The global surge in coronavirus cases in early 2020 caused an almost overnight disruption to clinical services. A solution for continuing critical clinical care of all patients alongside the need to minimize human-to-human contact had to be found quickly.
In April, Mediclinic Middle East rolled out its coordinated telemedicine service. This allowed patients who would typically attend one of our units in person to access assistance from the comfort and safety of their homes. This is how it’s worked out so far...
Finding a safe space
Mediclinic Middle East’s hospitals and clinics are found in three United Arab Emirates (UAE) cities: Abu Dhabi, Dubai and Al Ain. With seven hospitals and more than 900 inpatient beds, we serve many people in our communities with a variety of serious health problems.
Our patients may be receiving ongoing cancer treatments, having planned surgery, or may come to us with an acute medical emergency, for example.
Our hospitals are complemented by 20 clinics offering diverse services to fully meet the primary healthcare needs of the local population. Our patients come to us for wide-ranging reasons, including dentistry, maternity services, bariatrics, family medicine, breast cancer screening, and many more.
In addition to serving the local resident population and expatriate communities, we welcome international patients for elective surgeries and procedures. Our highly regarded cancer treatment center in Dubai is popular with overseas patients, for example.
When the coronavirus began to cause serious problems and compromised the safety of our clinics in the UAE, it was clear that we would need to work swiftly to take care of our patients in a new, unprecedented way.
Our patients needed to stay home, and we needed to move online.
Moving forward
We wanted to continue to provide the same seamless experience our patients are used to.
Our patients benefit from a multi-disciplinary setup which minimizes inconvenience and makes good use of central administration. In more usual times, our patients can easily go between our hospitals and clinics to access the appropriate consultations and treatments as necessary.
Indeed, a foundation of our ability to provide the highest quality clinical care is our excellent infrastructure. Rigorous high standards have been established and care processes are regularly vetted by both our own and international standards.
Maintaining this high standard of continuous care was of paramount importance as we looked for online solutions. A seamless healthcare experience was a must, even under the most restricted of circumstances.
The solution
Our response to the coronavirus crisis was to introduce a telemedicine service with two parts.
1. Video consultation on demand
Our patients can access (and within a short time frame) an on-demand consultation with a family medicine doctor or general practitioner.
The service operates within our normal working hours in the UAE (Saturday to Thursday, 9am to 5pm). Patients can access appointments through a web-based platform, found through our website and powered by an independent telehealth company.
This service fully replicates our non-emergency clinic service. Patients are able to get prompt advice on their own or their family’s health concerns. They can be referred to a specialist doctor within Mediclinic if necessary.
This on-demand consultation service is complemented by a new pharmacy home delivery service that can bring prescriptions for new or existing health conditions.
2. Pre-booked video consultations with specialists
This enables specialist doctors to continue the care of all their usual patients. Patients seeking advice for new health conditions can also access this service, either through referral by a general practitioner or by their own request.
Our website has a comprehensive listing of all our clinical staff, enabling patient choice. Telemedicine appointments with their choice of doctor can be booked through our dedicated contact center.
In addition, physical consultations remain available at both our hospitals and clinics, if required. The appointments follow strict COVID-19 safety guidance and infection control protocols to ensure patient safety. To increase patient choice at these times, many of our hospital-based clinical staff are also seeing patients in our clinics.
Our findings
Our telemedicine system has been very successful. Here are some of our findings, also discussed in more detail by Dr. Rahul Goyal, a consultant in family medicine, at the HIMSS & Health 2.0 Middle East Digital Health Conference & Exhibition on December 1, 2020.
1. More face-to-face time with patients
It surprised many colleagues when they found that telemedicine appointments often improved communication and dialogue for two reasons.
Doctors say they spend more time focused on their patients during video appointments and are less inclined to look away at computer screens as they would in an in-person appointment.
Secondly, more time is spent in preparation for each appointment. This has improved patient-doctor dialogue and has gone some way in off-setting the inability to make a physical examination.
Less stressful consultations
Physicians are also finding that online appointments are less stressful because they are able to better prepare themselves. There is a resulting reduction in assumptions that leads to high-quality care. This is especially true for patients who have a comprehensive medical picture that has built up through our own records.
In addition, the recent launch of Malaffi, the UAE’s first regional health information exchange, has enabled both doctors and patients to better access longitudinal health records for many more of our patients.
Remote care enabled
The Malaffi system has also enabled very fast access to coronavirus test results through its lab, often before the patient has received the results. This has made timely and appropriate clinical care for patients possible, even remotely.
We have found that telemedicine has been excellent for the home monitoring of chronically ill patients. We are able to do visual checks of the patient alongside the remote extraction of their vitals at regular intervals. This has meant we have been able to alert families promptly regarding the need for inpatient or additional care, as appropriate.
We have been able to provide reassurance when necessary and have found that video conferencing has empowered patients (and their parents when the patient is a child) because they are actively involved in their own care.
Telemedicine has been particularly useful for postnatal care: caesarean section wound checks, lactation consultancy, and even baby massage classes have all worked well online.
Our future with telemedicine
Beyond the COVID-19 pandemic, we now expect to carry on utilizing telemedicine.
We will continue to find new applications for telemedicine where possible to make the best use of our resources and maximize convenience for our patients. There will be an increase in home care services as long as they continue to meet both high-quality clinical care standards and patient preferences.
To do this, we will be further investing in our digital infrastructure. We will also be focusing on upskilling and telemedicine training for our clinical staff. This should improve confidence, which one of the reasons telemedicine was so little practiced until the pandemic.
Just like the American Medical Association, we also call for telemedicine to be a core competency in the UAE for successful medical students.
Telemedicine has proved itself more than worthy of becoming an integral part of Mediclinic’s future.