Healthcare Global - November 2014

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FINANCE

Healthcare IT M&A Sees Increase in 2014

SUPPLY CHAIN

Is Concierge Medicine the New Primary Care?

TRIOC P 10 HES

PROFESSIO T N IN BRAZILALS

Cloud Computing

The Pulse of the Healthcare IT Industry?

BIG DATA Four Ways to Improve Hospital Operations

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EDITOR’S COMMENT

It’s all going to the cloud S E C U R I T Y T H R E AT S A N D B R E A C H E S

have increased

throughout the years not only within the health care industry, but in all sectors worldwide. As a means to combat this, health care organizations have begun to adopt cloud-based services to source all of their medical records and defend their internal servers.

The accelerating migration to could computing represents a change for the health care industry and in this month’s feature How Cloud Computing is Changing the Health Care IT Industry, we discuss these changes and how they will affect the industry moving forward.

Similarly, big data is invaluable in its ability to offer managers a high level of view of the day-to-day operations of their hospital.

Nowhere is data expanding at such a rapid rate than in the field of medicine. We share the four ways in which big data can improve your hospital operations to empower your practice.

We wrap up the November issue of Healthcare Global by traveling to Brazil and featuring the richest health care professionals making an impact on the industry.

We hope you enjoy this issue and wish you the best of health!

Stephanie C. Ocano Editor stephanie.ocano@wdmgroup.com 3

CONTENTS

28

Features

8

Hospitals

Four Ways Big Data Can Improve Your Hospital Operations

22

Technology How Cloud Computing is Changing the Healthcare IT Industry

TOP 10

Richest Healthcare Professionals in Brazil

36

16 Finance

Supply Chain

Healthcare IT M&A Sees Increase in 2014

Is Concierge Medicine the New Primary Care?

5

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CONTENTS

70

Sindusfarma

48

Anywhere Healthcare

56 ANAFAM

COMPANY PROFILES

62

AMMTAC

AUSTRALIA 48 Anywhere Healthcare

LATIN AMERICA

78

Instituto Biocor

56 ANAFAM 62 AMMTAC

BRAZIL 70 Sindusfarma 78 Instituto Biocor

7

H O S P I TA L S

Four ways Big Data Can Improve Your Hospital Operations When it comes to daily management, big data is invaluable in its ability to offer managers a high level view of what is happening in every aspect of the hospital’s day-to-day operations W R I T T E N B Y: A D A M G R O F F

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November 2014

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H O S P I TA L S

THE MEDICAL WORLD is growing with each new patient and hospital data is growing right along with it.

From medical records to network operations, if your hospital isn’t taking advantage of a healthy dose of big data, then your management team is missing out.

When it comes to healthy data management, here are just a few ways big data can improve your hospital.

1. Patient Healthcare Nowhere is data expanding at such a 10

November 2014

rapid rate than in the field of medicine.

Each new patient comes with their very own set of medical data and hospitals are really beginning to feel the data management crisis. By turning to big data, your management team can create a better healthcare infrastructure.

Big data collects and stores massive sets of data that your hospital can use to keep tabs on everything from patient recovery rates to hospital finances.

The use of visualization tools

Big data collects and stores massive sets of data

“Big data analytics in the healthcare field are helping physicians better track their patients’ medical conditions� to show the results yielded by big data is an important part of making sense of big data and using it to demonstrate trends, results and areas of concern to colleagues.

Big data when properly visualized provides an easily understandable overview of key

points, supporting decision making.

Examining big data can help managers to see where there are bottlenecks and less than optimum results in patient care.

Tackling those issues means better results for patients and a more efficient hospital, too.

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H O S P I TA L S

“Hospitals around the world are beginning to adopt electronic medical records as their primary source for compiling all clinical data, and for the right reasons” 2. Electronic Health Records Hospitals around the world are beginning to adopt electronic medical records as their primary source for compiling all clinical data, and for the right reasons. Electronic medical records improve outcomes, convenience and costs.

Patient health records are an 12

November 2014

important step in ensuring your hospital gives the most appropriate care to its visitors. The problem is records that aren’t intuitive and immediately available don’t have as great of an effect on a patient’s recovery rate or the quality of their future visits.

Big data is making it possible for

W AY S B I G D ATA C A N I M P R O V E YO U R H O S P I TA L O P E R AT I O N S

electronic health records to make their way into hospitals. With electronic health records, doctors can get the most up-to-date information on their patients’ changing health conditions.

For example, the Medical Center Health System in Odessa, Texas uses electronic health records to automatically input health data into the system before the patient leaves the room.

This ensures that if a patient is transferred to another wing in the hospital, the next physician to receive the patient will have real-time patient records.

they’ve had in the past 12 months.

By scouring data sets like this, pediatricians at the hospital can get a complete understanding of their patients.

4. Readmissions and Big Data Medicare and Medicaid are instating a new rule that charges hospitals for any patients who are readmitted in the first 30 days of being released. This could end up costing your hospital a substantial amount of money with each Medicare patient.

3. Predictive Analytics If your hospital’s management team isn’t convinced about big data, then the analytics that go with it will certainly change your mind.

Big data analytics in the healthcare field are helping physicians better track their patients’ medical conditions by collecting and analyzing each piece of the medical data puzzle.

Children’s Medical Center in Dallas, Texas for example is using big data analytics to assess their asthma patients’ medical history all the way down to the number of inhaler refills 13

H O S P I TA L S

Health Information Exchange in the Healthcare System

Fortunately, big data can automatically correlate patient data and analyze regression rates to avoid premature releases. By tracking the data behind regression rates, hospitals can discover any unforeseen issues and extend patient discharge dates until all medical concerns are alleviated.

By using big data, hospital management can gain a highly 14

November 2014

“By using big data, hospital management can gain a highly realistic and accurate view, sometimes in nearly real time, of what is happening across the hospital�

W AY S B I G D ATA C A N I M P R O V E YO U R H O S P I TA L O P E R AT I O N S

Doctors can make highly realistic and accurate judgements realistic and accurate view, sometimes in nearly real time, of what is happening across the hospital.

This allows them to get a high level view of how resources are being used and allocated. This accurate reporting provides a valuable tool for streamlining operations.

For example, management might use big data to get an overview of surgery scheduling. They can use

this data to coordinate surgery schedules with more precision, cutting down resources wasted due to poor scheduling. This fine tuning of resources can be applied across the board, from medical supply ordering to bed allocation.

XXX When it comes to managing your hospital’s data, big data can help get your medical world running more efficiently.

15

FINANCE

HEALTHCARE M&A SEES INCREASE IN 2014

As the healthcare industry continues to flourish, so has the number of mergers and acquisitions, making 2014 the most successful to date Writ ten by: STE PHAN I E C. OCANO

E IT

H E A LT H C A R E I T

MERGERS AND acquisitions in the healthcare industry have consistently been on the rise, and according to a recent report by Berkery Noyes, an independent mid-market investment bank, healthcare mergers and acquisitions (M&A) have garnered an aggregate value of $5.45 billion.

The report analyzed M&A activity during the first half of the year and compared it with four previous six-month periods from 2012 to 2013 and included information and technology companies that service pharmaceutical, healthcare payer and healthcare provider spaces.

Total deal volume increased 18 percent since the second half of 2013, with the median revenue multiple decreasing from 2.5x to 2.0x over the past six months. Deal volume in the healthcare IT segment increased by 17 percent, from 65 to 76 transactions, making it the largest increase on a half year basis throughout the past twoand-a-half years, the report stated. “In the rapidly changing healthcare information/technology marketplace, both strategic and financial buyers are on the hunt for attractive acquisitions of scale,� said Tom O’Connor, Managing Director at Berkery Noyes, 17

FINANCE

The market for Pharma IT saw a volume increase from 15 to 24 transactions.

in a news release. “Companies with good scale, recurring revenue, and high growth rates with a large addressable market opportunity, whether they are long term care information/education/technology providers, revenue cycle management, point-of-care information solutions, or one of many other attractive niches, are in high demand from both private equity and strategic buyers.”

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“Financial buyers also have over $500 billion of dry powered which they can leverage 4x-8x times. It is a seller’s market as with all the attractive dynamics noted above there remains a lack of quality assets of scale available so any attractive assets commands high valuation and multiple buyers,” added O’Connor.

Additional markets covered in the report included pharma IT, which

H E A LT H C A R E I T

“In the rapidly changing healthcare information/ technology marketplace, both strategic and financial buyers are on the hunt for attractive acquisitions of scale” - Tom O’Connor saw a volume increase from 15 to 24 transactions. The largest deal in both the segment and overall industry was Dassault Systemes’ acquisition of Accelrys Software, a provider of scientific lifecycle management software for chemistry, biology, and materials research, for $652 million.

Consumer healthcare increased from 16 to 21 transactions and the healthcare business services segment improved from 44 to 49 transactions.

“A broad range of information, data, technology, knowledge management solutions, and services are leading

to end-to-end offerings for the pharmaceutical, biotechnology, and life sciences industries. Evidencebased marketing is a key trend in this segment, with its emphasis on data, science, pharmacoeconomics, and comparative effectiveness,” said Jeffrey Smith, Managing Director at Berkery Noyes.

“We expect to see continued robust new business formation in the life sciences commercialization space, with an emphasis on proprietary intellectual property assets, new software analytics, regulated content solutions, patient engagement, mobile, and global platforms,” added Smith.

Dassault Systemes purchased Accelrys Software, a provider of scientific lifecycle management software for $652m.

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FINANCE Taking a look back, three mergers and acquisitions from the healthcare industry stand out from the rest as the most expensive of all time.

At a total end price of $72.4 billion, the merger resulted in GlaxoSmithKline.

This year, the company applied for regulatory approval for the first vaccine against malaria.

3. GlaxoSmithKline – $72.4 Billion In January of 2000, UK pharmaceutical companies Glaxo Wellcome and SmithKline Beecham announced that they would be merging their operations, but it was not until December of that year that the merger was completed.

2. Sanofi-Aventis – $73.5 Billion In the year 2004, sales of pharmaceutical products worldwide came to $550 billion leading to companies seeing the need to expand.

Sanofi-Synthelabo made a takeover bid worth $60.5 billion for Aventis early in the year but the French company rejected the bid feeling it was too low.

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H E A LT H C A R E I T

In August 2004, Sanofi-Synthelabo acquired Aventis for $73.5 billion. The takeover was finalized on December 31 of that year, creating Sanofi-Aventis.

1. Pfizer – $110 Billion In 2000, Pfizer acquired WarnerLambert, bringing together two of the fastest growing companies in the pharmaceutical industry. With Warner Lambert, Pfizer gained numerous product lines from pharmaceuticals to Listerine mouthwash.

In an interview with the New York

Times back in 2000, William C. Steere Jr., then the new chairman of Pfizer Inc., said, “Pfizer and Warner-Lambert represent a new competitive standard for our industry. By combining two world-class organizations to create the fastest-growing major pharmaceutical company in the world, we are positioned for global leadership.”

It was a statement that rang truth, as recent news has highlighted the company for being on the path to curing cancer.

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S U P P LY C H A I N

Is Concierge Medicine the New Primary Care?

IS CONCIERGE MEDICINE THE NEW PRIMARY CARE?

What is concierge medicine and why is it steadily growing within the healthcare sector?

Wr i t te n by : STE PH A N I E C . O C A N O

EARLY ON IN the 1930s, the way physicians made their living was primarily through house calls. In fact, 40 percent of medical visits were made by a doctor visiting a patient in the comfort of his home, according to the American Academy of Family Physicians.

Over time, this percentage steadily dropped due to a lack of funding, an increase in health establishments and following the trend of common practice – until now. Concierge medicine is where patients pay an annual fee to their doctor for enhanced care, and it is a practice that has seen growth in the sector of healthcare for the past few years.

Founded on the belief that healthcare should provide the highest standard of personal care that is equally convenient and accessible, one health startup has unveiled a doctors-on-demand mobile service that connects a physician face-to-face with patients no matter their location.

Developed by co-founders Sam Zebarjadi, Dr. Sahba Ferdowsi and Nafis Zebarjadi last year in South Florida, Medicast is an on-demand, location based service available 24 hours a day, seven days a week. The 23

S U P P LY C H A I N program has extended its services to San Diego, Orange County and Los Angeles, and expects to reach other metropolitan areas this year.

The Rise of Concierge Care Convenient access to quality healthcare is something every healthcare professional strives to achieve. By simply pulling up an app, patients can request a physician to make a visit to their home, office or hotel.

Concierge medicine is still relatively

new but it’s a trend that is catching on. According to the trade publication Concierge Medicine Today, the sector is growing 10 to 15 percent each year.

“There is a proliferation of on-demand services in every aspect of today’s society, and people are becoming busier and their time is more valuable,” said Dr. Sahba Ferdowsi, Chief Medical Officer at Medicast. “Additionally, they are looking for solutions to their current frustrations with healthcare.”

Ferdowsi believes Medicast

“Personal house calls allow the patient to be treated in the comfort of their own home and receive a higher standard of care from start to finish” – Dr. Sahba Ferdowsi

IS CONCIERGE MEDICINE THE NEW PRIMARY CARE?

Medicast has brought back the house call doctor

is just one solution to providing a high quality, compassionate service that has been eroded from the original healthcare system.

“Personal house calls allow the patient to be treated in the comfort of their own home and receive a higher standard of care from start to finish,” said Ferdowsi. “The average length of an in-office doctor visit is six to eight minutes. Our doctors spend an average of 30 to 45 minutes with each patient, and the visit can happen right away, as opposed to waiting days for an appointment.”

With direct primary care now available 24 hours a day by simply using the Medicast mobile app, logging onto the website or making a phone call, consumers can opt out of countless hours in a waiting room and lines at the pharmacy by choosing a private house call with a certified, local physician, ultimately freeing their schedules for a healthier time better spent.

Advantages of Personalized Care for Both Patient and Doctor 25

S U P P LY C H A I N

‘Concierge medicine is attractive for a number of reasons, but most importantly, it allows healthcare providers to mobilize their practice in the palm of their hand’

According to Sam Zebarjadi, CEO of the service, the primary benefit of personal house call visits is that it allows patients to get treated sooner and therefore healthier faster.

“Doctors carry many medications with them which can be dispensed immediately, so the healing process can start right away,” Zebarjadi said. “The doctor can also see the patient in their own environment and assess how that may be contributing to their health.”

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November 2014

“One advantage is that the physician is able to assess the patient in their home, so they are able to gather information that they would not be able to get in a clinical setting (for example, an asthmatic who lives in a smoking environment),” added Ferdowsi. “The physician does not have to rush through the visit and has the time to have educational discussions with the patient where they might not otherwise.”

Ferdowsi also believes that

IS CONCIERGE MEDICINE THE NEW PRIMARY CARE?

concierge care may ultimately reduce healthcare costs, overall benefitting the industry.

“The majority of healthcare costs today are spent on overhead including facility costs, administrative needs, etc. and cutting down on those costs will drive decreased fees and ultimately improve patient outcomes,” said Ferdowsi.

The Future of Healthcare “Telemedicine will play a part in the care process but nothing will replace the in-person relationship that is needed between the physician and patient for a variety of reasons, namely the ability to diagnose certain conditions that require a physical exam, with an added benefit being an opportunity to immediately dispense medication,” said Zebarjadi. “House calls are a way to satisfy this need in a manner that is compatible with the rapidly growing on-demand culture we are seeing in society today.”

Concierge medicine is attractive for a number of reasons, but most importantly, it allows healthcare providers to mobilize their practice “in the palm of their hand.”

“When tied in to the overwhelming

demand for healthcare services, [Medicast] creates a novel way to use technology to empower their practice and make the patient experience better,” said Zebarjadi.

“We’ve seen an overwhelming response from physicians all over the country who are interested in being a part of what Medicast has to offer because they find it a refreshing take on the practice of medicine.

An additional benefit that is very enticing to physicians is the flexibility to practice on their own schedule.”

Thanks to the rise of mobile health applications and concierge medicine, doctors have more time to engage with patients, communicate with pharmacists, and ultimately, improve the continuity of care.

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TECHNOLOGY

HOW CLOUD COMPUTIN THE HEALTHCARE IT IN

Healthcare organizations are adopting cloud-based s alternative to traditional information technology serv will this trend affect the industry as a whole?

W R I T T E N B Y: S T E P H A N I E C . O C A N O 28

November 2014

NG IS CHANGING NDUSTRY

services as an vices, but how

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TECHNOLOGY CLOUD- BASED SERVICES are steadily becoming more widely adopted by healthcare organizations.

The past year alone has seen a surge of interest regarding the potential of cloud computing with many players set to start moving healthcarerelated applications across to cloud platforms in the coming months.

The accelerating migration to cloud computing represents a change for the way the healthcare industry sources its information technology (IT). But will this shift affect other areas of healthcare? According to Accenture, the answer to that question is “yes.”

Healthcare is moving to a digital platform, becoming more patientcentered and data-driven. Large international players such as Microsoft, Qualcomm Life, Philips, Verizon and AT&T have launched cloud-based vertical solutions aimed at the healthcare sector, and the global trend is that cloud solutions are supporting greater sharing and accessibility of health data.

Medical imaging is one of the most prolific uses of cloud in healthcare.

By using a cloud solution for storing and sharing large data files involved in medical imaging saves 30

November 2014

‘Regulation is pushing the industry towards storage, collaboration and sharing in the cloud’’

IPHONE 6: A LIFESAVER?

hospitals, physicians and other organizations in healthcare costs while boosting speed and efficiency.

Widening access to healthcare means companies need greater agility to adapt to change at high speed and low cost, and cloud

computing can solve this. The demand to reach, engage and manage millions of individual endcustomers calls for more powerful systems. At the same time, this flood of patient data needs to be securely shared with healthcare providers.

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TECHNOLOGY

‘Healthcare is moving to a digital platform, becoming more patient-centered and data-driven’

Electronic Medical Record Integration With recent changes to HIPAA and an increased demand for more control over health data, the adoption of electronic medical record systems has emerged as a top priority within the industry. The largest driver for EMR adoption, however, remains to be government incentive schemes aimed at the deployment of healthcare IT. To meet the growing demand, EMR applications and technologies such as secure text messaging are increasingly moving to SaaS delivery models.

Regulation is pushing the industry towards storage, collaboration and sharing in the cloud.

Security Within The Cloud With the move towards electronic medical records, the cloud opens up the prospect of patient health information flowing throughout the world. Security concerns such as the risk of unauthorized access or loss of sensitive information can be addressed by the right combination of currently available cloud provider security capabilities and third-party security products and services.

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November 2014

IPHONE 6: A LIFESAVER?

Cloud computing can help secure shared data

Cloud computing can help secure data shared between different parties through encryption and tokenization of data at rest, in transit and in process. Healthcare providers will need to define the security responsibilities between the tenant and cloud vendors.

Five security measures healthcare

organizations can take to keep their data secure include: 1. Taking a headcount.

Review your employees’ favorite apps for file sharing and collaboration and consider whether any meet the department’s security and other criteria. Upon determination, your 33

TECHNOLOGY

More and more healthcare providers are adding cloud services organization can standardize these apps and educate employees about their availability.

2. Reading the fine print.

Have an attorney scrutinize your cloud services contract and service level agreement (SLA). Determine where your data will be housed and how this location could affect your 34

November 2014

organization’s legal abilities. Be sure to include penalties in the case of failure.

3. Strengthening the network.

As more healthcare providers add cloud services, it is crucial that infrastructures support these additions. Without a reliable network, employees will soon figure out workarounds such as unsecured public Wifi.

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

4. Inventory PHI. Protected health information (PHI) has to be safeguarded. Organizations must therefore consider who has access to data, both internally and at service providers, how it is stored and protected. Ensure that your cloud partners are HIPAA-certified, depending on usage or data stored or accessed.

5. Developing an incident-response plan.

Include contact information, guidelines and a review of insurance coverage for partners as well as employees.

Additionally, stay up-to-date on current local and federal laws.

Entering a New Era As healthcare companies consider the opportunities and risks surrounding cloud computing, they can be sure their competitors are now evaluating cloud solutions, and quite possibly, adopting them.

The healthcare industry’s migration to cloud is inevitable; it’s only a matter of time before all healthcare organizations embrace cloud computing.

‘The healthcare industry’s migration to cloud is inevitable; it’s only a matter of time before all healthcare organizations embrace cloud computing’ Inside Healthcare Cloud Computing 35

TOP 10

Richest Healthcare Professionals in Brazil The richest people in Brazil make up a combined worth of R$ 643.6 billion ($274.6 billion) and a handful of those individuals work in the healthcare industry. Here are the ten richest healthcare professionals in Brazil W R I T T E N B Y: STE PHAN I E C. OCANO

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TOP 10

09

Carlos Pires de Oliveira Dias –

R$ 1.03 billion ($440 million) Carlos Pires de Oliveira Dias is a board member of the pharmacy network Raia Drogasil. He graduated in economics from Mackenzie University.

10

Antonio Carlos Pipponzi –

R$ 1 billion ($427 million) Antonio Carlos Pipponzi serves as President and CEO of Raia Drogasil SA – the fourth largest chain of drugstores in Brazil and second largest in the state of São Paulo.

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R I C H E S T H E A LT H C A R E P R O F E S S I O N A L S I N B R A Z I L

08

Geninho Thome – R$ 1.16 billion ($496 million)

Brazil holds the second position in the dental implant market in the world, second only to the United States. Geninho Thome is President of Neodent – a privately held dental company specializing in the design development and manufacture of dental implants. The company holds a third of the Brazilian dental implant market.

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TOP 10

07

Marcelo Henrique Limirio Goncalves – R$ 1.32 billion ($564 million)

Marcelo Henrique Limirio Goncalves serves as a member of the Board of Directors of Hypermarcas SA – a company engaged in the manufacture of pharmaceuticals. Marcelo began his career at Neo Quimica in 1995. Two years later, he was appointed coordinator. In 1998, he became partner and director at Logus Propaganda and subsequently acted as Chief Marketing and Industrial Officer at Neo Quimica. Marcelo graduated in administration from Universidade Catolica de Goias.

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R I C H E S T H E A LT H C A R E P R O F E S S I O N A L S I N B R A Z I L

06

Paulo Sergio Barbanti – R$ 1.39 billion ($594 million)

In 1968, Paulo Sergio Barbanti founded Intermédica – a health business plan with assets including 90 surgical centers, 11 hospitals, eight emergency rooms and a professional network of 5,600 from around the country. With a total of 3 million beneficiaries, including health and dental plans, Intermédica has a strong presence in São Paulo.

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TOP 10

05

Jose Seripieri Filho – R$ 1.51 billion ($645 million)

Jose Seripieri Filho began selling health plans in the late 1980s. His experience in the industry led to the formation of Qualicorp Consultoria e Corretora de Seguros de Vida e Saude Ltda. Jose introduced the business model of making group adhesion health plans possible through partnerships with professional associations, which later on became an industry standard.

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R I C H E S T H E A LT H C A R E P R O F E S S I O N A L S I N B R A Z I L

04

Francisco Deusmar de Queiros – R$ 2.18 billion ($932 million)

Francisco Deusmar de Queiros owns the second largest pharmacy chain in Brazil in sales, behind only newly consolidated Raia Drogasil. Pay Less, earned $3.2 billion in 2012 and last year was expected to reach revenues of R$ 4 billion and 17,000 employees, according to Forbes Brasil.

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TOP 10

03

Jorge Moll Filho – R$ 3.17 billion ($1.35 billion)

Jorge Moll Filho is a Brazilian cardiologist and entrepreneur who founded Cardiolab – a health diagnostics imaging laboratory – in 1977 and was later rebranded as Labs D’Or – a network of health diagnosis centers throughout Rio de Janeiro. Today, Rede D’Or operates 24 hospitals in several Brazilian cities with more than 4,000 beds. Another four hospitals are in the planning phases.

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R I C H E S T H E A LT H C A R E P R O F E S S I O N A L S I N B R A Z I L

02

Dulce Pugliese de Godoy Bueno – R$ 4 billion ($1.71 billion)

In 1972, Dulce Pugliese de Godoy Bueno cofounded Amil Participacoes with her former husband Edson de Godo Bueno. With the acquisiotion of a few medical practices, Amil was tuned into a successfully publicly traded health insurer and hospital operator. Dulce received a PhD in management from McCombs School of Business at the University of Texas at Austin and was assistant professor in the pediatrics department at Universidade Federal do Rio de Janeiro.

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TOP 10

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R I C H E S T H E A LT H C A R E P R O F E S S I O N A L S I N B R A Z I L

01

Edson de Godoy Bueno – R$ 5.79 billion ($2.47 billion)

Edson de Godoy Bueno is Brazil’s richest healthcare billionaire. In 2012, UnitedHealth Group purchased 90 percent of Brazilian insurer and hospital operator Amil Participacoes for $4.9 billion from Edson, with Edson retaining 10 percent of the share. Edson then went on to buy $470 million worth of UnitedHealth shares and joined the board.

According to Forbes, Edson is the son of a truck driver who decided to become a doctor at the age of 14 while working at a clinic. He later purchased the clinic before getting a medical degree from Universidade Federal do Rio de Janeiro.

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Anywhere Healthcare: Bringing healthcare toall 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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A N Y W H E R E H E A LT H C A R E

A

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 50

November 2014

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 cloudbased 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 new and better solutions to improve their services. Australia does not have ubiquitous access to one backbone of Internet, so

AUSTRALIA

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-of-pocket 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.

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A N Y W H E R E H E A LT H C A R E 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 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 patientcentre care, third-party vendors

AUSTRALIA

are also engaged to assist in areas of high service demand such as Medical Transcription.

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 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

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A N Y W H E R E H E A LT H C A R E

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 54

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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

Company Information INDUSTRY

Health EMPLOYEES

Samuel Holt, Director of online care REVENUE

$5.9 billion PRODUCTS/ SERVICES

Healthcare consultations via video

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.

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Company name: National Association Headline to the Report of Pharmaceutical Standfirst nectio et eic tenis sit laborum arum lit Manufacturers: volorum eria nat quid quiam restibus, sit, quaestenim as ent hillaut etur accabor sam, omnimporume evernam Written by: Eduardo faccus Pasquel, eatur Communications director Written by:by: Produced Laura LucyClose Verde Produced by: James Hayes

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A N A FA M

T

ANAFAM is composed of 28 companies and more than 20,000 employees

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here were only 12 Mexican pharmaceutical companies engaged in the manufacture of solvents and simple formulas in the XX century. In this context they also had some providers, especially from Europe, who were responsible for the imports of drugs.

By May 12, 1945, a group of businessmen were called in order to create the National Association of Manufacturers of Pharmaceutical and Medicinal Chemicals, a direct predecessor of what is now the National Association of Pharmaceutical Manufacturers, Ac (ANAFAM).

ANAFAM has served as a representative of the pharmaceutical industry, mostly in the Mexican capital, as well as some established companies in the international market, which are actively involved and recognized in the supply of medicines both in the public sector (government) and the private market.

Our associates cover a production of 60 percent of the requirements of the public sector, 18 percent of the needs of the private market, which represents a supply of 40 percent of the medicines consumed in the country.

Investing in research and development (R&D) has been one of ANAFAM’S greatest efforts, with a dedicated 15 percent of the total investment in this field.

ANAFAM is composed of 28 companies, which together make up a workforce of over 20,000 employees. One of ANAFAM’s major objectives is that in Mexico the principle active ingredients

L AT I N A M E R I C A

(API’s) necessary for the production of all drugs is manufactured in the country.

Also, because today biotech drugs have become an important option for the treatment of many of the most serious diseases, ANAFAM we have established a solid commitment to the purpose of promoting the I&D, as well as production bio comparable for biotech and throughout Mexico and other countries.

Another of the fundamental purposes of the laboratories that are part of ANAFAM is to be involved and support our facilities and quality systems, which are at the forefront, which will allowed the consumer’s confidence.

Aware of the importance of preserving our environment, companies in ANAFAM we continue

Key People

Alfredo Rimoch President of the association

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President Rimoch in a presentation to members of ANAFAM

A N A FA M

L AT I N A M E R I C A

to make a significant investment of resources in order to prevent pollution and to develop industrial activities to protect nature.

ANAFAM insists on enforcing the regulations in order to avoid health risks in addition to promoting an environment of fair competition.

We affirm that: it is necessary that policies regarding industrial property and the right balance to ensure our people’s innovation in health and universal access to medicines.

Because our commitment lies in forming companies with high ethical standards, we have integrated the Board of Ethics and Transparency of the Pharmaceutical Industry (CETIFARMA), while sign and take the principles contained in the Code of Ethics and Transparency in the Pharmaceutical Industry.

“ANAFAM affiliates represent a supply of 40 percent of the medicine consumed in Mexico”

Company Information INDUSTRY

Industrial Association HEADQUARTERS

Mexico FOUNDED

May 12th, 1945 MEMBERS

28 KEY PEOPLE

Alfredo Rimoch (President), Luis Jorge Pérez Juárez (Vice-president), Oscar Osorio (Vicepresidente), Guillermo Funes (Secretary), Ho-Chi Vega (Treasurer)

– Alfredo Rimoch, president of the association

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Mexican Association Company name: of Transfusion Medicine: Headline to the Report

Standfirst nectioand et eic tenis sit laborum arum lit History perspectives volorum eria nat quid quiam restibus, sit, quaestenim as ent hillaut etur accabor sam, omnimporume Written by: Clotilde Estrada Carsolio, President of AMMTAC evernam faccus eatur Produced by: Lucy Verde Written by: Laura Close Produced by: James Hayes

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A M M TA C

A

AMMTAC National Congress participants

MMTAC’s mission is to cause the continuous update of the personnel involved in the Transfusion Medicine with high level educative activities, consensuses and discussion forums that allow to exchange ideas among scientists, academic and technological associates in Mexico.

It is a multidisciplinary non-profit association aim at leaders within the area of Blood Banks and Transfusion Medicine. Since 2012 they have their own offices and library.

ACADEMIC ACTIVITIES: • Thirteen national congresses.

• A joint congress with (ISBT) .

• An event called “Jornada de Medicina Transfusional”. All celebrated within the Mexican territory, with an average attendance of 1200 people including members from Central and South America.

• Monthly academic sessions each second Thursday of the month, also with virtual assistance.

• Four Transfusion Medicine Diplomat.

• One Aphaeresis Diplomat.

• Contact with experts with aims of academic support for diverse courses, diplomats and other academic events.

PUBLICATIONS: • Memories of congresses and Work Day. • Cuatrimestral magazine.

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L AT I N A M E R I C A

• 2007 elaboration, of “Guides for Clinical Use of Blood”, available for free in the web page.

• August of 2011. Edition of the book “Inmunohematología (Recommendations of Experts of the Mexican Association of Transfusion Medicine AC)”.

• 2012, publishing AMMTAC editors of the book “Transfusion Medicine 10 years” 52 chapters of transfusion medicine topics.

• 2013, publishing AMMTAC editors of the book “Blood Fractionation”.

COMMUNICATION AND DIFFUSION: • Web page, with compatible platform with movable devices, Facebook page and Twitter page. Publication in Web and Facebook of links to promote national and international consultation and advanced training courses

Key People

Clotilde Estrada Carsolio President of AMMTAC

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C O M PA N Y N A M E

Since 2012 they have their own offices and library

“The continuous improvement of processionals involved in the business of Transfusion Medicine”

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of scientific material and laws of application for Blood Banks.

• First child and youth drawing contest “Blood Donation importance”.

INTERRELATION WITH INSTITUTIONS: • Institutional member of (WAA) the World Aphaeresis Association.

• Institutional member of the Iberoamerican Cooperative Group of Transfusion Medicine

SECTOR

(GCIAMT).

• Active Participation in the International Society of Blood Transfusion(ISBT).

• Active Participation within the advice of the Farmacopea Mexicana.

• Active Participation in the Mexican Accreditation Organization (EMA).

• Active Participation in National Medicine Academy.

• Integration like Civil Association within Mexican

At the 2014 AMMTAC National Congress

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A M M TA C

In the development of conferences and events for today’s healthcare executive in Mexico

Health Secretary.

BENEFITS OF THE MEMBERSHIP: • Discounts in publication purchase and participation of academic activities • Obtaining of certainties with aims of certification or accreditation.

List of certified committee members

LEGISLATION: • Consultant’s office of expert scientists in the elaboration of the NOM-253-SSA1-2012, Official Mexican Norm For the Disposition of Human Blood and its Components with Therapeutic Aims.

PRESENT TIME SUBJECTS:

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L AT I N A M E R I C A

• Promotion of blood transfusion security through promotion of the repetition voluntary donation 2,7% Is the present number of voluntary donation in Mexico among the general population.

• Service to the community and promotion of blood transfusion security. - Requirements, and explanatory video of the blood donation as well as adresses (including location maps) and telephones of the blood donation points of the Mexican Republic.

• In progress 2ndo Child and youth drawing contest “Importance Blood Donation” • 2014 September, the Mexico’s XII National Congress session took place, in Boca del Río, Veracruz, and was very successful as a record of 1,267 people was registered, between congressmen, teachers, chaperones and commercial exhibitors; and the 2nd children’s drawing contest took shape.

• 2015 XIII National Congress join with ISFA congress. Cancún, Mexico from the 13th to the 16th of May.

Company Information NAME

Mexican Association of Transfusion Medicine INDUSTRY

Civil, Non Governmental HEADQUARTERS

Mexico FOUNDED

December 13th, 2001 WEBSITE

www.ammtac.org

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SINDUSFARMA:

UNION OF THE INDUSTRY FOR PHARMACEUTICAL PRODUTS IN THE STATE OF Sﾃグ PAULO WRITTEN BY: NELSON MUSSOLINI

PRODUCED BY: KARLA SOHN

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S I N D U S FA R M A

W Nelson Mussolini, Executive President of SINDUSFARMA

Nelson Mussolini during presentation in workshop about traceability of medicines

ith 81 years of existence, Sindusfarma is the largest entity representing the pharmaceutical industry in Brazil. Presently, it convenes 182 national and international companies that have over 90% of the medication market in the country.

In broad lines, Sindusfarma guides its associates in the fields of sanitary regulation, and market and labor regulations. It is also active in economic and taxation issues, besides taking part in discussions with the government and agencies in the field regarding all matters relating to development, production and expansion of the access to medication for the population at large.

Knowledge Throughout its trajectory, Sindusfarma has reaffirmed its commitment with the dissemination of scientific knowledge and the enhancement of professionals in the pharmaceutical industry. Since 2000, the meetings and workshops fostered by the entity have attracted approximately 95 thousand participants.

Sindusfarma also holds large events, such as the Sindusfarma Quality Awards, Excellence Award in Occupational Health and Safety, the Boomerang Award and the Sindusfarma Open Games, among others.

Major Themes Sindusfarma has held a dialogue with authorities, specialists in the health fields and with society

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regarding major sectoral themes.

One of these is the reduction of the steep tax burden that falls upon medications in Brazil. It is absurd that taxes represent one third of the end price of medication- 33.9% -, while the world average in terms of drug taxation is of 6.3%.

It is Sindusfarma´s understanding that the pharmaceutical industry that has settled in the country faces distortions in economic regulation. For example, there is the need to modernize legislation that sets forth prices and readjustments for medication, as the law in force penalizes productivity gains and inhibits investments in Research and Development (R&D).

The correct remuneration for innovation is fundamental for companies to become motivated to invest the steep resources needed for state-of-theart medication.

Solemnity of Sindusfarma of Quality Award, held at the HSBC Brasil playhouse, in SĂŁo Paulo w w w. s i n d u s f a r m a . o r g . b r

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Cleiton de Castro Marques and Geraldo Alckmin

S I N D U S FA R M A

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Sindusfarma stand in FCE 2014

Access to medication One of Sindusfarma’s constant concerns is the sustained increase in access to medication for the Brazilian population.

How to guarantee access to more modern medication for the serious diseases that have a broad incidence - cancer and degenerative diseases such as Alzheimer, among others -, in a context in which health resources are finite, on the part of companies as well as for the government?

Sindusfarma understands that this goal will demand delving deeper in the partnership between the government and the pharmaceutical industry, to make the most of the State’s purchasing power and the ability companies have for production and innovation. Besides enhancing the private and public health systems, that is, greater rationalization, both have to increase the quality of their expenses. w w w. s i n d u s f a r m a . o r g . b r

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S I N D U S FA R M A

Excellence of Health and Safety Management in the Workplace Award winners.

Ceremony held at the Clube SĂ­rio, in SĂŁo Paulo

Outlook Sindusfarma is an advocate of the thesis that Brazil needs to define a clear strategy for the development of the pharmaceutical chain. In the 1970’s, Brazil missed the opportunity of create a sound pharmachemical industry, based on medications from chemical synthesis.

The great opportunity at present lies in biotechnology. The international pharmaceutical industry is investing heavily in biotechnological products, and Brazil cannot miss this chance.

Sindusfarma has reiterated to the government that the source of capital is not the most important factor. Instead, it is allowing research to be carried out in Brazil, and setting up a tripod in Brazil similar to the one that sustains 76

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Company Information INDUSTRY

Pharmaceutical HEADQUARTERS

S達o Paulo, SP - Brazil FOUNDED

1933 NUMBER OF MEMBERS

182 companies MANAGEMENT

the pharmaceutical poles of developed countries: close collaboration between private initiative and academic institutions, with government support, by means of incentives.

Government cannot take on the role of companies in the development and production of medication. As happens elsewhere in the world, the high risk involved in R&D projects for medications should fall upon private initiative.

Executive President: Nelson Mussolini Executive Vicepresident: Lauro Moretto

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Biocor:

research, technical improvement and continuous investments Whether for healthcare or disease treatment, the Institute always wants to be top of mind in healthcare Written by: Flรกvia Brancato Produced by: Karla Sohn 79

BIOCOR INSTITUTO

B “We reaffirm our actions for the society with innovative practices in terms of the environment and the social responsibility” – Dr. Mario Vrandecic, CEO

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iocor Instituto, a hospital, has been recognized over the years as an international source of diagnosis and treatment of heart diseases. Recently the hospital becoming a general hospital and gained a reputable reputation for their other clinical practices. For almost 30 years, Biocor has been in the spotlight as a Center of Reference for highly complex diseases, with facilities for outpatient care, hospitalization and urgency/emergency, in 40 medical specialties.

Located in a 32-thousand-square meter area in the famous neighborhood of Nova Lima, in the State of Minas Gerais, the complex is fully equipped for appointment reservations and diagnosis services. Biocor also provides a skilled clinical staff comprised of self-employed and experienced physicians, including about 1,200 collaborators ready to provide humane support with quickness, efficiency and security to all of its 320 beds.

ONGOING GROWTH Biocor Instituto, conscious of the importance of higher education and keeping up with new technologies, continues to invest in all areas of operation, especially in the modern integrated computer system, keeping focused on the strategy of differentiation in technology, electronic medical records and humane support.

Associated to over 70 providers of Healthcare Plans, Health Insurance Companies and Self-

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Management Companies, Biocor services are available to nearly 2 million people. “The affectionate and ever-present attention ensures Biocor Instituto a rare level of approval: 99.7% of the patients and family members say they are pleased with the services of the institute,” states the CEO of Biocor Instituto, Dr. Mario Vrandecic. Dr. Vrandecic believes that continually strengthening advanced and complete service makes all the difference.

“The index attests the status as a reference in the sector, thanks to the modern infrastructure and state-of-the-art technology combined with a very particular way of welcoming and caring for people in a very special moment, when they are coping with health conditions,” he adds.

Still with a strategic view focused on keeping itself as a domestic and international reference in highly complex diseases, the hospital continually invests in the improvement of organizational and personnel management.

“Since 2012, our workforce has grown by nearly 11 percent, combined with

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BRAZIL

solutions in technology and mechanization of processes,” says Vrandecic.

The goal of the company is to continue to increase sales revenue. The CEO explains that by focusing on the ongoing healthcare improvement, physical improvement and expansion, following a previously set plan and taking the sustainability policy into account, “the growth trend is a positive one. The average annual growth has been 16 percent since 2012, and for 2014, our expectations remain the same.”

INVESTMENT PLANS The investments will be in the expansion of the physical structures, machinery and equipment, as well as in IT, with emphasis on the 64-Channel Multislice Computed Tomography, which is already in operation. It is one of the most advanced CT Scanners in the world that allows performing examinations more quickly and with high-resolution

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New nursing stations equipped to serve patients

Well equipped suites provide comfort to patients

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images, including 3D technology, thus increasing the accuracy of vascular injury diagnosis by means of the double reading of images. The machine provides better evaluation in other body segments and accurate measures for a better therapeutic planning when performing examinations such as angiotomography, hepatotomography, virtual colonoscopy, enterotomography, urotomography, volumetric analysis, among many other applications.

The areas of technical and professional education also stand out, which involve the Own School of Nursing Technicians which schedules more than 28 scientific events annually. Vrandecic further states that other goals of the company should be noted, such as Biocor’s social responsibility. “We reaffirm our actions for the society with innovative practices in terms of the environment and the social responsibility, in addition to events held on a weekly basis with our patients, such as the Art in the Yard program”, he explains.

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New nursing stations equipped to serve patients

“In the last three years, BRL 35 million has been invested in works, equipment and preoperating expenses, and the same amount is expected to be invested in the three-year period from 2014 to 2016” – Dr. Mario Vrandecic, CEO

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The Chairman points out that “the Institute has been guided by analyses and actions that take into account the global good and not only local good. In the last three years, BRL 35 million has been invested in works, equipment and preoperating expenses, and the same amount is expected to be invested in the three-year period from 2014 to 2016”. Finally, Biocor’s Master Plan anticipates the incorporation of a new area of approximately 6 thousand square feet. In its final

phase of study, this project will provide new beds, enlargement of the ICU, surgery tower, oncological sector, and the emergency room, Day Clinic, etc.

EXCELLENCE AND RECOGNITION Biocor Instituto was the first hospital in Brazil to be awarded the International Certificate ISO 9000 for all of its sectors. A pioneer in health quality management, it is certified by the NIAHO (National Integrated Accreditation for Healthcare Organizations) – an international accreditation developed by DNV - Det Norske Veritas (a Norwegian certification company w w w. b i o c o r. c o m . b r

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BIOCOR INSTITUTO

Dr. Mario Vrandecic, CEO and Dr. Erika Vrandecic, Medical Director

existing for over 144 years) and approved by the Centers of Medicare and Medicaid (CMS) of the American Government, which aim to train and certify hospitals not only in the United States, but also in other countries, focusing on the security of processes, relationship and organization of the Clinical Staff.

Modesty aside, Biocor has also been awarded the integrated management certifications ISO 9.001:2008, ISO 14.001 and OSHAS 18.001, accredited as ONA Level 3 excellence. All of them evidence even more the establishment of Biocor Instituto as a reference of excellence in health services, standing out by its consistent management system and its 88

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commitment to the scientific, technological and human development.

MANAGEMENT SYSTEM POLICY • To follow the laws and the integrated management system, being aware of the mutual relationship among institute, patients, agreements, physicians, Information Security, and the environment; • To assist patients in a humane, professional and devoted manner, following the highest standards of modern medicine, with efficiency, Information Security and cost balance; • To use research and development as a means for the ongoing improvement of services, with Information Security, and minimizing risks to patients, as well as the occupational, environmental, civil responsibility and financial risks; • To disseminate and delegate to each member of the organization the responsibility for the service provided, minimizing the risks to patients, and the Information Security, occupational, environmental, civil responsibility and financial risks, by means of ongoing training; • To involve suppliers and institutes of cooperation and support in the constant search for the best ways to provide the services, so as to meet the environmental, occupational, Information Security and the institute needs.

Company Information INDUSTRY

Healthcare HEADQUARTERS

Nova Lima, Minas Gerais - Brazil

FOUNDED

1985 PRODUCTS/ SERVICES

High complexity hospital MANAGEMENT

Mario Vrandecic: CEO Heloisa Vrandecic: Finance Director Erika Vrandecic: Medical Director Ektor Vrandecic: Clinical Director

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