by Laurie Barenblat – LGT Impact Fellow 2016
Founded in 2011, dr.consulta is a network of low-cost, pay-per-service medical centers in the city of São Paulo, Brazil, offering affordable and high-quality healthcare to those in need. The medical centers offer appointments with over 45 specialties and more than 2,000 lab tests are available to patients. In 2016, the number of medical centers nearly tripled in size, growing from 10 to 28, employing a network of nearly 1,000 doctors who complete over 110,000 visits per month. Three more centers have already opened in the first quarter of 2017, with plans to expand to a total of 50 by the end of the year.
Dr.consulta focuses on using technology and LEAN processes to increase the efficiency of the operation and improve quality of care. Prices are set to be within reach for all levels of income, thus helping the estimated 2.8 million people who have lost their health care in the last year and a half, according to data recently released by the National Supplemental Health Agency (ANS).
The operations at dr.consulta are strikingly efficient and organized, in contrast to SUS, the public healthcare offering in Brazil, which often involves overcrowded waiting rooms and wait times of several months to make an appointment. Patients can schedule appointments with dr.consulta online via the website or mobile app, and can almost always find an available appointment for the next day. Walk-in appointments are even possible, based on availability. The goal is that the time spent in the clinic from start to finish be less than 55 minutes.
In May 2016, I joined dr.consulta to support an increase in the utilization of the clinical outcomes data gathered through their proprietary electronic medical record (EMR). They had already designed a set of over 80 medical decision-support guidelines, as well as set of health programs geared towards diabetic and hypertensive patients, and I assisted in the development and implementation of these projects into the EMR with the support of the IT team.
I was also able to consult on enhancements to the EMR to increase the ability to collect more distinct data points during a consultation, such as past medical and family history. With this data, dr.consulta will be better able to measure the quality of care via various outcomes measures, with regard to preventive screenings and important markers for chronic disease patients. They will also be able to utilize the increased amount of discrete clinical data to further analyze their population, predict health risk, and prevent adverse outcomes. Other enhancements to the EMR would be adjusting the display of some of the patient details to be more patient-centered, thus allowing for physicians to easily and efficiently benefit from the data collected from the patient’s visits to any of the over 45 specialties that dr.consulta offers.
In order to classify their patients and offer them the best plan of care possible, I created a health questionnaire and implemented a pilot to test the idea of a “health check” for a small business, along with the use of the questionnaire. By combining the data collected from the questionnaire, along with biometrics data collected from the health check, I created a report that each participant received and reviewed with a physician, showing the patient’s risk of developing heart disease in the next 10 years, his “heart age”, and a ranking of the risk of the data points that we had collected. I also then created an aggregate report that we presented to the HR manager of the client company, summarizing the data points and overall health risk of the workforce who participated in the program. Based on these data, the client company opted to offer a check-up at dr.consulta to their employees with the highest number of measured health risks.
This questionnaire is being adapted to be used for other B2B activities, as well as B2C. It will be used to aid in the suggestion and categorization of patients for the diabetic and hypertension chronic disease health programs and for the entrée into a B2B health program.
Each new dr.consulta medical center that opens, provides an opportunity for more and more patients to access the medical care that they need at a price that they can afford. With the continuous growth of the size of the network, along with the addition of the medical guidelines and chronic disease management programs to their system, dr.consulta will be able to decrease the future cost of healthcare for patients and B2B clients, while simultaneously improving the overall health of Brazilians in an efficient and effective way.
Targeting dr.consulta’s most largely served population is a women’s center, with its own distinct space inside the Teodoro medical center, offering high-quality, convenient gynecological and obstetric services, such as digital mammography and bone densitometry.
Simple, yet comfortable, waiting area for patients to be called in for the pre-consult stage of their appointment.
Reception area with prices clearly marked on a menu of services.
A timeline aids in setting patients’ expectations for their visit in the medical center.