfcaring at home, NICE recognisedthat were were several legitimatereasons why home haemodialysis(HHD) had largely given way toperitoneal dailsysis (PD) and HDtreatment in renal centres andsatellites (CHD). The NICE rec-

ommendation created little move-ment in practice and, while thereare occasional examples of suc-cess, less than 2% HD patients inthe UK are currently self-caring onHHD. Peritoneal dialysis remainsthe preferred home therapy al-though the numbers on this suc-cessful therapy are also dwindling- currently 19% dialysis patients.One of the barriers to the rejuve-nation of HHD has been the lackof a dialysis machine which is mo-bile and would allow self-caringpatients to travel and to dialyseaway from the home base. A fur-ther difficulty has been the capitalcost of converting a patient’shome to accommodate standardmachines which typically have ahigh demand for water, pre-processed by reverse osmosis,and adequate drainage.

Specialist article: The Rejuvenation of Home Dialysis – Clinical and Financial Considerations

by Dr R N Greenwood

Patient Robert Downer dialysing during the NxStage initial trials

February 2010 | 26


NxStage in the US addressedthese needs and designed a dial-ysis machine specifically for homeuse and travel. The NxStage Sys-tem 0ne is a small compact dialy-sis system which employs asimple keypad operation and a“drop in” cartridge to replace thecomplex blood tubing setup foundon traditional machines. The sys-tem which is designed for 5 or 6‘short’ sessions weekly uses pre-prepared bags of dialysis solution(as in automated PD) or producesbatches of sterile fluid from a do-mestic cold water supply. Homeconversion costs associated withtraditional installations are thusaverted. The machine has

been in clinical use in the USAsince 2006 and there are cur-rently over 5000 patients usingthe system with over 6,500 pa-tient years clinical experienceaccumulated. Kimal, the com-mercial partner to NxStage inthe UK worked with Dr RogerGreenwood, a consultantnephrologist at Lister hospitalin Stevenage to bring this sys-tem into the UK and to enablethe dialysis community to ben-efit from this technology, thefirst country in Europe andoutside the US. In January2009 the system attained CEapproval (a legal requirementin Europe).

The Lister renal unit (LRU) is alarge dialysis provider serving thepopulations of Hertfordshire, Be-fordshire and parts of Essex (pop-ulation circa 1.2 M). At thebeginning of 2009 there were 365patients treated in haemodialysiscentres located in Stevenage,Luton and St Albans, 38 patientsat home on PD but no patients onhome haemodialysis. The LRUwas one of 25 centres in the UKwith no HHD programme. The ac-cumulating evidence regardingthe benefits of frequent treatmentand the availability of the NxStagemobile system were the spurs toestablishing a home programmebased on free choice for patients

Patient Marina Ridley with Nephrologist Dr R N Greenwood and Kay Deck of Nx Stage

February 2010 | 27


to choose their preferred technol-ogy and treatment schedule.Four patients were trained onNxStage beween July and No-vember 2009 as part of a locallyagreed pilot to assess the effec-tiveness of the technology and toassess whether the 5x or 6xweekly sessions could be af-forded within the cost envelopesagreed with local commissioners.All four were trained, masteringthe ‘button-hole’ needling tech-nique and sent home within 28days with excellent clinical out-come and patient satisfaction.There were significant benefits inblood pressure control and senseof wellbeing in all four patients, 2of whom currently dialyse 5xweekly and 2 dialyse 6x weekly.

Following this 4-patient pilot studyit was necessary to prepare abusiness plan around the aspira-tion to have 10% HD patients self-caring at home by 2015 forapproval by the host NHS Trust(East and North Herts) and localcommissioners. The outline busi-ness case (OBC) compared thecosts around a growth of homeHD to 10% with a second sce-nario in which the Lister renalservice remained heavilyweighted towards in-centre HD.Projected savings in pathology,pharmacy, travel and holiday dial-ysis were considered. The OBCshowed that the higher dispos-ables and machine lease costsassociated with high frequencyHHD were offset by savings instaffing and by deferring the capi-tal, running and depreciationcosts of new renal units. Thecomparison suggested that a

surge towards more home ther-apy would not only result in ahealthier dialysis population butcost saving of about £1/3M over a5 year period.

Unfortunately, in most health caresystems, re-imbursement has fos-silised around standard 3x weeklyin-centre HD and home therapyby HD has always been regardedas less expensive than CHD andhas been remunerated as such.With the current system of re-im-bursement, the low ‘tariff’ for HHDis a disincentive to pursue thesehealth gains and costs savings.To influence the Department ofHealth to encourage local com-missioners to set reimbursementlevels which recognise that themajority who choose HHD will bedialysing up to 6x sessionsweekly and to incentivise HHD isthe challenge of the moment.

There are encouraging signs thatthe NHS will indeed support thosepatients motivated to optimisetheir health prospects throughself-care, to remain well and tostay out of hospital. NxStage is proving a popularchoice among new patients andthose currently on dialysis whowish to become independent andfree to travel. Being ‘custom-de-signed’ for the job this device islikely to be a major catalyst in re-juvenating self-care.

Author: Dr R N Greenwood,Consultant Nephrologist, Lis-ter Hospital, StevenageFurther details on NxStagecan be gained by visitingwww.kimal.co,ukor contacting Kimal direct [email protected]

The Lister Renal Unit team with Kay Deck of NxStage & Helen Tot-man, clinical nurse specialist of Kimal

February 2010 | 29


middle east hospital magazine february 2010

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