Arab Health Review





Innovative devices for the
Middle East
 

 

The 38th Arab Health Exhibition and Congress was held in Dubai from 28-31 January 2013. The event provides a platform for the world’s medical device and equipment manufacturers and medical service providers to showcase their products to a wide network of interested stakeholders and to meet the medical community in the Middle East.

Middle East Health was at the event. This year’s expo was clearly bigger than the previous year – a healthy sign that the industry in the region remains robust. There were literally thousands of exhibitors. We spoke to some of them.

Masimo’s rainbow technology

We spoke to Joe Kiani, the CEO of Masimo. Remarkably Kiani started his business, which focuses on developing non-invasive patient monitoring technologies including medical devices and a wide array of sensors, in his garage in 1989 and has built it into a publically traded company with a turnover in excess of US$500 million. Masimo is responsible for the invention of award-winning Masimo SET pulse oximetry (which resolved the problems of low perfusion and motion in pulse oximetry), Masimo rainbow Pulse CO-Oximetry and new Masimo noninvasive and continuous total hemoglobin (SpHb) monitoring technology.

Masimo rainbow technology allows clinicians to non-invasively measure multiple blood, fluid, and ventilation parameters that previously required invasive or complicated procedures, including SpHb oxygen content (SpOC), carboxyhemoglobin (SpCO), methemoglobin (SpMet), PVI, and RRa, along with Masimo SET Measure-Through Motion and low perfusion pulse oximetry for oxygen saturation (SpO2), pulse rate, and perfusion index (PI). With touch, drag, and drop functionality, clinicians can move, expand, or collapse any parameter on screen for real-time analysis.

Masimo Pronto-7

Among several new products that the company was showcasing, was the Masimo Pronto-7 – a new palm-sized handheld device designed for quick and easy noninvasive spot-checking of haemoglobin (SpHb), SpO2, pulse rate, and perfusion index at the point-of-care.

The device offers a breakthrough new solution for measuring haemoglobin in less than one minute – without needles, time-consuming laboratory analysis, blood contamination, hazardous medical waste, and patient discomfort associated with traditional blood tests.

Kiani pointed out that the Pronto-7 “Puts the power of accurate non-invasive haemoglobin spot-check measurements into any clinician’s hands, in virtually any environment.” “This product can be used away from the clinical setting and will greatly increase access to healthcare. Maternal mortality is high due to anaemia in areas with little or no access to healthcare.

This portable technology will enable the patient to be easily monitored,” he explained to Middle East Health.

With dimensions of just 13 cm x 7.2 cm x 2.5 cm and weight of 296 grams, Pronto-7 is lightweight and convenient. It is fast and accurate, and with embedded 802.11 b/g and Bluetooth communication capabilities it makes wireless printing and emailing of test results quick and easy.

iSpO2

Masimo’s iSpO2 pulse oximeter cable and sensor with Measure-Through Motion and Low Perfusion Masimo SET® technology is a consumer pulse oximeter for use with Apple’s iPhone, iPad, and iPod touch. iSpO2 uses the same technology found in Masimo’s breakthrough line of pulse oximeters and Pulse CO-Oximeters – the standard- of-care pulse oximetry technology at work in leading hospitals around the world – providing accurate measurements, even during challenging conditions of motion and low perfusion.

GE unveils new Silent Scan MR

At Arab Health 2013, GE Healthcare unveiled a new [510(k) pending] Silent Scan MR, a technology designed to address one of the most significant impediments to patient comfort – excessive acoustic noise generated during an MR scan. Conventional MR scanners can generate noise in excess of 110 decibels levels, roughly equivalent to rock concerts, and requiring ear protection. GE’s pending Silent Scan technology is designed to reduce MR scanner noise to near background sound levels and thus improve a patient’s MR exam experience.

“Silent Scan promises to be a huge breakthrough for the MR industry and for patients everywhere,” said Maher Abouzeid, GE Healthcare’s new President & Chief Executive Officer for the Middle East and Pakistan. “It reflects our focus on humanizing healthcare technologies. Excessive acoustic noise is a major cause of patient discomfort during MR scans and GE is addressing that with Silent Scan, a major innovation in the healthcare industry.”

Historically, acoustic noise mitigation techniques have focused on insulating components and muffling sound as opposed to treating the noise at the source. With Silent Scan, acoustic noise is essentially eliminated by employing a new advanced 3D acquisition and reconstruction technique called Silenz, in combination with GE Healthcare’s proprietary design of the high-fidelity MR gradient and RF system electronics. Silent Scan is designed to eliminate the noise at its source; with Silent Scan, patients will experience a more relaxing scanning environment.

Speaking at the unveiling, Tom Gentile, President and CEO, GE Healthcare Systems remarked that the Middle East region was “growing tremendously” for the company. “We’re seeing an explosion of mobility and connectivity,” he said.

Cancer patients in the region

As part of its US$1 billion oncology commitment and marking World Cancer Day, GE Healthcare showcased its range of leading oncology solutions at Arab Health 2013, highlighting the benefits of GE’s established portfolio for patients across the Middle East. Among the solutions highlighted were the SenoBright Contrast Enhanced Spectral Mammography (CESM) and FlightPlan for Liver, that have the potential to help healthcare providers improve outcomes in breast and liver cancer for the region’s anticipated 140 million and 12 million cases respectively, across the Middle East (according to stats from ‘rightdiagnosis.com’.)

Brainlab launches Buzz Digital OR

For the second year in a row, Brainlab, the German provider of software-driven medical technology that supports targeted, lessinvasive treatment, chose Dubai’s Arab Health to reveal its new system in the Middle East. Buzz Digital OR was launched in the presence of Stefan Vilsmeier, President and CEO of Brainlab.

Buzz Digital OR is a centralized information hub with a full HD 42” display featuring a multi-touch control interface. This computer- and IP-based system allows for the effective handling of information relevant in the OR. The control interface streamlines and enables intuitive management of medical images and other patient information. With the flexibility to manage video images from endoscope, microscope, etc., communication with other medical equipment, and documentation of patient treatment, Buzz simplifies effective management of increasingly complex operating room data requirements.

“Buzz Digital OR is a highly advanced surgical device, tailored to meet the specific needs of the surgical environment,” said Stefan Vilsmeier, “We understand and embrace the trend of fusing medical equipment and IT systems inside healthcare facilities, as this allows for intelligent, scalable, and flexible OR integration solutions; we expect that hospitals and surgeons are going to reap benefits by installing Buzz systems, and will offer new possibilities in data flow and patient care.”

Buzz Digital OR effectively manages advanced OR workflow – facilitating planning, navigation and intraoperative imaging connectivity. The newly designed control concept for Buzz also enables intuitive management of data sources and displays with drag and drop functionality. Fast and easy access to medical image data is provided through the integrated interactive DICOM viewer. Procedures can be conveniently documented with screenshots or dual channel recording.

A system that can run data across the hospital IT network, Buzz Digital OR has already attracted attention in the Gulf region, with King Fahd Hospital Jeddah to be the first in the Middle East to purchase it, along with Brainlab latest technologies, and thus taking steps towards creating state-of-the-art, integrated operating suites with Brainlab solutions.


Mecomed – working for the benefit of the medical technology manufacturing industry

Middle East Health spoke to Craig McLaren, the Chairman of Mecomed, about the association which represents medical technology manufacturing companies – mostly multinationals – active in the MENA region.

McLaren, who is also the Regional Managing Director, MD&D, Johnson & Johnson for Middle East, Egypt and Pakistan, explained that the association took effect in 2007 and keeps growing each year as new companies join.

“Currently we represent 18 organisations and we expect it to grow to about 22 by the end of this year – which will represent about 80% of the industry,” he said. “We have five steering groups of activity,” he said.

“Each organisation can participate in these steering groups.” These cover regulatory activity, healthcare compliance, diagnosis related groups, industry data analysis, and a marketing steering group.

He said that perhaps the most important of these – or where they have had the most traction – is the group dealing with regulatory issues. “As markets around the region become increasingly regulated, Mecomed has set up this group to better understand the needs and challenges that are being faced in each country – not just us as a technology association, but also to see if there is a way we can collaborate and assist the authorities to smooth the path for them in setting up a regulatory environment.

“Because we represent global companies we can draw on our experiences in Europe, the US and other emerging markets to assist local authorities in terms of reference points.” He explained that with rapidly evolving regulations the association also assists their members to gain clarity on new regulations. “We act as a single point of contact for our members and the authorities,” he said. Another important part of their work is to help members with business integrity or healthcare compliance.

“We live in a part of the world where the corruption index is still fairly high. We represent companies who are increasingly having more of a presence in these markets, but at the same time rely on distributors as a third party intermediary.

So what we are trying to do is establish a common code of ethics within the region and within our industry to stop behaviour that is unacceptable. In this way we can cut out wastage in the system which will ultimately benefit the patient.”

He mentioned as an example healthcare practitioners going for a meeting in a beach resort. “This used to happen regularly in this region, but this for us would not be viewed as acceptable as this sort of meeting should not be considered a holiday.

It should be a serious meeting with scientific content, so the value of these meetings will ultimately benefit the patient.” Another area of their work has to do with ‘diagnosis related groups’ or DRGs. This steering group is looking at reimbursement in a healthcare system.

It has been recently introduced by the Health Authority in Abu Dhabi and other regions in the Gulf are considering it. This is reimbursement for a procedure, for example, paid for by the funder, whether it be a health insurance company or a state-sponsored organisation. “The challenge is to get reimbursement set at the right levels so you get an efficient system, but you don’t compromise on quality for the patient,”

McLaren explained. He said they were also doing work internal to the industry and noted the lack of good data available to their members, for example, determining benchmarks for rewarding people who work in the industry.

This is available from research done for the pharmaceutical industry, but there is very little data on this in the medical device industry. “One of the things we have been able to do is work within our own membership and work with an external organisation to provide our members classified data so they in turn can provide the industry with a common set of data points.

So, for example, they can say the average salary for a sales manager in Saudi Arabia is X and in the UAE it is Y. “In this way we can add value for our members.” The fifth group has to do with marketing Mecomed in the short and long term. He concluded by saying they have seen substantial change in the medical industry in the past two years, but he believed this was just the tip of the iceberg.

“As these markets look set to experience massive change in the next five years, the work of Mecomed will become increasingly important – and increasingly large. And hopefully we will start to have more collaborative work with the authorities.”


Super hygiene qualities of Nora rubber flooring systems make it ideal for healthcare

We spoke to Martin Koch and Steven Mc- Fadden of Nora Systems, a specialist manufacturer of customised rubber flooring solutions tailored to the healthcare industry. Koch is the Chief Communication Officer for the company and McFadden is the regional manager for the Middle East.

Germany-based company Nora Systems develops, manufactures and markets highquality, resilient floor coverings. With a market share of over 80% in Germany and more than 50% worldwide, nora systems is the global market leader in the market for rubber floor coverings. The main focus of its business activities lies in the market segments of health care, education, transportation, industry and public buildings, as well as commerce and services.

The company opened a subsidiary office for the Middle East region in May 2011.

Koch explained that Nora floor coverings are based on high-quality natural and industrial rubber, which is mixed with naturally occurring minerals and other components such as environmentally compatible colour pigments, drawn into blanks, pressed and then vulcanised under heat and high pressure. “This process gives the coverings their permanently resilient qualities and resistant surface. Nora floor coverings are practically indestructible, displaying scarcely any signs of wear even after years of intensive use.”

With more than 300 shades of colour, different surface structures and inlays for innumerable composition possibilities, the standard Nora assortment gives architects, planners and building developers a wide array of options for creative interior design. Key to Nora’s flooring is its capacity to maintain a high degree of hygiene and clean air – essential for any healthcare environment.

Hygiene problems can be caused by floor coverings of linoleum or PVC because their polyurethane coatings are only a few micrometres thick and are open to attack from dirt particles. These open up fine cracks or microscopic holes that viruses and bacteria start colonising very soon after.

“An alternative for perfect hygiene is provided by rubber floor coatings from Nora systems. Owing to their extremely tight surface and their UV polymerisation, they need neither a coating nor varnish. The danger of viruses or bacteria penetrating the floor covering is therefore eliminated,” said Koch.

Unlike other flexible floor coverings, Nora rubber coverings do not present gaps that must be sealed – and that therefore provide a further niche for microbes. Even after thorough cleaning, the gaps in floor coverings can still offer pathogens a place where they can settle and multiply.

Nora rubber coverings do not contain plasticisers (phthalates), so they cannot shrink, for instance like PVC floor coverings, when these substances volatilise over time. Rubber floor coverings retain their dimensions even after decades. Yet their gap free installation minimises not only the danger of microbial invasion.

“There is also no time consuming and costly sealing maintenance, so Nora floor coverings are also the most economical solution for clinics over the long term.

“Moreover, a floor covering’s disinfectant properties are also very important for an extensive hygiene concept at hospitals. Nora rubber floor coverings are resistant to surface disinfectants. Also the short term action of solvents or diluted acids or alkalis leave no permanent marks. Even substances containing iodine like skin disinfectants can be removed with ease,” said Koch

“Rubber floor coverings not only present convincing hygiene aspects. Especially hospitals and healthcare facilities attach great importance to the quality of indoor air. Nora system blue is a low emission system that applies not only to the rubber covering itself, but also to all of the installation materials.”

The sealed and uncoated surface of Nora rubber floor coverings also makes unnecessary the use of aggressive cleaning agents – and this too helps to minimise emissions to indoor air.


Speech recognition software set to change the face of medical reporting

Nuance Communications, the maker of the well-known Dragon Dictate voice recognition software which magically turns speech into text, was at Arab Health to show off their new voice recognition software developed specifically for the healthcare industry. We spoke to Anne Durand-Badel, International Marketing Manager at Nuance, about the product – Dragon Medical.

Durand-Badel explained that by using Dragon Medical, doctors can use their voice to efficiently navigate clinical systems and dictate medical decisions and treatment plans directly into a patient’s electronic record.

“Dragon Medical allows doctors to dictate in their own words, generating ‘once and done’ documentation which they can dictate, edit and sign in succession.”

Doctors further accelerate the dictation process by operating macros to re-use frequently- dictated text.

“This approach dramatically reduces the time doctors spend documenting care. Dragon Medical is the only product from the Dragon family that automatically encrypts all audio and text data, thereby supporting patient security and confidentiality, a necessity for all medical organisations.”

She said the company works closely with Hospital Information System (HIS) development companies, like Cerner and GE Healthcare, to tie in the voice recognition software with the electronic patient record and other areas of the HIS.

Durand-Badel noted that the system does require some initial training and following this you can expect around 90-95% accuracy.

“The system has been designed to understand specific voice accents such as those of the United States, England, France, Australia and others,” she said.

In the demo Nuance provided for Middle East Health the system clearly understood the accent of an Egyptian voice speaking English and it picked up some fairly complex words correctly, like ‘atherosclerosis’ and ‘cardio-vascular disease’.

Local partner

Durand-Badel said the company was working with regional partner Emerging Technologies. By working with the local partner “Nuance Healthcare is able to provide a localised service for customers across the Middle East, providing a voice recognition solution for the multi-lingual, multi-cultural community of doctors in the region. The software is capable of learning and adapting to its users and is able to recognise different accents, making the native language of the user no barrier to the ability to enjoy the benefits of the technology.” She said the Ministry of Health of the United Arab Emirates awarded Nuance Communications and partner Emerging Technologies a contract to roll out voice recognition in a first phase to over 1000 medical professionals at the country’s hospitals and clinics in 2012.

Sheikh Khalifa Medical City and Cleveland Clinic Abu Dhabi have also installed the software.

“We have had a lot of interest across the region,” she said.

The state of the art Sidra medical facility in Doha, due to open later this year, has also installed Dragon Medical.


Philips Healthcare shows off some of their research work

We spoke to Dr Henk van Houten, General Manager Philips Research, Programme Manager Healthcare, about some of their products that are in the research pipeline.

“In research we have a number of innovation areas, but let us focus specifically on oncology,” Van Houten said.

He said Philips was looking at new screening solutions for breast cancer based on photon counting. Simply put, this device measures the intensity and phase of light that is beamed through the breast and in this way it can detect tumours in the breast tissue more accurately than xray mammography.

He also talked about the research Philips is doing into creating low stress environments for patients to help them make important decisions with better clarity of mind – for example if the patient is faced with a choice of different approaches to treat prostate cancer. Philips has created an environment – a special room with ambient lighting that can be adjusted to the appropriate mood. In this room the patient is presented information – gathered during consultation with a specialist – that is specific to his or her condition. With this tailored information and in this stress-reducing environment the patient should be better equipped to make a clear decision when faced with a variety of options.

Dr Matthew Harris, Senior Manager Communications, Philips Group Innovation, explained: “What you have here is technology that is personalised to the patient, so that patient’s profile and risk stratification is presented to them so they can understand the benefits and side-effects of each option.”

Although this low-stress environment is still in the research phase, it is envisaged that a hospital or cancer centre would incorporate such a space into the building as a service for their patients.

In a press statement Philips pointed out that the World Health Organisation (WHO) estimates that there are more than 272,000 cancer-related deaths in the Middle East and North Africa annually and this is set to increase significantly by 2030. WHO has determined that the priority areas for intervention are: primary prevention and early detection, particularly of breast cancer; integration of cancer interventions into primary health care; and promotion of palliative care, including home care.

The company noted that they were developing oncology solutions appropriate for the region. Some of these were on show at Arab Health including the Sonalleve MR-HIFU therapy system which is being studied as a non-invasive method for destroying tumours in the body, as well as the a home clinical monitoring prototype system designed to support cancer patients being given chemotherapy.

Dr Van Houten explained that the home clinical monitoring prototype measures the white blood cell count as this is an early indicator of whether the patient is strong enough to endure the next chemotherapy session.

The prototype device is 3G enabled so the physician can read the patient’s white blood cell count and let the patient know whether they should stay at home or visit the cancer centre for the next session of chemo. The benefits of this are obvious – such as avoiding the inconvenience and unnecessary stress to the patient of travelling to the cancer centre for chemotherapy only to find when they get there that they are not strong enough for the next chemo session.

Dr Van Houten pointed out that Philips started putting some of their research work on the exhibition floor at RSNA a few years ago – an initiative to get feedback from medical professionals.

“It’s been working very well,” he said.

Diederik Zeven, General Manager, Philips Healthcare Middle East and Turkey, highlighted the ambient experience room they had on the show floor at a previous Arab Health exhibition as an example of how they show off some of their research, and added one of the results of this was a large order for the ambient experience setup by the Farah Medical Complex in Amman (reported in the January 2013 issue of Middle East Health).

 Date of upload: 10th Apr 2013

 

                                  
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