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Mohammed bin Rashidmedical university.. Investment in knowledgeto serve humanity

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Dubaito host 1stRegional Health Regulation Conference

f o r M e d i c a l T o u r i s m

DubaiA Global destination

1st issue 22 October 2014 - Monthly Magazine of Dubai Health Authority in cooperation with the Balsam for Health Promotion

B e c a u s e H e a l t h i s W e a l t h

The development and enhancement of the health care system in Dubai has always been a prime focus of Dubai Government and Dubai Health Authorities. Healthcare system advancement is one of the

important strategic developments of any city as it is one of the key indicators of progress.

Over the last few years, Dubai Government has paid keen interest in developing and implementing several laws and regulations in favor of health care sector which has facilitated and encouraged new investments and development resulting in a total uplift of the health care industry. New jobs have been created which has given space to include diversified workforce comprising of various nationalities

from across the globe.

The region's first ever Health Regulation Conference organized by Dubai Health Authority starting from Oct 22- Oct 23 will create a platform to increase medical tourism. This conference is the first ever health regulation conference in the UAE region and it reflects the keen interest of Dubai Government and Dubai Health Authority to keep up with the latest trends and technology in the field of healthcare.

This conference will not only help to open new venues for healthcare development, but it will further enhance healthcare standards, patient safety and quality care.

Dubai Government and Dubai Health Authority is also paying attention to importance to health education and disease prevention. "My Health" magazine is one of the channels to reach out to people in Dubai as well as UAE and promote the sense of healthy living and also encourage medical tourism.

My Health (Sehhaty) magazine will be available in English and Arabic language options.

We hope SEHHATY magazine will help all its readers to lead a healthy life

Engineer Essa Al Haj Al MaidoorDirector-General Dubai Health Authority

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Initially, the Department of Health and Medical Services (DOHMS), which was created in 1973, was the functioning authority that almost exclusively focused on health service delivery.Therefore, the DHA was created, in June 2007, by Law 13 issued by His Highness Sheikh Mohammed bin Rashid Al Maktoum, Vice President and Prime Minister of the UAE, Ruler of Dubai, with an expanded vision to include strategic oversight for the complete health sector in Dubai and enhance private sector engagement.His Highness Sheikh Hamdan Bin Rashid Al Maktoum, Deputy Ruler of Dubai and UAE Minister of Finance is the President of the Dubai Health Authority. His Excellency Engineer Essa Al Haj Al Maidoor is the Director General of the DHA.The DHA’s aim in Dubai is to provide an accessible, effective and integrated healthcare system, protect public health and improve the quality of life within the Emirate. This is a direct translation of the objectives of the Dubai Strategic Plan 2015 launched by His Highness Sheikh Mohammed bin Rashid Al Maktoum. Keeping the strategic plan in mind, the DHA’s mission is to ensure access to health services, maintain and improve the quality of these services, improve the health status of nationals, residents and visitors and oversee a dynamic, efficient and innovative health sector.In addition to overseeing the health sector for the Emirate of Dubai, the DHA also focuses on providing services through DHA healthcare facilities including hospitals (Latifa, Dubai and Rashid), specialty centers (e.g. the Dubai Diabetes Center) and DHA primary health centers spread throughout the Emirate of Dubai.The main pillars of service delivery at DHA health facilities are quality, efficiency, patients and staff. It is our aim to maintain and improve the quality and efficiency of DHA health services. An important aspect of the service delivery strategy is to focus on patients, their needs and satisfaction as well as attract, retain, nurture and support outstanding staff.

Vision:

Healthy, Happy and Safe Community.

Mission:

Develop an integrated and sustainable healthcare system that ensures delivery of comprehensive and excellent services to achieve the highest international standards in health of individuals and community.

ValuesPeople First

Excellence in ServiceHonesty

Team SpiritEfficiency

Creativityand Innovation

6 - Mohammed bin Rashid

medical university .. Investment in

knowledge to serve humanity

8 - Dubai.. A Global destination

for Medical Tourism

12 - Dubai to host 1st

Regional Health Regulation

Conference

14 - DHA, Berlin to collaborate in

residency doctor training

18 - Rashid Hospital trauma care

centre ranks in the top 10

22 - Patient Satisfaction Secrets in

hospitals

28 - Planning Your Medical Travel

30 - What Is Vaser Liposuction?

36 - Facts on Women and Heart

Disease

38 - 5 Tests to Keep Your

Brand Relevant

About us: Contents

Editor-in-chief

Ghanim Lootah

Managing Editor

Mahmoud Youssef Al Ali

Medical Media & Marketing Consultant

Bassam Darwish MD

Editorial board

Husni AlbalwnahTalal AlDebyiat

Fadi Wannos Kamakshi Gupta

Nancy Bhatia

Coordinator

Ashwaq Abdullah Hala Darwish

Art Director

Talah Abdullah Mohammed

Contact us

042197066043794707

E-mail :ashwaq@dha .gov .ae

hala@balsam-group .com

Sehhaty ,The official monthly magazineof Dubai Health Authority, in cooperation

with Balsam For Health Promotion

SEHATY magazine aims to achieve the following: - Promote medical mourism in Dubai.- Enhance the communication between (DHA) and all beneficiaries of the healthcare system like investors, patients, medical service providers and others. - Promote the quality and safety concepts related with healthcare facilities.- Educate people by focusing on issues related to healthy life routine, chronic diseases and how they can handle it.- Spread health awareness amongst people, information about Medical practices, new developments in the healthcare sector and all the laws and legislations related to it.

Dubai Healthcare City has announced the setting up of the Mohammad Bin Rashid University for Medicine and Health Sciences and the launch of the Mohammad Bin Rashid University Hospital.

This announcement comes in line with the directives of His Highness Sheikh Mohammad Bin Rashid Al Maktoum, Vice-President and Prime Minister of the UAE and Ruler of Dubai, The Dubai Healthcare City authority explained that the university will provide students, both citizens and residents, with a range of academic medical programmes and postgraduate programmes, and the university will receive the first batch of students in September

2015, according to the specified criteria, to ensure the selection of students qualified to study medicine.The first phase of the project will include the Faculty of Medicine and the Dental College, which exists already. The university is scheduled to receive 50 students during its first year in the College of Medicine, in addition to higher education students specialized in dentistry.The Dubai Healthcare City authority

Education

Mohammed bin Rashid medical university .. Investment in knowledgeto serve humanity

6ISSUE (1) October 2014

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The first phase of the project

will include the Faculty of Medicine and

the Dental College,

which exists already

H.H. Sheikh Mohammed Bin Rashid Al Maktoum

pointed out the integrated vision behind the launch of the university and explained that in its second phase, more colleges and specializations will be added, including nursing and midwifery, public health and pharmacy.These specializations will be added gradually to achieve the authority’s vision in building a wide base of sustainable and high-quality medical expertise and finding a highly competent set of experts and specialized teams.Currently, Dubai Healthcare City is holding discussions with a select group of international academic institutions in

order to ensure the curriculum offered by the University of Mohammad Bin Rashid for Medicine and Health Sciences is in keeping with the highest international standards in this area. The university will be licensed and all its scientific programmes accredited by the specialized authorities through the application of international standards in classifying universities


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Dubai

A Global destinationfor Medical Tourism

Strategy

H.H. Sheikh Hamdan Bin Mohammed Bin Rashid Al Maktoum

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ISSUE (1) October 2014

Engineer Essa Al Maidoor, Director-General of the Dubai Health Authority (DHA) announced the medical tourism strategy for the emirate of Dubai.“In line with the vision, leadership and encouragement from Sheikh Hamdan Bin Mohammed Bin Rashid Al Maktoum, Crown Prince of Dubai and Chairman of the Dubai Executive Council and as per the goals of the Dubai Health Sector Strategy 2013-2025, we are focusing on developing Dubai’s

medical tourism initiatives,” said Al Maidoor. “The medical tourism strategy has been designed over two phases, the first one has been chalked out until 2016 and the second until 2020,” he further said.Dr Layla Al Marzouqi, Acting-director of health regulation department at DHA, said that Dubai as a destination itself is unique as it blends the East and the West through the various leisure and entertainment options in the

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Emirate. Dubai has visitors from across the globe coming here for business, exhibitions and conferences, shopping and entertainment or on their annual family holiday and has amongst the best tourism infrastructure in the world. “More importantly, we already have a medical sector that is well regulated through the health regulation department of the DHA. In terms of the

The medical tourism strategy has been designed

over two phases, the first one has been chalked out until 2016 and the second

until 2020

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M tourists

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health sector, the number of health facilities in Dubai is around 2,518 and more than 70 per cent of our hospitals are internationally accredited, the emirate has more than 25, 846 health professionals in the private sector, who speak more than 40 languages. All these factors will help drive the medical tourism initiative,” added Dr Lyla.In terms of the strategy she said that it will be implemented in phases, “We began the ground work for the medical tourism initiative around the last quarter of 2012. In 2013, we completed a thorough analysis of the competitiveness and prioritization of services. In 2014 we will build on this knowledge and promote Dubai’s strengths in terms of medical tourism, we will launch a dedicated portal for medical tourism as well as brand the medical tourism initiative for Dubai and

launch medical tourism packages to be promoted in target markets.”“Moving further in 2015 we will build on the brand and our facilities to grow the initiative and in 2016 we will focus on sustaining the strategy as well as evaluating and monitoring it so that we can decide the further course of action. All through, the key element will continue to be a well-regulated health sector with due regulations in place as quality of services is an essential component that leads to the organic growth of medical tourism,” she added.Speaking about the potential of the sector, she said: “In 2012, the number of medical tourists that visited Dubai were 107,000 and the revenues generated were Dhs652, 700,000.”“By 2016 we expect a 15 per cent jump bringing the total number of tourists to 170,000 and the revenues to AED 1,184,882,113 and by 2020 if we consider a 20 per cent jump, it brings the number to 500,000 tourists and revenues to AED 2,619,673,731.”In terms of services, Dr.Laila highlighted that the authority will focus on orthopaedic and sports medicine, plastic surgery, ophthalmology, dental procedures, dermatology, preventive health check-ups and wellness and skin care services


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Dr Layla Al Marzouqi, Acting-director of health regulation department at DHA

Dubai will host the 1st Regional Health Regulation Conference this year focusing on the latest advances in the field of regulation.The congress will be organised by INDEX Conferences and Exhibitions and will take place on the 22nd and 23rd October at the Conrad Hotel Essa Al Maidoor, Director-General of the DHA, told a press conference that, "Health regulation is one of the fundamental pillars to achieve sustained growth and ensure patient safety. As Dubai strives to further develop and expand the health sector, regulation of facilities and healthcare professionals will become even more important in our race for excellence. Quality players and competition leads to organic growth of medical tourism as well, it becomes a natural extension of health delivery and health regulation

sets the platform for achieving this. This conference provides an opportunity for stakeholders to discuss the latest advances in the field and facilitates knowledge

This conference will focus on the latest advances in the field of regulation. Dubai offers one of the most advanced regulatory standards

Dubai to host 1stRegional Health Regulation Conference

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exchange." Dr. Layla Al Marzouqi, acting - Director of Health Regulation at the DHA, said, "This conference will cover the latest advances in regulation. In parallel, we will hold a medical tourism exhibition showcasing the excellent medical tourism facilities that Dubai s private and public sector have to offer. Members of the Dubai Medical Tourism Club will take part in this exhibition. The members of the club are those hospitals that have been given platinum, gold or silver membership based on their capability to provide medical tourism services." In terms of regulation, Layla added, "This conference will focus on the latest advances in the field of regulation. Dubai offers one of the most advanced regulatory standards. We are keen to share our experience as well as gain knowledge from experts in the region and abroad." Layla said the conference will discuss pertinent topics, such as regulation, as a benchmark to ensure

quality and patient safety, regulation as a parameter to promote organic growth of medical tourism and other important topics such as malpractice and quality assurance.Layla said all healthcare professionals and facilities in Dubai adhere to advanced health regulation criteria set by the authority to ensure high-quality healthcare and patient-safety.The conference is supported by the Sheikh Hamdan bin Rashid Al Maktoum Award for Medical Sciences, Department of Commerce and Tourism Marketing, Dubai Sports Council, General-Directorate of Residence and Foreigners Affairs, Emirates Airlines as well as several private health facilities including Mediclinic, Saudi German Hospitals, Tarabichi s Centre of Joint Surgery, Burjeel Hospital, Aster Medical, Al Garhoud Private Hospital, Iranian Hospital, and Julphar.

Health regulation is one of the fundamental pillars to achieve sustained growth and ensure patient safety

H.H. Sheikh Hamdan bin Rashid Al Maktoum


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The Dubai Health Authority signed a historic agreement with Berlin for collaboration in trauma and orthopaedic surgery training.

The agreement, paves the way for resident doctors in Dubai to complete their six year German board residency training program in trauma and orthopaedic surgery without having to go abroad for the first five years. This essentially means, the Chamber of Physicians in Berlin and the German Orthopaedic Board, have recognized, for the first time, an international health facility to be at par with the health services provided by German health facilities. At the end of six years, DHA resident doctors will receive a German Board

News & Views

DHA, Berlinto collaboratein residency doctor training


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specialization after fulfilling the necessary requirements. HE Eng. Essa Al Maidoor Director-General of the DHA, said: “This is a moment of pride for us. This is the first time the German Board has signed such an agreement with an international health entity.

The agreement opens up the doors for our doctors in Dubai to seek specialization in trauma and orthopaedic surgery in Dubai while ensuring they get a German Board Qualification. The program is mirrored to follow the German program, meaning our doctors will seek an international qualification without having to move abroad for several years.”Al Maidoor: added: “The Trauma Centre in Dubai provides high-level of quality care and we are proud of this affiliation. For us, at the DHA, human-resource building is of vital importance so that we can keep up with population growth as well as fulfil human resource requirement when the new projects are completed.” He added that continuous medical education and human resource development are important pillars, particularly for the health sector.Rd. Med. Günther Jonitz, President of Chamber of Physicians in Berlin seconded this opinion. He said:

“Human capital is the most valuable resource and cooperation as well as continuous medical education is important to ensure better patient outcomes. This

is a pilot project, a new way of cooperation and in future, this can be the blue print for cooperation in other medical specialities as well. Dr. Jamal Al Mulla, Director of the program and consultant trauma surgeon at Rashid Hospital’s Trauma and Emergency Centre, said: “The program is in accordance with the German regulations for specialist training of the Berlin Chamber of Physicians and after satisfactory completion of the six years program, the graduates will be German Board certified and will attain membership to the Berlin Chamber of Physicians. Thus, the program is equivalent to going abroad and studying there.”He added as part of the program German consultants will visit Dubai twice a year from the German Trauma and Orthopaedic Society and that the program will be audited twice a year as well.Dr. Bilal El Yafawi, co-director of the program and consultant ortho-trauma at Rashid Hospital’s Trauma and Emergency centre, said: “Our medical residents will spend five years at the Trauma Centre and they will study in Berlin for the last year. The program offers the right mix of practical and theoretical experience and once the doctors complete their specialization they will work at the Trauma Centre as a specialist registrar in Orthopaedics and Trauma Surgery.”


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We will replicate this model for fields such as cardiology and nephrology so that the best minds in the field working across various DHA hospitals and health centers can come together and ensure the same level of care is provided across all DHA health facilities,” he said.In a move to standardize diabetes care and management in Dubai, the Dubai Health Authority (DHA) has set up a diabetes management task force, said a top health official. Essa Al Maidoor, Director-General of the DHA said: “The first task-force we set up is for diabetes care and management due to the prevalence of the disease in the UAE and globally.We will replicate this model for fields such as cardiology and nephrology so that the best minds in the field working across

various DHA hospitals and health centers can come together and ensure the same level of care is provided across all DHA health facilities,” he said. “The move will also facilitate best practice management across health facilities.”In the case of diabetes, the DHA has specialized units at some DHA hospitals, diabetes clinics across primary health centers and a specialized Dubai Diabetes Center.“The task-force will ensure all primary healthcare centers and hospitals in Dubai adopt the latest software and practices available at the Dubai Diabetes Center so that unified diabetes care and management is provided across all DHA facilities. Once this plan is implemented, the center will focus on chronic diabetes management cases,” said Al Maidoor.

DHA sets up DiabetesCombat and Control Committee

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He further said this will also help improve customer experience and lead to enhanced patient outcomes.Dr Fatheya Al Awadi, Consultant endocrinologist and chairperson of the Diabetes Control and Combat Committee said:“In 2010, the Dubai Diabetes Center implemented an in-house

electronic software system custom designed by the DHA IT department for diabetes management. It has shown excellent results and has led to positive patient outcomes. Therefore we will implement this system across all DHA hospitals and primary healthcare systems

DHA sets up DiabetesCombat and Control Committee

DHA vision: To have centres of excellence for all health specialities.


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Dubai Health Authority’s Trauma and Emergency Centre at Rashid Hospital recently featured in the top ten list among more than 300 trauma centres that are part of the biggest polytrauma registry in Germany.A polytrauma registry exists in a few countries in the world and Germany has the biggest polytrauma registry worldwide.

In 2011, Rashid Hospital’s Trauma and Emergency Centre became the first in the Middle-East region to be included in this registry.Dr Alya Saif Al Mazrouei, CEO of Rashid Hospital, said: “The poly trauma registry is extremely detailed and takes into consideration every step from the time a patient with poly trauma is brought into the

Rashid Hospital trauma care centreranks in the top 10

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hospital, until the patient is discharged. As part of this cooperation, we send complete details of how we treat every polytrauma patient at our hospital to Germany and they analyse our data and benchmark it with other reputed hospitals in the registry. Being in the top ten is a matter of pride for us and reinforces the need for us to continue our efforts to provide high level of critical care management to our patients.”The registry is the largest trauma registry and includes hospitals from Germany and 18 neighbouring countries. In 2011, Dubai’s Trauma and Emergency Centre at Rashid Hospital became the first establishment from the Middle-East region to be a part of the registry. A team of specialists from German visited the Trauma Centre in Dubai and audited it before inviting the centre to be part of the registry.Dr Bilal Al Yafawi, Consultant, Trauma and Orthopedics, at Rashid Hospital highlighted that this registry is only for

those cases which are considered to be polytrauma cases- which means the patient has ensured multiple injuries and is in a critical condition.The details of each polytrauma patient that are sent to Germany include blood investigations, x-rays, details of surgeries performed, ICU management etc.Dr Yafawi, added: “There is no doubt that this is an extremely comprehensive system and helps provide us with valuable data.”He added that the Trauma and Emergency Centre receives approximately 300 patients per year, as compared to hospitals in Germany that receive 150 to 200 cases. “ Of the polytrauma cases we receive, majority are men and the average age group is 30 to 35 years, which is the working population as opposed to hospitals in Germany where is average age group is 58 years.”He added that the registry provides useful data which can be further analysed to understand trends and take evidence-based decisions

Dr Alya Saif Al Mazrouei

Trauma and Emergency Centre receives approximately 300 patients per year, as compared to hospitals in Germany that receive 150 to 200 cases


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Dubai Health Authority, DHA, announced that displayed several "breakthrough IT solutions" during GITEX 2014 ICT technology tradeshow, in line with the vision of transforming Dubai into a smart city. Among those is, DHA said, "the first-of-its-kind pilot project in the region that involves the use of motion-sensing technology to transform physical therapy." The project will ensure physiotherapists can tailor-make home based exercises for patients that can be monitored by the system to ensure patients are exercising in the right manner.DHA also introduced the Sehhaty (Arabic for my health) and the Doctors in Dubai app, and said both were developed internally. 'Sehhaty' has a plethora of features that allow users to view the details of appointments, check medical tests results and health card details.Parents who use the app can view their children’s vaccination details and synchronise them with their calendar in

order to receive alerts every time their child’s vaccination is due.‘Doctors in Dubai’ enables users to search for a doctor or health facility in Dubai.Inspired by Windows 8, the app is compatible with all platforms - Apple iOS, Google Android, Blackberry and Windows Mobile, among others.In addition to using apps for the convenience of customers, DHA also developed smart inspections systems to further develop the manner in which the health sector in regulated

Smart Gate

Dubai Health Authorityto display IT solutions at GITEX


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Patient Satisfaction Secrets in hospitals

Each person in the health facility to be familiar with the assets to deal with complaints from patients

Care

As patient satisfaction and the patient experience start to take the spotlight in healthcare,

there’s a need for straight, useful talk on these subjects. Here are nine points that will keep you on the right track in hospitals and other healthcare environments. .

Patient satisfaction isn’t the enemy of medical outcomes. Done right, the work you do on patient satisfaction, on improving the patient experience, will also contribute to improving your medical outcomes. In the hospital, and upon discharge. This should be obvious, but our ingrained conception of win/lose, zero-sum gets in the way of seeing this clearly. A good night’s sleep – nurses coming when you need them without making you suffer in agony – scheduling that is prompt and makes sense – physicians involving the patient and family in treatment and follow-up: Of course these contribute to, rather than get in the way of, improved outcomes. It’s (sorry, neurologists) a no-brainer.

Improving the patient experience is about systems as much as it is about smiles. It can mean hiring [as Mayo Clinic once did] industrial engineers to time how long it realistically will take to wheel a patient from appointment to appointment, so that the idea of a schedule can be taken as a serious concept and you’re not letting down patients and gumming up the system all day. Inevitably, improving such systems will improve smiles in the end. Improving the patient experience and patient satisfaction is about smiles, not just systems. The systems and processes you’ve put in place that work for most of your patients in most situations emphatically will not work for all of your patients in all situations. And when a patient doesn’t fit into your system, or a patient’s circumstances don’t fit into your list of expected scenarios, you need smiling, helpful, empathetic employees, administrators, managers, executives who will address what needs to be done (including simply delivering an apology) regardless of the fact that they had hoped their systems would suffice. Part of this is that everyone in your organization needs to learn to handle customer complaints and concerns:”I can’t help you, I’m the wrong person” is unacceptable; “Absolutely: let me get you to the person who can take care of that” can work wonders.

Cues to indifference are everywhere–and it’s where much of patient dissatisfaction lives.

Healthcare professionals avoiding eye contact with “civilians.” Med students hurrying self-importantly down the halls, nearly running down the slow-moving patients who won’t get with the program. Patients ignored by nurses who haven’t yet clocked in and therefore don’t realize they are already (poorly) representing their institution.

Doctors in the hallway loudly carrying on about the relative benefits of different Canyon Ranch vacations they’ve taken. Two radios playing at once from two administrative areas (with the waiting area for patients and their families located equidistant to both).

Vending machines that are left out of service indefinitely. Vending machines that require exact change, but there’s no change machine.

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Improving the patient experience and patient satisfaction is about smiles, not just systems. The systems and processes you’ve put in place that work for most of your patients in most situations emphatically will not work for all of your patients in all situations

Offload transactional tasks to appropriate automation and self-service: patients don’t like seeing wasted time, inefficiency, and typos any more than you do. While human beings are important in all service environments, including and especially healthcare,

there are some tasks that automation does better and that self-service may do the best. Filling out patient-related forms is one of these. Your patients and their families have a lot of positive experience these days with efficient online and mobile-based models, and it makes them impatient with inefficiency and duplicate processes.… But realize that great customer service must be delivered on a customer’s schedule.

Your quest for speed cannot become a quest to hurry patients. Doing that it going to lead to frustration and, ultimately, noncompliance and other outcome problems.

Your quest for efficiency can often be at odds with your quest to improve the customer experience, if you don’t realize that there is value in being inefficient when it comes to that untidy link in the chain: the patient. You have to do everything you can experience your care as your patients do. Park where the patients do. See how easy it is/isn’t to get to the front door on crutches. Take a tour of your hospital with someone who hasn’t been there before, and let them show you whether they can really find where they’re going.

You’ll be amazed how many mis-aligned, out of date, confusing signs you have. It all makes intuitive sense to you, of course, because you have been in your building enough times that you know your way around in your sleep (Probably, I suspect, literally.) And,

once a year, do a “full bladder exercise”: Everyone who works with patients should drink two or three liters of water–it is incredible how your perception of a “reasonable delay” between call button and response changes when you have a full bladder. If you want to ace your HCAHPS and other measurements don’t think too specifically; think instead in terms of “halo effect”: The halo effect I’m referring to is the human tendency to cut you slack when they have a generally positive impression of you. let a generally positive experience with you “infect” areas in which you may not have been entirely up to snuff.

Taking a sample HCAHPS question where your goal is to have an answer of “always” (for example: “During this hospital stay, how often were your room and bathroom kept clean?” ). “Always kept clean” is, strictly speaking, an impossibility. Not even Four Seasons or Ritz-Carlton can pull that off; they may tidy your room three times a day, but that’s plenty of time to trash it in between. Yet it is possible to get an “always” response from a patient. Because the way patients remember is more holistic (sorry, I know that word can lead us down an icky path; I promise I won’t use it again) than you think it is.

An overall extraordinary experience with your facility and organization. will convince a patient to cut you slack while a generally poorly treated patient is going to grade you literally on your HCAHPS. And a literal reading of/response to the HCAHPS questions isn’t going to turn out all that well for anyone

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Technological innovation has been a cornerstone of gastroenterology .Over the past few decades, exciting strides forward in GI/endoscopy technology are the biggest advancements in the fieldThese advancements are the product of better technology, better equipment and innovative uses of the improved technology. One of the most important and widely embraced improvements is in endoscopic image clarity.On the diagnostic side:Florescence endoscopy, chromoendoscopy , confocal endoscopy ,narrow band imaging and the nearly 360 degree view

fuse endoscope are now widely available giving us an image quality like watching an ultra high definition TV.The high resolution, high definition and high magnification endoscopy now allow us to examine the mucosa and even overlying capillaries in very fine details. By using narrow band imaging wherein a light of very narrow wavelength is projected on the mucosa can help the endoscopist differentiate lesions as benign or malignant. The Special endoscopes now even allow endoscopists to see individual cells. The capability also exists to do ultrasound from the inside of the gut lumen and

Advancement in the Field Of Gastroenterology

and New GI TechnologyDr. Adnan AbuhammourBoard Member DHCC Authority,

Chairman - AMC

Dubai Health City

MedicalTechnology

ال اختصار


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sample tissues outside of our GI tract such as those found in the pancreas and the chest through endoscopy with guidance of EUS.It is very exciting to practice gastroenterology in an era when we have the capability to investigate the gastrointestinal lumen with high definition cameras. Now, we can utilize video capsule endoscopy in which a capsule takes films as it travels through the GI tract and sends the images to a receiver outside of body. In addition we can also implant a wireless capsule in the esophagus to measure the acid exposure over 48-72 hours .High

resolution esophageal manometery , a procedure that helps determine how the muscle of the esophagus and the sphincter works by measuring the pressures they generate.Enhanced visualization of colon adenomas has been made possible by several developments to improve detection rates including narrow band imaging (NBI) and high-definition colonoscopy.An additional exciting technology is transient elastography which provides a reliable non-invasive way to assess the degree of liver fibrosis.One of the most exciting advances in

There have been significant

treatment modalities developed,

many of which continue to evolve, that

broaden the possibilities of

treatment with success that

rival surgical therapies.


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the gastroenterology field took place in August of this year when the FDA approved Cologuard, the first and only noninvasive stool DNA screening test for colorectal cancer. The test detects both DNA and blood biomarkers associated with colorectal cancer and pre-cancer in the stool and is highly accurate.ERCP catheters and devices have also improved, providing a much smoother experience for both endoscopist and patient. Cannulation percentages will continue to improve with decreasing risks of complications such as pancreatitis as we continue to learn about the pancreaticobiliary tract. The ability to extract stones has never been easier than now as we have newer disposable baskets and the like which help us accomplish our goals On the therapeutic side:There have been significant treatment modalities developed, many of which continue to evolve, that broaden the possibilities of treatment with success that rival surgical therapies. Radiofrequency ablation for high-grade dysplasia in Barrett's esophagus is available for prevention of esophageal cancer; endoscopic mucosal resection and endoscopic submucosal dissection for treatment of Barrett's esophagus and superficial cancers of the esophagus, stomach and colon. Natural Orifice Transluminal Endoscopic Surgery (NOTES) offers the possibility of removing organs such as the gallbladder or appendix via natural orifices such as the mouth and results in scarless surgery.

Peroral endoscopic myotomy provides a natural orifice approach to performing the Heller myotomy for the treatment of achalasia. Endoscopic full thickness resection is being evaluated to allow complete removal of tumors without any scars. The other exciting innovation is improvement in our ability to close perforations or defects in the wall of the gut. This has been made possible due to special clips such as over the scope clips or endoscopic suturing devices. This has increased our confidence to attempt removing large polyps or superficial tumors through techniques such as endoscopic mucosal resection or dissection. These procedures have helped many patients avoid surgery.During the past few years, there have been many advances in pharmacotherapy in the field of gastroenterology. Most notably, a new treatment for hepatitis C which can cure the patients andKill the virus in nearly 100 % of the cases. The availability of the Biological medications for patients with inflammatory bowel disease namely Crohn’s disease and Ulcerative colitis. Also the utilization of the Nanospray (Hemospray) to stop the bleeding from most of the GI bleeding pathologies.We also look toward the future for even more new technologies like endoscopic drug delivery systems for pancreatic tumors and digital spyglass technology which will allow us to visualize the biliary tree and do biopsies


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Plastic surgery

Once you have determined that a procedure is appropriate and you have selected a qualified plastic surgeon, you are ready to begin planning your medical travel.A qualified plastic surgeon can help you plan your medical travel.Planning Checklist1- Schedule a pre-consultation that may be conducted using one or a combination of the following:In person through a local associate or office in your home countryBy telephoneUsing an online formOver the Internet using a service such as Skype™2- Make sure the surgeon and the clinic or

hospital staff who will care for you both before and after your surgery can speak your language.3- Obtain a price for your surgery and ensure that you have a clear understanding of what is included. 4- Determine how you will finance your procedure and travel needs. Find out which payment methods your surgeon accepts such as cash, traveler's checks or credit cards. Ask about available financing options.5- Schedule your surgery with the practice. Determine required lab work and vaccinations. Find out how far in advance you need to arrive to have your

Make sure to provide the doctor in your home country documents related tosurgery and to ensure communication between him and the surgeon to be able to follow the health care necessary

PlanningYour Medical Travel


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consultation.6- For continuity of care make sure your local doctor is informed about your surgery and provides any relevant medical records to your surgeon. Make sure your surgeon can send information about your procedure to your local doctor.7 - Determine your potential recovery and aftercare needs. How long will it be before you can return home? What is the schedule for follow-up visits?8 - Locate emergency care providers in the country you are traveling to and at home.9 - Make your travel arrangements. Considerations include:- Where will you stay the night before surgery and while you recover?- Which airport is closest to the practice?- Do you need a passport? Do you need a visa?- Will you need foreign currency or traveler's checks?- Who will drive you to your hotel and help care for you after surgery?10- Pack for your trip. In addition to typical travel supplies, helpful items after surgery may include:- Sun protection such as a hat, scarf or sunscreen.- Clothing that is easy to put on/take off.- Special compression garments or a surgical bra.- Pillows for the neck body or back to support specific areas after surgery


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It is suitable for overweight people who have excessively large abdomen or thighs that makes it difficult for them to exercise

Plastic surgery

Liposculpturing procedure to remove excess, stubborn and uneven fat is an established procedure. It has improved many people’s lives and has given them the dream shape they were looking for.Dr Sanjay Parashar, Consultant Plastic Surgeon at Cocoona center in Dubai says “VASER (Vibration Amplification of Sound Energy at Resonance) is a technology that simplifies the process of Liposculpturing. Vaser selectively emulsifies fat and removes it giving a smooth skin surface. This minimally invasive procedure uses ultrasonic waves to selectively break the fat cells and leaves surrounding structure intact that helps a uniform skin contraction with minimal side effect to the skin”.The first generation Ultrasonic lipo was popularized by Zocchi in Italy. I had an opportunity to use that almost 14 years ago. It had significant disadvantages such as risks of burns as it was a high power machine using Solid probe that focalized all its energy at the tip increasing the risk of damage to the skin and deeper structures. The second generation ultrasonic lipo was lower energy and had hollow cannula. But it was not as effective. Vaser came as third

generation technology that used solid cannula with specialized rings to dissipate the energy allowing circumferential energy distribution. This uniform emulsifies the fat with minimal risk to the skin. Vaser has been approved for use by FDA.Vaser Hi definition lipo is yet another advancement that allows removing excess fat around the muscles and contours the skin over the muscle highlighting the muscular silhouette. It is suitable in areas such as tummy, waistline, chest, arms and thighs. Vaser 3 Dimensional lipo is more suitable for women and it allows removal of fat all around the midriff giving a 3 dimensional sculpted look to the body with Hour glass figure.Vaser 4D Liposculpt is nothing but removal of fat fround around the muscles in some areas and reinjecting the fat to enhance the muscular outline such as chest, arms, calves etcWho are the best candidates?It is suitable for overweight people who have excessively large abdomen or thighs that makes it difficult for them to exercise. Vaser mega liposuction can be done to remove large amount of fat in a single session and allows them to restart their life

Dr Sanjay Parashar,

Consultant Plastic Surgeon

What Is Vaser Liposuction?


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and get into a healthy lifestyle.In normal weight people with stubborn and genetic fat pockets vaser can help to remove those excess eg chin, neck, arms, tummy, love handles, thighs and kneesIn body builders who have fat collection under the skin that hides there muscular silhouette. Vaser Hi definition is a useful procedure for tummy and chestMen with problems of Gynaecomastia can benefit by using vaser.Vaser is also useful for people desiring Brazilian butt lift. The removed fat can be used to augment buttocks.How is the procedure performed?The targeted area is injected with

tumescent fluid that help anaesthetize the areas. Small probes are inserted through a small incision port. This probe resonates at high frequency disrupting the fat from its attachments.The loose fat cells are than removed by low power suction. This preserves the matrix that contracts over a period of time.After the procedure patient goes home with a bandage. Post surgery they have to wear a pressure garment.ResultsThe significant advantage of this procedure is less bruising, swelling and discomfort. This allows an earlier recovery and results are visible as early as few weeks.


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My InsuranceCredit Card…!!

“You mentioned that the overall annual limit of the medical policy your company has provided is 3 Million Dollars. Does it mean that I will be able to spend 3 million dollars on my health every year?” the educated lady with the round glasses and smart business suit asked me. She was the HR Director of a large organization where I was doing a presentation to the company’s executives on their newly purchased health insurance scheme. That was back in 2007 when I was the Regional Manager of an international private medical insurer and it pretty much summarizes the way we look at health insurance as citizens and residents living in the Middle East.

Health Insurance

Dr. Ayham RefaatFounder & Managing Director – Accumed PM


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In this region, the health insurance card has been viewed more as a credit card than a risk mitigation plan. Much of that attitude is attributed towards the fact that health insurance has been predominantly provided by the employer as part of the employment incentives offered to staffs during the recruitment process.The economic crisis which has hit the world back in 2008 contributed further to the phenomenon with regional governments looking at cutting their own expenditure in all sectors, including healthcare. In the process, this accelerated the implementation of mandatory insurance to all population in order to shift the financial burden to the employers who had to provide health insurance for the staffs and their families. The UAE was the first to implement this policy in its capital Abu Dhabi in 2006 and followed by Dubai recently. Saudi Arabia is also undergoing the same process, while other GCC countries are expected to follow suit sooner than later. The legislation in UAE was aimed to provide access to quality healthcare services that are cost-efficient. At the same time, it brought up many investment opportunities in the recession-proof health sector. The most notable positive outcome was the collection of accurate data allowing the regulators in Abu Dhabi & Dubai to analyze the healthcare sector thoroughly and take informed decisions. That was accomplished through the implementation of Medical Coding principals and the

enforcement of electronic Medical Billing as a must for the reimbursement of medical services to the health providers.Medical Coding is the process of assigning codes to a patient’s medical diagnosis and procedure descriptions which should be performed by certified coders and only after reviewing the clinical notes of the physician. By conditioning the payment of services to the implementation of Medical Coding, both medical services providers and insurance companies are forced to report actively and accurately the services rendered to patients which is the prime outcome of Medical Billing. However, the question remains on how much we have benefitted from the data that has been collected so far. And how did that reflect on us as patients and community? The answer remains ambiguous when several indicators show that quality of healthcare provided in the GCC is still questionable, and the financial sustainability of the healthcare market is still uncertain.At AccuMed, we conducted a case study that looked at top five conditions in the UAE and analysed different laboratory

The economic crisis which has

hit the world back in 2008 contributed

further to the phenomenon with regional governments

looking at cutting their own

expenditure in all sectors,


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diagnostic procedures used to diagnose diabetes, hypertension, anaemia, thyroid disorders and Vitamin D deficiency. The study looked at 598,000 laboratory claims that took place in 2011-12 amounting to approximately AED236 million, of which an amount of AED20.4 million (8.6%) of claims that were submitted were found to be disputable between the insurance companies and healthcare providers. The debatable amount reflects the inconsistencies in the number of tests performed and billed versus the ones paid for. It was notable that in many cases medical providers’ requests for tests that insurance companies do not identify as medically necessary to diagnose the condition. Simultaneously, we have frequently seen specific tests that the insurance company deems as necessary diagnostic procedure, which it will be paid for should be requested by the physician, yet the physician does not consider it as medically necessary from a clinical point of view. As part of the same study, we analysed another 25,844 cases of diabetes and found that the number of tests requested to diagnose diabetes (being the same and only diagnosis code) during the same visit ranged from 2 to 12 tests, with values ranging from AED 40.23 to AED 157.27 per case.On similar lines, we have analysed 10,016 cases of hypertension, for which two to 12 tests were prescribed and the average prices ranged from Dh32.56 to Dh187.19. In the 4,790 cases of anaemia analysed, six to 16 tests were requested with costs ranging from Dh58.62 to Dh153.23. It is not uncommon for us as public to compare experiences we receive at healthcare providers and find that

we are being treated differently, often for the same health condition. This shocking discrepancy is due to the lack of standardised medical guidelines. Generally speaking, both physicians and insurance clinical staffs in the GCC come from different medical schools with different approaches for diagnosis and treatment. This is probably one of the major reasons behind the known phenomenon of Doctor Shopping or Healthcare Shopping in the GCC. Cost also is a factor of utmost importance. Healthcare costs in the GCC are surging, partly due to this growing area of dispute between medical services payers and providers upon what are the medically necessary treatments, procedures and medications. The immediate public reaction we have seen after releasing our study was geared towards physicians’ overutilization when prescribing higher number of tests. Many assumed also that the lower number of tests is likely to be underutilization and questioned quality of care. It was obvious to us that the problem is the absence of knowledge on what should be the optimum utilisation to start with!It is only logical to define ideal utilization first before judgements are made. All stakeholders, namely medical services providers and insurance companies led by the regulator, should agree on Clinical Care Pathways that are derived from our own market data, demographic indicators and population needs. Clinical Care Pathways are medical guidelines that are based on evidence-based practices in which the different tasks performed by the clinicians involved in the patient care are defined, optimized and sequenced. This multidisciplinary


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management tool is vital to manage the quality aspect of healthcare in relation to the standardization of care processes. Such standardization reduces the variability in clinical practice and improves quality as it illustrates a structured and cost effective care map based on evidence based practice.As a patient, I would want to know that my physician is following the best practices to treat my condition. I would also want to be sure that my insurance company will be compliant and cover me for the same as disapproving my treatment on debatable clinical basis might force my physician to choose a lower quality route of treatment, especially when I can’t afford to pay for the optimal treatment in cash. Clinical Care Pathways will help providers improve the quality of their facilities and secure payments against services rendered. On the other hand, insurance companies will ensure beneficiaries will be treated from the first round, hence reducing unnecessary losses derived from patient hopping between facilities. Regulators should inspire innovation and reward quality in order to maintain a stable healthcare system that has a healthy population, attractive investment opportunities, and to better position the UAE as a serious competitor in the sought after share of the global medical tourism industry. Over my 15 years of experience as a clinical practitioner, a hospital management consultant, a health insurance specialist, and the founder of the Medical Billing industry in the Middle East; I have understood that health insurance is not about treating the policy beneficiary, rather, it is about who pays the bill for the treatment -the patient himself, the hospital, or the insurance?

This is because an insurance policy is underwritten to cover specific conditions up to different sub-limits that differ from one policy to another. This clinical dispute between physicians and insurance staffs is arising due to each having completely different agendas and purposes of their work. Having a predominantly insurance-driven focus might affect the financial sustainability of the region’s healthcare sector, leaving medical services providers and payers to grapple with the actual costs of healthcare services. The loser at the end is us the public as such grabble will affect our cost of living, both directly and indirectly, regardless of our naive assumption that our employers are paying for it. Private insurance companies will also seek to minimise their losses as much as possible. When loss ratios worsen, the insurance company will either reduce the policy benefits and consequently the patient’s coverage as a beneficiary, or will demand an increase in premiums which will be registered on the employer’s financial books as an increase in cost that can be only recovered by increasing the selling prices of products and services. This lack of awareness by the public on the effect that such exercises might have on their own cost of living is dangerous and requires a major effort from the regulators and the media to spread such consciousness in the public mind in order to empower patients to question how they are being treated, and how their insurance policies being charged, but that is a different story…


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Heart disease is the leading cause of death for women in the United States, killing 1 in every 4 female deaths.- Although heart disease is sometimes thought of as a "man's disease," around the same number of women and men die each year of heart disease in the United States. Despite increases in awareness over the past decade, only 54% of women recognize that heart disease is their number 1 killer.- Heart disease is the leading cause of death for African American and white women in the United States. Among Hispanic women, heart disease and cancer cause roughly the same number of deaths each year. For American Indian or Alaska Native and Asian or Pacific Islander women, heart disease is second only to cancer.- About 5.8% of all white women, 7.6% of black women, and 5.6% of Mexican American women have coronary heart disease.- Almost two-thirds (64%) of women who die suddenly of coronary heart disease have no previous symptoms.4 Even if you have no symptoms, you may still be at risk for heart disease.SymptomsWhile some women have no symptoms, others experience angina (dull, heavy to sharp chest pain or discomfort), pain in the neck/jaw/throat or pain in the upper

abdomen or back. These may occur during rest, begin during physical activity, or be triggered by mental stress.Women are more likely to describe chest pain that is sharp, burning and more frequently have pain in the neck, jaw, throat, abdomen or back.Sometimes heart disease may be silent and not diagnosed until a woman experiences signs or symptoms of a heart attack, heart failure, an arrhythmia, or stroke.These symptoms may include- Heart Attack: Chest pain or discomfort, upper back pain, indigestion, heartburn, nausea/vomiting, extreme fatigue, upper body discomfort, and shortness of breath.- Arrhythmia: Fluttering feelings in the chest (palpitations).- Heart Failure: Shortness of breath, fatigue, swelling of the feet/ankles/legs/abdomen.- Stroke: Sudden weakness, paralysis (inability to move) or numbness of the face/arms/legs, especially on one side of the body. Other symptoms may include: confusion, trouble speaking or understanding speech, difficulty seeing in one or both eyes, shortness of breath, dizziness, loss of balance or coordination, loss of consciousness, or sudden and severe headache.7Risk Factors

Heart disease is the leading cause of death for African American and white women in the United States. Among Hispanic women, heart disease and cancer cause roughly the same number of deaths each year. For American Indian or Alaska Native and Asian or Pacific Islander women, heart disease is second only to cancer.

Facts on WomenandHeart Disease

Facts& Figures


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High blood pressure, high LDL cholesterol, and smoking are key risk factors for heart disease. About half of Americans (49%) have at least one of these three risk factors.Several other medical conditions and lifestyle choices can also put people at a higher risk for heart disease, including:- Diabetes- Overweight and obesity- Poor diet- Physical inactivity- Excessive alcohol useScreeningTo reduce your chances of getting heart disease it's important to- Know your blood pressure. Having uncontrolled blood pressure can result in heart disease. High blood pressure has no symptoms so it’s important to have your blood pressure checked regularly.- Talk to your healthcare provider about whether you should be tested for diabetes. Having uncontrolled diabetes raises your chances of heart disease.- Quit smoking.- Discuss checking your cholesterol and triglycerides with your healthcare provider.- Make healthy food choices. Being overweight and obese raises your risk of heart disease.- Limit alcohol intake to one drink a day.- Lower your stress level and find healthy ways to cope with stress

Know your blood pressure. Having uncontrolled blood pressure can result in heart disease. High

blood pressure has no symptoms so it’s important to have your blood pressure checked regularly.


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Teststo Keep YourBrand Relevant

Marketing

A critical view of your brand can make it enduring and stronger.A hospital’s brand is extremely important. With the changing healthcare environment brands are in transition with new alliances, new ventures, a host of rating organizations, consumer-driven marketplace and so much more. Which means it’s more difficult to keep a strong and consistent brand.It’s crucial for hospitals and healthcare organizations to frequently revisit the brand, reassess and keep the brand as clean and consistent as possible. Here are 5 tests every brand should ask and consider on a regular basis.1. How is your brand perceived in the

marketplace?What is the consumer perception of your brand? Is it gaining strength or waning? Does the consumer have a clear idea of what and who the brand is? Do they know what the brand stands for? Is the brand relevant to the consumer?2. How is the brand communication?Take an inventory of all brand touch points. Patients, physicians, providers, payers, employees, management and board. What is the brand communicating to each? Is it consistent? Does it reflect the mission and values of the organization?3. Analyze your brand architecture.In many ways this may be the most difficult.

5


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Teststo Keep YourBrand Relevant

As organizations grow and change, it’s difficult to keep consistent and clearly defined brand architecture. Do patients understand the different product and service lines and how they relate to each other and to the master brand? Is there confusion? A weak brand architecture creates weak brand equity.4. Assess the brand expression.Does the brand have a consistent image, look and feel across all touch points? Can the consumer tell that all parts of the brand are part of the overall brand family?5. Examine the brand expression.How is the brand expressed? Does it have a consistent tone, personality and message?

Do all the communications speak the same voice and reflect the same character and heart? In today’s environment it’s so easy to get sidetracked, disjointed and inconsistent. It’s easy to get going in too many different directions and sacrificing the brand for expediency or politics. And when this happens, the brand is weakened. Healthcare marketers should constantly be asking these questions and diligently communicating a consistent, well-planned and strong brand. Across all platforms, to every audience and with every execution. I know it’s easier said than done. But we must always be fighting the good fight to protect and enhance our brand


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Pulses

I would like to share a very interesting conversation between myself and one of the most renowned healthcare specialist from a different country. During his visit to Dubai, he asked me with a surprise " what is the secret behind such happy and peaceful looking faces of people in Dubai? I am amazed to see how every one in Dubai have a joyful smile like a child does while watching a water fountain dancing over the serene music".With the same kind of smile, I answered "that's because it is DUBAI. I further told him, "Dubai is like a huge tree that is growing and prospering day by day, providing shelter to many under its shadow, taking away all the tiredness, providing fruits of joy and success to people hanging on to it. Dubai is a city of dreams for many where almost impossible dreams have come to reality. "He indeed agreed with my thought. He further added " Dubai is becoming a medical tourism destination with enhancement in healthcare options and quality care. Dubai is turning into a world leader not only in healthcare but also in business development and finance which is supported by various distinct international conferences held each year that has grabbed attention of many investors from various sectors across the globe. Our conversation continued and we agreed upon the same thought in the end that is "Dubai is a place where health and happiness are two sides of the same coin".According to World Health Organization health does not mean the absence of disease but a state of complete well-being of physical, mental and social. And in Dubai health is further defined with a holistic professional approach which leads to health and happiness in the minds and hearts of UAE. And this is the goal, Dubai government and Health Authorities is aiming to achieve in this city where humanity come first before any material pleasure. True happiness is self enlightenment. Real happiness lies in the state of mental satisfaction and peace obtained by feelings of joy and love in everyday life. Material possession is a temporary state of happiness.To stay healthy, one must feel positive, happy and bear healthy thoughts. Negative thoughts and feelings are triggering factors that take us to the path of self destruction and disturb our social and professional life. On the other hand all the positive emotions increase productivity and strengthen social and family relations.Happiness can never be measured by bank accounts. Instead it is measured by the quality of human relationships and the ability to give and this is the lifestyle of people in DubaiDubai, indeed it is. The place we all love and adore deeply in our hearts. It truly is oasis of security and safety and a land of beautiful, healthy and happy hearts

Dr. Bassam DarwishMedical Media & Marketing Consultant

Because it's DUBAIHealth & Happiness

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