The U.A.E.
has long been working to establish itself as a global hub for healthcare. Since the first hospital was opened in the emirates in the 1960s, the sector has grown exponentially. According to government statistics, there were 45 hospitals in the public sector and 98 in the private sector by 2017.
Data from a 2021 Dubai Healthcare Investment Guide indicates that by 2019, there were six public and 33 private hospitals in Dubai alone. Today, the healthcare sector is a competitive market, with hospitals and holding companies investing in technology and partnerships to offer local and international patients top-of-the-range care.
For the 254-bed American Hospital Dubai, based in the emirate’s Healthcare City, this has meant capitalizing on medical technologies and education to establish itself as a key player. Having invested 25% of its total budget into technology in the last five years, the hospital reports that it saw its total net revenues grow 78% between 2017 and 2021. Since it was established in 1996, it has treated more than a million patients and performed over 150,000 surgeries.
The last two years have seen a swathe of tech-based announcements from the private healthcare provider. In January 2022, it partnered with Siemens Healthineers to give it access to the medical device company’s latest diagnostic imaging and lab diagnostics equipment. Six months previously, in July 2021, the hospital launched a robotic surgery training hub and education academy onsite and at the College of Medicine at Sharjah University in partnership with Robotics Surgical Systems and British medtech company CMR Surgical.
The hospital already has a team of laparoscopic surgeons that are also able to perform, teach, and attest robotic surgeries. “We started with one surgeon; right now, we have 16,” says Sherif Beshara, CEO of American Hospital Dubai, and Group CEO of the Mohamed & Obaid Al Mulla Group, which owns and operates the facility. “You cannot have a center of excellence if you don’t have education or research. So, we are using the latest technology to teach others, to expand our know-how, and to build an American Hospital care network.”
While it works to establish its own regional care network, the American Hospital also benefits from the expertise of the global Mayo Clinic Care Network as one of only a handful of Middle Eastbased international members of the knowledge-sharing organization. The network connects experts around the world so that they can share and learn from the research and experience of multiple healthcare providers. It has more than 40 international members, including Saudi German Hospitals in Riyadh and Cairo, the International Medical Center in Saudi, and the American Hospital Dubai in the U.A.E. “It’s about quality of care,” says Beshara. “They support us in getting second opinions.”
Pooling technology and expertise has led to a number of recent firsts for the American Hospital Dubai. In June 2021, one of its patients—a 72-year-old British
“You cannot have a center of excellence if you don’t have education or research. So, we are using the latest technology to teach others, to expand our know-how, and to build an American Hospital care network.”
Sherif Beshara
expat—became the first to have both his knees, which were degenerating, replaced with implants using a ROSA robotics system. In the October, a 63-year-old Nigerian medical tourist became the first at the hospital to undergo bone marrow transplant treatment, just one month after its bone marrow transplant unit had opened.
“Right now, American Hospital is a destination for complicated patients and surgeries. It’s for people that are really stuck and need a proper solution for their complications,” insists the CEO. His approach to creating a specialized USP for the hospital is one that he has followed since he first took its helm just three and half years ago. Coming from a corporate rather than healthcare background, at the time it was an unexpected career turn for the professional lawyer.
Beshara started out in private legal practice in 1999, holding senior roles in legal counsel for Barclays Bank and Air Arabia before joining the Mohamed
& Obaid Al Mulla Group and becoming its Group Chief Legal Officer in 2017. At the time, the private family-owned business had been active since 1942 and had a diverse portfolio across a number of sectors, including in healthcare through the American Hospital Dubai, which follows American healthcare protocols, governed by an inhouse auditing system, with all 220 physicians American Board Certified or equivalent. Some of the family group’s other holdings include 21.7% of Dubai Insurance, 26.1% of Emirates Investment Bank, and 10.2% of Dubai Refreshments. Five years ago, its new recruit thought he could see some untapped potential.
Beshara approached the board with an idea: an overhaul in the cooperate governance structure to stimulate growth. “They had an amazing portfolio, but they were on silent mode for many years,” Beshara explains. “We suggested dividing the group into four sectors—healthcare, hospitality, real estate, and investment—and recruiting a CEO for the group.” The leadership were convinced to go ahead with the restructuring plan, but the first person to accept the Group CEO position pulled out at the last minute. The board turned to Beshara to fill the role. He stepped into his current position in November 2018, deciding from the start to focus on healthcare. “I was sure that American Hospital was the gate to growth for the whole group,” he says.
At the time, the U.A.E. was investing considerably into its public and private healthcare sectors. Data from the U.S.-U.A.E.
Business Council indicates that in 2018, total expenditure on healthcare for the emirates stood at $18.2 billion, and was expected to rise to $21.3 billion by 2021. According to the World Bank, in 2019 the U.A.E. was spending nearly 4.3% of its GDP on healthcare at $1,843 per capita. By then, the American Hospital Dubai was one of the Mohamed & Obaid Al Mulla Group’s biggest assets, but it had been facing increasing competition from new market entrants for nearly a decade, and that had impacted its results. To get it back on track, it needed new investment to help it rival other big players in the U.A.E.’s burgeoning private healthcare sector and to help it claw back some market share.
Approaching the task from the perspective of a patient, Beshara made innovation and technology core to his new vision for the
hospital, investing in robotics programs across general surgery, gynecology, neurology, and orthopedics. Using robotic tools to perform surgery via smaller incisions is reportedly more precise, more accurate, and less invasive—although even with robotic surgery, the power is still very much in the hands of human surgeons, who control the movements of the robot arms via a console. Faster recoveries and fewer corrective surgeries potentially make robotics cheaper for insurance companies and less risky for patients. For Beshara, the benefits are multiple. “The complications from laparoscopic is much higher than robotic,” he explains. “For me, the main advantage is that you don’t need many narcotics after the surgery, or you don’t need a narcotic or painkillers at all.”
While the hospital expanded with the new tech, it was far from the only player recognizing the opportunities. Globally, as healthcare has continually digitized, the market for surgical robots has risen considerably. According to estimates from Statista, the global market size for surgical robots stood at $4.5 billion in 2016, $5.1 billion in 2017, and is forecast to hit $12.6 billion by 2025. In the U.A.E. alone, Al Zahra Hospital and Mediclinic City Hospital in Dubai, and Cleveland Clinic Abu Dhabi are among some of the biggest private players also investing in the latest robotic equipment.
However, as competition heats up, experts believe that investments in technology should be carefully implemented. “With several competing hospitals in the Middle East racing to adopt the latest technologies, healthcare providers cannot depend solely on new technologies to add a competitive advantage,” says Jad Bitar, Managing Director and Senior Partner at the Boston Consulting Group. “Hospitals should use new technologies to change the way they operate both clinically and how they serve patients. The ensuing paradigm could drastically improve the hospital’s outcomes, in parallel to raising patient satisfaction.”
While American Hospital Dubai’s leadership continued to reassess its infrastructure and its position in the market, early 2020 saw the global Covid-19 pandemic hit. In response, the Mohamed & Obaid Al Mulla Group quickly converted one of its hotel assets, the Holiday Inn Express at Dubai Airport, into a temporary 390bed field hospital purely for Covid-19 patients. The American Hospital closed its two satellite clinics in Barsha and Al Khawaneej and moved nurses to the new campus. “On the first day we opened, I found my housekeeping staff waiting outside the hotel—they were panicking, they didn’t want to enter,” remembers Beshara. His response was to move the entire management team to the hotel, converting one of the boardrooms to a command center and having daily meetings to plan as the situation progressed. “We stayed in the hotel for 55 days; we didn’t spend one night in our homes,” says the CEO.
Dealing with a global pandemic didn’t stop American Hospital from continuing with its investments in technology and research. In early-June 2020, it opened an AI research lab within the hospital’s data center in collaboration with U.S.-based medtech company Cerner to use big data analytics and machine learning to support clinical research and improve operations, as well as collect valuable data on Covid-19 admissions. Later that month, it announced that it was partnering with Cerner and Oracle Cloud Applications for a digital transformation overhaul, implementing
a new electronic health record to help physicians improve care for patients, and a new resource planning platform to help the hospital reduce costs and enhance productivity.
Its developments in AI could put American Hospital Dubai ahead of the curve. “The Covid-19 pandemic has clearly accelerated the transition towards digital healthcare with AI and robotics gaining momentum in the Middle East, but its penetration in the healthcare sector is still lagging compared to more developed markets,” says Nikhil Idnani, Managing Director & Partner at Boston Consulting Group. “While the adoption of AI in clinical decision support is expected, its application in true clinical settings remains contentious.”
In January 2021, American Hospital Dubai and Cerner announced the outcomes of the first model from their AI research lab, which used data to make predictions on Covid-19 patient mortality and ICU admissions. Findings included that the top three chronic conditions contributing to higher ICU admissions and mortality in Covid-19 patients were hypertension, diabetes, and chronic kidney disease. The model also found that the risk of ICU admission for women that tested positive for Covid-19 was higher if they had a body mass index above 25. The lab is now working on its second model, looking at people that suffer from asthma and factors contributing to emergency department admissions.
In the meantime, the CEO is planning local expansion through outpatient clinics and day-care surgeries, while also eying investments in Egypt. And as the hospital’s robotic surgery training hub welcomes new students, he’s still clear on where the real value lies. “You can invest billions in tech, but you cannot drop the human brain. Human capital is number one, then technology, then the vision and strategy and spirit,” he reasons. “Then you press start and go.”