Aster's Alisha Moopen: Gulf healthcare should look to home, not hospital

DUBAI: Gulf health care needs to move out of the hospital and nearer the home according to Aster DM Healthcare deputy managing director Alisha Moopen.

The group is investing heavily in technology to help the remote monitoring of patients, freeing up hospital beds for acute care.

It has already pioneered home-based intensive care in India and Moopen believes the concept could also be extended to the Gulf states such as Saudi Arabia where there is no shortage of hospital beds but a gap at the primary care level.

It comes at a time of huge upheaval in the regional health care sector where a decade of rampant hospital-building aimed at high-income patients has come unstuck, mirroring similar trends across the retail and residential real estate sectors.

“There is a strain because of the oversupply in general,” said Moopen, the daughter of founder Dr. Azad Moopen, who grew the company from a single clinic in Dubai in 1987 to become a vast regional health conglomerate employing more than 17,000 people.

“Everyone came in and set up for the top 10 percent of the population but at the bottom end there is a huge gap,” said Moopen in an interview in Dubai.

Now regional health care groups such as Aster are recasting their operations to adapt to the changing patient profiles in cities such as Dubai.

Aster runs 25 hospitals across the GCC and India in addition to 116 clinics and 238 pharmacies.

In Saudi Arabia, the group operates the Aster Sanad Hospital in Riyadh, a 218-bed facility with another 69 beds in the process of being added as a part of an expansion plan.

Moopen sees the Kingdom as a big health care opportunity even though it is already well served with hospital beds.

“They have a lot of beds already in the system but what is missing is the primary care link. With the disease patterns you are seeing right now, what you really need is people to be managed at the primary care level. The incidence of obesity, diabetes and hypertension is huge so it requires a lot of effort in terms of lifestyle changes. I don’t think building hospital after hospital is the answer,” she said. “Primary care intervention is really what
is required in Saudi Arabia with its disease pattern and population demographics.”

More than 13 percent of hospital beds in Saudi Arabia are currently occupied by long-stay patients, according to the “Essence of Extended Care” report from KPMG.

The report said there is strong evidence to show health care provision in the Kingdom is far more skewed toward traditional hospital-based services than the world’s best performing health systems.

KPMG estimates OECD countries spend about 28 percent of their health care resources on inpatient care, compared to 47 percent in Saudi Arabia.

The consultancy believes Saudi Arabia has huge potential to make greater use of technology to improve out-of-hospital care, home monitoring and tele-medicine.

Aster is already investing heavily in such technology.

“Technology is the key thing going forward,” said Moopen. “We have remote lifestyle disease programs. How do I know how many steps I’ve taken per day? How do I know what my blood sugar levels look like? You don’t need thousands of doctors, you just need a health management team that can take care of the wider population. This is an area we will invest in.”

Moopen said that a key factor in reducing the overall incidence of lifestyle diseases in the Kingdom was getting the payment model right between the health care provider and the ultimate payer — whether that is an insurance company or the government.

“Outcome-based measures and incentives are what need to be there to get you from a fee-for-service model to an actual improvement in the
health index.”

Aster is also investing in the home care sector and recently acquired a specialist home care health company in Abu Dhabi. In India, it has also been able to deliver the services typically reserved for an intensive care unit (ICU) in a home setting.

“In India, we have even delivered an ICU from the home — where if you have a ventilated patient who has to stay 90 days in a hospital it doesn’t make sense for the patient and it doesn’t make sense for the health system. So we have been able to move the patient back into their home and provide the care that is needed and ensure that they are monitored as efficiently remotely.”

Moopen sees huge potential for this approach in the Gulf.

“It comes back to culture,” she said. You don’t want your parents as they get older being in the hospital for long extended periods. If there is a way they can be closer to you but still get the proper care being rendered, that is ideal.”