How a small clinic is having a big impact on healthcare in Brazil
By Sasha Banks-Louie, Oracle
Tuesday, 01 May, 2018
Brazil's inability to provide some 150 million uninsured residents with access to healthcare has created a significant market opportunity for low-cost medical clinics like Dr. Consulta.
Launched in 2011 in São Matheus, one of São Paulo’s poorest neighborhoods, Dr. Consulta charges patients a flat fee of $30 to meet with a physician of their choosing, in any one of 50 specialties. The fee is sometimes reduced or even waived, depending on the patient’s health condition and ability to pay. Prices for exams such as MRIs, blood tests and mammograms range from $3 to $30 and are done on-site.
The company’s business model contrasts sharply with other private healthcare providers that work with network plans and insurance companies to pay for their services. Coverage, on average, costs Brazilians $120 each month for premiums that typically buy access to one ‘in-plan’ general practitioner. Additional fees for off-site exams, lab work or specialist visits can rise to more than $200 each.
“Brazil’s private healthcare system is designed to maximise collections from health insurance companies,” says Thomaz Srougi, founder and CEO of Dr. Consulta.
Yet, only 25% of the country can afford private health insurance, so the majority of Brazilians turn to public healthcare. Unlike Dr. Consulta’s clinics, which make money from a high volume of low-price out-of-pocket payments, the country’s public system is funded through federal, state and local tax revenue. But poorer municipalities have funding shortages, so their clinics have outdated and sparse medical tools, unsanitary conditions and overcrowded facilities. According to the World Health Organization, Brazil has just one physician for every 1000 patients. At Dr. Consulta, the ratio is one specialist for every 80 patients.
Smarter, faster healthcare
Dr. Consulta employs 1300 physicians who treat 100,000 patients each month. The healthcare provider relies on cloud applications to manage costs; swift and accurate diagnoses are made possible thanks to machine-learning algorithms that correlate clinical data, such as new drug therapies, with patient health conditions and treatment results.
“AI has made it possible for us to develop our own medical records system,” Srougi says. “Now, we can we analyse scientific and medical statistics that help us identify the probability of someone contracting a chronic health condition in the future, and then treat them immediately to reduce, or eliminate that risk,” he says.
Dr. Consulta also uses cloud applications to help run its marketing, finance and supply chain operations. The increased efficiency has allowed the company to expand from a single clinic in a low-income slum to a network of nearly 50 health management centres across São Paulo.
“The huge amounts of clinical data being collected and stored are enabling Dr. Consulta to provide precise medical outcomes and strengthen a new type of long-term relationship with patients,” Srougi says.
Timing is everything
Dr. Consulta sees much of its success resulting from these close, long-term relationships it’s developing with patients. This requires its medical centres to provide a constantly evolving range of health services, particularly as patients grow older. Brazil currently has an elderly population of about 16 million, who are mostly indigent and infirm.
Dr. Consulta also reaches out to patients with updated information and recommendations about the particular illnesses or conditions that brought them into the clinics in the first place. To tailor these communications, patient information from the company’s core health management data warehouse is fed into Oracle Responsys, part of Oracle’s marketing cloud applications. Based on the patient’s age, health history and treatment plan, the Responsys app automatically recommends new health services, provides links for patients to schedule a service and then, after each visit, sends a follow-up survey to solicit feedback on the patient’s experience with the new service, the physician who treated them and their results. “How we time our marketing communications has to be very precise,” says Jorge Tung, Dr. Consulta’s chief product officer.
Platform for expansion
The company has been growing quickly — 300% per year during the past six years — putting more pressure on the company to cut costs, scale the business and maintain its quality of service.
The company uses Oracle Financials Cloud, part of the Oracle ERP Cloud suite of applications, to process hundreds of thousands of payments and invoices from its health centres each month. At the current rate of expansion, “it would be a nightmare to manage all of our transactions using spreadsheets and [on-premises] accounting software”, says Gaston Perez, Dr. Consulta’s chief technology officer. “That would require our staff to spend hours doing manual data entry to consolidate the data from each clinic and upload it to our core finance system.”
Perez is also using Oracle Supply Chain Cloud to order medical supplies, manage inventories and track supplier profiles across its distributed network of clinics.
“This wouldn’t have been possible without the cloud,” Perez says. “A sudden material outage would seriously undermine our ability to provide the services we need.”
Perez attributes significant savings to how fast and easy it was to implement Oracle Cloud applications. “We didn’t need to acquire hardware or install any software,” Perez says. “We just log in and the app is there. It’s saved us a lot of money and allowed us to move fast and grow fast.”
Guilherme Azevedo, the company’s chief of people operations, sees the cloud as the linchpin that helps Dr. Consulta consistently provide efficient, quality and affordable healthcare services to patients.
“If we have bottlenecks, or we deliver a bad experience, we are done,” says Azevedo. “If we can’t scale the business to keep up with demand, we are done.”
The company expects to open four new medical centres next month and post its first profit by the end of the year.
Despite its rapid expansion, the company services just 4% of Brazil’s total patient population. “That’s nothing,” Azevedo says. “We have so much more room to grow.”
Originally published here.
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