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EF: 2020 was the year of diagnostics, 2021 the year of vaccines, and 2022 the year of rethinking healthcare and bringing patients back to care. What do you think 2023 will be a year of in Mexico?
JD: The last couple of years were centered around Covid recovery, which brought an influx of investments into the Mexican healthcare infrastructure. 2023 will be the year of digitalization, categorized into two dimensions. Several established hospitals and companies have yet to commit to digitalization and data services fully. Secondly, as an industry, we need to create a favorable environment for new start-ups to succeed and for skill growth to scale up.
To fully digitalize the healthcare industry, we must be more digitally aware, savvy, and willing to adapt. Artificial intelligence, digitalization, and data management create an efficient and effective workflow, making digitalization the leading trend globally. This year will mark the beginning of digitalization in Mexico.
EF: How do you assess the progress of the goals you set for yourselves, and what else does this year have in store for Philips Mexico?
JD: The Mexican healthcare system favors financially stable people with premium healthcare insurance. There are no waiting lists if you have access to the private sector, and most private hospitals offer premium healthcare services comparable to or even better compared to European Countries and the USA. Unfortunately, in the public segment, this is different. The majority of people are dependent on public healthcare services. As a result of this, the system gets overloaded easier, resulting in longer waiting lists, etc. Despite this, public healthcare services in Mexico are good, and the public sector generally buys premium equipment. This is remarkable compared to other countries in the region.
Driven by key trends such as aging, a fast-growing middle class, chronic disease, unhealthy living habits, staff shortages, etc., the healthcare system will likely get under more pressure. The healthcare system requires innovative solutions to meet the increased demand of the fast-growing middle class.
Indications showed the beginning of digital transformation, mainly related to electronic patient records. In 2022, we sold our first Electronic Patient Record system to the public sector, which we will be implementing in 2023. As a result of that, digitalization in the public sector is starting to take off.
Since last year our goal has been to increase access to care. Expanding our product and technology footprint is the best way to increase access. Our top priority is to provide premium technology. We will continue improving procedural treatments by quickening them while maintaining their quality. Last year we made much progress despite the global supply disruptions. We won 3% of the market share, propelling us closer to where we envision. For collaborations between the public and private sectors, all the stakeholders need to step up and make the partnership a reality.
EF: Could you elaborate on the difference between the public and private sectors? How do you assess the sectors regarding the latest technologies, and what can be done to change that?
JD: There aren’t many differences between the sectors regarding equipment adoption. Both sectors buy mid to premium-quality MRI scanners, CT scanners, etc. The main difference is in the informatics or software businesses. The public sector has slower digital adoption due to the complexity of different processes. The private sector can decide what to buy while the public system undergoes a tender procedure. Transparency and purchasing justification are required when equipment or digital tools are purchased. Usually, in a tender bid, the equipment with the lowest price is awarded the tender. In informatics, it's difficult to compare different technologies and solutions, which makes it complicated for public tenders. As a result of this, adoption is slower.
In informatics and software solutions, comparing different products is difficult because some systems perform differently. It is especially difficult to frame the requirements of other systems in a tender. As a result, it becomes extremely difficult for the government to purchase certain software because the tender process does not allow it. AMIIF and many other organizations are working with the government to change or at least amend the system.
This is the main reason for the slow rate of digital adoption in the public sector. Public hospitals and healthcare service providers want to use digital tools. The hurdle is the purchasing of those tools. Most people in the public sector also work in the private sector, mostly as part-timers. They see and understand the real benefits and advantages of using technology. It is about finding ways to purchase it.
EF: How do you assess interoperability in Mexican healthcare right now, and what would you suggest as steps to improve this and increase the collaboration of data?
JD: The challenge of data management and interoperability is the same worldwide. The interoperability solution is to create more open-source platforms. These are platforms where individual companies can produce applications, integrations, and plug-ins to further expand the capabilities of a platform.
Two main challenges need to be solved. The first is data sensitivity. Many software systems manage patient data. They are private for security and confidentiality reasons. The second challenge is the technology itself. Digitalization is just beginning to dominate the industry, which has created a competitive environment. Everyone wants to be the first to deliver the best solution. However, many companies fear using open-source platforms because they believe others will copy their solutions.
Tasy, the EMR solution we sell in Mexico and other countries in Latin America, is becoming a more open-source solution. We have begun working with start-ups in Brazil to develop apps and integration plug-ins in the EMR solution to make it more interoperable. Interoperability is key to improving efficiency in the system. Real digital transformation integrates and plugs all brands and hospital solutions into the same data. It will take some time to get to the same level as other industries.
EF: If interoperability is the key to success in efficiency, how do you assess the need for collaboration among stakeholders like the government, MedTech, and other companies in the healthcare industry?
JD: It takes time to complete all the required paperwork before you are admitted or attended to in a hospital. There are no electronic records of anyone’s medical history or insurance coverage, and this is all information they ask everyone when they are admitted. The process is so long because it is all paper based. If an app or document linked to an EMR system is created, all people must do is scan their QR code or app at the hospital to get admitted. The QR code or app will have all your information, medical history, and insurance coverage. The same code or app can give you access to digital pharmacies. The app can go as far as to track your medication intake and keep your doctor informed of your condition. There are smartwatches, electronic medical records, digital pharmacies, and telehealth. All these apps are available individually. It is just a matter of integrating them all into one. The next billion-dollar company in healthcare is going to be the one that is connecting all the dots but to succeed; it will require an industry change in which data is secure but shared.
This is something a company does not have to create from scratch. The only way to integrate it all into one is to create an industry standard of integrating data management and patient flow between the different systems in the healthcare industry. I am optimistic and pessimistic at the same time. It is possible to create an integrated approach. However, the biggest issue we will have to resolve is the number of steps we need to take and the number of different service and solution providers at each stage. The only solution to this integration is to have all the companies make their solutions fully open source. The only other way to solve this is to create an AI solution that automatically integrates everything.
Besides, hospitals will need to work on simplifying processes throughout the hospital. The amount of paperwork the average nurse has to maintain and fill on a daily basis is crazy. This should all be app-based and digital.
The lower adoption rate is why the systems are less integrated than the other sectors. I believe this is related to data sensitivity. No one wants to share their patient data with other profilers. Blockchain has true potential as a technological tool, but there has yet to be a real-use case within the medical industry. It is currently being used in the supply chain and can be used in healthcare to protect and track patient data.
EF: How are you contributing to local innovation in Mexico, and how do you instill an innovative mindset in your employees?
JD: The main reason we don’t produce innovative products locally is because of the technological complexity of our solutions. Because of that, we focus on a couple of central innovation hubs, specifically in the Netherlands, China, India, Israel, and the United States. The other countries, we are present commercially to sell and service.
One of the biggest local innovations we are focusing on is shifting the relationship with our customers; from a transactional to a long-term partnership. One key element is becoming a strategic advisor/consultant for our customers and being involved in their longer-term planning.
In the last few years, I have seen a huge innovation drive in Mexico. I talk with many start-ups and founders and have invested in some start-ups within the health-tech space in Mexico myself.
Many of our customers, hospitals, and clinics need help with efficiency. We have a dedicated organization team called the Healthcare Transformation Services that helps identify workflows and how to improve them in hospitals. The team allows hospitals to design or redesign new hospitals to fit the ideal workflow created for efficiency automatically. We also help with the automation of the inventory supply system. Hospital inventory should always stay supplied because it causes delays across the board.
An example of what we do is image-guided therapy. The average procedure takes approximately 45 minutes. Much of this time is spent cleaning, prepping, and moving within the room. We monitor the movement of people in the surgical room; then, we use AI to identify how much a person moves and how much they should move. Sometimes the solution to improve efficiency is straightforward, for example, by changing the set-up of the room or changing where the anesthetist is located. We are innovative through our client consultations for the improvement of their workflow and operating systems.
We drive for the early adoption of technology. We pilot new technologies in Mexico. For one of the biggest private hospitals in Mexico, we will install a first-of-its-kind spectral CT system. It is the first in Latin America. Before we commercially sell systems, we work together with hospitals here to test the systems and get their feedback.
EF: How do you see the value of the hybrid model going forward, and how else do you attract top talent to Philips Mexico?
JD: We implemented the hybrid model after the pandemic Top companies awarded us for the way we implemented our hybrid system. It worked very well for us because of our flexibility. We work in the office two to three days a week, and for the rest, we work remotely. Everyone has much flexibility in alignment with their manager; they can choose when and where they work. I only partially support completely remote work because there is little to no engagement with the company and co-workers. When hiring, we require people willing to use the hybrid model. I am personally not a big fan of fully remote working models, as you need to engage face-to-face to build engagement and culture. However, the hybrid model is perfect. You use your days in the office to engage and work with the teams and your days at home to focus on individual tasks.
I see the productivity of the days off from the office. In the beginning, many people feared covid since the last big wave was at the beginning of last year. However, that all changed during the course of the year. We do an employee engagement survey every quarter, and the previous quarter had the best results in the history of Philips Mexico. We want people to come to the office and engage with their co-workers. To boost employee engagement, we organize out-of-office outings and exercises. We now see more people in the office on more days. This is what sets us apart from other companies. I think we also need to rethink the concept of an office. For example, not every meeting, workshop, or event needs to take place in the office indoors. Make use of the beautiful nature surrounding Mexico City, go for a hike with your team, have meetings outside, etc. By doing so, you will automatically notice that people get more engaged and inspired. If you get stuck with something, go for a walk outside. There is no roadblock big enough that a 30-minute walk in nature cannot solve.
EF: If you had to create your own start-up company in the Mexican healthcare sector tomorrow, what would you create and why?1
JD: I would create a platform connecting Mexico’s population to healthcare, fully digital, linking all different steps in the healthcare system. In Mexico, if you are well-connected, getting the care you need is very easy. It is different from other countries because, in other countries, there are referral systems. Many people are stuck in the middle and do not know which specialist to go to for their condition, how to track their data, etc. So, it's time for a “digital hospital” where you can find everything you need, and that keeps track of your health. Integrating hospitals, insurance providers, EMRs, etc. This is the future.
EF: If you were to create a roadmap to the future for other executives leading the healthcare industry, what three pillars would you name?
JD: The risk of working in the healthcare sector anywhere in the world is that it is a traditional business. It's a relatively old-school industry. The leadership needs to transform and create an appealing work environment within the healthcare sector in Mexico. We need younger executives who do not conform to traditional healthcare but to the tech world. I encourage many tech talents to start working in healthcare. The healthcare sector will be the next disruptive sector after fintech and e-commerce. The first pillar is young, innovative people who will take leadership roles in start-ups and established companies.
The second pillar is to become fully digital by integrating our different solutions and services. Everyone has a smartphone or access to some form of technology. We should leverage it and improve their access to healthcare.
The third pillar is to disrupt the regulatory framework completely. The paperwork and complexity needed to innovate or sell a product in Mexico slow down the transformation we need. If the FDA or European legislators approve technology or products, it is unnecessary to repeat the same process in Mexico. We should agree to use a global standard of either the FDA or a combination of the FDA with European regulators. If they approve a product, there should be no delays everywhere else for the early adoption of technology.