November 2, 2021
Hermes Pardini is one of the largest diagnostic medicine companies in Brazil. David Quites, Corporate Manager of the Pardini Group, recently sat down with Bruno Toldo, an intensivist and Infor’s CMIO in Latin America. Read on for their discussion about interoperability and how it impacts operational efficiency, productivity, and patient and physician engagement.
Question: Please tell us about your role and the history and success of Hermes Pardini.
Answer: I’m David Quites, Corporate Manager of the Pardini Group. I’m responsible for the company’s core systems that are directly related to operations, as well as being responsible for interoperability.
The Pardini Group’s purpose is to provide healthcare technology to those who need it, wherever they are. We have 125 proprietary units serving an average of 16,000 customers per day, in addition to more than 6,000 customers in the lab-to-lab business in the two cities we serve. There are 296 channels serving customers, literally from Oiapoque to Chuí, and more than 88,000 kilometers covered daily between all of our laboratories, which is the equivalent of two trips around the world every day.
We have an operational technical center that uses one of the six high-throughput systems in the world today, with the capacity to carry out 160 million medical exams per year. This capacity is even greater with the other technical centers that we have around the country in the main capitals: São Paulo, Goiânia, Santa Catarina, and Rio de Janeiro.
Q: Hermes Pardini is at the forefront of value-based medicine and new renumeration models within the area of laboratory analysis and medical exams. How did Infor’s Cloverleaf solution and clinical interoperability help Hermes Pardini with precision medicine?
A: The Pardini Group has 24 years of experience in the specialty of precision medicine, which is made viable by the interoperability of health data. Interoperability consists of the sharing of data after normalization, which allows for a homogeneous reading and the decomposition of this data. To take full advantage of this granularity, we have to not only transport but also store this data, allowing access to it in an individual and secure way. This ability translates, for example, into individualized genomic and genetic interpretation and the development of applications and user planning. It’s a personalized way to put the individual at the center of care.
The Cloverleaf platform was able to help us in this journey, from data entry to the data normalization and integration process.
Q: Your exam results process spans the collection to the delivery of the exam results, whether in the hospital environment or through a website that the patient can access. Did you see efficiency gains in this process after you started using Cloverleaf for interoperability?
A: Cloverleaf helped us deal with the challenges related to interfacing with our partner laboratories. In the Brazilian market, there are software houses that provide solutions for these laboratories, and we needed to speed up activation and interfacing with them. This process used to take 25 days. This meant that financial revenues were held back for 25 days due to the interface process.
In this process, two major activities are critical to completing the interface. The first is that we need to make the registration of the exam codes compatible between the two institutions, which we call “from/to.” The second activity is to carry out all the configurations of the exam or reporting results. During the first phase of the Symphony project, which was the name given to the Cloverleaf solution in the Group, we were able to automate 100% of the “from/to” processes for the main software houses in Brazil. And we made considerable progress with these software houses in automating the results, which made the process practically plug and play.
The result was that the interface time with the software houses dropped from 25 days to 10 days, on average. We gained 15 days in revenue capture for the lab-to-lab business, which made a big difference in the company’s operating cash flow.
Q: Interoperability is a well-known reality in the American healthcare system, but here in Brazil it’s something new, with new standards and structures—principally FHIR. Did you encounter any challenges in the implementation of Cloverleaf?
A: When you adopt a proactive position, as the Group always does in its initiatives, pioneering efforts come with challenges. On the other hand, it gives you an advantage over your competitors. It can be complex because no one has done it before.
We had the challenge of first creating a solution that would allow for identification and ensure compatibility among all the possible databases of records. To do this, we had to employ innovative technologies such as artificial intelligence and machine learning with algorithms that increasingly improve accuracy and have a direct effect on the amount of time to interface. The project also involves engaging external business partners to converge interests in establishing data security protocols in message exchange. There are different architectures in each of the systems, with different protocols for which we had to establish standards.
Q: We talk a lot about clinical exams, laboratories, lab-to-lab operations, and the exam as a commodity. Hermes Pardini works with large volumes and very high production streams that number in the thousands or millions of processed exams. When a patient, who is a customer of Hermes Pardini, goes to the laboratory to get exam results, it is as if it were B2C, when the customer is the end consumer. Did this interoperability strategy and the use of Cloverleaf also offer benefits to the patient, the end customer?
A: Cloverleaf helped us to address critical challenges in the interfacing of the results of exams. In the end, this is what our customers want: a result within the terms of the service-level agreement and, of course, with the consistency, coherence, and reliability expected of that result to make a clinical decision.
We also have another line of business: our hospital clients. The hospital business is very intense in the sense of urgency, of having a patient waiting in a bed for an outcome, a decision, to see an improvement, and to get out of that situation. This requires a robust tool that offers a secure interface, provides scalability and redundancy, and provides data security. It is extremely sensitive data on each of these lives that we take care of. Cloverleaf helped us on this path to enable faster and more secure interfacing with our laboratories in these hospitals.
We also used Cloverleaf to manage some of our pandemic challenges. This included the notifications of results, attributed by an Ordinance of the Federal Government of Brazil, to make it possible to take all sanitary measures to combat Covid-19.
Q: What is your vision of the future, considering all the innovation and collaborative efforts of Hermes Pardini? How do you see the future of the interoperability project with Cloverleaf and this mastering of data in the Hermes Pardini ecosystem?
A: We have a very ambitious digital roadmap, with several initiatives underway. The Cloverleaf solution is a vital component of this landscape. For this architecture to be sustainable, Cloverleaf ensures the coherence and consistency of this data that is transported and integrated within our various systems, including partner systems.