A demographic shift where population above the age of 60 are expected to rise considerably in the next decade, increased private sector participation and increase in health insurance coverage are amongst some of the chief factors raising the stakes for high growth opportunities in the healthcare sector landscape of the Kingdom of Saudi Arabia. In addition, the country’s ambitious Saudi Vision 2030 and National Transformation Program 2020 (NTP) seek to improve the quality of healthcare services and facilities while optimising available resources thereby boosting opportunities for increased private sector participation.
Alaa Adel, senior director and general manager in Cerner Middle East, who focuses on client satisfaction and organisational growth in Africa and Saudi Arabia, opines that despite the inherent challenges in the system, government initiatives are changing the dynamics of the healthcare sector in Saudi Arabia. Effective regulatory frameworks will help facilitate the flow of private investment, he says, and the encouragement of public-private partnerships will sustain growth even in the face of long-term challenges.
In an interview with Arab Health Magazine, Alaa Adel says that as the government switches over from its role as that of a service provider to a regulator, competitiveness and quality care services will be given a boost leading to increased efficiency and improved outcomes.
“A sweeping change in imminent and on the horizon,” he adds, “and this change needs to be embraced. Ultimately, a healthier population leads to enhanced productivity for the national economy.”
- What, according to you, are the major healthcare challenges in Saudi Arabia today? Can the existing model of healthcare delivery meet the future needs of a growing and ageing population in the country?
I have seen over the last couple of years the advancement of healthcare services in Saudi Arabia and how that has influenced life in the Kingdom and the health map of the country in a very positive way. I believe the current 2030 healthcare vision will provide the Kingdom with efficient healthcare services. However, with every nationwide programme and new developments, there are a few challenges that need to be addressed. These include:
- Rapid increase in expenditure: Healthcare services are free for all Saudis. In a rapidly growing and ageing population, this tends to be a costly model.
- Waiting time: This is another challenge as we see waiting time of several months in certain cases for patients to get surgery or procedures done.
- Shortage of qualified healthcare resources: This is true not only for Saudi Arabia, but other GCC countries too. Relying on expatriates to make up for this shortage may lead to other impediments like language barriers between care providers and patients.
- Digital transformation: Adoption of modern technology in combination with healthcare best practices is required to enhance patient care and deliver the highest quality of service.
- Restructuring: The public sector will need to undergo a transformational shift from its status as a cost centre to a revenue centre in alignment with Vision 2030, and this could lead to several hurdles in the initial stages of implementation.
- Insurance sector: The insurance market in Saudi Arabia is maturing fast in expectation that moving forward, healthcare organisations will do more to improve health with less resources and improve health outcomes. This is a double-edged sword as with the little resources they have, organisations are now in the position of having to decide where they get the most bang for their buck and also show the best outcomes. Insurance companies will have a big role here and need to keep up with this shift.
- Public health management: Around 5 million pilgrims visit Saudi Arabia every year, which provides a major challenge in providing health services and containing infectious diseases arising from such a large mass gathering.
That said, I believe the competent and able teams in the Kingdom responsible for the delivery of the 2030 healthcare vision are hugely talented and have thoughtfully strategised innovative ways and measures to achieve this vision.
- What are the main drivers of new demand for quality healthcare in Saudi Arabia in the medium to long term? What is the outlook for the sector in the medium to long-term?
The current leadership in Saudi Arabia has given a thrust to improve healthcare quality in the country for two main reasons: improving the welfare of the citizens and higher efficiency compared to the current model. These are in line with Saudi Vision 2030 and one of the main changes it will bring about lies in the financing of healthcare. The government is encouraging private investments in the healthcare sector and is preparing to switch its role over the long term from that of a service provider to a regulator. This will create competitiveness in service quality amongst all service providers and stakeholders, including the current government-run hospitals, which will lead to service improvement and increased efficiency.
- What are some of the operational challenges that Saudi Arabia has to contend with? How can a more effective integrated continuum of care be brought about to overcome these challenges?
Several operational challenges including long waiting times, high appointment no show rates, underutilisation of resources, and tight controls may limit the agility of the leaders and block or delay some of the creative changes required to solve the current problems. Technology now offers many solutions to address some of these challenges. The direction should be to have better visibility to manage the available resources and better engage the patient for better results. If we can increase the percentage of care delivered outside the four walls of the hospital using the available technology and by relying more on primary healthcare centres, we should see natural improvement in the above-mentioned challenges.
We also need to keep in mind that lifelong learning and continuing education of healthcare professionals are critical to improving healthcare, patient outcomes and population health. This by itself will largely address the continuum of healthcare.
In addition, operational changes should also be reviewed regularly between both the public and private sectors to achieve the best synergy between the two entities.
- Obesity is a growing concern in Saudi Arabia. What are the specific healthcare challenges that lifestyle habits and rising incidence of non-communicable diseases are causing in the region? How can these be addressed?
Obesity is an increasing challenge in many countries especially with the onset of the modern life style. Several noteworthy campaigns have been launched in Saudi to raise awareness on these issues. However, the impact has been minimal to lead to a big shift in results. The problem is that fast food is quick, unhealthy options are tasty, and hectic work schedules or sedentary lifestyles - even with entertainment - does not leave much time for exercising. While people know that these are bad choices and will have a negative effect on their health in the future, what is required is a direct and timely incentive for individuals to make the change.
At Cerner, our experience in addressing this issue with the introduction of a programme linking one’s activity level and BMI with the discounts one can get from health insurance and a few other similar incentives has shown promising results. We need to look at new methods of enhancing obesity assessment and management programmes if we need to have a healthier and happier population.
I believe, we should maintain an attitude that more can be done from adopting a preventative approach rather than looking at it from a curative perspective. It is imperative to address this challenge and encourage people to make healthy lifestyle choices through raising awareness amongst the public and design efforts and strategies to combat obesity so that the consequences brought on by the rising incidence of non-communicable diseases such as cardiovascular diseases, diabetes, etc are greatly reduced.
- How has the rapid pace of technological innovation and digital disruption affected the healthcare delivery system in Saudi Arabia?
Technology is playing a big role in our lives across all industries and healthcare is no exception. In Saudi Arabia, healthcare stakeholders are welcoming digital disruption to transform the sector in the coming years. For example, in many cases where the need for physician opinion or consultation is urgent but does not require a personal meeting, physician e-visits can be done over the phone or through video conferencing. This will be much more efficient and convenient for both the patient and the physician and will lead to better results as opportunities for complications are reduced (if the patient waits or took wrong medication on his own). In addition, a virtual waiting room is better than the physical one to help prevent infection between patients.
The availability of multiple devices and solutions which can track our health (activity, vital signs, sleep, sugar levels) can provide a much more comprehensive picture about our condition to our healthcare providers and allow for early warnings and proactive engagement.
Also, the sharing of data across facilities and the possibility of having a single patient file across providers is a game changer as it negates the need for unnecessary examinations and conflict of treatments which arise from fragmented care.
- In your opinion , what would be some of the ideas or solutions for a nationwide healthcare programme ?
- Use technology to aggregate patient data and have national registries; modernise primary care centres
- Increase collaboration between different facilities and organisations (including private sector) to efficiently utilise existing resources.
- Switch the focus from sick care (treating illness) to preventive care (avoid illness and staying healthy); create public awareness of adopting healthier lifestyle habits
- Attract qualified clinicians and offer continuous professional development to improve quality of care
- Implement best practices and innovative strategies to improve care coordination and manage multiple chronic conditions.