ceo 360 degree perspective gcc healthcare df ppt oct 09 · increased private investments immediate...

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360 Degree CEO Perspective of the

GCC Healthcare Industry

© 2009 Frost & Sullivan. All rights reserved. This document contains highly confidential information and is the sole property of Frost & Sullivan.

No part of it may be circulated, quoted, copied or otherwise reproduced without the written approval of Frost & Sullivan

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© 2009 Frost & Sullivan All Rights Reserved

Agenda

The GCC Healthcare Industry OutlookAOverview By AreaB

Top 10 GCC Healthcare Trends1.

The Healthcare Crisis2.

Shifting Healthcare Expectations

Convergence in Healthcare

3.

4.

Healthcare Infrastructure1.

2. Medical Technologies

Emerging Geographies5.


The GCC

Healthcare

Industry Outlook



The Healthcare Crisis

Top 10 GCC Healthcare Trends

GCC Introduction


ProjectedImpact on the

GCC HealthcareIndustry

High Impact

Low Impact

Certainty

Low High

2008– 2018

Top 10 GCC Healthcare Trends


Patient Centric Care

and Holistic Approach

2008 20182013

Power Patient

Generation

Major Trend

GCC Healthcare In Pace With The Other Developed Regions

Customized

Solutions

Personalised

Healthcare

Private

Investment

Hospitals Go

Virtual

Smarter

Drugs

Devices Become

Monitors

Innovation vs.

Knowledge

Government

Initiatives

Health

Insurance

1

2

3

4

5

6

7

8

9

10

Selective and Customized CarePatients gain access to

health quality information

Initiation Customised Adoption Process

Holistic healthcare Solutions

One Stop Solution Customised Services &

Products Complete Customization

Genetic Testing

Targeted Clinical Trials

Information based medicine

Major diseases understood at molecular level

Wellness Care Presymptomatic diagnostics

& treatments

Increased Private Investments Immediate Private Investment OptionsMore Private Companies invest in

facilities and services

All departments/buildings within

hospitals are connected

Medical communities

become interconnectedRegional/Country-wide

Connectivity

Non-invasive delivery Drug cocktails will enhance productivity, memory,

and physical performance

Disease management Remote Patient Monitoring Self-monitoring

Increasing Expatriate Medical professionals keep

up with knowledge growth.In – House

Big Pie in Healthcare services Liquidating Healthcare Equilibrium

Expansion of Domestic

Insurance SectorIncreased Adoption and

Upgrading regulatory framework Customized individual insurance plan


� Healthcare is challenged by Five interlocking crisis that make present healthcare systems unsustainable:

� Manpower Crisis

� Less Private Investments in Healthcare

� Regional Concentration

� Health Sector Reforms

� Health Insurance

Healthcare Crisis Faced By The GCC Countries

The GCC governments currently provide the lion’s share of health-care financing today—approximately 75 percent. To lessen the government burden, all GCC countries have recently

passed, or are in the process of passing, health-care insurance legislation.

Health Insurance

Manpower Crisis

GCC counties has ~75% expatriate physicians and ~80% of

expatriate nurses population

Majority of the GCC countries require more aggressive reforms and government regulations in areas like health insurance, clinical trials, medical devices and

pharmaceuticals

Health Sector Reform

Currently government holds majority of the healthcare investments (~70% ). The total hospital bed requirement is going to be more than double by 2018

Less Private Investments in Healthcare

Most of the healthcare players are focused only in major cities / towns

Regional Concentration


Macroeconomic Indicators Of The GCC - Improving Slowly

The GCC GDP in USD Bn

4 %

3 %

2.4 % 2.8 %

3.9%

2.9%

GDP in USD Bn

(2008)

Healthcare Spending

as % of GDP

The GCC GDP grew at ~7% per year between 2002-2008

GDP is expected to reach ~1267 USD Bn by the year end 2018

Economic integration within the

region

Government reforms

Supportive demographics

Accumulation of wealth &

financial liquidity

Drivers for Growth

The Highest GDP growth rate is expected to be achieved by Saudi Arabia, Oman and Bahrain by the year 2018

More spending need to achieve international standards

GDP Growth: The growth of GDP is expected to be grow at a CAGR of 4.8% by 2018

Gross domestic product (GDP) Expenditure on health does not exceed more that 4% in any GCC countries

© 2009 Frost & Sullivan All Rights Reserved 8

Total Healthcare Expenditure country wise USD Bn

Average 2256

GCC has the lowest per capita total

expenditure on health when

compared to most regions of the

world

Macroeconomic Indicators Of The GCC Countries –High Income But Low Healthcare Spending

The new insurance law is expected to have positive impact on healthcare expenditure

More spending on healthcare infrastructure and facilities are required in order to take the healthcare services to higher level

to match international standards

Demand of quality healthcare services are going to impact the per capita expenditure in future

Saudi Arabia and UAE are expected to account for almost 76% of the total market value


GCC Country wise Population in MnPopulation Age Density (in %)

Age Structure in GCC Vs Other Regions (in %)

Demographic Driving Healthcare Demand

The GCC Population in MnGCC Country wise Population in Mn


Projected Increase In Treatment Demand In The GCC By 2025(%)

Digestive diseases

Skin diseases

Nutritional deficiancy

CNS disorders

Road traffic injuries

Dental & Gum diseases

Non Infectious Respiratory diseases

Infectious diseases

Occupational diseases

Maternal & Perinatal conditions

Endocrine disorders

Congenital Anomalies

Cardiovascular Diseases

Diabetes

Sense Organ Diseases

Masculoskeletal diseases

Cancer

Other Injuries

Urogenital diseases

Mental disorders

Average Growth

Rate of Treatment

Demand = 240%

Average Growth

Rate of Treatment

Demand = 240%

Governments in the region have begun to focus on preventive care for lifestyle

diseases.

Lifestyle diseases such as diabetes, high blood pressure, heart disease, and obesity

account to 50% of deaths in the Gulf region.

The public healthcare system largely focuses on general treatment and is under equipped to

deal with affluence-related ailments.

Heart diseases related to diabetes were responsible for 31% of all deaths in 2008.

The proportion of nationals suffering from diabetes in the UAE has reached 24%, the

second highest in the world.

Rise in Lifestyle Diseases Creating Challenges

2006

2025


A Major Boost Will Come From Mandatory Health Insurance

Welfare Model

Market Model

A shift from…..

Drivers …..

�Currently GCC approach to healthcare is less efficient and will eventually become so expensive as to be unsustainable

�High native birth rates

�A growing aging population burden

�A steep rise in the incidence of chronic illness

�Poorly controlled inflation

�Technological innovation and increasing medical complexity�Rising healthcare expenditures

Shift of more of patients from public sector to private sector healthcare

The presence of private health insurers should improve the transparency of healthcare spending and benefits

throughout the GCC.

Abu Dhabi has licensed 27 players; Saudi Arabia has licensed 11, with 14 additional players awaiting their

licenses.

Governments are moving to healthcare models that require employers to

provide some level of coverage, as well as opening up their markets to private

insurers.

An increase in private-

sector participation in healthcare

Unprecedented opportunity to design,

early on, an optimal insurance model to fit

the population

Opportunity…..

Increase in burden of private healthcare

leading to more private participation and new

players

Privatization

of public health assets as a logical next step toward equilibrium


Consumer Experiences In Other Markets Affecting Expectations From Healthcare

Greater variety of providers, products and services e.g. expensive health plans and alternative medicine services

Power patients have increased access to computers and information through multiple channels to seek and analyse health information


Predictive tests

Disease Management

Gene Mapping &

Functional Analysis

Tailored Treatments-

Genomic/Proteomics based

Preventative Programmes

Health Management

Bio Chips: Controlled Released

Delivery Systems

Telemedicine

Remote Patient Monitoring

Drug Delivery

IT / Digital Information Systems

Nanotechnology

Convergence In Healthcare Enables A Preventative Approach To Healthcare

Medical Devices

Medical Technologies

Life Sciences

Technology…….Enables it

Economics………………Require it

Demographics………….Demand it

Enabling personalisation, targeted medicines, new drug delivery mechanisms, virtual patient monitoring tools, and

allowing a preventative approach to healthcare


A Modern Healthcare System Is On The Horizon Demanding

A Healthcare Paradigm Shift

Unorganised Sector Healthcare Organized Sector

...From

Partial Out of pocket payments Cost Insurer or Employer paid

Provider Centric Focus Patient Centric

Centralised – Hospital Monitor De-Centralised–Shift to Community

Curative Approach Preventive

Lager Infectious Disease BurdenLarger Infectious Disease Burden

DiseasePattern

Increase in lifestyle driven diseases

Discreet Healthcare System Comprehensive Healthcare

...To

Low Quality; Low Volume Quality High Quality ; High Volume


GCC Emerging Geographies

Saudi ArabiaHigh oil prices supported by

non-oil sectors such as finance, construction, transport, communication and

petrochemicals;

United Arab Emirates

Growth supported by domestic credit expansion, high population

growth, infrastructure spending and the vibrant non-oil sectors

KuwaitGrowing oil sector, huge projects in

pipeline for non-oil sectors.

QatarGrowing oil and non-oil

sectors, hydrocarbon boom, billing up large

external and fiscal surpluses

Oman

Service sector, oil and gas based industry and hydrocarbon. Post

BahrainMain driver are non-oil sectors,

financial services, manufacturing and tourism. Ongoing

diversification plan


Agenda

The GCC Healthcare Industry OutlookAOverview By AreaB

Top 10 GCC Healthcare Trends1.

The Healthcare Crisis2.



3.

4.

Healthcare Infrastructure1.

2. Medical Technologies

Emerging Geographies5.


Healthcare

InfrastructurePrivate Investment – A Major Opportunity

Expatriate Dependence

Emerging Markets

Snapshot of Infrastructure Details


Infrastructure Details Of The GCC Countries

Private hospitals are relatively new in the region and their role in healthcare provision is limited. However, Qatar and the UAE have

made significant headway in recent times

The growth of private healthcare services in the region, especially in Saudi Arabia and Oman, has stagnated in large part because of

the availability of free public services

Private hospitals tend to profile themselves either as providers of comprehensive services or by specializing on the treatment of

complex diseases

Governments in the region are actively providing incentives to attract private sector players, although the economic rationale of

some of the measures is debatable.

Oman has the lowest private sector participation in the region

Usually Private sector runs more hospitals but the number of privately controlled hospital beds is lesser

Expatriates in the region can access government healthcare services at heavily subsidized prices

Bahrain has been a pioneer in allowing the private sector to operate hospitals as early as in 1992.


Number of beds: Country – Wise Number of beds required up to 2018

Volume Growth

Infrastructure Details Of The GCC Countries

59%

22%

49%

9% 17%

22% 30%

Key Drivers

Growing Population

Matching Recommended

Standards

Increase in Health

Expenditure

Government Health

Reforms

Increasing Health

InsuranceIncrease in

Lifestyle Diseases


Heavy Dependence On Expatriate Healthcare Staff

Expatriate Physicians Expatriate Nurses

Expatriate Pharmacist


Joint Ventures

Increasing Private Initiative A Major Opportunity

Private hospitals are relatively new in the region and their role in healthcare provision is limited. However,

Qatar and the UAE have made significant headway in recent times

The growth of private healthcare services in the region, especially in Saudi Arabia and Oman, has stagnated in

large part because of the availability of free public services

Private hospitals tend to profile themselves either as providers of comprehensive services or by specializing on

the treatment of complex diseases

Governments in the region are actively providing incentives to attract private sector players, although the

economic rationale of some of the measures is debatable.

Privatization of Public departments

Drivers of Private Investment Growth

Encouraging Corporate and

cooperative Projects

Subsidies for private projects

Federal Health Insurance Scheme

Fair & Liberal allocation of medical

licenses

Providing technical advice to

private players

Integration of Private & public

players

Providing equitable playing fields

Incentives through land & licenses

FDI in 2007 (USD Bn)FDI in 2007 (USD Bn)


Medical

TechnologiesKey Opportunities

Future

Key Trends

Technical Innovation


Technical Innovations Will Shift Healthcare From An Acute “Find It And Fix It”System To A “Wellness Tracking” System In GCC

Current Healthcare Systems

Suffer from the

“RADAR” Syndrome

Electronics Health Records (EHRs)

Chronic Disease Management Systems

Clinical solutions – Decision Support

Tools, Research Tool and Reference Tools

Disease Management Program

Home monitoring devices

Personal Health Records

Web- based education and support

Patient Scan

Good Chronic

Disease care

Patient Patient

Support Support

ToolsTools

Telehealthfor virtual interactions

Sharable Sharable

PersonalPersonal

Health Health

RecordsRecords

Web portalsto EHR Systems

Provider Provider

Support Support

ToolsTools

� System oriented to acute illness

� Patient’s role not emphasised

� Follow up sporadic

� Prevention overlooked

Patient then disappears from radar screen

� Patient Appears

(falls sick)

� Patient is treated

“find it and fix it”

� Patient is discharged

Future Healthcare Systems

Must Apply a

“GPS” Logic


20072007Volumetric Imaging SystemsWeb Based PACS

20102010Multimodality SystemsMobile/Roaming PACS

20152015Image Enabled Electronic Health Records

Medical Imaging

Medical Imaging

Interoperability Key To Adoption In An Increasingly

Patient-centric Healthcare Delivery Model

20072007

Networked Modular Systems

20102010Move from Critical Care towards Sub Acute Care

20152015

Monitoring of Patients at Home

Patient Monitoring

Patient Monitoring

20072007

Clinical Systems

20102010Next Generation Integrated Clinical & Financial Systems

20152015Personal Health Management Systems & Tools

Healthcare IT

Healthcare IT

MedicalImaging

Healthcare IT

PatientMonitoring

The 3 areas are converging driven by a reorganization of HC

delivery. From large scale hospital care with high density of

specializations and technologies to a network of competence

centres achieving high quality outcome and economies of

scale, linked with primary and long term care facilities.


Snapshot of Potential Opportunities – GCC

Mammography

Ultrasound

CT

MRI

X-Ray

3D Imaging S/w

CAD S/w

PACS

EMR

PAS

CPOE CIS

LIS

CDSS

Primary Care IT

Anesthesia Care

Obstetrics & Neonatal

Vital Signs Monitoring

Critical & Cardiac Care

ProjectedRevenues In

2012

High Revenues

Low Revenues

Growth Rate (2007-2012)Low High


Next Generation Clinical, Administrative And Financial IT Systems & Applications Enable Medical Error Reduction, Clinical Optimization And Evidence-Based Medicine

Mainstream Adoption by 2012

� To facilitate and standardize care delivery, investment will go into sophisticated clinical, administrative and financial systems such as the EHR, CPOE, PACS, ERP and Enterprise

Scheduling Systems.

� The use of wireless devices within hospitals will increase to the point where coverage and quality-of-service issues will almost disappear.

Mainstream Adoption by 2020

� Regulatory compliance will have a slow but steady influence, particularly in the area of disaster recovery and business continuity.

� Clinical vendors offer more-comprehensive and affordable remote-hosting and high-availability options

� Organizations that have already made the leap to “Next Generation” systems will be looking to further leverage their investments through physician and patient portals, remote access applications and mobile extensions.

20072007--20122012CardiologyPACS/CIS

PACS/RISERP for

Healthcare

CPOE

Remote Monitoring

Enterprise Scheduling

ePrescribingEHR

Physician &Patient portals

eVisits

Emergency DeptAutomation

20122012--20202020

Patient Self-Service Kiosks

Personal “Cradle to Grave”Health Records

EHR Access Through Bedside Multimedia Terminals

Tele-Pathology

Disaster Recovery & Business Continuity

Integrated Clinical/Financial Systems

ICU Telemedicine

Ambulatory EHR

Personal Health Management Tools

Critical CareIT Systems

� While “return on investment”

remains a critical factor for Health

organizations when deciding IT

investments, it will not become the

sole factor in determining the value

of IT on service quality or outcomes.

� Home healthcare could evolve from a

sporadic practice today to a

mainstream care delivery model in the

next 5-10 years.

� Services like Online Consultations,

In-home Vital Signs Monitoring and

Online Disease Management

increasingly gaining momentum.Context Management

CCOW Protocol

Speech Recognition

Electronic Data Interchange

Tablet PCs& PDAs

Enterprise MPI

Distributed Antenna Systems

20072007--20122012

Natural LanguageProcessing

VoIP

Biometrics

Business Process Management

Hand-writingRecognition

RFID

BluetoothWirelessNetworking

Grid Computing

Data Lifecycle Management

SemanticInteroperability

Semantic Web

Service OrientedArchitecture

Home HealthServices

20122012--20202020


With The Goal Of Creating A Single View Of A Patient’s Health Information, Hospitals Are Investing In Technologies To Pull Together All Departmental Systems Into An Integrated EHR

Intensive CareCardiology

Nursing

Pharmacy

Radiology

Laboratory

EHREHR

Emergency Room

SurgeryRehabilitation

Home Care

GPs/Physicians

Billing/Finance

� Integration cost represents 15–20% of hospital IT budgets

� Main cause is lack of adequate healthcare IT standards

� Current messaging and technology standards are not universally used in all product portfolios

� interoperability between systems using all or some of these standards has not been convincingly validated, while some of the standards conflict with one and other.

� Integration cost represents 15–20% of hospital IT budgets

� Main cause is lack of adequate healthcare IT standards

� Current messaging and technology standards are not universally used in all product portfolios

� interoperability between systems using all or some of these standards has not been convincingly validated, while some of the standards conflict with one and other.

StandardisationStandardisationLegislationLegislation

Regulations Governing Healthcare Stakeholders Regulations Governing Healthcare Stakeholders Regulations Governing Healthcare Stakeholders

InitiativesInitiatives Business ComplianceBusiness Compliance

95/46/EC95/46/EC

HIPAAHIPAA

Single Market RegulationsSingle Market Regulations

Messaging StandardsMessaging Standards

Terminology StandardsTerminology Standards

Integration InterfacesIntegration Interfaces

JCAHO & NCQAJCAHO & NCQA

CEN TC 251CEN TC 251

21 CFR 11 21 CFR 11

Corporate ComplianceCorporate Compliance

Business ContinuityBusiness Continuity

IT SecurityIT Security


Strong Foundations Required to Foster Widespread Adaptation of eHealth Models Medical Technologies Industry Has The Opportunity To Build & Shape The Future

eHealth

Ensure ClinicianBuy-in

Encourage LargeScale Pilots

Use InternationallyAccepted Interoperability Standards

Enable Policies

Personalized

Health Care

Add Value for

Patients & Providers

High Quality, Safe

Health Care

Individuals Self-

Manage their Health

Improved Public

Health

Lower Cost

Health Care

Security &

Fraud Detection

Foster Adoption


The Magnitude Of Growth, The Need For Fast Retrieval, 24/7 Availability And Improved Record Management Is Forcing A New Look At Operational Data Management

2020

2015

2010

2005

Integration Images forContext Based Medicine

3D – 4D ImagesVideo Images

Digital Cardiology

Digital X Rays

Exa Bytes

Tera Bytes

Giga Bytes

2020

2015

2010

2005

On the MoveData Access

Enterprise-wide PACS

Cardiology PACS

Radiology PACS

Data Generation Data Access and Communication

Data Storage

� No other industry in the past has

required such a phenomenal amount

of data to be stored for such long

periods of time.

� Enterprise-wide databases are

expected to grow 30-fold during the

next decade.

� The amount of data generated, used and stored in the modern healthcare environment is increasing

dramatically every year.


PACS & Software Services To Drive Growth In Medical Imaging Market

� Modality markets not

likely to show

considerable growth

� Image management

tools and services to

contribute to greater

market share.


Move From Critical Care To Sub-Acute Care EvidentRussia & China High Growth Markets For Patient Monitoring Equipment

• © 2009 Frost & Sullivan. All rights reserved. This document contains highly confidential information and is the sole property of Frost & Sullivan

• No part of it may be circulated, quoted, copied or otherwise reproduced without the written approval of Frost & Sullivan

• Frost & Sullivan takes no responsibility for the information supplied to us by manufacturers or suppliers or users

• This Market information is based primarily on secondary sources, interviews and therefore, is subject to fluctuation and Frost & Sullivan takes no

responsibility in terms of arriving at any decision so made as a result of this information

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3

Dorman Followwill, Partner & VP Healthcare, Europe,

Israel & Africa

Dorman Followwill is Partner, Executive committee director and Vice President Healthcare Practice for Frost & Sullivan Europe, Israel and Africa (EIA). He works closely with companies in the healthcare space supporting several key new business development initiatives in EIA.

Followwill is instrumental in Driving the Chairman’s Series on Growth for the EIA region. Followwill headed sales as member of the Executive Committee for EIA, and drove record margins in 2008 for the region; he also manages Presentation and Sales Training initiatives.

Followwill has driven several Consulting Business Development Successes in Europe including PlasmaSelect Healthcare, Merck Chemicals and Montagu, a leading private equity firmHe earlier worked with Frost & Sullivan’s Healthcare Practice in North America, as Global Vice President, moving onto becoming a partner. In his North American stint, Followwill, was responsible for generating total of $6.8M in margin over the period 2002-2005.

Followwill has spoken at numerous industry events and conferences and has been featured in leading healthcare media

Dorman FollowwillPartner, Executive Committee Director & VP HealthcareEurope, Israel & Africa

BA, The Management of Organizations - Stanford University

ceo 360 degree perspective gcc healthcare df ppt oct 09 · increased private investments immediate...

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