Sustainability for the Brazilian healthcare system

By 2iM

Obtaining consistent data from real-world practice is challenging. In addition to dealing with unstructured data, there are missing and inconsistent data. It is very common for care processes not to follow protocols validated by medical societies, and the use of therapies is not always foreseen in these protocols. Despite these obstacles, 2iM’s Health Value Score (EVS) emerges as a valuable tool to assess different perspectives through adequate mapping of care pathways.
By implementing the framework for Rheumatoid Arthritis care pathway in other healthcare services, the winner of the 2023 VBHC Prize Dragons Endorsement, and implementing care pathways for other clinical conditions such as Diabetes Mellitus, Breast/Prostate/Lung Cancer, Kidney Colic, Cataracts, and Lower Back Pain, 2iM seeks to continuously improve the care process for the population. Similarly, it aims to support the incorporation of value-based technologies and improve the operational efficiency of institutions.
With this same logic, 2iM has expanded the use of EVS not only to assess care pathways but also to analyze ambulatory and hospital health services. In the hospital sphere, new EVS models have allowed evaluation beyond the hospital’s clinical staff to include hospital networks and ambulatory services serving both the public and private sectors. This approach provides essential data to managers for strategic decision-making and institutional certifications. However, persistent challenges in obtaining relevant data led to the creation of Operational Hospital Sustainability Index (ISO Hosp), an index based on Item Response Theory, focusing on indicators relevant to evaluating the hospital’s operational efficiency and, consequently, its sustainability by identifying waste, with clear revenue recovery opportunities based on Diagnosis Related Groups (DRG) indicators.
ISO Hosp, developed after evaluating 129 hospitals and 1.3 million in hospitalizations in Brazil’s Unified Health System (SUS), does not require direct action from managers in data collection, as it is extracted directly from SUS Database – DATASUS. This innovative method stands out for its automatic application and focus on indicators such as mortality, readmission, compliance with expected days of hospitalization, and the total cost of care. This advancement creates a data lake, fueled by various projects, which will soon enable the use of artificial intelligence for situational diagnoses and strategic plans.
In parallel with these innovations, 2iM plays an active role in promoting continuing education, highlighted by its participation in the LATAM Oncology VBHC Forum in collaboration with IBRAVS – Brazilian Institute of Value in Health. This international initiative not only provided a comprehensive theoretical environment but also promoted practical workshops, such as a VBA exercise, bringing together professionals from the public and private sectors in countries such as Brazil, Colombia, Argentina, Chile, Panama, and Mexico.
Thus, facing the challenges of obtaining real-world data, 2iM not only innovates in its evaluation approaches but also promotes knowledge dissemination and international collaboration, strengthening the constant pursuit of more efficient and patient-centered health care.