Innovation in health care makes the most sense when you put the patient first. Today, fortunately, we see the combination of technology and professional medical care more and more often, and the NEO Hospital group is an excellent example of this. I talk to Joanna Szyman – president of the NEO Hospital Group, vice-president of the management board in the Upper Finance Group and a member of the General Council of the Polish Federation of Hospitals about the current activities and plans for the future.
1. You have extensive business experience in the medical and insurance market. Do you consider yourself an innovator in the health market?
Joanna Szyman, president of the NEO Hospital Group: As a co-founder of NEO Hospital, I will answer yes without hesitation. In this project, innovations occur in many areas, not only new or significantly improved medical services, but also entire organizational processes. NEO Hospital started operating in the hospital at the beginning of 2019. At that time, we were a medical start-up our goal was to create one of the most innovative and patient-friendly medical centers in Europe. Today, the hospital consists of a 270-person team of specialists and doctors. NEO Hospital offers personalized and innovative medical care, incl. in the field of gynecology, urology and oncological surgery. 98% of procedures are performed by the hospital using minimally invasive methods, including the use of the da Vinci robot or with the support of Holo technology (augmented reality). We have created a Robotic Surgery Center that is unique in Poland, which today is responsible for 20% of all procedures using the da Vinci robot in the country. For creating this center, the hospital was honored with a prestigious award in an international competition organized by the International Hospital Federation (IHF Awards) in the American College of Healthcare Executives Excellence Award for Leadership and Management category.
People are our key capital, determining the success of our hospital, which is why many innovations concern the organization of work. We operate on the basis of multi-profile departments, we have no head physicians, only interdisciplinary expert teams. Coordination of work and patient care is crucial. The standards of care in our hospital are based on EBM (evidence-based medicine) and VBHC (value-based medical care). Data collection and monitoring in clinical, qualitative and financial areas as well as ensuring safe access to data play a key role. Most of our processes function digitally. We use digital devices, cloud solutions, we work with electronic medical documentation and electronic document circulation from the first day of our activity.
One of our most important values is communication and transparency of activities. We focus on creating a work environment that stimulates self-fulfillment, competence development and diversity. Only in the last year, we increased employment by 43%. We care about work ergonomics, development and training of staff. One of the most advanced centers for educating doctors in the field of minimally invasive techniques in Poland was established in NEO Hospital, using the latest technologies, including virtual simulations and artificial intelligence systems. Over 200 doctors have already benefited from the courses at the hospital. This is important, if only because there is a severe shortage of surgeons in Poland, which means that many procedures, even urgent ones, have to be waited for months, if not years. At the same time, the quality of these treatments could be much higher if the latest technologies, including robotic surgery, were more commonly used. It is very important to me that surgery in Poland is conducted by well-coordinated and motivated teams, and the work of each of its members is equally appreciated and respected. In health care, we need balance, cooperation and change, thanks to which the talent and ambitions of all people will be fully utilized. Therefore, many of the activities of NEO Hospital are focused on promoting the idea of equality.
Our greatest concern is the practical implementation of the “Patients First” and “Excellent Patients Experience” philosophy. In line with the patient value-based care model, the hospital has modern competence centers for the treatment of civilization diseases, including the Obesity Treatment Clinic, accredited by the International Bariatric Club – Oxford University.
NEO Hospital also runs the first Polish research and development program in the field of oncological gynecology using the da Vinci system. The launch of the program was possible thanks to funding from the European Union. The value of the project is PLN 12,3 million.
Our strategy is based on interconnected business, social and environmental goals for sustainable development. We have implemented a sustainable strategy for the use of natural resources such as water and energy, waste reduction and management, and we use and buy products that have a minimal impact on the environment. Over 40% of the hospital area is biologically active, which has a positive effect on the well-being of patients and employees.
2. How do you, a woman managing a medical facility, perceive innovations in the field of health? What is the new normality and what is innovation?
JS: I understand innovations in the field of health broadly – they are both new or improved services or products, but also processes and organizational systems. The future of medical care is medical care “without walls”, that is, more and more digital. Digital health will provide us with more health data than ever before, and artificial intelligence will help us analyze it to find new treatments for disease, reduce administrative tasks, improve medical practices, and optimize the schedules of both doctors and patients. It is a future that is becoming a reality. The time needed to achieve the next milestones decisive for progress in individual fields of medicine is greatly reduced. In addition, the pandemic forced regulatory changes in which e-health ensured access to care without reducing its quality.
Investments in electronic health record systems provide the necessary foundation for clinical data, understanding the health of the population, and the ability to deliver digital care in an increasing number of use cases. Service delivery models are shifting towards “value” based payments, taking into account quality and consumer expectations, towards insurance models. This year, we are witnessing a breakthrough in the hospital insurance market – Lux Med, the largest player on the market of private medical services, has entered the market with an offer of hospital insurance, which provides wide access to hospital care 24/7.
Operations and procedures that once required large incisions and weeks of recovery are now minimally invasive, more precise, and allow patients to resume their normal activities in much less time. Innovative interventions and therapies, in particular surgery, are becoming more precise, less complex, less invasive and less expensive. These values are ensured by, among others, surgical robotics, which has become a standard for many surgical procedures and brought about the beginning of a fundamental change in surgery. Today, the most widespread and dominant robotic system used in surgery worldwide is the da Vinci system by Intuitive Surgical. This technology has been developed for over 20 years. Currently, 4 generations of these platforms are available. There are nearly 7000 da Vinci robot installations in the world, in 69 countries. The global number of centers using 20 or more da Vinci surgical systems in their structures is already close to 30%, those that use 7 or more, we have 50%! These data show that robotic surgical technology has entered the standardization phase. Today, surgeons supported by robotic systems are moving away from “tissues and instruments” to the world of “information and energy”, “bits and bytes”. Probably the next frontier of surgery is the integration of digital surgery, including artificial intelligence, augmented reality, device automation and miniaturization.
3. What are the challenges related to the implementation of innovations in a medical facility?
JS: One of the main challenges is limited resources, including financial, human and organizational resources. However, the biggest challenge in implementing innovation is building an organizational culture that fosters change and is based on understanding the role of innovation. In order to implement innovations, an organization-wide strategy for the development and implementation of innovations is needed, which requires a continuous process of education, communication, incubation and development of ideas and investments in this process. And it is not only about the development of hard digital or technological competences, but about a change in social, cognitive and psychological competences, including cooperation and cooperation. Leadership and management involvement in these processes are also very important.
4. What are the benefits of implementing technological innovations in hospitals?
JS: It obviously depends on the innovation we implement. I will give a few examples based on the experience of NEO Hospital, where we use digital devices, cloud solutions, we work with electronic medical documentation and electronic document workflow. These solutions allowed us to reduce the cost of document handling by approximately 75%, reduce the time spent on searching for a document by approximately 90%, and reduce the costs generated by purchasing office supplies by approximately 50%. We have implemented many modern technologies that allow for the improvement of safety, precision and shortening the time of the procedure, e.g. the Carna Life Holo technology used in the planning and during oncological procedures. The use of technology allowed us to shorten the duration of the procedure by approx. 30%. Another example would be the use of echolaser (ultrasound-guided laser ablation) to treat benign thyroid nodules. This technology allowed us to move from surgery in an operating theater to a minimally invasive method performed on an outpatient basis. Our goal is to maintain high effectiveness of treatment, sustainable reduction of surgical complications and no need for lifetime pharmacological substitution. Echolaser in the treatment of thyroid nodules was a real breakthrough, thanks to which about 150 people a year, only at the level of our hospital, do not need to have surgery, they can receive a procedure lasting 10-20 minutes. This means less burden for the patient, shorter hospital stay (max. 4 hours), faster convalescence. It also means lower consumption of resources (a 3-person team is enough, not a 6-person team for an operating theater and, of course, care in the ward), as well as medicines and materials.
5. We all know that technology costs money, both to implement and maintain. And the financial situation of medical entities is difficult. Does investing in technology make sense in this situation? Is it even a necessity, because, for example, it will allow for savings in a certain perspective?
JS: I always see the implementation of innovations as an investment. In the NEO Hospital strategy, we continuously invest in research and development to remove barriers to further innovation. Over the past three years, the value of investment in research and development accounts for approximately 20% of NEO Hospital’s revenues. Medicine is an evidence-based discipline, our motivation is to seek more efficient and effective ways to improve outcomes while lowering overall costs. Clinical and economic efficiency are very important. In the last three years, we have tripled our revenues. However, this significant increase in scale of operations did not require a commensurate increase in resource use. We worked on the effectiveness, among others, based on the selection of medical technologies supporting minimally invasive procedures, allowing to shorten the duration of hospital stay and the convalescence period.
6. Neo Hospital, which you manage, is famous for its openness to innovative solutions. Every now and then you communicate new treatment programs based on the use of robotics or cooperation with technology suppliers. There are many startups on the market that offer interesting solutions, but you can often hear from them that hospitals do not always have the opportunity and are open to investing in technology. Why then do you succeed? What could you advise other directors?
JS: At NEO Hospital, as part of the innovation laboratory (Living lab), we have created unique opportunities to test innovative solutions for medicine with the involvement of users of solutions, in their natural surroundings. In the process of creating innovative solutions for medicine, it is important to refer to real circumstances, the real environment or the context of using a product or service. In our innovation laboratory, it is possible to carry out tests, including in the area of digital technologies. The program is dedicated to start-ups, business environments, academia, creators of innovative digital services and solutions that can be used in medicine, or solutions improving the efficiency and safety of in-hospital processes. Tests with users: doctors of various specializations, nursing staff, epidemiology team, or managers, reflect as much as possible the context of use in the user’s natural environment, i.e. in a hospital, clinic, operating theater. As a consequence, engineers, inventors or other creators gain real feedback about their product. Among the benefits for living lab users are the so-called time to market innovation and the ability to create solutions that meet your needs more, as they are verified and validated with the involvement of potential users. Using the environment of interdisciplinary living lab teams means that the created products or services maximize value, taking into account the expectations of users and business requirements.
So far, thanks to Living Lab, we have implemented technologies such as Carna Life Holo, RSQ Motion or Eco Light Biosafety Technology OCTA UV-System in NEO Hospital.
I strongly encourage you to use this model of operation, as it supports the growth of innovation and strengthens the competitive advantages of a medical facility.
7. Finally, our traditional question about what projects you observe, what kind of support you support, what implementations on the Polish market at the meeting point of medicine and technology are currently waiting for.
JS: I keep my fingers crossed for the success of RSQ Technologies. It is an extraordinary company that has created a modern ecosystem of products for medical facilities that allow you to implement innovations at every stage of the treatment process. The complexity of the RSQ Health ecosystem is best presented on an example. A patient with pain comes to a physiotherapist. It is tested with hyper-precise RSQ Motion sensors, which results in the limitation of movement. The visit is documented in the RSQ Physio app and the patient is referred to an orthopedist who uses the RSQ Doctor app.
Thanks to the integration of the applications produced by RSQ, the doctor can see all documentation along with traffic measurements. The doctor dictates the documentation to the phone and issues an e-referral for diagnostic imaging. The steps are performed on the phone and take less than 20 seconds.
During the X-ray examination, artificial intelligence supports data analysis, detects an anomaly of the bone structure, and the doctor makes a decision regarding the procedure.
During the procedure, the surgeon uses RSQ HOLO and special holographic goggles. Thanks to HOLO, operators have at hand medical documentation with 3D reconstructions in the form of holograms.
After surgery, the patient returns to physical therapy. Thanks to the validation of progress with RSQ Motion, the physiotherapist measures the effectiveness of the rehabilitation program on an ongoing basis to ensure that the patient returns to full life, sports or professional activity.
I look forward to seeing more of these end-to-end user-friendly solutions focused on patient value where technology helps people live happily, consciously and in good health.