Healthcare Global - July 2014

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TOP 10

Apps for Medical Professionals

SOCIAL MEDIA

McKesson Lessons on effective Supply Chain Management

Delivering better patient outcomes



EDITOR’S COMMENT

Customizable solutions maximize supply chain efficiency I N T H E J U LY I S S U E of Healthcare Global, we feature the Healthcare world as a technology-driven set of businesses driven by patient engagement. In our Hospital sector of the magazine, this issue showcases the problem maintaining your hospital or healthcare business’s brand in the Middle East among the rising intellectual property concerns in today’s healthcare landscape. The Finance section of the magazine holds a feature on choosing the right healthcare loan for your organization, whether it be a hospital, health IT company or private practice. In the Top 10 section of the magazine this month, we feature the Top 10 Paid Healthcare Apps that medical professionals should not be without their smartphone or tablet. Also in the Supply Chain sector this month, we feature an exclusive interview with McKesson’s VP Todd Tabel, as HCG investigates this industry leader’s success. Additionally, be sure to read the Technology section to tune into the conversation of the marriage between social media and healthcare, in order to stay on-top of current industry conversations. Enjoy the issue!

Alyssa Clark Editor Alyssa.Clark@wdmgroup.com 3



CONTENTS

FEATURES

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Technology Sowing Seeds of Social Networking in Healthcare

TOP 10 ‘Paid’ Apps for Medical Professionals

Hospitals Protecting your healthcare brand in the Middle East

14 Finance Finance & Insurance: How to Improve Your Hospital’s Financial Performance

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Supply Chain McKesson VP gives how-to tips for effective supply chain management

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CONTENTS

52 Hospital Metropolitano Vivian Pellas

70

Hospital e Maternidade Santa Joana

COMPANY PROFILES LATIN AMERICA 52 Hospital Metropolitano Vivian Pellas

AUSTRALIA 62 Anywhere Healthcare

BRAZIL 70 Hospital e Maternidade Santa Joana

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H O S P I TA L S

PROTECTING YOUR HEALTHCARE BRAND IN THE MIDDLE EAST A steep price to pay if the brand is not protected W R I T T E N B Y: A LY S S A C L A R K

THE MIDDLE EAST has emerged as an important market, and considering the region’s boost in recent years, it has become one of the most sought after destinations for multinational companies from across the world. However, it is of paramount importance that every company or service provider protects their brands. 8

July 2014

This is true not only for healthcare, but for any other fields. The Middle East today offers splendid opportunities, but along with come a number of difficulties. Not only is it important today to protect your brand, but also send the message across to mischief makers that the brand owner takes the matter seriously.


Trademark protection One of the biggest problems that healthcare service providers and pharmaceutical companies face worldwide is that of counterfeiting. Not so long ago, the world was shocked to discover fake Apple stores in China. More hilariously, there was also a fake Steve Jobs whose face was used to sell those products.

Counterfeit medicines are a global nuisance. Needless to say, they put public health in jeopardy. They also take a severe toll on the brands which are counterfeiting, and cost professionals and service providers their goodwill and ruin reputations. Every year, thousands of lives are lost because the patients were treated with counterfeit medicine. These fake 9


H O S P I TA L S medicines are so sophisticatedly packaged, and are often circulated very convincingly by criminals, that even veteran doctors may fail to recognize them. Similarly, there are a number of other manufacturers who try to pass off counterfeit surgical goods and similar equipment as authentic. Every year, many cases are reported globally when institutions run into legal disputes over trademark infringement. Even hospitals are not immune to such practices. Hence, it is imperative to register

one’s trademark. For starters, trademark registration offers the brand owner the right to use a particular name, logo, phrase or certain words exclusively. Whether for licensing or franchising, trademark registration is a necessary step in any commercial strategy. The Middle East, today, is an important market for any multinational looking for expansion. Hence, it is important that they protect their trademarks and make sure that crooks do not take advantage of them. Moreover, trademark registration is also an important step in building brand identity; and it definitely gives the brand owner an advantage over its rivals. Not only for foreign investors, trademark registration is a must even for local brands. It helps in building market presence, and a big advantage of registering a trademark is that it can help a brand or service providers reach out to the diaspora all over the world. Benefits and price As many Middle Eastern countries are seeing hefty investments in various fields and their economic profiles rise,

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P R O T E C T I N G Y O U R H E A LT H C A R E B R A N D I N T H E M I D D L E E A S T

Brand fraud is a multi-million dollar industry

‘..medicines are so sophisticatedly packaged, and are often circulated very convincingly by criminals, that even veteran doctors may fail to recognize them’

the governments today are alert about the dangers of counterfeiting and are reaching out to investors to help them protect their brands. For example, the UAE has a recordal and complaints system for trademarks, which can be used to enforce action against counterfeit drugmakers. Other countries, like Saudi Arabia, have a number of civil and criminal sanctions against counterfeiters and infringers. In recent 11


H O S P I TA L S

Cerberus investigates cases of infringement

years, a number of agencies have been launched in the Middle East, like Cerberus, which investigate into cases of infringement. However, one obstacle on the way is the cost of registering trademarks, which is higher in most Middle Eastern countries than other parts of the world. It can be estimated that thousands of dollars are spent by brand owners 12

July 2014

in professional fees, obtaining documents and other legal necessities to register their trademarks in UAE. Unlike the European Union, it is not possible to obtain a trademark that with a region-wide registration in the Middle East. However, it is possible to obtain patent production in the GCC countries (Bahrain, Kuwait, Oman, Qatar, Saudi Arabia and UAE)


P R O T E C T I N G Y O U R H E A LT H C A R E B R A N D I N T H E M I D D L E E A S T

‘In recent years, a number of agencies have been launched in the Middle East, like Cerberus, which investigate into cases of infringement’ through a single application cleared by the GCC Patent Office. This can be very valuable for pharmaceutical companies or other healthcare/ surgical equipment manufacturers, who plan to rollout or trial their products across the region. It is thus, important to recognize the real cost of not registering a trademark. While the expenses may seem high initially in most Middle Eastern countries, there will be a heavier price to pay if the trademark is not registered. Many shops in the region are brimming with foreign made goods, but at ridiculously low prices- which is a sure sign of counterfeiting. Unfortunately, the average customer may not be able to recognize these fake products and be easily swayed by the low prices. But in the end, dissatisfaction with the product will affect the brand. This is particularly true for drugs and medicine manufacturers, but other manufacturers of healthcare-related

articles may also be affected equally. Thus, the real ‘cost’ that a brand owner should consider is their brand identity, goodwill and reputation. By protecting their trademarks, they can confidently stride through the land of opportunities.

H T T P : // W W W . C E R B E R U S I P. C O M / A U C T I M ON ITORI NG

Cerberus website 13


FINANCE

Finance & Insurance: How to Improve Your Hospital’s Financial Performance Hospitals today are judged on their ability to meet certain financial goals. Healthcare Global looks at ways hospital execs can ensure the health of their balance sheets as well as their patients

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FINANCE FOR TEN YEARS running, an annual survey of top issues confronting hospitals by the American College of Healthcare Executives has determined that financial challenges are the number one area of concern. With an influx of new patients and increased competition between insurers, healthcare providers are under serious pressure to cut costs and increase revenue. Here are a few key things to focus on when strategizing. Keeping spending down A 2012 study from L.E.K. Consulting that polled 200 hospital leaders identified cost containment as their most pressing need. Bob Lavoie, vice president of L.E.K. Consulting, recently told Bob Herman from Becker’s Hospital CFO, “More and more, we see larger hospitals trying to rationalize their costs, and standardization often helps with inventory management. A hospital may have 1,200 suppliers, and want to get it down to 700 by taking seven vendors in one category down to two or three.” Direct negotiations with suppliers may reduce costs and simplify the purchasing process. 16

July 2014

Hospitals try to rationalize their costs Working only with vendors who offer the best value in cost, service and quality decreases the likeliness of excess buying. And keeping a watchful eye on inventory limits ordering, prevents shortages and leads to better organization. Maximizing facility use To many healthcare providers who are already struggling financially,


H O W T O I M P R O V E Y O U R H O S P I TA L’ S F I N A N C I A L P E R F O R M A N C E

building new facilities is not a viable option. But making the most of current resources can lead to money saved (and sometimes even made). Assessing a patient’s propensity to fall and taking preventative steps can lessen the likelihood of injuries and damages. Up-to-date communication systems keep the ship running smoothly through clearer exchanges and potentially heightened responsiveness.

s

‘..monitoring staffing needs and balancing them with capacity whenever possible can streamline service and increase patient satisfaction’ 17


FINANCE

‘With medical technology constantly evolving, it is crucial that healthcare providers stay on the cutting edge in order to remain competitive’ Performing regular technology updates keeps inconvenient outages at bay. And monitoring staffing needs and balancing them with capacity whenever possible can streamline service and increase patient satisfaction. Maintaining a competitive edge With medical technology constantly evolving, it is crucial that healthcare providers stay on the cutting edge in order to remain competitive. Outpatient care is on the rise and telemedicine has quickly become the new frontier. Clinics and hospitals worldwide have taken steps towards making patient services available in a virtual capacity. Providing 18

July 2014

It is crucial that healthcare providers stay on the cutting edge in order to remain competitive patient care in convenient—and nontraditional—locations benefits patients through accessibility and healthcare providers through increased business. Cleveland Clinic has long been utilizing innovative technology in their practices. The Clinic was the first in the nation to


perform a successful face transplant and has been dispensing second opinions online via their MyConsult program since 2002. Soon, they will be offering walk-in appointments amid retail establishments, on campuses and in business parks through virtual clinic kiosks. These fully equipped,

private and secure kiosks provide basic medical care and advice to busy patients who might otherwise forego the opportunity to consult a medical professional. They also rate well, as those used in Cleveland Clinic’s pilot program scored a 93 percent patient satisfaction score. 19


FINANCE Trimming just 5 or 10 percent from energy bills, hospitals and care systems can make a real impact on their finances

Implementing green initiatives A guide recently published by the American Hospital Association titled Environmental Sustainability in Hospitals: The Value of Efficiency asserts “By trimming just 5 or 10 percent from energy bills, hospitals and care systems can make a real impact on their finances.” The savings can be substantial, as 20

July 2014

‘Every $1 a nonprofit hospital or care system saves on energy is equivalent to generating $20 in new hospital revenues’


H O W T O I M P R O V E Y O U R H O S P I TA L’ S F I N A N C I A L P E R F O R M A N C E

“Every $1 a nonprofit hospital or care system saves on energy is equivalent to generating $20 in new hospital revenues, and for-profit hospitals can raise their earnings by a penny a share by reducing energy costs just 5 percent.” But the benefits of environmental sustainability are not merely financial. As the guide points

out, “Hospitals and care systems that pursue sustainable initiatives find benefits in multiple areas. Their efforts contribute to a healthier environment, improve the organization’s public perception and can help their local communities.” Although green initiatives often bring upfront costs, they pay off in the long run.

PROMOTING WELLNESS We’ve all heard the adage that an ounce of prevention is worth a pound of cure. Companies worldwide have adopted wellness programs in order to keep their employees healthy, and many providers now offer similar programs as part of their plans. Similarly, more and more insurers are incentivizing members to stay in shape. But such programs are not just for patients. Healthcare providers need to remember to take care of themselves as they care for others. Hospital Impact blogger Scott Kashman, currently the chief administrative officer of Cape Coral Hospital, believes that “We owe it to our employees, volunteers and physicians to educate and provide them with better options to live a healthier lifestyle.

We also owe it to our community to ensure we have a healthy team to care for them, provide exceptional service and keep costs down.” Maintaining a healthy workforce decreases the likelihood of absences, improving patient care and projecting a positive image.

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S U P P LY C H A I N

McKesson VP gives how-to tips for effective supply chain management HCG interviews Todd Tabel, vice president of McKesson Supply Chain Solutions, to get inside the innermost workings of the dominance of McKesson in supply chain expertise, and learn why these models have become the model for healthcare providers today W R I T T E N B Y: A LY S S A C L A R K

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S U P P LY C H A I N ARGUABLY THE WORLD’S best healthcare IT supplier, McKesson stands as a successful Fortune 500 company leading the way in providing customized healthcare solutions to its international, health-focused clientele for over 20 years. McKesson Technology Solutions partners with its clients by focusing on their respective needs, delivering unique health solutions for integrated care management that enables payors, providers and patients to transform the business and process of care. Focusing primarily on its acute care in hospitals and warehouse management solutions, McKesson has become the one to watch throughout healthcare, as competitors, providers and startups alike look to this industry leader to model their own up-and-coming supply chain solutions. In terms of how McKesson is able to diagnose and analyze company data to generate solutions, vice president Tabel points to user experience as a point of concentration: “The world has changed a lot in the last decade or so,” says vice president Todd Tabel, Supply Chain Solutions, “If you think about it that way, you realize that even payment methods have 24

July 2014

McKesson has an artificial intelligence engine to help find the right healthcare supplies

changed significantly (what will and won’t be reimbursed), making the right decision upfront even more critical than ever before. We’ve got a solution in that area that is very similar to a Google-like search engine. It allows you to use an artificial intelligence engine to help you find the searches of the right supplies in your organization. We embrace a lot of consumer-driven inspiration, like Amazon, in order to provide for a richer consumer-like environment.”


F E AT U R E A R T I C L E S H O R T E N E D H E A D L I N E

The difference lies in the approach With more than 250 managed care clients and 92 percent of the nation’s top 25 health plans using various McKesson’s solutions today, this organization’s supply chain model is being emulated throughout the industry. Targeting acute care hospitals specifically, the McKesson Artificial Intelligence (AI) platform and consumer-driven IT solutions focus

on efficiency, customer need and cost-effectiveness in order to improve revenue for clients and reduce overall expenses. The vice president of McKesson Tabel went on to comment on the evolution of its healthcare IT solutions and the current state of today’s market, saying, “Given health care reform today every healthcare executive is looking at operating margins for some way to 25


S U P P LY C H A I N either improve revenue or reduce expenses. For the most part, hospitals are looking to reduce expenses in non-labor areas, with medical supplies becoming the secondgreatest lever afterwards. Research also suggests that supplies are overtaking labor as the top area for new savings. Everybody is looking for an opportunity to reduce non-labor expenses and the McKesson Strategic Supply Sourcing TM solution is able to identify opportunities for those organizations.” Fusing of innovation and interoperability Healthcare executives are honing in now, more than ever before, on how to invest short-term in the best healthcare IT solutions in order to cut costs in the long-run. McKesson holds true to its beliefs in not only putting the consumer or client first, but doing

so with a company-wide sense of integrity to move these businesses forward with the best possible IT services. Management executives at McKesson exude this internalized commitment to healthcare excellence, reminding fellow industry members and customers that healthcare IT solutions are not a one-time service; this relationship is a constant work-in-progress to ensure the customer’s success rises in line with the ever-increasing changes of the healthcare marketplace. This proves to be the inherent difference between McKesson and others in its field — an innate commitment to true, quality, customer-centered service. “There lies the difference of the solution: the customization in the consumer-driven AI platform,” says Tabel. “There really are three unique things that we provide in this

‘We have business advisors that are constantly monitoring the performance of the organization, pulling out what opportunities are represented in their eyes bringing those forward, and it’s all a part of the cost of the solution.’ 26

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F E AT U R E A R T I C L E S H O R T E N E D H E A D L I N E

Healthcare executives are honing in now, more than ever before, on how to invest short-term in the best healthcare IT solutions

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S U P P LY C H A I N

Constant IT performace monitoring part of our supply chain. We have business advisors that are constantly monitoring the performance of the organization, pulling out what opportunities are represented in their eyes bringing those forward, and it’s all a part of the cost of the solution. It’s not some special highest-end consulting project. In a world of cloud computing, we believe that you have to operate a little differently and we do with this solution, because we do have some traditional software solution.” Tabel suggests that part of managing and innovating a supply chain requires not only being ahead of the curve, but anticipating and 28

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reacting to market changes before they happen. Customer service is emulated throughout the McKesson team, turning this company pillar from a mission into the standard business approach: Vice president Tabel continues, “A typical IT provider can sometimes be accused of developing, selling and installing a solution while only leaving the installer support number for customer reference. This is just a standard part of doing business to most providers, so on an ongoing basis, we understand that we’re representing the opportunity center there. We’re monitoring the system


M C K E S S O N ’ S E F F E C T I V E S U P P LY C H A I N M A N A G E M E N T

performance, so we can understand things like: why Nurse-X tending to buy off contract a little bit more? How is she making those non-formulary decisions? We can determine things like why Physician-X drives a majority of the business and what his

specific preferences are. It’s these types of realities that present a great opportunity for us to go in and analyze. So, to do this, we put our feet on the street in order to assist customers with the success and deployment of this developed solution.”

ASK THE EXPERT Finally, HCG sat down with the industry leader and asked McKesson how to encourage up-and-coming health solutions companies to embrace innovation and interoperability. HCG: If you were to coach a healthcare start-up, who looked to McKesson for ways to improve its own IT solution, what would you say to those start-ups? How would you coach them in building their own business? McKesson: I would say one of the tenants that we’re constantly following up with is the development of our cloud-based solution and drive to put the customer first. We believe the way to achieve success is to think and act on behalf of the customer, to remove the burden of the customer in an implementation, and to automate those practices. As a company, you’ll see greater return, and you’ll be much

closer to the customer, because you will get to know them personally and understand how their system operated. It’s no longer an unsupported process; it’s not just a 1-800 number anymore. It’s real commitment to a real subject matter expertise that customers can then have access to, and have a frank dialogue with in order to help them navigate a healthcare crisis. It’s about becoming a business partner with the customer; be a good, active business partner and take the opportunities that are presented to you. To stay updated on Tabel’s view of the healthcare supply chain, subscribe to his blog at www. healthcaresupplychaintalk.com

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TECHNOLOGY

SOWING SEEDS OF SOCIAL NETWORKING IN HEALTHCARE W R I T T E N B Y: B Y D R E X E L D E F O R D , F C H I M E , F H I M S S , F A C H E , C H C I O C EO O F N EXT WAVE CO N N ECT

SOCIAL MEDIA HAS proven to be a tour de force in facilitating personal connections. Faced with regulatory, budget and care challenges, the healthcare industry is primed for leveraging social collaboration to speed solutions for operating more efficiently, complying with regulatory and legislative requirements, and ultimately, delivering better patient outcomes. Next Wave Connect is the first social collaboration community to afford this opportunity to healthcare 30

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industry professionals and peers, across all types of healthcare organizations. The Vision: Leveling Up Healthcare icon Ivo Nelson envisioned Next Wave Connect as a forum for uniting healthcare professionals who were independently struggling with universal challenges presented by the many changes—regulatory, operational, and others—swirling throughout the industry. Ivo believed


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TECHNOLOGY that social networking would take healthcare’s face-to-face collaboration/sharing at conferences to a whole new level. Social media enables us to maintain valuable connections and continue collaborations that tend to fade between meetings and industry gatherings, and end up relegated to impersonal and far less productive email. Next Wave Connect affords personal networking opportunities to everyone in healthcare, providing a venue where staff at all levels can build connections that help them do their jobs better to benefit their organizations. Ivo’s legacy of innovation in healthcare has left an imprint at Perot Systems, Healthlink (acquired by IBM), Encore Health Resources, and now Next Wave Connect. When Ivo approached me for my reaction to his novel concept, I thought, “Finally, someone who agrees that healthcare could really benefit from the power of social tools to crowd-source and problem-solve.” After all, we’re not shy about sharing clinical discoveries or best practices in electronic health records deployment, etc. at conferences and in journals. 32

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‘In the spirit of finding better solutions and more efficient processes—that save time, effort and money for hospitals, clinics, pharmacies, eldercare facilities’ Together, we understood that the real winners of Next Wave’s business model would be patients and their families—with better, faster, cheaper, and safer access to higher quality healthcare. Providers with access to a steady stream of shared information and perspectives about healthcare’s tough issues would develop answers faster—about patient care, business operations, and IT initiatives to name a few. They would not waste time reinventing the wheel, and members would leapfrog ahead by learning from others. Network of Public and Private Communities In the spirit of finding better solutions and more efficient processes—that


S O W I N G S E E D S O F S O C I A L N E T W O R K I N G I N H E A LT H C A R E

save time, effort and money for hospitals, clinics, pharmacies, eldercare facilities, etc.—Next Wave Connect was introduced in October 2013, and crowd-sourcing answers arrived on the healthcare scene. So what makes Next Wave tick? Next Wave members can create public communities that focus on major healthcare issues: Security & Privacy, Meaningful Use, Data Analytics, Accountable Care Organizations (ACOs), ICD-10, etc. Members log in, choose public Connect Communities to follow, and

then collaborate with other members on everything from specific problems and challenges in their organization to industry breaking news. Members can create their own “by-invitation-only”, private communities focused on topics that are proprietary to their organizations. They invite their “trusted circle” of peers to join the collaboration by following the community, posting comments and questions, and adding their own material to the library created in each community.

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TECHNOLOGY

Next Wave Connect Community Managers are “virtual hosts”

For convenience, the conversations from all Connect Communities a member is part of are posted directly to their “wall”, the first thing they see when logging into Next Wave. From there, the member can navigate to a specific community according to their priorities. Community Managers and ACEs You could call Next Wave Connect Community Managers “virtual hosts” who ensure that members find each 34

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other to achieve positive outcomes. They answer questions, add interesting and provocative content, and generally help moderate and summarize discussions happening on Next Wave. They may also introduce industry experts to Connect Communities when members need help. These industry experts are dubbed Advisory Council Experts (ACEs), distinguished healthcare gurus in various professional areas, from


S O W I N G S E E D S O F S O C I A L N E T W O R K I N G I N H E A LT H C A R E

information technology to public health and more. They fill a number of roles that help members work through challenges they are facing by providing advice and guidance based on their own years of experience. ACEs also provide valuable content, comments, articles, and blogs that Next Wave members can follow, comment on, and share with other members. Vendors, Associations and Other Partners In keeping with the nature of a collaborative approach to solving challenges in our industry, Next Wave Connect makes room for involving the expertise that our partner organizations offer. After all, these people are working with us to address

our needs, and have much to gain from doing so. In order to facilitate productive connections between members and partner experts, Next Wave offers “Engagement Marketing.” The timing of this process couldn’t be better for our partners in light of the demise of traditional advertising and marketing tactics. We fast forward through television commercials. We give promotional emails three seconds to impress us. We toss direct mail appeals into the recycling bin. As a result, Next Wave’s partners are looking for new ways to engage with their current and potential constituencies. Enter the concept of Engagement Marketing. Next Wave partners can

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TECHNOLOGY build their own public Next Wave Connect communities to demonstrate thought leadership, publish white papers and other compelling content, advertise webinars and conferences, and adjust company and product branding in real time as it evolves to keep up with the ever-changing marketing environment. Next Wave partners are also building private communities and inviting current and potential clients to meet and connect. Collaboration with customers is extremely helpful

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to partners as they strive to enhance existing products and services, as well as expedite creation and delivery of new ones, that will help the healthcare industry. Partners are using Next Wave Connect for ongoing collaboration with their healthcare advisory board members and other focus groups they’ve created.


S O W I N G S E E D S O F S O C I A L N E T W O R K I N G I N H E A LT H C A R E

One Resource, Infinite Possibilities Next Wave Connect makes it easier for healthcare personnel to stay on top of the latest and most pressing issues in the industry through connections with industry peers and leaders. Instead of having to visit a myriad of websites—trade publications, companies, and associations involved in healthcare— one log-in at one site gives members access to unlimited choices and information that is not available anywhere else. Members can follow numerous Connect Communities and a multitude of industry expert ACE bloggers; collaborate publicly and/or create private communities; and help partners develop solutions for the industry’s challenges. With Next Wave Connect you can start conversations, crowdsource solutions, share messages, and interact across communities— that’s what real life problem solving is all about. By building a group of collaborators who have various skills and experiences, you’re much more likely to find the help you need to solve the problems you’re working on.

Communication + Collaboration = Success A closer connection between the healthcare professionals and partners fosters true alignment of our industry to improve the quality of healthcare. Next Wave Connect is a conduit for direct feedback, sharing best practices, and generating new ideas and concepts for products, services and business processes. It all adds up to success for everyone involved.

ABOUT THE AUTHOR Drex DeFord, a retired lieutenant colonel with the United States Air Force, has 25+ years of experience working with healthcare organizations, innovating information technology systems to their optimal efficiency. He is a past board chairman with the College of Healthcare Information Management Executives (CHIME), a former national board member of the Healthcare and Information Management Systems Society (HIMSS), and a fellow in the American College of Healthcare Executives (ACHE), CHIME, and HIMSS.

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TOP 10

TOP10

‘Paid’ Apps for Medical Professionals A look at the Top 10 apps Medical Professionals should have on their tablet, and why it is that these applications continue to excel in the mHealth market Written by: Sheree Hanna


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TOP 10

10

Learn Muscles

By Real Bodywork — $2.99 This application provides a great resource for testing, referencing and any educational needs surrounding the study of anatomy and physiology. 40

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The program includes 141 muscle images with name, action, origin, insertion and comments, plus audio pronunciation guide, a quiz maker, an action viewer and six short videos. Rated 4.4 stars out of 5 on the Store ratings guide, this application keeps you up-to-date on your facts, while doing so in an engaging and user-friendly way.


‘ PA I D ’ A P P S F O R M E D I C A L P R O F E S S I O N A L S

09

Paramedic Protocol Provider

By Acid Remap — $9.99 Paramedic Protocol Provider provides quick offline access to over 350 field treatment protocols from the USA, Canada and Ireland. This resource is available for Android, iPhone, iPad and iPod touch that gives real-time offline search of field treatment protocols. Less than the cost of a field manual, this solutions provides an easy, user-friendly and efficient way of providing the best care while doing so in the more effective way possible. Paramedic Daniel Egg states, “As a practicing paramedic I personally find Paramedic Protocol Provider to be one of the most useful applications in my iPhone. It has become an invaluable tool for rapid reference in the field, and it is one of the easiest and fastest ways we have to provide the most current protocol updates to our system. It is a resource I recommend to anyone who works in EMS.” 41


TOP 10

08

Lab Values Pro

By Hipposoft — $2.99 Available on the iPad and iPhone, the app offers lab reference values, medical abbreviations and medical prefix and suffixes. This application stands as a premium resource for all healthcare professionals, doctors, nurses, and students with 42

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its comprehensive library of lab reference values, medical abbreviations and medical prefix/ suffixes. General Practitioner Donald Craig says, “I use this app everyday at my clinic and in the hospital. It’s not just the lab values but the clinical info that’s so valuable in this app. I can quickly look up info about a lab which is invaluable especially when you don’t have an internet connection to do a web search.”


‘ PA I D ’ A P P S F O R M E D I C A L P R O F E S S I O N A L S

07

ASRA Coags

By American Society of Regional Anesthesia and Pain Medicine — $3.99 Designed and based on the popular article, “Regional Anesthesia in the Patient Receiving Antithrombotic or Thrombolytic Therapy: American Society of Regional Anesthesia and Pain Medicine Evidence-Based Guidelines”, this application allows you to search by either brand name or generic name. The app allows recommendations from either block type or intervention type, with reference to recently published ASRA guidelines. ASRA Coags makes the ASRA Anticoagulation Guideline reference available along with drug-specific summary information.

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TOP 10

06

BiliCalc

By Jacob Beniflah — $1.99 This application deals with pediatrics, and is useful both for practicing physicians as well as concerned, loving parents. The program allows you to input the infant’s age at time of lab or manually input both the birth date and hour, as well as lab date and hour. Connecting directly to source journal articles, nomograms, and list of neuotoxicity 44

July 2014

risk factors, this device support both US and SI units and is rated 4.5 stars on the Store’s ratings guide. On the Apple Store it is described as, “Designed by a pediatrician, BiliCalc uses the American Academy of Pediatrics 2004 “Management of Hyperbilirubinemia in Infants Greater than 35 Weeks of Age” to calculate the threshold for starting phototherapy based on the patient’s age, bilirubin level, and neurotoxicity rk is. In addition, it will also tell you the patient’s risk zone using the Bhutani Nomogram.”


‘ PA I D ’ A P P S F O R M E D I C A L P R O F E S S I O N A L S

05

MedCalc

By Mathias Tschopp & Pascal Pfiffner — $1.99 MedCalc gives the user easy access to complicated medical formulas, scores, scales and classifications. Each formula has been individually designed and optimized for the small iPhone screen. The main features of the app include: a very large (more than 300) selection of relevant formulas, scores, scales and classifications, detailed information and bibliographic references for each formula, support for US and SI units, with easy switching from the keypad, custom overlaid controls: no sliding in and out to input values, search for equations by name or keywords, and a customizable list of favorite equations MedCalc offers access complicated medical formulas, scores, scales and classifications. This app is rated three stars for users for ease of access and likeability compared to its competitors. 45


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Pill Identifier

By Drugs.com — $0.99 To address the issue of leftover prescription pills or the misuse of prescription medication, Pill Identifier is working to keep the public safe with its latest addition to 46

July 2014

the mHealth scene. Pill Identifier edition is a searchable database which includes more than 10,000 Rx/OTC medications found in the U.S. Features “search as you type” functionality. The app encourages users to contact healthcare providers if pills are not matched in its internal system, or encourages safe ways of disposing of the unwanted pills.


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ASCCP Mobile

By Drugs.com — $0.99 To address the issue of leftover prescription pills or the misuse of prescription medication, Pill Identifier is working to keep the public safe with its latest addition to the mHealth scene. Pill Identifier edition is a searchable database which includes more than 10,000 Rx/OTC medications found in the U.S. Features “search as you type” functionality. The app encourages users to contact healthcare providers if pills are not matched in its internal system, or encourages safe ways of disposing of the unwanted pills.

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A Cleaner, Healthier Future Whatever sector you work in, so does Diversey—from Healthcare, Retail, and Lodging to Food Service, Food and Beverage, and Building Service Contracting. Our application expertise ranges from kitchen hygiene and laundry to building care. This allows us to offer unique solutions that fully integrate product systems, floor care machinery, cleaning tools and services Our level of expertise and the results we deliver have convinced many world-class companies to work with us. Coca-Cola, McDonalds, Hilton, WalMart, PepsiCo, Compass, Marks & Spencer, ISS, and Accor are just some of the household names with which we have forged lasting partnerships. For more information please visit us online at www.diversey.com

CLICK HERE

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‘ PA I D ’ A P P S F O R M E D I C A L P R O F E S S I O N A L S

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Critical Care ACLS Guide

By Informed Publishing — $5.99 Created by Informed Publishing, this app is backed by the leading organization in emergency reference since 1986. The Critical Care ACLS Guide allows access to physicians, paramedics and nurses to review ACLS drug doses, access EKGs, look-up patient medications,

bookmark frequented data, add notes and provide an expanded search capacity to users. “I have been using Informed’s Critical Care ACLS Guide for years and never go to work without it,” reports Shaun Michael Scott, RN, EMTP, CareFlite Flight Nurse. Rated four stars by users, this app is not only user-friendly, but is cost-effective for the amount of services provided by this handheld medical tool.

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Micromedex Drug Reference

By Truven Health Analytics — $2.99 Micromedex Drug Reference Essentials gives consumers realtime access to drug information. As a part of the Micromedex Medication Management apps bundle, this app can work in tandem with Micromedex Drug Interactions and Micromedex IV Compatibility to provide a wellbalanced healthcare suite of services. In operation for over 40 years, this organization has provided hospitals and healthcare providers with an exceptional single source site for clinical information including: need-to-know drug, pediatric, disease, lab and toxicology information for patient and consumer education.

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Hospital Metropolitano Vivian Pellas: Nicaraguan medical excellen

Changing the development of medicine in Central America Written by: Rebecca Castrejon Produced by: Carmenza David Interviewee: Dr. William Abdalah, medical director


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Vivian Pellas culture

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or years, the institutional values held by Hospital Metropolitano Vivian Pellas have been the foundations supporting the medical center’s status as one of Nicaragua’s best. The growing bonds between the hospital management and medical staff continuously improve service quality.

Dr. William Abdalah, Medical Director of

“We are eager to perform at our best, revolutionizing the way medical services are being provided in our country,” says Dr. William Abdalah, chief physician at Vivian Pellas.

Hospital Metropolitano Vivian Pellas

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Medical management Dr. Abdalah, current chief physician at Hospital Metropolitano Vivian Pellas, has been a part of the hospital’s history since the facility’s inception and design, being consulted about the acquisition of medical equipment and surgical instruments. Afterwards, he became involved as head of the surgery department until 2013, when he was appointed as chief physician. Abdalah is a general surgeon and he also earned an MBA; these academic achievements and experience have been key factors for a proper balance by keeping the medical staff aligned with the hospital’s enterprise vision. His 11-year experience managing private practice hospitals provided him the necessary leadership at his current position as chief physician.


L AT I N A M E R I C A

Entrepreneuring medical staff Vivian Pellas has established cooperation agreements with institutions in the United States and Central America with the purpose of increasing their staff’s medical knowledge. Some of these institutions are the Baptist Health Systems and Jackson Memorial Hospital (both in Miami, Fla.), as well as St. Luke’s Episcopal hospital (Houston, Texas). Exchange programs with other medical centers in Central America and the Dominican Republic are held through Asociacion de Hospitales Privados’ (private hospitals association) connections, these programs have brought benefits in nursing practices. Health professionals go through constant training to be prepared for the necessary endeavors demanded by the opening of new service units. In order to accomplish medical excellence, the staff undergoes

“We are eager to perform at our best, revolutionizing the way medical services are being provided in our country” - Dr. William Abdalah, Medical Director of Hospital Metropolitano Vivian Pellas

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Hospital Metropolitano Vivian Pellas

training abroad in the fields of new diagnostic areas, acquiring scientific knowledge regarding these and other subjects. To set some examples, the medical staff heads to Miami and Mexico to receive training by experienced doctors for the proper reading of images produced by a 128-slice tomography; and also to take courses updating them in specialties such as cardiology and neuroscience. “We are constantly raising our entire staff’s knowledge level for advanced technology operation, providing the most exact evaluations to our patients,� says Abdalah. Staff

Hospital innovation There are three important projects under development among the planned excellence centers: 56

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Hospital Metropolitano Vivian Pellas

1. The opening of a diabetes clinic in a new five-story facility under construction, including a multidisciplinary care unit. 2. Upgrades and innovations in the cardiology unit, which will include catheterization for pacemaker implantation, and cardiac e lectrophysiology, afterwards. 3. The opening of the neuroscience unit. This department is currently formed by a multidisciplinary team, properly trained to manage CVA with the most advanced technology, prehospital, and rehab services.

“We want to thrive into a regional reference for medical centers, with the support of what we’ve already achieved, along with the stem cell therapy clinic, taking ourselves into a level which will allow us to provide medical services to a larger population�

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nicaragua@scientific-centroamerica.com

www.scientific-centroamerica.com

www.cobas.com

www.crilamyt.com | mproanio@crilamyt.com


H O S P I TA L M E T R O P O L I TA N O V I V I A N P E L L A S Currently, the Stem Cell Therapy area is also part of the ongoing extension, working along with local colleges whose research protocols are based on stem cells obtained from abdominal fat for tissue regeneration. Stem cell therapy at Vivian Pellas is used mainly for osteoarthritis treatment, to be applied to burn victims, for patients suffering peripheral circulatory collapse, for development of kidney tissue, and for inflammatory diseases such as asthma. “We want to thrive into a regional reference for medical centers, with the support of what we’ve already achieved, along with the stem cell therapy clinic, taking ourselves into a level which will allow us to provide medical services to a larger population,” says Abdalah. Growth and expansion Business development plans consist of doubling the hospital’s capacity in its actual location. The diagnosis and outpatient surgery branches program will be running by 2015, mainly focused on patients suffering from diabetes. Branches will be located in different areas in the country. North and southeast Nicaragua are being evaluated as possible locations for this expansion.

Nurse attending patient

Nurses

The future for Hospital Metropolitano Vivian Pellas The goal is to become Central America’s best hospital by 2017. For this purpose, a strategic plan has been developed to make Vivian Pellas the w w w. m e t ro p o l i t a n o . c o m . n i

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Under this extension, the hemodyalisis units will expand, and the available seats for patients with terminal kidney disease will increase to 30. Outpatient surgery services will increase as well, with the construction of two new operating rooms.

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Medical technology Vivian Pellas hospital owns the country’s fastest MRI scanner, which has constant upgrades including updated training for the medical staff in charge of the device’s operation, particularly for those in the neuroscience unit.


L AT I N A M E R I C A

region’s top reference for medical centers with the highest standards, also to sustain leadership as the country’s best nursing facilities, to increase brand presence in other markets; and to hire radiotherapy, transplant and molecular biology services, due to the high rate of patients with terminal illnesses. “At Hospital Metropolitano Vivian Pellas we want to change the way medical services are provided in the country. That’s the reason to install multidisciplinary practice among the medical community,” says Abdalah

Company Information INDUSTRY

Health services HEADQUARTERS

Managua, Nicaragua FOUNDED

May, 2004 EMPLOYEES

600 KEY PEOPLE

Dr. William Abdalah (chief physician), Gilberto Guzman (CEO), Sandra Picado (supply manager), Arlen Pérez (medical tourism manager), MBA Carolina Castro (marketing and sales manager) PRODUCTS / SERVICES

Hospital, maternity ward, neonatology, intensive care, emergencies, pharmacy, medical imaging, laboratory, specialties, etc. REVENUE www.facebook.com/HospitalMetropolitanoVivianPellas

USD $200 millon

https://twitter.com/HMetropolitano www.linkedin.com/company/hospital-metropolitano-vivian-pellas w w w. m e t ro p o l i t a n o . c o m . n i

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Anywhere Healthcare: Bringing healthcare to all of Australia

By enabling specialist healthcare via video consultations across the country, Anywhere Healthcare has made a name for itself in the future of healthcare. Written by: Laura Close Produced by: Jeff Soboleski


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NYWHERE HEALTHCARE, a subsidiary business of Medibank, is a health services organisation that provides a range of healthcare initiatives to the state and federal government and large corporate and non-profit companies. Because Anywhere Healthcare was developed in a governmentbacked environment, the organisation was not necessarily born out of a strong underlying business strategy. However, as innovators in their field, the Anywhere Healthcare team has worked to develop a model that is both scalable and sustainable. They have achieved the scale part of the equation, as the organisation now understands the dynamics of running a purely online medical practice. To make their operation sustainable, Anywhere Healthcare is looking to make the medical consultation process more efficient through a number of initiatives. Samuel Holt, director of online care, knows innovation is key: “The answer isn’t in just trying to replicate what happens in the face-to-face world, it is in looking at healthcare and streamlining care so that maybe it can be potentially faster and more efficient.” VIDEO CONSULTATION TECHNOLOGY The core of Anywhere Healthcare’s service is to enable patients to connect with a healthcare provider via video. To encourage regional doctors to connect their patients in rural or difficult-to-reach areas with city specialists, there are incentives and other government funding available under the Medicare system. The organisation employs cloud-based practice-management software, used by clinicians and practice management staff to store patient referrals, images and scans provided by their network of 1,000-plus referring practitioners across the country. Vidyo, a video conferencing platform, make the video consultations possible. Technology moves fast, so Anywhere Healthcare is always looking for 64

July 2014



Australia’s most experienced medical transcription company run by doctors – for doctors Seamless integration with all leading practice software More streamlined operational workflow Reliable, affordable and available Accurate and cost-effective Inhouse, outsourcing or co-sourcing FREE electronic document delivery and distribution via OzePost Let our specialist consultants demonstrate how OzeScribe could be the answer to your transcription questions.

Call us: 1300 727 423 or visit: www.ozescribe.com.au

new and better solutions to improve their services. Australia does not have ubiquitous access to one backbone of Internet, so Internet access can be relatively poor in less populated areas. The organisation is always looking for technology that can provide a more stable environment through which people can access consultations. Moving forward, Anywhere Healthcare is looking to provide patients with access to general practitioners and allied health practitioners for consultations. These services will be offered at a 100 percent out-ofpocket fee, as there is currently no funding for an individual to talk to a general practitioner or allied health practitioner online. This service focuses specifically on convenience and accessibility for patients in rural and regional areas. Anywhere Healthcare intends to use apps to provide additional and improved services to interested patients. Instead of making an appointment to see a specialist online, patients will be able to take a picture of their wound or skin lesion and, using an app, be able to collect the information 66

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AUSTRALIA

required by a specialist to make a remote diagnosis. The process would include capturing the relevant information, sending it to Anywhere Healthcare and having an appropriate specialist review the images and notes, with a diagnosis potentially being available in as little as 24 hours. CONTINUOUS IMPROVEMENT Anywhere Healthcare is constantly evaluating its practice and services offered to ensure that they are clinically relevant and appropriate. They have engaged approximately 30 specialists in varied fields of practice, and have 14 employees who focus on the clinical, IT and marketing aspects to support and build the practice. Furthermore, to ensure the timely delivery of patient-centre care, third-party vendors are also engaged to assist in areas of high service demand such as Medical Transcription.

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“Anywhere Healthcare is looking to make the medical consultation process more efficient through the use of technology� It is not hard for an organisation like Anywhere Healthcare to attract employees, as people like the work the company is doing. Their employees, specialists and referring GPs believe in equitable access to healthcare and in improving healthcare

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AUSTRALIA

in regional or remote areas. Anywhere Healthcare enables specialists to work flexible hours, and to fit a telehealth practice around their other public and private practice commitments. Anywhere Healthcare also enables specialists to work from any location within Australia, provided they have access to the Internet, which particularly suits specialists who have young children or who are winding down from the long hours generally required to maintain a full time practice, as well as those who wish to live in regional areas but do not have sufficient local patient demand to make it viable. Anywhere Healthcare has experienced strong growth; since the practice was launched in October 2012, the number of consultations they conduct has grown on average by around 30 percent compound, month on month. Holt believes there’s significant untapped potential for health consultations online. Currently, approximately one percent of all psychiatry consultations in Australia are conducted online, and there is the opportunity for most areas of healthcare to reflect similar numbers. With more than 100 million consultations conducted in Australia each year, Anywhere Healthcare has a large market to target. In three to five years’ time, the organisation aims to be conducting somewhere between 300,000 to a million video consultations and asynchronous healthcare interactions each year.

Company Information INDUSTRY

Healthcarey EMPLOYEES

4,800 KEY PEOPLE/ TITLES

Samuel Holt, director of online care REVENUE:

$5.9 billion PRODUCTS/ SERVICES

healthcare consultations via video

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Santa Joana Gr

Santa Joana Group on the way to becoming an i benchmark in high-risk pregnancy, gynecology a Written by Simone Talarico Produced by Sergio Ambrosino


Group

international and obstetrics.

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Adult intensive care unit (ICU)

ccording to the Brazilian National Health Agency, the Private Health System - also called the Supplemental Health System - served approximately 35 million beneficiaries in 2003. Today that number is around 50 million. The growing demand is not new to the Santa Joana Maternity Group, a national reference in high-risk pregnancy, gynecology and obstetrics, which has overseen 40,000 births annually. The history of Santa Joana Group began in S達o Paulo with the Santa Joana Hospital, a 65-year-old facility that is fully related to mother and infant care. In January of 2000 Santa Joana made its first acquisition, Pro Matre Paulista Maternity, quite traditional in S達o Paulo.

Endometriosis center

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Breastfeeding support 73


Comfort

Suites for natural childbirth


BRAZIL

Family space, rooms in which families can accompany childbirth moments

“More recently, five years ago, we teamed up and bought part of the two maternity hospitals Perinatal in Rio de Janeiro, and it was then that we formed the group,” explains Dr. Marco Antonio Zaccarelli, General Director of the Santa Joana Group. “Today there are four units, as in Rio de Janeiro we have a unit in Barra da Tijuca and one in Laranjeiras.”The group was then established, and today is considered the largest group of maternity hospitals in Latin America, with a union of doctors in São Paulo and Rio de Janeiro working with the same ideals and exchanging experience, knowledge and technology, focusing on a certain specialty attracted patients from around the country. One of the procedures by which the Group is known is the correction of myelomeningocele in an open surgery, which began at the end of the year 2012 in the Pro Matre Maternity but increased in number considerably in the past year. “We did 110 procedures in 2013, and we had fantastic results with over 90 percent success,” says Dr. Zaccarelli. “We are, I think, second in the world in annual statistics. The service is headed by Professor Moron, and we have had visits from heads of w w w. h m s j . c o m . b r

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Smith & Nephew is a British company with over 150 years dedicated to developing medical devices for providing efficient, fast and cost-effective treatment. Present in over than 90 countries worldwide, Smith & Nephew came to Brazil in December, 2013. Currently the company is organized in two business units: ADVANCED WOUND MANAGEMENT and ADVANCED SURGICAL DEVICES offering together, more than 1,000 products. The purpose of the division of ADVANCED WOUND MANAGEMENT is to find innovative solutions for the prevention and treatment of acute and chronic wounds. Our products are designed to help accelerate the healing process and improve people’s life.

ACTICOAT™

PICO™ RENASYS™

OPSITE™

www.smith-nephew.com ™Trademark of Smith & Nephew


BRAZIL

One of the lowest rates of hospital infection in the country

maternity from everywhere in the world to watch the results, and see the technique he employs here.” As one of the largest referral centers for high complexity in gynecology and obstetrics and neonatology in Brazil, the Pro Matre Maternity needed to expand. “Today we received moms from all over Brazil, who come here when they receive diagnoses of conditions that are beyond the average obstetrician’s routine. So now we are expanding in an area of 600 square meters, which will allow us to build 15 new apartments. We also got an area outside the hospital, where we moved the support area, a dining hall and cloakroom for the staff, and we will be able to expand a little more,” says Dr. Zaccarelli. At the moment, the two units of São Paulo, the Santa Joana hospital and the Pro Matre Maternity, are also going through the

Human milk for 100% of premature babies

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S A N TA J O A N A G R O U P accreditation process of the Joint Commission International (JCI). “JCI contributed much to improve and enhance patient safety within the hospital, and we made several adjustments to implement action plans for improvement upon analysis of indicators, both of non-compliance, adverse events, and satisfaction surveys customer, which unfold into improvement plans,” says Dr. Zaccarelli. NATIONAL AND INTERNATIONAL REFERENCE Since 2005 the Group has been affiliated with the Vermont Oxford Network, an institution responsible for processing data from infants less than 1600 grams admitted to 650 neonatal ICUs at the best hospitals in the world. Maternities of the Santa Joana Group are the only ones in the country that are part of the Vermont Oxford and the indicators of the Group are among the best in the network. “We are the only organization in Brazil which has a partnership with the Vermont Oxford Network Institute,” reveals Dr. Zaccarelli. “The intention of the group is that of from being a national benchmark in high-

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G Y N E C O L O G Y, O B S T E T R I C S A N D N E W B O R N

Smart room, ready to attend high complexity surgeries

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Dr. Zaccarelli

“The intention of the group is that of from being a national benchmark in high-risk pregnancy, gynecology and obstetrics, we become considered an international benchmark. That’s the big goal and our focus.” – Dr. Zaccarelli, General Director

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Semi-intensive therapy unit for high-ris

risk pregnancy, gynecology and obstetrics, we become considered an international benchmark. That’s the big goal and our focus.” In logistics, the Santa Joana Group has been working on a joint action with other hospital institutions and materials suppliers to implement a barcode structure within the GSI standard, the data matrix code. “This is something that greatly facilitates the traceability of medicines and equipment within the hospital, if the industry has to provide the barcode within the specifications that include batch, validity, and finally all this information,” explains Dr. Zaccarelli.


BRAZIL

Company Information INDUSTRY

Santa Joana Group HEADQUARTERS

São Paulo, SP FOUNDED

1948 EMPLOYEES

3,100 PRODUCTS/ SERVICES

sk pregnancies

For that, the Santa Joana Group has been working on an initiative in a joint effort in partnership with ANAHP (National Association of Private Hospitals). “We are spreading, with the pharmaceutical industry, the importance of the materials to already come with the bar codes in the patterns of the data matrix,” concludes Dr. Zaccarelli. “This is an important process that prevents unitarization of the doses, where you’re more exposed, because it increases the risk of error when you have to do that inside the hospital.”

Focus on women’s health, pregnancy and newborn MANAGEMENT

General Director: Dr. Marco Antonio Zaccarelli

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