NEOM is not just an innovative project; it’s a mind shift, according to Hany ElOsman, Head of Computational Medicine & Digital Health Tech CMD
Personalised medicine is the ultimate goal in healthcare. But given the challenges facing the sector, such as workforce, interoperability and many more, it’s not necessarily within our grasp at the moment. Nevertheless, the vision remains, particularly in Saudi Arabia’s new region of NEOM, where an integrated health, well-being and biotech ecosystem is creating an unparalleled endto-end system that is entirely centred on the individual.
With world-class treatment and inclusive care, NEOM is harnessing innovative technology, research and education to become a global leader in the field. Heading up the computational medicine and digital health side is Hany ElOsman, who reports to Dr Mahmoud Yamany, Sector Head Health, Wellbeing & Biotech, across all aspects of data application and technology infrastructure including medical devices and clinical integration.
Hany’s background is in clinical laboratory medicine with a focus on haematology and immunology. In the early years of the internet he became fascinated by the potential of computer technology and, as he says, he realised there was a better way to serve the healthcare community than grading leukaemia slides in a basement laboratory.
A former Epic project manager in Damman and a clinical transformation programme manager at University of Washington Medicine, in 2019, he was selected by NEOM to lead their digital health programme. He encouraged them to view healthcare from a completely different perspective, that of computational medicine which applies methods from computational sciences, engineering, and mathematics to improve the understanding and treatment
of human diseases.
Hany, please explain how NEOM’s approach to healthcare is unique.
Medicine is different from any other field as it’s intimately related to a person and their location, genes, environment and way of living. Algorithms in medicine now view humans as a whole body system in relation to environment and genetics, as opposed to the traditional way of examining individual diseases and organs. So, in today’s world, we should be looking at medicine not via the disease or the condition, but by population-based mapping based on behaviour, environment and genetics. We can also apply methods from computational medicine to improve understanding and treatment of human diseases. Interestingly, the genetic portion only forms 25-35 per cent of the whole equation.
When I joined NEOM to lead the computational medicine and digital health for health, wellbeing and biotech, I advised that they should shift the healthcare system from the traditional reactionary mode into a more proactive mode by using data. Many of the systems that we buy in the Middle East are built and designed for a particular geographical region in countries with policies and insurance platforms that are not relevant to us. Currently we are heavily reliant on these technologies, but if we are willing to make a bold and deep move, we can rethink our approach and create our own systems.
How are you aiming to achieve this goal?
We are starting with a population health management approach to understand our population. There are 110 different nationalities now living in NEOM so we have a wide genetic pool represented in the population. There are close to 5000 full time employees and 75,000, contractors and transient workers, so we have a broad potential variety of sickness and disease. This information will help us build the first medicine system in the Middle East that could become a model that we can offer to our fellow GCC countries and Africa. At the same time, it may be a way for us to shine so we no longer become solely a buyer, but actually contribute to the future of medicine and healthcare.
We have finished our pilot phase that has proved that the data works, and that the system can function in diagnosis and assessing probability. Now we are entering phase two where we start connecting it to healthcare, for example to the genetic lab, the environment, and even with the socio-economic determinants through the NEOM digital ID that analyses shopping behaviours and other habits.
What does this mean from a healthcare data perspective?
The pilot project was voluntary, so people were able to opt out. But we made it clear that if only their medical records were accessible then the probability of proactively predicting their future health would be 40 per cent. However, if they are willing to share more information, there would be a much better indication. In this way, a citizen will be part of the equation, not just a listening body or an innocent bystander.
During the pilot, we interviewed people and asked questions such as: how would you like your healthcare system to function? Some participants were just looking for a simple technology and only wanted to know the cost, while others wanted to know if they were going to die of a heart attack like other family members.
What role does digital health play in NEOM’s vision for health and wellness?
People need to understand why they should do something, rather than because the doctor tells them to do it. Right now, for example with wearables, you could receive an app notification that shows your A1 haemoglobin reading is 7.9. Good, but what does that mean? Currently, you have to find the time to meet with your physician who has only ten minutes to explain it to you. But we owe patients a proper explanation.
Part of the problem is that, although wearables are helpful, they are marketed as consumables so it’s easy to stop using them. In NEOM, we don’t want to give people wearables for the sake of it. We want to become an authoring environment where we decide and dictate what type of data set is actually relevant to our population.
For this reason, we are introducing a gamification pilot phase that shows patients the relationship between these data points and sickness or wellness, so they are part of the equation. If a patient feels they are part of the recipe, he is not just a customer waiting for a chef to prepare something for him.
I remember one of my professors saying that if you ask an individual before they are diagnosed with stage four lung cancer if they’re willing to share their data, they often say no. But the minute they are diagnosed, they are willing to share that data even with the milkman if there is a glimmer of hope for treatment.
How do you reach populations that might be a little bit less used to dealing with such ideas?
By defining rules and responsibilities. When we say we want the system to bring people into the equation, we’re building it in a gamification mode. I remember in Seattle I saw a couple in their 70s in the park looking for something. When I asked if they needed help, they said they were playing Pokemon Go, which made me realise everyone likes to play games.
What happens if you are diagnosed with an illness or a condition? If you are educated, you might go to Google, but you will end up with seven to nine different diagnoses that might not apply to you. Someone else might ask their neighbour or friends. But if we build it in a simple gamification, the patient is now part of the equation. They can ask questions based on knowledge. It’s important that everyone takes an interest in their own health and becomes used to asking the right questions.
For this reason, we’re building a wellness pod for children and our very first client will be the NEOM hospital. Here the children can do a vital signs check and through gaming and videos begin to understand, for example, the consequence of eating a lot of chocolate and not exercising. So this generation will grow up dealing with digital health as the norm.
Healthcare solutions should never take choices away. I should not stop anyone from eating a cheeseburger, but at least I can educate them about reducing the amount of times they consume them. That’s a plus.
Do you think people will be worried about losing their privacy?
We aren’t going to build this system in one day because it’s actually a movement. And as a movement, everyone feels empowered and part of it, so they will want to grow it. But if it’s just a system that we are building and then throw at people, it’s going to fail. For this reason, it needs to be supportive rather than directive. Again, this idea comes from computer games where assistants begin by giving suggestions, so people learn as they guide and support them.
In itself, NEOM is more of a capability build rather than a structure. It’s a mind shift from ‘let’s just get money and go buy cars’, to thinking that in Neom there is a great opportunity to change minds somewhere, whether it’s mobility or healthcare or biotech. We have to take this chance.
Do you think your vision will be followed by other healthcare systems?
I don’t know about the NHS, but we’re getting a lot of good traction from the US where we sent the system for third party review without telling them it’s from the Middle East. They liked the concept design and the data architecture, and how it addresses healthcare overall. They have asked to use the prototype but we said it wasn’t the right time.
How much do you think NEOM will show us what the future looks like in digital healthcare?
I have lived several times in Saudi Arabia and the new generation of Saudis is completely different from the generation of 1985,1995 and in 2001. To the Saudis of today, NEOM is not just a product; NEOM is a mind shift.
In my own view, we know everybody will become ill. But if I can slow down that prognosis of sickness and put the power back into the communities and save 10 per cent of the population in the first year, then 20 per cent the next year, we can free up the clinicians to treat people who are really sick. By focusing on population health and computational medicine, we can identify the right treatment plan and put a dollar amount to it. But for this to happen, we have to engage the people and bring them along with us. At the end of the day with healthcare, the key ingredient is participation.
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