CEO of King Saud University Medical City (KSUMC), Dr Ahmad Hersi, provides an overview of the prominent hospital group and Saudi Arabia's oldest and largest academic medical centre, offers insights into KSUMC's collaborations with international organizations, its focus on prevention and pre-hospital care, and establishing itself as one of the leading centres for clinical trials in the Riyadh region. In addition, he outlines the medical city's strategy for talent attraction and retention.

 

Could you tell us a little about yourself and your career trajectory?

I am a cardiologist and electrophysiologist by training with additional qualifications including  an MBA and a Master’s in Clinical Epidemiology. I am actively involved in conducting clinical trials. With 18 years of professional experience, I have held various leadership positions within King Saud University Medical City (KSUMC). Beginning  as the head of cardiology, I later became the head of the cardiac centre. Subsequently, I was appointed as the Chief Medical Officer (CMO), and for the past four years, I have served as the CEO of this institution.

I also served as a consultant to the Ministry of Health from 2014 and 2015. During that period, I spearheaded the response to the initial outbreak of MERS. I worked closely  with the World Health Organization (WHO) as a member of an international committee, developing a blueprint for MERS R&D and research.  Furthermore, I have played a key role in driving the healthcare sector’s transformation initiatives in Saudi Arabia.

 

Can you tell us more about King Saud University Medical City?

KSUMC stands as a prominent hospital group in the region, serving as the oldest and largest academic medical centre in Saudi Arabia. Established in 1970 as the first university hospital affiliated with a medical school, KSUMC has evolved significantly  from its origins as a small downtown Riyadh hospital. Presently, it comprises three distinct hospitals: King Abdelaziz University Hospital, renowned for its expertise in otorhinolaryngology (ENT) and ophthalmology; King Khaled University Hospital, a comprehensive tertiary care facility; and the world’s largest dental hospital, officially acknowledged by the Guinness World Records in October 2023. With an impressive capacity of about 1,300 beds, KSUMC manages a substantial patient load, including approximately 1,200,000 outpatient visits, 67,000 admissions, 34,000 surgeries, and around 190,000 emergency visits on an annual basis.

 

Last year, KSUMC signed a memorandum of understanding (MoU) with the US-based Houston Methodist Hospital, what was the rationale behind the move?

We are currently in the process of implementing a strategic objective focused on collaborating with international organizations to facilitate technology and knowledge transfer, as well as to glean insights from their expertise. Our MoU in this regard is notably ambitious, with the primary goal of enhancing staff training across various critical areas including quality, innovative care delivery, and patient experience. Following the signing the MoU, numerous exchange visits have been organized. We anticipate that the comprehensive benefits of this partnership will materialize by the fourth quarter of 2024.

Furthermore, in September of last year, we entered into another significant agreement by signing an MoU with an Italian group to establish the joint operation for our cardiac centre. This partnership entails the creation of a special purpose vehicle entity that will oversee the management of the centre. We are currently at an advanced stage of this collaboration and anticipate finalizing the business model in the near future. These strategic initiatives are core to our goal of positioning ourselves as a premier academic healthcare centre in the region.

These international collaborations are in alignment with the new vision set forth for KSUMC, which strives to rank among the top 10 universities and medical centers globally. This vision has led to government support, allowing us to break free from bureaucratic constraints and concentrate on fostering innovation, attracting top talent, and effectively commercializing our research endeavors.

 

How are you leading the shift towards a more privatized and clustered healthcare system with the 21 health clusters across the country? How has the experience been so far?

Undoubtedly, the current landscape is quite challenging, given the significant changes that are underway. These changes are not only altering our operational practices but also impacting regulations and the overall landscape of the sector, leading to a comprehensive transformation. This transformation places a considerable amount of pressure on management to remain updated on best practices and to consistently deliver world-class services. Consultancy firms have played an important role during this period of change, offering meaningful perspectives into best practices and illustrating how other organizations have managed similar transitions. Attracting top talent is another critical aspect of our strategy. However, this process is inherently dynamic and presents its own set of challenges that require ongoing attention and adaptation.

Having a strategy in place, with the support of consultants, is one thing, but implementation is crucial. We are privileged to have a leadership team that understands the need for support and provides the necessary resources. Saudi Arabia has invested significantly in talent, producing well-trained physicians and healthcare workers. Many of our consultants and doctors are graduates from Canada, the US, and Europe, bringing back valuable experience to implement here.

This approach significantly facilitates the transition process as it alleviates the need for substantial investment in capacity building, given that, we already have a pool of well-trained professionals at our disposal. KSUMC has a long-standing tradition of sending doctors overseas for training, a practice that dates back to the 1970s. Those who trained me were trained in Canada, which has been instrumental in shaping our training programmes here. While we can always use more doctors, we are fortunate to possess a critical mass of highly skilled Saudi physicians who are adept at caring for our population and mentoring the next generation of healthcare professionals. This solid foundation of a well-trained medical professional equips us to navigate the ongoing transformation with confidence and efficacy.

 

What opportunities do you see for enhancing the services you have been operating for years?

One significant opportunity to improve healthcare services in Saudi Arabia lies in capitalizing on our country’s strong connectivity. With 97 percent of the population being well-connected, we are situated in a unique environment with the essential tools to advance remote and telemedicine services. This includes the utilization of wearables for data collection aimed at disease prevention and the integration of artificial intelligence (AI) to elevate patient care standards. Saudi Arabia stands at the forefront of incorporating AI and connectivity into its healthcare system, placing us in an advantageous position to harness these technologies for streamlined and effective healthcare delivery.

Moreover, our young population presents a significant opportunity for proactive healthcare intervention. Given the elevated incidence of non-communicable diseases such as obesity, diabetes, and hypertension, there is a prime focus on prevention strategies and lifestyle modifications. The government’s efforts to improve infrastructure for sports and physical activities create a foundation for the health sector to heighten public awareness and promote lifestyle changes. By shifting the focus of care upstream, our goal is to prevent diseases rather than solely treating them, thereby ultimately cultivating a healthier society in the long term.

 

Prevention is a key pillar of Saudi’s healthcare transformation. How do you see the role of prevention evolving within your institution, and what steps are you taking to push the frontiers in this area?

Prevention is crucial in our healthcare strategy, prompting us to transition from a model centered on hospital-based care to actively participating in accountable care organizations as part of this transformation. The delivery of care should not start in the hospital; we must bolster our capabilities in the primary care sector. This shift involves expanding primary care services and the tailored training of our healthcare workforce to meet these evolving needs effectively.

Furthermore, pre-hospital care holds significant importance in our healthcare approach. For example, in the context of heart failure management, we prioritize the management of risk factors before patients are admitted. We have specialized clinics that are dedicated to addressing these risk factors and providing proactive care to patients, aiming to effectively manage their conditions before they escalate. Our goal is to address lifestyle-related issues and prevent the onset of diseases, emphasizing a preventive healthcare approach from the outset.

One of our recent initiatives involves screening the relatives of young individuals with type 1 diabetes for autoimmune diseases. Recognizing the autoimmune component of type 1 diabetes, we aim to identify and intervene in family members to prevent the onset of diabetes. This proactive approach in screening and early intervention is expected to yield significant long-term benefits in terms of disease prevention and management.

In essence, the shift towards prioritizing upstream care necessitates a fundamental change in the mindset of healthcare providers. While it requires an upfront investment, both from institutions and the government, the long-term benefits such as decreased disease burden and improved overall health outcomes make it valuable and worthwhile pursuit. By emphasizing preventive measures and early interventions, we can pave the way for healthier lives and a more sustainable healthcare system in the future.

 

Digitalization and AI are creating significant buzz in healthcare. How do you see their impact on healthcare delivery and excellence?

There is indeed a lot of hype around AI in healthcare, but it is essential for us to actively embrace this technology rather than waiting for it to be fully proven. AI has the potential to revolutionize healthcare, particularly in the realms of diagnostics and service delivery optimization.

In diagnostics, AI shows great promise, boasting algorithms that can surpass human capabilities in terms of diagnostic accuracy. Nonetheless, there are challenges, including the need for a legal framework. Patients still prefer human interaction, and the existing legal system is not adequately equipped to address issues arising from AI diagnostics, such as accountability for erroneous diagnoses. Moreover, the responsibility for updating AI algorithms with the latest medical knowledge remains a concern. Despite these challenges, AI can streamline processes by prioritizing the reading of medical images, allowing human radiologists to focus on more complex cases.

In terms of delivering care and optimizing services, AI plays a crucial role in managing waiting lists, addressing patient no-shows, prioritizing screenings, and flagging issues that require immediate attention. These AI applications streamline care processes, enhancing efficiency without the legal implications often associate with diagnostic applications.

Within our hospital, we acknowledge both the potential and the limitations of AI. Many of our AI projects are research-focused, particularly in diagnostics, due to licensing and validation issues. Different populations might respond differently to certain algorithms, making it a moving target. While there is a lot of hype, we are investing significant time, effort, and research into AI, recognizing its potential to revolutionize healthcare delivery.

 

Can you share any initiatives or work being done in clinical development to advance R&D, particularly with regard to clinical trials?

We have established ourselves as one of the leading centres for clinical trials in the Riyadh region with our clinical trial unit being among the first in the area and earning a strong reputation. Approximately 40 to 60 percent of our trials are industry-sponsored, while 30 to 50 percent are investigator-initiated clinical trials, reflecting our academic institution’s commitment to research.

Notably, we have led the way in conducting the first-in-man device trials in the entire MENA region, demonstrating our eagerness to be at the forefront of clinical research. We believe that clinical trials not only benefit patients but also contribute positively to the economy and overall healthcare system by raising care standards.

We conduct phase two, three, and four medication trials and have also ventured into phase one device trials, marking significant achievements in our clinical research capabilities. This continuous effort demonstrates our unwavering commitment to advancing clinical development and R&D in the healthcare sector.

 

You mentioned that you are looking to advance medical practices by nurturing future generations of health leaders. Can you tell us about your approach to talent attraction and retention?

We have a comprehensive strategy for talent attraction and retention, especially considering our role in educating medical students, residents, and fellows. As the first medical city in Saudi Arabia, KSUMC is at the forefront of education and talent attraction.

Our approach to nurturing future health leaders is multifaceted. Firstly, we offer continuous professional development courses to help staff develop essential skills and meet the requirements of leadership roles. These courses are tailored to different levels of leadership, from managers to executives, and may involve in-house training or sending staff to reputable organizations like INSEAD and MDI for non-degree-based training.

We also use various tools and vendors to assess the training needs, aptitudes, and personalities of our leaders. This ensures that our training programs are targeted and effective, addressing the specific needs of each individual rather than applying a one-size-fits-all approach.

Additionally, we support the development of healthcare MBAs among our leaders. Most of our leadership team hold MBAs in healthcare from various institutions. This combination of medical and management training ensures that our leaders are well-equipped to handle the complexities of running a healthcare institution.

To further support this, we have implemented a policy requiring robust training for anyone in a leadership position. Since I became CEO, this has been a priority, and we have invested significantly in leadership development. This investment is paying off, as it ensures that all leaders within our organization speak the same language and understand the same concepts.

We also focus on process improvement training. For example, we have trained a significant portion of our hospital staff in Lean Six Sigma and Balanced scorecards, ensuring that each department has people who understand and can apply these principles to improve efficiency and address specific challenges within their areas.

Overall, our philosophy is to educate and empower our staff, giving them the skills, they need to identify and solve problems within their departments. This approach not only improves the quality of care we provide but also fosters a culture of continuous improvement and professional growth.

 

Has KSUMC received any international recognition thus far? How important are awards in amplifying your work?

Recently, KSUMC has been honoured with two prestigious awards, being named Hospital of the Year in Saudi Arabia and recognized as a Green Hospital. Our pioneering efforts in addressing greenhouse gas emissions, including the implementation of a solar system that reduced our electricity consumption by 16 percent, have been instrumental. We have achieved a 46 percent reduction in energy consumption  through the adoption of measures, such as using LED lighting and low-energy solutions.

Our efforts have led to our recognition as the Green Hospital by Healthcare Asia. Moreover, we received an award for being the best performing hospital in Saudi Arabia in terms of prevention and innovation in oncology care. One of our unique initiatives includes providing chemotherapy at home, which ensures safe and efficient treatment for our patients. This initiative, along with our broader home healthcare services, reflects our commitment to pushing the boundaries of patient care and delivering innovative healthcare solutions.

 

What do you hope to be remembered for at KSUMC once you take on your next challenge?

I aspire to leave a lasting legacy at KSUMC by nurturing capable, well-trained successors who can lead the institution to greater heights. I have full confidence in the exceptional talent within KSUMC, and I believe that they have the ability to elevate the institution to the new levels of success.