HRH Princess Haya gives the keynote speech at Leaders in Healthcare 2017
Ladies and Gentlemen,
I am relieved to see that I cannot be easily substituted by a robot – no matter how impressive or technologically advanced it is!
I am once again honoured to be among so many distinguished members of the medical community and pleased to be able to personally welcome you to the UAE, particularly the Emirate of Dubai.
I feel that even in this most advanced technological era, on occasions such as this, seeing friends and familiar faces that I have not seen in a while always reminds me of the importance - and power - of the human touch.
If the exam question were “where would you hold a conference about innovation, technology and future vision”, most students would say the UAE, among other leaders in the region.
Everyone here knows I am allowed to be a little biased, but like the rest of the people who live in the Emirates, I take pride in the nation’s leadership.
The way Dubai has evolved over the past decade is testament to His Highness Sheikh Mohammed Bin Rashid Al Maktoum’s leadership and forward thinking when it comes to innovation and vision.
His Highness Sheikh Mohammed’s desire to make Dubai the best hub for business, financial services, education and healthcare is driven by his sense of duty to the people of the Emirate. He has created a city where people can live and be happy, a reflection of how important humanity is to him.
The UAE’s founding forefathers – the late Sheikh Zayed bin Sultan Al Nahyan and the late Sheikh Rashid bin Saeed Al Maktoum – were of the same mind, establishing a sense of unity across the Emirates, essentially, creating life in the desert in one of the most challenging climates in such a short period of time.
I was especially delighted to hear the focus of this conference is something that we, in Dubai, also excel at – technology and innovation.
We have seen an emergence in the rise of smart technologies across the healthcare industry. The UAE Ministry of Health and Prevention, for example, last month, launched a robotic pharmacy in Al Fujairah hospital, whereby a robot is programmed to perform a number of tasks, from preparing a prescription to arranging stock and taking inventory – all at the click of a button.
Last year, the Ministry signed an agreement with Philips, to launch Tele-ICU, a remote critical care system that offers round-the-clock medical consultancy services in areas of critical care, medical simulation and telemedicine. It essentially links critical care doctors and nurses to ICUs in remote hospitals.
In 2014, the Ministry had also installed first-of-its-kind medical equipment in Al Qassimi Hospital to allow for a robot to conduct catheterisation and cardiac surgery. Two days later, the first successful robotic operation was conducted.
What I am most proud of is that all of the people in the healthcare industry across the UAE are driven to do their best. Our leadership always reminds us of.
The evidence so far suggests that we are making progress, but the road ahead is long and full of challenges that we must overcome in order to deliver our objective of providing the best healthcare for our people.
I am very proud to be able to make a statement that reflects the humility of our healthcare teams. The combination of ambition and humility is the kind of balance that healthcare needs, and here in the UAE, we have that balance. Our leadership has embraced technology to ensure quality, and it has never forgotten its people. Moreover, that is our message to all of you who visit us today. Our nascent system is exemplary in its approach to technology.
There is no doubt that advances in technology have changed many of the things we do, not just in medicine, but in life.
There is no longer a need for us to learn how to read a map – just use Google maps. Mental arithmetic and times tables – why bother, just use a calculator. Learning to drive – why would you do that, with the promise of a driverless car that can park itself?
Like everyone else, I am amazed and enjoy innovative technology, but I do not believe that one should not learn to do things for themselves. We must not accept a future for our children that deprives them of learning the most basic of skills.
Unfortunately, all too often, over-promise and under-delivery are what we experience. Look into the future; if we were to rely fully on available technologies, you would not have travelled to Dubai for this gathering, because you could have joined it on-line!
You would not have had the chance to debate with your peers or listen to the fascinating panels you see today; all you would have to do is download it from the app store. You would not be inspired by a conference like this if you could not meet friends and colleagues, you would just read the Q&A on the website.
With all these fantastic technologies around us, one would be forgiven for asking, “Why do we bother anymore with ‘human’ made stuff?”
Some of the most beautiful artefacts in today’s world, like the ancient astronomical computer known as the astrolabe or the Chinese counting tool we know as the abacus, are valued because they are handmade.
Why do we bother to even visit a sick friend or have any human contact at all? The reality is, no matter how far technology advances, there is no substitute for the human touch. And this is nowhere more crucial than in healthcare.
While the world is going digital, and advances are made daily in a variety of sectors, many medical technologies are decades old. Even today, a standard medical black bag is more likely to have a 150-year-old stethoscope lying next to a 100-year-old blood pressure cuff, than a new electronic gadget. Designing and adopting new medical technology remains painfully slow, perhaps driven by our caution to save lives, and our conservative approach to risk.
However, despite our conservatism, disruptive technology is already in development for many problems in healthcare. As many of you know, a disruptive technology is a new, unproven, way of doing something that often renders the traditional process obsolete.
Healthcare professionals have traditionally favoured well known, sustainable, continuously improving technologies. They tell me that they find that disruptive technologies lack refinement, often have teething problems, and frequently, despite great technological advances, lack proven practical application.
Genetic data is now readily available to hundreds of people, revealing what medical conditions they are susceptible to. Wearable devices which can measure our vital signs and health parameters anywhere - not just the doctor’s office or in hospital - continue to grow at 20% per year, with over 230 million units sold in 2015.
You might imagine that healthcare is a peculiar place for robotics to take off. After all, caring for someone is one of the more human things we can engage in. And yet robots are making impressive progress, both in terms of what they can deliver, but also in terms of their growing acceptance by both patients and clinicians.
Robots are being used in a variety of ways; training doctors of the future, rehabilitating patients, restoring lost limbs or other body parts, as well as allowing the performance of previously impossible procedures, often with fewer complications, shorter hospital stays, reduced costs and better outcomes.
The Sci-Fi futuristic doctor diagnosed a patient by having them swallow a tiny sensor. The reality is the Pillcam, where the patient swallows a pill equipped with a camera that transmits live video feeds from inside the colon. Science fiction is now a reality.
I suppose the real question is, how can we convert all these advances in technology into tangible benefits for patients? This can be hard because medical education is focused on curing disease using old proven technologies, leaving doctors relatively unprepared to embrace modern ones.
Regulators are also struggling to deal with these innovations, as often there is no available evidence that the introduction of these new technologies conveys any patient benefit, and perhaps more importantly, that they are not harmful.
Patients are just as bewildered by these advances. We may be able to make health sensors available to everyone, but these devices provide raw data, most frequently without explanation of what it means, and no guidance on what to do with the information. Patients soon become frustrated and disengage; the device is then left sitting on the kitchen table.
The internet has made information readily available – anything we do not know, we just Google. So it is not surprising that 90% of patients use Google to research medical information.
In addition, the availability of algorithms, apps, smart health trackers and cheap genome sequencing has handed more power to patients and is allowing them to make medical decisions without consulting doctors. However, without the expertise of physicians, patients can fall prey to misinformation.
A recent report in Scientific American has highlighted patients often rely on information obtained via the internet to make decisions about their health, even though little is known about the accuracy of the medical advice obtained.
Less than 50% of 1300 websites examined contained recommendations that were in line with current medical guidelines, and 20% gave incorrect advice.
The abundantly available information has eroded the once sacred doctor-patient relationship. Recently published research in the New England Journal of Medicine suggests that public trust in the leaders of the U.S. medical profession has declined sharply over the past 50 years with only 34% having confidence in the leaders of the medical profession in 2012 compared to approximately three-quarters of those surveyed in 1966.
There is no question, however, that the public still views physicians as individuals with integrity, with 69% rating them as having very high or high honesty and ethical standards.
It is clear that we have no option but to embrace disruptive medical technologies as otherwise, we are in danger of changing the doctor-patient relationship and alienating our patients.
It may be possible that disruptive medical technologies could lead to better healthcare. Applied correctly, new technologies have the potential to help doctors with routine tasks so that they spend more time with the patients.
Telemedicine, smart health applications, algorithms, data analysis and pattern recognition, may improve the actual process and, when combined with the human touch, lead to more cost-effective treatments, with improved outcomes.
I have already alluded to the difficulty faced in embracing new technology in healthcare. To ensure a successful adoption, we need to equip the physician, the patient, and the system with the right tools and knowledge.
We also need to improve medical training to ensure future generations of doctors are proficient in the use of technology, social media, and digital platforms. Once understood, it is the duty of healthcare professionals to join forces with regulators to ensure that new systems are introduced in a measured and sustainable way, with clear benefits to patients.
We must continue to encourage patients to keep control of their health by providing them with the correct education, and smart devices with which to gather, interpret and act on this information to improve their health.
We must not allow disruptive technologies to become destructive. New technologies should stimulate us into thinking differently; they are not meant to stop us thinking at all. Machines make better decisions when the task is simple, and the answer is certain. This is not always the case, as sometimes there is a doubt, a grey area, where one needs the human brain, pragmatism, experience and often gut feeling to make the right choice.
While a repeat process can be automated to reduce variation and improve outcome, there are parts to every process that require human touch and skill. We must not automate to the detriment of our workforce if there are no clear benefits to our patients.
Automation and use of artificial intelligence may help companies streamline their operations and economise on scarce resources, but it necessitates retraining and absorbing the workforce that is getting replaced due to automation.
In the long run, we have to provide alternatives to the workforce, and not just in mature economies, but also in developing economies with high population growth rates. Failing to do so will dampen economic growth and market performance, and will disenfranchise people.
Last year’s Arab Youth Survey highlighted that the biggest driver for extremism is unemployment. If you are in the medical profession, you can persuade yourself you are saving a life by automating what was previously done by a human, and yet you have taken the jobs of so many others. We need to find a balance where automation is used for good by not hurting human beings who might not be sick but still have families to feed.
Furthermore, who would innovate if we only had standard processes that could be easily automated and controlled by algorithms? Would Sir Roy Cahn have done the first liver, heart and lung transplant? Would we have IVF today? How would you convince traditionalists that Dubai, a city in the Arabian Peninsula, was going to become what it is now?
Look around you at the Burj Al Khalifa, Dubai Canal, Emirates Airlines, the list goes on. These are not the ideas of a machine, but rather, the vision of a great leader, His Highness Sheikh Mohammed, who defied machines and traditional thinking to achieve what many others would have considered impossible.
And most importantly, apart from the architectural prowess that Dubai, and the UAE, are so proud of, look at how the leadership of our nation has created a culture of harmony and peace for more than 200 nationalities.
In the end, if you ask our leaders what was most important to them, they would tell you ‘humanity’. And this is my point, this is where the balance lies – we have seen all kinds of machines and technologies that have created the architecture, but in the end, it was for the benefit of the people, to give them a home for the future. This same balance needs to be struck between innovation and medicine.
With this in mind, I wish you all the very best of luck for 2017 and beyond, and urge you as clinicians, healthcare providers, industry leaders, medical equipment companies, regulators, and insurance providers to work together to ensure that this amazing technological revolution in medicine works alongside doctors to produce the best results, and not replace human beings.