Middle East injects high tech into health care

Tony Glover: The Arabian peninsula, an ancient cradle of medicine,is showing the world the way ahead, this time by integrating electronic data management with treatment.

Leading hospitals in the region are incorporating the mobile clinical assistant to access and store patients' medical records.

The region's hospitals, particularly those here and in the kingdom of Saudi Arabia, are rapidly becoming world leaders in the development of potentially life-saving technologies. Despite the changes that have taken place in information technology over the past decade, most of the world's hospitals are still mired in the 20th century.

Records are often kept on paper stored in cardboard files. Crucial X-rays are frequently misplaced. Dangerous drugs are sometimes wrongly prescribed as a result of overworked doctors' illegible handwriting. Usually, the only concession to the computer age in the average ward is a semi-obsolete PC on the ward nurse's desk. But in the Middle East, new technology is being tested that may soon help to bring the world's hospitals kicking and screaming into the 21st century. Leading IT companies are coming to the region to test new devices and procedures designed to streamline hospital procedures and improve patient care.

According to Dave McCarron, the health manager for Intel Digital Health Group in Europe, the Middle East and Africa: "Saudi Arabia and the UAE are the most interesting Middle Eastern countries in terms of IT because of their focus on e-health." King Fahd Medical City (KFMC), a government-funded healthcare facility in Riyadh, is a prime example. Ever since it opened in October 2004, KFMC has aimed at being a fully integrated digital hospital, making the transition from paper-based to electronic medical records. It is designed to be a model for health care in the rest of the kingdom.

KFMC, consisting of four hospitals and four medical centres, is claimed to be the largest health facility in the Middle East, built at a cost of more than US$600 million (Dh2.2 billion). In a project with Intel, KFMC has undertaken a pilot at its Children's Hospital designed to develop truly 21st century bedside, or mobile point of care (MPOC), technology. The pilot has already reduced the time it takes nurses and doctors to access patient medical information by 75 per cent. It has also reduced the time it takes to enter data by 60 per cent. It is hoped that the solution will ultimately help reduce the time taken for each patient consultation by 30 per cent, enabling as many as nine more patients to be treated each day.

The hospital initially considered using bedside computer terminals for the pilot. These not only provided patient entertainment but also access to the hospital's digital patient records. But the units had a serious drawback: their limited ability to allow hospital staff doing their rounds to easily update electronic records. A device called a mobile clinical assistant is being used instead. It is a hand-held tablet computer that allows doctors and nurses instant, on-the-go wireless access to patients' records. The device can also document a patient's condition in real time, improving working practices and reducing administrative workload.

"The mobile clinical assistant will help us to significantly improve the level of care we offer our patients," says Khalid Mal Salama, a spokesman for KFMC. Mr McCarron says: "Everything in hospitals moves very quickly. The only thing that moves slowly is information. The solution effectively removes the boundaries to accessing information." The devices used in the pilot were Motion C5 tablet PCs from Motion Computing running Microsoft's Windows XP. But Mr McCarron stresses this product is not the only type of hardware that will start appearing on hospital wards in the Middle East.

"This is not about a one-device-fits-all approach. Different alternatives may be more suitable in other environments," he says. Apple, for example, is also trying to promote the use of its tablet computer, the iPad, in health care. Its supporters believe the real potential for the iPad in the medical field will lie in the ability to write custom applications for the hardware.As well as providing a number of bundled applications at the point of manufacture, the iPad has access to Apple's App Store, which now offers more than 140,000 applications.

Christine Chang, a healthcare technology analyst at the research company Ovum, says: "Mobile health is one of the most exciting areas right now. iPhone apps, for example, that help patients track their diet, exercise and medications will empower patients to take control of their own health." But consumer devices such as the iPad and the iPhone were never designed for the rigours of a busy hospital; an environment where purpose-built devices such as the Motion C5 tablet computers used in the KFMC pilot may have an edge. Staff who go from one sick bed to another must avoid carrying germs on the touch screens of portable devices.

"As well as functionality, it is also important to judge hospital devices from an infection perspective," Mr McCarron says. "The Motion tablet can easily be disinfected and is designed to be splash proof." Just as important as the portable devices are the wireless networks that support them. In the case of the KFMC Children's Hospital, a Cisco wireless network was used. "The reliability of the wireless network and back-office software is crucial as, when a system goes down, nurses and doctors will usually say the hardware isn't up to it," Mr McCarron says.

There is a growing belief across the region that it is essential to ensure that new IT dovetails sufficiently with workaday hospital routines. The strategy of thoroughly testing the latest technology in a traditional hospital environment may one day help to reassert the Middle East's historic reputation as the home of enlightened medical treatment. Shiraaz Joosub, the chief IT architect to the greenfield project Sidra Academic Medical and Research Centre in Qatar, told the third annual Middle Eastern Healthcare Expansion conference in March: "Safety and effectiveness of technology in health care ultimately depend on its human users, ideally working in close concert with properly designed and installed electronic systems.

"Any form of technology may adversely affect the quality and safety of care if it is designed or implemented improperly or is misinterpreted." [e-mail]