7:00 am - 8:45 am

Continental Breakfast
Sponsored by DaVita
Healthcare Partners

Saudi – US Healthcare Forum 2015 Registration & Continental Breakfast

The Ritz Carlton
Al Hada Area, Mekkah Road
Riyadh - Saudi Arabia

9:00 am - 11:30 am

Workshop #1

Building the Framework for Successful Healthcare Infrastructure Projects

Worldwide, current demand for infrastructure is about $4 trillion in annual expenditures with a gap of at least $1 trillion every year. It has been well documented that public sector money alone cannot bridge this gap. Against these facts, infrastructure provides one of the most important areas for private sector alternative investment, particularly as this type of asset offers the necessary conditions for better balanced long-term investment strategies through deployment of public private partnerships. It is important that such projects be bankable and represent the best value for money in terms of delivery models. Much progress has been made in disseminating best practices for delivery models created through public-private partnerships -- which can offer a convenient way to access private sector capital and can also offer a clear advantage in transferring risk to the one party, amongst a number, that is most capable of managing it. Such a dedicated infrastructure asset class could also attract investors assessing their long-term portfolio strategies which, typically, are in good alignment with the lifetime of such operating assets.

These principles are equally important for countries looking to build or expand their social infrastructure (e.g., health and education). Moving from broad principles of worldwide application, to nation-specific considerations, to particular case studies, the speakers for this workshop will address the following topics:

• Steps appropriate to a nation’s Mitigation of Political & Regulatory Risk In Infrastructure Projects – including thoughts on a current World Economic Forum report of the same name.
• Steps appropriate to deploying a successful national PPP Program, with “lessons learned” from projects present and past – as well as from current efforts to structure renewed national PPP Programs.
• Steps appropriate to deploying a successful Healthcare PPP within the current political and regulatory environment of the Kingdom of Saudi Arabia.
• Relevant case studies, including a successful healthcare PPP that shifted operating risk from the sovereign to a healthcare system under agreement to deliver population health management in return for largely capitated payments.

9:00 am - 11:30 am

Workshop #2

The Challenge of Medical Research: From Bench to Bedside

Translational research takes basic scientific discoveries and translates them into effective treatments and tools that improve quality of life. It's commonly dubbed “bench to bedside” research, referring to the scientist's lab bench and patient's bedside. Translational research also goes the other way, from the clinic to the lab. For instance, a medicine may provide benefits for some individuals. But researchers don't yet understand why or which individuals will benefit most. These situations provide opportunities for physicians and therapists to work closely with scientists doing basic research. Developing these partnerships is an important goal. Scientific discoveries and technological developments, when translated to industrial mass production, must go through painstaking engineering studies and amplification experiments to achieve suitable and stable results. Especially in the health care industry, which involves human lives, the scrutiny of new products must be particularly meticulous, and the road from research to clinical use can be extraordinarily long. In many countries, research institutes and universities are the main force of technological advancement, but because of a lack of intrinsic motivation, external economic support, and social resources such as closely related capital investors, the percentage of inventions that go to mass production is less than 30%. Scholars mostly concentrate on the pioneering side of technology, but research at this stage shows a low degree of technological maturity. The intrinsic high risk in health care R&D severely limits its rapid promotion, resulting in a number of failed industrialization attempts. On the other hand, industry demands mature and low-risk technologies and is very reluctant to put money into projects that show low short-term return. Again, in the health care industry, it takes years of research and application to acquire a regulatory approval. Few companies have the patience to babysit seedlings; thus, their experience in finance and operation helps little when it comes to the translation from a laboratory into a company.

9:00 am - 11:30 am

Workshop #3

Improving Innovation in Healthcare Delivery: Socially Effective vs Cost Effective

Limiting the growth of health care costs while improving population health is perhaps the most important and difficult challenge facing global healthcare policymakers. The role of innovation in advancing these social goals is controversial, with many seeing innovation as a major cause of cost growth and many others viewing innovation as crucial for improving the quality of patient care and innovative outcomes. Academics and professionals argue that mitigating the tension between improving health and controlling costs requires more-nuanced perspectives on innovation. More specifically, they argue that policymakers should carefully distinguish between innovative activities that are worth their social costs and activities that are not worth their social costs and try to encourage the former and discourage the latter.

11:30 am – 1:00 pm

Prayer / Lunch break

1:00 pm – 3:30 pm

Workshop #4

Hospital System Challenges: Insurance & Electronic Record Training

While a range of challenges face the efficiency of hospital management, the collection of patient data health does not flow among healthcare systems in a cohesive or standardized way. Entities within the healthcare system face challenges when collecting race, ethnicity, and language data from patients, enrollees, members, and respondents. Explicitly expressing the rationale for the data collection and training staff, organizational leadership, and the public to appreciate the need to use valid collection mechanisms may improve the situation. Nevertheless, some entities face health information technology (Health IT) constraints and internal resistance. Indirect estimation techniques, when used with an understanding of the probabilistic nature of the data, can supplement direct data collection efforts. Although hospitals, community health centers (CHCs), physician practices, health plans, and local, state, and federal agencies can all play key roles by incorporating race, ethnicity, and language data into existing data collection and quality reporting efforts, each faces opportunities and challenges in attempting to achieve this objective. Considering the market for cooperative health insurance in Saudi Arabia started with only 1 company in 2004, it currently involves about 25 companies. The introduction of a cooperative health insurance plan within the region is intended to decrease the financial burden on Saudi Arabia due to the costs associated with providing health services free-of-charge. It will also give people more opportunity to choose the health services they require. The real challenge for policy-makers in Saudi Arabia is to introduce a comprehensive,fair and affordable service for the whole population. Clearly, lessons can be learned from the experiences of other countries, including the advantages and disadvantages of different private-public strategies.

1:00 pm – 3:30 pm

Workshop #5

The Need & Importance of Individual Certification & Institutional Accreditation

Although the words ‘certification’ and ‘accreditation’ are often used interchangeably as meaning the same thing, in healthcare they have a distinct difference. Specifically, ‘certification’ usually refers to an individual health professional who has been credentialed (“certified”) after meeting certain requirements including passage of an examination. On the other hand, ‘accreditation’ is a word applied to the approval an entire institution, organization, or program such as a hospital or clinical laboratory, or an educational program or school, usually based upon adherence to standards as determined by an onsite inspection team. Yet, the two concepts are similar in many ways: both are non-governmental, historically voluntary processes by which an eligible individual or institution is publicly recognized as meeting standards of competency or quality as determined by either examination or on-site inspection. While they are each non-governmental private sector entities, increasingly over the years, both in the US and abroad, certification and accreditation agencies have partnered with governmental bodies to improve and maintain the quality of practitioners and institutions, either as an alternative or supplement to regulator inspections and licensure examinations. This workshop will examine the role of both given their respective, and critical, impact on the healthcare sector.

1:00 pm – 3:30 pm

Workshop #6

Regional Organization of an EMS: An American Example

Regionalization of EMS is defined by the American College of Emergency Physicians as "a systematic method of bringing patients with time-critical illness to designated facilities in a defined geographic region with the capabilities and resources immediately available to provide appropriate, specialized treatment." In the US, there is a renewed emphasis on the development of evidence-based, national performance measures for EMS.Regionalization is an important component of this overall strategy that seeks to optimize individual patient and population outcomes; maximize specialized and limited resources; and avoid fragmentation, redundancy and waste. The U.S. has wide variability in EMS systems, even within a single state such as California. Regionalization solutions in urban vs. rural systems and those with volunteer vs. private vs. public (firefighter) EMS providers differ markedly.This workshop will describe key factors essential for EMS regionalization, including the importance of integration of information technology. Participants will have the opportunity to work through a series of case studies including addressing the controversies surrounding hospital diversion policies and designation of specialty receiving centers.

8:30 pm - 11:00 pm

Evening Activities

7:00 am – 8:20 am

Continental Breakfast
Sponsored by AECOM

Saudi – US Healthcare Forum 2015 Registration & Continental Breakfast

The Ritz Carlton
Al Hada Area, Mekkah Road
Riyadh - Saudi Arabia

8:30 am - 9:30 am

Opening Plenary of Saudi – US - Healthcare Forum: New Era of Outbreaks

Saudi Arabia and the United States have been close partners in health cooperation for over three decades. Currently, a number of U.S. scientists have collaborative National Institutes of Health grants with Saudi partners. The Centers for Disease Control and Prevention (CDC) has a long history with the Saudi Ministry of Health and Saudi Arabian National Guard Health Affairs; both have hosted CDC experts for one to two year stints and work with the CDC on infectious disease surveillance during the yearly Hajj pilgrimage. CDC also works closely with Saudi Arabia on a range of issues including smoking cessation, breast cancer awareness, control and prevention of diabetes and heart disease, and epidemiology and surveillance of infectious diseases. In keeping with its interest in developing knowledge-based industries, Saudi Arabia and the U.S. together have significantly expanded their joint scientific research and technological development.

9:30 am – 9:40 am

Session Break

9:40 am - 10:40 am

Gates Foundation Keynote Panel: Innovation in Vaccines

Vaccines, by any measure, are among the most impactful public health strategies. For just 25 dollars, a child can be protected for life against a range of deadly and debilitating diseases. Still, millions go unvaccinated either because of inequitable access or because effective vaccines do not yet exist for many infectious diseases, especially those that plague the world's poor. The solution requires a global approach covering basic science to local distribution and administration. The last 15 years have seen great progress towards these goals. The Bill & Melinda Gates Foundation and others have invested billions of dollars into developing new vaccines. Gavi, the Vaccine Alliance has brought together governments, NGOs and the private sector to bring prices down, bring new manufacturers online, especially in developing countries, and build delivery systems for routine immunization in the world's poorest countries. A worldwide effort to eradicate Polio forever, the Global Polio Eradication Initiative, is implementing a strategy to reach every last child, in some of the world's remotest and most unstable regions. The world's increased preparedness was tested with the Ebola outbreak in West Africa. Despite the disease spreading rapidly in the first months of the outbreak, an incredible mixture of science and bravery has ensued in the race to develop, test and deliver a vaccine. This panel will explore how the world, and Saudi Arabia in particular, is participating in one of the most powerful movements in global health.

10:40 am – 10:50 am

Session Break

10:50 am - 11:50 am

Good Governance Critical in Sustainability of Healthcare Quality

Public demand for healthcare services is increasing, along with raised expectations over the quality of care. At the same time, the healthcare providers have to cope with financial pressures and a need to demonstrate long-term sustainability while coping with major systemic changes. In this context, it is important to have robust governance arrangements to help manage "best practices" way through the myriad of complex, and sometimes competing, challenges facing professionals in the medical sector. In many healthcare systems/institutions, there are well developed governance arrangements that support strong performance. However, over the last few years, financial governance has advanced at the cost of clinical governance and this imbalance needs to be addressed, especially since there is a very slow transition towards governance and decentralization in the public sector.

11:50 am – 12:20 pm

Prayer Break

12:20 pm - 1:20 pm

The Shift from Communicable to Non-Communicable Diseases

Generally, in the past two decades, there has been a dramatic shift in the causes of the NCDs in the Middle East whereas in 1990 communicable diseases accounted for more than 70% of premature death. With a decrease of more than 15% during the past 20 years, the main causes of disease burden in the Middle East have shifted from infectious and communicable diseases to NCDs because of improved health standards in the region. Based on the WHO Fact Book for 2010, cardiovascular diseases account for 42% of the total mortality rate in 2010 in Saudi Arabia. Concentrating on NCDs programs related to these diseases is, therefore, justified. They are preventable, curable if detected early, and cost effective. Additionally, the World Health Organization Fact Book for 2014 demonstrates the proportion of mortality caused by NCDs.

1:20 pm – 1:30 pm

Session Break

1:30 pm - 2:30 pm

Private-Public Partnerships

The Kingdom of Saudi Arabia has ambitious plans to increase healthcare provision across the country. This session focuses on models of delivery for new healthcare infrastructure, the hospital buildings and surrounding environment including energy conservation solutions and utilities provision. It also, focuses on Models of public–private partnership in healthcare provision. The PPP3 model, according to the Bulletin of WHO (2006), in which a public authority contracts with a private company to build or run a hospital is, inevitably, seen mainly in countries with national health services. Various models have been developed, such as: Franchising : Public authority contracts a private company to manage existing hospital; DBFO (design, build, finance, operate) : private consortium designs facilities based on public authority's specified requirements, builds the facility, finances the capital cost and operates their facilities; BOO (build, own, operate): Public authority purchases services for fixed period (say 30 years) after which ownership remains with private provider; BOOT (build, own, operate, transfer): Public authority purchases services for fixed period after which ownership reverts to public authority; BOLB (buy, own, lease back): Private contractor builds hospital; facility is leased back and managed by public authority; Alzira model: Private contractor builds and operates hospital, with contract to provide care for a defined population.

2:40 pm -

Luncheon & Keynote Address: "The Importance of Halal Vaccines"

Opening Remarks:
Abboud Bejjani,
Regional VP / MEAP,
AbbVie

Keynote Speaker:
Dr. Muhammad Munir Chaudry,
President,
The Islamic Food and Nutrition Council of America

In Islam, the human body is holy. During his keynote luncheon address, Dr. Muhammad Chaudry, President of the Islamic Food and Nutrition Council of America (IFANCA), will define the need for a well-orchestrated industry strategy to create acceptable pharmaceutical vaccines, for the human body, that are halal "certified." To be "certified" as halal, Muslim scholars agree that Shari`ah provides a divine law of mercy that should be applied on all Allah’s creations, including animals. Now that other goods and services, besides food, are being "certified" as halal, including pharmaceuticals, it is important that transparency be implemented according to an acceptable and universal halal "process." If possible and properly certified, the development of halal vaccines would benefit the millions of Muslim pilgrims who journey annually to Saudi Arabia from the four corners of the world. For this reason, in the manufacturing of new halal vaccines, it is very important that they be formulated without contamination from any "haraam" ingredients, such as pork by-products.

7:00 am – 8:20 am

Continental Breakfast
Sponsored by DaVita
Healthcare Partners

Saudi – US Healthcare Forum 2015 Registration & Continental Breakfast

The Ritz Carlton
Al Hada Area, Mekkah Road
Riyadh - Saudi Arabia

8:30 am - 9:30 am

Benefits of Knowledge Transfer Between KSA & USA Including Continuous Education and Training of Manpower

There are great opportunities for both the exchange of knowledge transfer between the USA and KSA as well as employment opportunities between the two regions. The diversity of career and lifestyle opportunities available range from large tertiary hospitals in the major capital and regional cities, to smaller hospitals in regional locations, providing exposure to a wide spectrum of clinical and social experiences. The government of Saudi Arabia has given high priority to the development of health care services at all levels: primary, secondary and tertiary. As a consequence, the health of the Saudi population has greatly improved in recent decades.

9:30 am – 9:40 am

Session Break

9:40 am - 10:40 am

How to Improve Patient Safety: A Basic Tenet of Medical Practice

Healthcare professionals and their staff are anxious to deliver safe medical procedures. When shown effective methods for changing systems to make them safer, doctors, nurses, and pharmacists eagerly and energetically embrace them. A critical mass appears now to have been reached. Indeed, it may not be hyperbole to say that a deep cultural shift on this issue is underway. At its core, this shift means redefining how to accomplish one of the basic tenets of medical practice: patient safety. The vital first step is to recognize that, as in other complex fields of science, technology, engineering, and human endeavor, errors in medicine are caused by failures in the systems and organizations that human beings build. That said, healthcare organizations, doctors' groups, regulators, government agencies need to support healthcare standardization to ensure universal patient safety is a priority. In a study for Aljarallah and Alrowaiss ( 2013), The review of the records of the Medical Violation Committee (MVC) revealed 642 cases, most of which were from hospitals run by the Ministry of Health (MOH). The operating room was where most of the errors (20.4%) had occurred, followed by the emergency room (18.1%). Surgery was at the top of the specialties (25.1%). Most of the deaths occurred in surgery and obstetrics (about 25% for each), followed by other medical specialties (17%). About half of the lawsuit cases studied (46.5%) involved patients belonging to a relatively young age group (20-50 years). Most of the medical error litigations involved surgeons and obstetricians especially in MOH hospitals.

10:40 am – 10:50 am

Session Break

10:50 am - 11:50 pm

The Future of Primary Healthcare

While the long-term success of the Accountable Care Organizations (ACO) construct is not assured, its value and longevity will be measured by the ability of ACO partners to drive cost reduction while improving care quality and patient experience. Healthcare systems are cautious but increasingly keen on leading the formation of ACOs to avoid the risk of being left behind. According to a recent industry survey, 74 percent of hospital chief executives say that their organizations will be part of an ACO within the next five years. In addition, 16 percent of the respondents believe they already have the components for ACOs in place and 60 percent say they will have ACO components in place within the next five years. Primary care providers (PCPs) are interested in ACOs given their focus on managing across the care continuum with a strong emphasis on primary care. Specialists tend to be more cautious because ACOs encourage the shift of services from specialty to preventive care, as well as rationalize the use of expensive procedures and testing. However, even they are pursuing participation in ACOs to replace lost volume and gain a share of the anticipated savings. For this reason, 52 percent of physician group leaders indicated that their organizations will be part of an ACO within the next five years and 20 percent say they already have ACO components in place. Health care services in Saudi Arabia, according to EMHJ (2011), have been given a high priority by the government. During the past few decades, health and health services have improved greatly in terms of quantity and quality. Despite these achievements, the Saudi health care system faces many challenges which require new policies for PHC by the Saudi Ministry of Health (MOH), as well as effective cooperation with other sectors.

11:50 am – 12:20 pm

Prayer Break

12:20 pm – 1:20 pm

The Challenges of Managing Health Information

The lack of an information infrastructure to facilitate the conducting and rapid dissemination of relevant research present a major challenge to patient care and safety. Most hospitals lack an information infrastructure to use/analyze evidence at the point of care. Because of the absence of a health data collection system, patient policy and public health decisions that can affect the outcome of a clinical diagnosis become delayed which could otherwise rapidly assess and avert serious public health threats had there been access to a data bank of information. To date, the organizational, financial, legal, technical, and operational challenges of creating and sustaining health information infrastructure have been highly variable and technically idiosyncratic and have yet to produce sustainable business models that could be used in universal applications. To accelerate the growth of regional, or global, health information infrastructure, a more uniform and cost-effective approach is needed. As these infrastructure solutions evolve, these entities, or health information systems could provide critical data sources to accelerate the dissemination of health research. If done successfully, these databases could, over time, reduce the reliance on administrative data sets. While legal and operational policies are needed to oversee the use of these databases, both the private and public sectors will need to work together to determine appropriate requirements for confidentiality, informed consent, approved uses, and access fees.

1:30 pm -

Luncheon & Keynote Address: "America's Perspectives On and Benefits From Knowledge Transfer with the Arab World"

Opening Remarks:
Steve Lutes,
Executive Director,
U.S.-GCC Business Initiative & Director, Middle East Affairs,
U.S. Chamber of Commerce

Keynote Speaker:
Dr. John Duke Anthony,
Founding President & CEO,
National Council on U.S.-Arab Relations

In his 52nd year of studying and working on the Arab world, Dr. John Duke Anthony continues to examine ways to strengthen and expand the Arab – U.S. relationship. He continues his role as Founding President and CEO of the National Council on U.S. – Arab Relations to enhance awareness and appreciation of the need to strengthen and expand America’s relations with its strategic allies and working partners. A particular emphasis remains how best to further the goal of enhancing American knowledge, understanding, and appreciation of the unrivaled pivotal position and role of Saudi Arabia in the Arab countries, the Middle East, and the Islamic world.

1:45 pm –

C3 Saudi - US Healthcare Forum 2015 Closing