Healthcare Global - June 2015

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EMBRACING

a new era for

DIGITAL HEALTH Emergency preparedness for the modern hospital

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EDITOR’S COMMENT

Evolving with the times T O C O N T I N U E T O M E E T performance goals, the global

healthcare system needs to adapt to the digital era we have entered. Mobile technology is one step towards that evolution.

Aruba Networks shares their insight on how mobile tech is creating a radical shift in the future of healthcare in the feature “The hospital of tomorrow: Embracing the digital health era.”

On another note, climate change also affects a hospital’s functionality and a staff’s ability to deliver healthcare. In response, hospitals are turning to technology and big data to prepare for bigger problems that could arise in the future.

Hospitals need to realize that environmental preparedness goes hand-in-hand with geographic resilience, which leads to datadriven climate forecasts dictating infrastructure technologies.

But just as there is always innovation in the healthcare industry, there are certain practices that doctors hold on to simply because they work. We highlighted the 10 oldest medical practices that doctors are still using today.

In order for healthcare organizations to become smarter, more efficient and more comfortable for their patients, leaders need to start considering, and building around, the digital age.

We hope you enjoy this issue and wish you the best of health!

Stephanie C. Ocano Senior Editor stephanie.ocano@healthcareglobal.com 3

CONTENTS

Features

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HOSPITAL Emergency preparedness for the modern era

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TECHNOLOGY The hospital of tomorrow: Embracing the digital health era

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TOP 10 The UAE’s Top 10 Companies to Work for in 2015

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Company Profiles

Healthe Care

USA 28 PAML

AUSTRALIA 40 Healthe Care

LATIN AMERICA

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48 Foundacion Clinica 58 B.Braun Mexico 74 Fundacion Cardiovascular

PAML

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Foundacion Clinica

BRAZIL 84 Hospital Beneficencia Portuguesa 94 Grupo Centroflora

B.Braun Mexico

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74

Fundacion Cardiovascular

84 Hospital Beneficencia Portuguesa

94

rupo G Centroflora

H O S P I TA L

EMERGENCY

preparedness for the modern era A LOOK AT HOW HOSPITALS SHOULD REACT TO A RAPIDLY CHANGING CLIMATE. W R I T T E N B Y: S T E P H A N I E C . O C A N O

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H O S P I TA L IT’S NOTHING WE haven’t heard before—global climate change is a major and unprecedented public health threat, and it’s only getting worse.

Unlike infectious pandemics, such as the recent Ebola outbreak, there is no vaccine for a deteriorating planet’s effects on a population.

But it does mean one thing: a sicker public means more strain on hospitals and healthcare services.

According to the Centers for Disease Control and Prevention, climate change affects air quality (increasing respiratory and cardiovascular diseases), leads to food- and waterborne diseases and causes an uptick in extreme weather events, which injure and kill people in large numbers.

On the other end, climate change also affects a hospital’s functionality How are future extreme weather events likely to affect health care delivery

and a staff’s ability to deliver health care. So, in response, hospitals are turning to technology and big data to prepare for bigger problems that could arise in the future.

The Department of Health and Human Services recently published a report to identify best practices and provide guidance on affordable measures to ensure that the medical system is resilient to climate impacts.

According to the report, health care organizations previously only reacted to climate events as they occurred. Hospitals need to realize that environmental preparedness goes hand-in-hand with geographic resilience, which leads to datadriven climate forecasts dictating infrastructure technologies.

Climate challenges by region Northeast: Winters result in record-breaking cold temperatures, snow fall and rain Midwest: Excessive heat waves and flooding West Coast: Increasing temperatures and droughts How some hospitals have adapted to change

E M E R G E N C Y P R E PA R E D N E S S F O R T H E M O D E R N E R A

UCSF Medical Center Mission Bay Opening just four short months ago in February, the University of California San Francisco Medical Center at Mission Bay designed its hospital with climate disaster resilience, resource stability and patient care in mind.

In response to California’s drought, the medical campus uses an irrigation system that automatically adjusts water output depending on current weather fluctuations. It also has dual-flush toilets and low-flow, highefficiency showers and basins.

The hospital is expected to save nearly four million gallons of water each year.

Mission Bay has figured out how to cut that usage in half by incorporating a standalone central power station,

stated Pacific Standard. The station works alongside other energy-saving technologies, including heat recovery ventilators that reclaim energy from exhaust overflows, patient rooms with access to natural light, heating and cooling systems that can be controlled remotely in most parts of the facility, and cooling systems that can be controlled remotely in most parts of the facility, and a photovoltaic system that converts solar energy into electricity.

These methods are saving Mission Bay a reported $784,000 in annual energy bills and reducing its CO2 emissions by 20,000 metric tons.

The Lucile Packard Children’s Hospital at Stanford University also has a new wing opening in two years 9

H O S P I TA L

Lucile Packard Children’s Hospital and will be placing reusable water into a cistern from three sources: rainwater from the roof, condensate from the air conditioning system and the reject water from dialysis.

These methods give the hospital approximately 110,000 gallons of water at any given time, and if there were ever an emergency and the hospital didn’t want to use its fourto seven-day emergency supply of potable water to flush the toilets, it could drain the cistern water for other uses, reported the magazine.

The 268-bed Miami Children’s Hospital (MCH) serves seven counties in southern Florida, including populous Miami-Dade County, and is the region’s only specialty hospital 10

June 2015

for children. Beginning in 2001, MCH underwent a state-of-the-art retrofit to enable it to withstand a Category 4 hurricane. The hospital campus is now wrapped in a hurricane resistant shell.

The project was completed in the spring of 2004, just prior to Florida’s hurricane season. Young patients and their families did not need to evacuate from the hospital when Hurricanes Frances and Jeanne struck.

In addition, the hospital welcomed over 60 children who lived at home but were evacuated from the Florida Keys—children who depended on ventilators or other electricallypowered medical equipment. During Hurricane Frances, MCH was the temporary refuge for nearly 1,000

E M E R G E N C Y P R E PA R E D N E S S F O R T H E M O D E R N E R A

staff members and their families.

According to Kevin Hammeran, senior vice president and chief operating officer during the period, “The strengthened building has enhanced the hospital administration’s ability to recruit staff to serve during hurricanes.

Many employees feel safer at the hospital during a storm than in their own homes. We also have eliminated barriers by providing on-campus shelter for family members of stormduty staff. Knowing their spouses and children are within the safe confines of the hospital gives peace of mind to those working through the storm.”

In 2005, the hospital hosted medical evacuees and families who were displaced by Hurricanes Katrina and Wilma.

Looking ahead Given the current state of health care infrastructure resilience, how are future extreme weather events likely to affect health care delivery in the U.S.?

Most health care organizations have disaster mitigation or emergency operation plans, but not all of them provide organizational alternatives when the normal

Most health care organizations have disaster mitigation or emergency operation plans

daily movement of staff, patients, equipment, and supplies are compromised. The critical nature and interdependence of these processes represent a separate category of vulnerabilities that need careful attention, states the report.

To withstand whatever the future holds, it’s time to fundamentally rethink how hospitals operate. Health care systems in the U.S. are larger and more complex than ever before. We need more societal resources to buffer the impact from these climate events.

Part of that is making people healthier by focusing on preventative health care—because healthier people are more resilient to climate impact than unhealthy people—and the rest is using sustainable technologies to embed fortitude into hospital infrastructure and day-to-day operations.

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TECHNOLOGY

THE HOSPITAL OF TOMORROW: Embracing the digital health era ARUBA NETWORKS DISCUSSES HOW MOBILE TECHNOLOGY IS CREATING A RADICAL SHIFT IN THE FUTURE OF HEALTHCARE. W r i t t e n b y : C H R I S K O Z U P, S E N I O R DI RECTO R O F E M EA , ARU BA N ETWO RKS

FOR MANY GOVERNMENTS, how a country looks after its own health is often the cornerstone of any successful political campaign. Even if budgets rise for healthcare systems, aging populations mean that health services are being stretched more than ever.

So, where do healthcare organizations even begin to try and become more streamlined and deliver a service 12

June 2015

that’s equivalent to other industries?

To continue to meet performance goals, the global healthcare system has to evolve and mobile technology will be at the very heart of this change.

Technology is key to any 21st century business and healthcare is no different.

The hospital of tomorrow will be a shadow of what it is today and if the right decisions are made, technology

innovation will start to deliver huge benefits; not just to hospitals but to the patients it supports. We believe the hospital of 2025 will: Be 50 percent more efficient through the birth of the mCloud The mCloud will be a centralized, secure hub used for storing patient information that is accessible anywhere

and anytime across the globe. A centralized hub will mean tomorrow’s medical records will be stored entirely on a private and secure cloud service that can be accessed wherever and whenever required. This will drive efficiencies through the roof. mCloud allows hospitals to be part of a global, safe and secure network that gives doctors a broader set of 13

TECHNOLOGY

A centralized hub allows for remote accessibility of health records while maintaining security records and a much more robust and holistic view of a patient. The money saved on issues like incorrect diagnosis could be reinvested into R&D departments allowing healthcare organizations to expand at a much quicker rate than they are doing today.

This centralized system will be enabled by an advanced Wi-Fi network experience that allows for the real time prioritization of data. This will save valuable time on diagnosis.

Location services enabled by mobile technology will result in pieces of 14

June 2015

medical equipment being located much faster; items such as heart monitoring and other large diagnostic equipment will be easily located inside hospitals meaning patients will have access to the machines much quicker than is happening now. Beyond this, location-based mobile will give much more refined and detailed location services inside a building so doctors can track and trace things much quicker.

Reduce misdiagnosis by 75 percent through the partnership of real-time

E M B R A C I N G T H E D I G I TA L H E A LT H E R A

data and mobile technology.

Healthcare has traditionally lagged behind other key industries in terms of innovation—perhaps due to issues surrounding patient confidentiality.

However, the hospital of tomorrow will make use of real-time data through the use of mobile software and devices, all allowing for more accurate diagnosis giving consultants greater visibility into a patients ailments and reducing misdiagnosis by over 75 percent.

These rising levels of accuracy will also be driven by GenMobile who will be sharing data on mobile devices such as smartphones, wearables and tablets. As more and more hospitals become reliant on networks, IT security will become paramount so departments will need to invest heavily in order to alleviate some of the concerns often associated with network security.

From a management point of view, staffing levels will be much easier to control through the predictive capabilities of big data. Using mobile technology will see the rise of “virtual assistants” meaning that facilities are managed in a much more efficient way. The management of beds will also mean patients are less likely to

be waiting around for an empty bed, if beds are full or are about to become free, ward managers can be alerted to this in real time via their mobile device and react more effectively.

Deliver a truly paperless and wireless world driving better confidentiality and collaboration Whilst it’s not believed all working environments will be paperless, there is a big push for many industries to go that way and healthcare is no different.

The money spent on purchasing paper and document storage will reduce by over 80 percent equating to millions, if not billions of pounds saved each year.

Regional data centers vs. one central hub has been suggested as a way of easing many people’s fears that their records could be compromised, but as long as assurances over security are met, a paperless environment would have huge benefits to confidentiality. Within radiology, RIS and PACS systems have already led to paperless departments, saving space, time and enabling remote diagnosis from experts around the globe.

The implementation of wireless communications systems and VoIP goes hand in hand with this decline 15

TECHNOLOGY of the paper world. Doctors will be able to communicate and collaborate with either individuals or groups with the touch of a button. The response time will be instantaneous and, by having all the right people are involved in the decision making process throughout, this will reduce errors and misdiagnosis. Poor communication will be a thing of the past.

Be a customized and smart patient experience The hospital of tomorrow will be fully mobile, personalized and will resemble a modern day hotel.

With the traditional hospital consulting room showing minimal improvement since World War 2, many healthcare organizations have started to focus on “smart rooms” which will completely revolutionize the patient experience. The rooms of tomorrow will be entirely connected and have the ability to communicate not just with consultants but also with the hospital as a whole. The hospitals’ own personalized app will be at the very center of this. Computers and networks will connect both inside and outside the room. Remote consulting, which is already being 16

June 2015

The mCloud allows for real-time data trialed across various European countries will become the norm.

We’ll also start to see hospitals use their own apps to enable patients to make appointments through their mobile devices. Patients and visitors will be able to locate amenities once in the hospital, send and receive personalized messages to nurses and physicians, and access diagnostic results electronically just a handful of benefits. The bedside care of patients will transform in a huge way with mobility at the very core. Results of

E M B R A C I N G T H E D I G I TA L H E A LT H E R A

a to be shared between health care officials tests such as x-rays can be shared in an instant with decisions on next steps being made much quicker than they are today. Doctors will then be able to share information with each other digitally which means patients will no longer be waiting hours for guidance on next steps.

The road to the future While the hospital of tomorrow is undoubtedly some years from becoming a reality, the technology is in place to begin the transformation now.

It begins with a review of hospital networks and an understanding of who needs to use it. Medical staff, patients and visitors need to use the facilities in very different ways and with different devices, but we now have the capabilities to cater to each of these preferences.

In order for healthcare organizations to take this towards becoming smarter, more efficient and more comfortable for their patients, leaders need to start considering, and building around, the digital age.

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TOP 10

ANCIENT medical practices still in use These medical practices are considered medieval but their medicinal value still stands in modern times.

W R I T T E N B Y: S T E P H A N I E C . O C A N O

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TOP 10

SOMETIMES, EVEN IN medicine, it’s best to stick with what works.

While there is always innovation in the healthcare industry, there are certain practices that doctors hold on to simply because they work.

Here are the ten oldest medical practices that doctors are still using today.

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Cauterization

For thousands of years, human beings have used heat in the form of cautery to treat trauma and disease. Dr. William T. Bovie improved on this method in 1920 with the invention of electrosurgery, which uses an electrical current instead of heat to cut tissue or coagulate blood and stop bleeding. The Bovine unit passes high frequency alternating current into the body allowing the current to cut or coagulate. After 75 years this basic device remains a fundamental tool in the practice of surgery.

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June 2015

Maggot therapy

Since ancient times, physicians have used maggots to help clean injuries and prevent infection. Because maggots feed solely on dead flesh, doctors do not need to worry about them feasting on healthy tissue.

One study, published in 2014 in the Archives of Dermatology, showed that maggots placed on surgical incisions helped to clear more dead tissue from the sites than surgical debridement, the current standard of care in which doctors use a scalpel or scissors. Placed in tea bag-like packages, physicians are able to directly apply maggots to wounds, allowing them to work their magic.

ANCIENT MEDICAL PRACTICES

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Fecal transplant

The incidence of Clostridium difficile infection (CDI) has risen sharply over the last two decades.

Human stool transplants have been found to consistently cure up to 90 percent of patients who have had multiple episodes of C. difficile, an infection which causes serious diarrhea and affects about 3 million people per year.

These days, fecal transplants are done either by colonoscopy or by a tube that runs through the nose into the stomach, but a new study published in JAMA shows that there may be a less invasive—and equally effective—route by way of a pill.

Transsphenoidal surgery

Transsphenoidal surgery is a minimally-invasive procedure where surgeons access the brain through the nose to remove tumors.

According to Raj Sindwani, an otolaryngologist with Cleveland Clinic, the practice has been done for thousands of years, with the ancient Egyptians having discovered that the easiest access point to the brain was through the nose.

© Terese Winslow

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Trepanation

We’ve seen this practice hundreds of times in horror films—the threat of having someone drill a hole into your head—but doctors believe the practice actually serves some medical benefit.

Dating back to prehistoric times, trepanation was originally done to relieve bad spirits from a patient. In today’s industry, holes are drilled into the skull to relieve pressure after serious trauma to the brain has occurred.

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June 2015

Cesarean section

You might not even consider this an ancient practice since it is so commonplace today, but a Cesarean section (more commonly known as a C-section) is one of the oldest medical practices, dating back to 320 B.C. The mortality rate for the procedure was once very high, until the 1880s when a technique was developed to minimize bleeding. According to the Centers for Disease Control and Prevention, nearly one-third of all babies were delivered via C-section in 2012.

ANCIENT MEDICAL PRACTICES

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Leech therapy

Yes, this still exists. The first use of leeches in medicine dates back to 800 B.C., according to the British Medical Journal, when they were used in bloodletting (a practice believed to cure fevers, headaches and serious illnesses).

Today, leeches are used to stimulate blood circulation after skin grafts and reconstructive surgery. The leech’s saliva contains enzymes and compounds that act as an anticoagulation agent. The most prominent of these anticoagulation agents is hirudin, which binds itself to thrombins, effectively inhibiting coagulation of the blood.

Leeching might sound primitive, but the FDA approved leeches as “medical devices” in 2004 to drain pooled blood after surgery.

Acupuncture

This form of alternative medicine was developed in China approximately 4,000 years ago. Its intended purpose was to restore the body’s inner balance by placing needles at specific pressure points.

In today’s times, patients may seek acupuncture treatment for relaxation and pain relief. Acupuncture has also found a place in preventative care, particularly for its effects in the setting of hypertension.

Studies conducted have found that regular acupuncture treatments can lower blood pressure.

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June 2015

02

Aspirin

Acetylsalicyclic acid may be one of the world’s oldest medicines, being first referenced on a Sumerian stone tablet from 2000 B.C. Found in the bark of willow, myrtle and poplar trees, aspirin appears in pre-scientific medicine in cultures all around the world as an analgesic and anti-inflammatory, and was first shaped into purified pill form by German mega-pharmacist Bayer.

The first tablet form of aspirin appeared in 1900, creating

an ease of use that quickly expanded the drug’s recognition among professionals. Medical reports highlighted the benefits of aspirin, and its popularity reflected the already significant use of salicylic compounds, coupled with the fact that this new drug was considerably safer and comparably less toxic.

In 1915, aspirin became available to the public without a prescription, making it arguably the first modern, synthetic, over-the-counter, mass-market medicine and a household name around the world.

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01

Prosthetics

While most might consider this to be a modern invention, the oldest prosthetic was discovered on an Ancient Egyptian female mummy in 2011, according to The Lancet.

The mummy had two prosthetic toes made of leather and wood.

Researchers were skeptical as to whether the toes were actually functional or were created for purely cosmetic reasons. This led researchers to test them out on people who needed a spare toe (or two) and it was discovered that the ancient prosthetic toes really do work and can help people walk again.

Today, prosthetics come in many forms, including artificial limbs, hearing aids, knee replacements, dentures and artificial heart valves.

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June 2015

ANCIENT MEDICAL PRACTICES

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PAML

- Pathology Associates Medical Laboratories

With a focus in diagnostics with national corporate headquarters in Washington, PAML is a recognized leader delivering healthcare solutions.

Written by: Stephanie C. Ocano Produced by: Tom Venturo

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PA M L

PAML Lab

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June 2015

H E A LT H C A R E

PAML General Administration

Our goal is to do anything and everything to help you as a provider to succeed in delivering the highest quality of care.

This is the ideology behind PAML (Pathology Associates Medical Laboratories) – a medical reference laboratory serving physicians, hospitals and allied health professionals. Ranked among the top clinical reference laboratories in the nation and considered an industry leader in joint venture partnerships, PAML is dedicated to personalized service, rapid turnaround time and innovative information management systems.

We recently spoke with Dr. Francisco R. Velázquez, President and Chief Executive Officer at PAML, to further understand the history of the company and his methodology to become a driving force in the healthcare solutions industry.

From West to East – A History of Going Nationwide Founded in 1957 in the town of Spokane, Washington, PAML was initially focused on serving the Pacific Northwest region. From Montana to Idaho, the company soon discovered that its reach could extend much farther. Over the years, w w w. p a m l . c o m

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BreathTek® UBT for H. pylori

You Suspected H. pylori.

BreathTek UBT Confirmed.

To be sure of your diagnosis AND confirm treatment success, choose BreathTek UBT • Antibiotic resistance is approaching 25%, increasing the need for eradication confirmation1-3 • ACG* calls the UBT method “the most reliable nonendoscopic test…“ to confirm H. pylori eradication4 • BreathTek UBT offers excellent sensitivity (96%) and specificity (96%) to confirm eradication in adult patients5 • False negative test results may be caused by: − Ingestion of proton pump inhibitors (PPIs) within 2 weeks prior to performing the BreathTek UBT. If a negative result is obtained from a patient ingesting a PPI within 2 weeks prior to the BreathTek UBT, it may be a false-negative result and the test should be repeated 2 weeks after discontinuing the PPI treatment. A positive result for a patient on a PPI could be considered positive and be acted upon − Ingestion of antimicrobials or bismuth preparations within 2 weeks prior to performing the BreathTek UBT − Premature POST-DOSE breath collection time for a patient with a marginally positive BreathTek UBT result − Post-treatment assessment with the BreathTek UBT less than 4 weeks after completion of treatment for the eradication of H. pylori • False positive test results may be caused by urease associated with other gastric spiral organisms observed in humans, such as Helicobacter heilmannii or achlorhydria.

H. pylori can’t hide from BreathTek UBT… Approved as an aid in the initial diagnosis and post-treatment monitoring of H. pylori infection in adults and children ages 3 to 17 years Please see BRIEF SUMMARY on adjacent page.

Click here to learn more or visit BreathTek.com. *ACG, American College of Gastroenterology.

April 2015

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Brief Summary about BreathTek UBT Intended Use The BreathTek® UBT for H. pylori Kit (BreathTek UBT Kit) is intended for use in the qualitative detection of urease associated with H. pylori in the human stomach and is indicated as an aid in the initial diagnosis and post-treatment monitoring of H. pylori infection in adult patients and pediatric patients 3 to 17 years old. The test may be used for monitoring treatment if used at least 4 weeks following completion of therapy. For these purposes, the system utilizes an Infrared Spectrophotometer for the measurement of the ratio of 13CO2 to 12CO2 in breath samples, in clinical laboratories or point-of-care settings. The Pediatric Urea Hydrolysis Rate Calculation Application (pUHR-CA), provided as a web-based calculation program, is required to obtain pediatric test results.

The BreathTek UBT Kit is for administration by a health care professional, as ordered by a licensed health care practitioner.

Warnings and Precautions • For in vitro diagnostic use only. The Pranactin®-Citric solution is taken orally as part of the diagnostic procedure and contains Phenylalanine (one of the protein components of Aspartame), 84 mg per dosage unit, and should be used with caution in diabetic patients. (For reference, 12 ounces of typical diet cola soft drinks contain approximately 80 mg of Phenylalanine.)

• A negative result does not rule out the possibility of H. pylori infection. False negative results do occur with this procedure.

If clinical signs are suggestive of H. pylori infection, retest with a new sample or an alternate method.

• False negative test results may be caused by: — Ingestion of proton pump inhibitors (PPIs) within 2 weeks prior to performing the BreathTek UBT. If a negative result is obtained from a patient ingesting a PPI within 2 weeks prior to the BreathTek UBT, it may be a false-negative result and the test should be repeated 2 weeks after discontinuing the PPI treatment. A positive result for a patient on a PPI could be considered positive and be acted upon.

— Ingestion of antimicrobials, or bismuth preparations within 2 weeks prior to performing the BreathTek UBT — Premature POST-DOSE breath collection time for a patient with a marginally positive BreathTek UBT result — Post-treatment assessment with the BreathTek UBT less than 4 weeks after completion of treatment for the eradication of H. pylori.

• False positive test results may be caused by urease associated with other gastric spiral organisms observed in humans such as Helicobacter heilmannii or achlorhydria.

• If particulate matter is visible in the reconstituted Pranactin-Citric solution after thorough mixing, the solution should not be used.

• Patients who are hypersensitive to mannitol, citric acid or Aspartame should avoid taking the drug solution as this drug solution contains these ingredients. Use with caution in patients with difficulty swallowing or who may be at high risk of aspiration due to medical or physical conditions.

• No information is available on use of the Pranactin-Citric solution during pregnancy.

• For pediatric test results, the Urea Hydrolysis Rate (UHR) results must be calculated. The Delta over Baseline (DOB) results are only used to calculate the UHR metrics to determine H. pylori infection in pediatric patients. DOB results cannot be used to determine the infection status of pediatric patients. Use the web-based pUHR-CA (https://BreathTekKids.com) to calculate the UHR. • Safety and effectiveness has not been established in children below the age of 3 years.

Adverse Events During post-approval use of the BreathTek UBT in adults, the following adverse events have been identified: anaphylactic reaction, hypersensitivity, rash, burning sensation in the stomach, tingling in the skin, vomiting and diarrhea. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to establish a causal relationship to drug exposure.

In two clinical studies conducted in 176 (analyzed) pediatric patients ages 3 to 17 years to determine the initial diagnosis and post treatment monitoring of H. pylori, the following adverse events experienced by ≥1% of these patients were: vomiting (5.1%), oropharyngeal pain (4.5% to include throat irritation, sore throat, throat burning), nausea (2.3%), restlessness (2.3%), stomach ache/belly pain (1.1%), and diarrhea (1.1%). Most of the adverse events were experienced by patients within minutes to hours of ingestion of the Pranactin-Citric solution.

In another clinical study comparing the UBiT®-IR300 and POCone® in pediatric patients ages 3 to 17 years, the following adverse events were observed among the 99 subjects enrolled: 2 incidences of headache, and 1 incidence each of cough, dry mouth and acute upper respiratory infection.

May 2014

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References: 1. Vakil N, Megraud F. Eradication therapy for Helicobacter pylori. Gastroenterology. 2007;133(3):985-1001. 2. Vakil N, Fendrick AM. How to test for Helicobacter pylori in 2005. Cleve Clin J Med. 2005;72(suppl 2):S8-S13. 3. Chu Y-T, Wang Y-H, Wu J-J, Lei H-Y. Invasion and multiplication of Helicobacter pylori in gastric epithelial cells and implications for antibiotic resistance. Infect Immun. 2010;78(10):4157-4165. 4. Chey WD, Wong BCY; Practice Parameters Committee of the American College of Gastroenterology. American College of Gastroenterology guideline on the management of Helicobacter pylori infection. Am J Gastroenterol. 2007;102(8):1808-1825. 5. Package Insert for BreathTek UBT. Otsuka America Pharmaceutical, Inc; 2014.

©2015 Otsuka America Pharmaceutical, Inc.

April 2015

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PA M L PAML grew to encompass a wider geographical presence, additionally realigning its focus to diagnostics.

“About three years ago, we launched a professional services corporation,” said Dr. Velázquez.

“We developed a portfolio of complementary skills that are useful not only to us as a company but more importantly bring valuable services to those that we work with.”

Referring to PAML as a healthcare solutions company, Dr. Velázquez went on to explain that his primary goal was to do the best work possible, leaving his clients and partners with the solutions and a roadmap to providing better care.

“Our goal is to go in and help you and leave as quickly as we can,” said Dr. Velázquez.

Successful Direction How does a company remain competitive, especially within the

H E A LT H C A R E

healthcare industry? According to Dr. Velázquez, the answer is simple: pay attention.

“We pay attention to new developments,” clarified Dr. Velázquez. “And not just in the healthcare industry, but in others as well.”

“It’s important for us to understand what the world around us is doing because ultimately most of the trends that we see in other industries will come to healthcare,” he continued.

PAML also connects with higher level academic institutions to understand where innovation is headed. By spending time with entrepreneurs and those investing venture capital dollars in new technologies, PAML successfully keeps its “finger on the pulse.”

Innovative Solutions PAML is striving to close the gap in

“It’s important for us to understand what the world around us is doing because ultimately most of the trends that we see in other industries will come to healthcare” – Dr. Francisco R. Velázquez, President and Chief Executive Officer w w w. p a m l . c o m

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Sarstedt - solutions for the clinical lab Sarstedt offers modular technology for efficient sample preparation. With options for bulk loading, identification, decapping, sorting, aliquoting, and recapping - we provide the automation you need now plus the ability to add more later. And because we are also a global manufacturer of premium consumables, we can provide the total solution for all of your requirements.

Sarstedt is a proud business partner of Pathology Associates Medical Laboratories.

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PA M L the continuum of care between the time that individuals are consumers and the time that they are patients.

“Right now, both worlds don’t connect and we’re looking to connect those better,” said Dr. Velázquez.

With more consumers looking for ways to proactively manage their health, many have turned to the internet for help in accessing medical resources to help them make smart decisions. In response to this, late last year PAML unveiled its website for Cinch™, the company’s new consumerbased product line that empowers individuals to reveal their health through easy access to laboratory testing and information.

“Our Cinch product line is a step above what is currently being offered in the market for directto-consumer laboratory testing,” said Shawn Whitcomb, PAML’s Chief Information Officer in a press release. “We are delivering the same superiority in laboratory testing that patients receive from their physician, but with much more convenience and flexibility, and often at a lower cost than a traditional physician visit.”

H E A LT H C A R E

Additionally, PAML recently launched another brand titled AION (meaning “life” or “longevity” in Greek) which aims to assist physicians practicing personalized medicine by delivering evidencebased testing utilizing robust diagnostic technology to detect risk factors and biomarkers associated with aging.

Through clinical relevance and uniformity of testing, AION aids physicians in their efforts to monitor patients and manage treatment programs over time. AION also provides nationwide concierge phlebotomy services to healthcare providers that do not have in-house drawing personnel, as well as an online portal delivering enhanced reports.

“We’ve segmented the areas of wellness we serve into traditional and clinical wellness, wellness for consumers, wellness for the ageing population and we’re now entering into corporate wellness for employees,” said Dr. Velázquez.

Why Choose PAML? “In short, we’re a true partner,” said Dr. Velázquez. “Our goal is for you to w w w. p a m l . c o m

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PA M L

QUANTA Lite®

Calprotectin Differentiate between IBS and IBD with a non-invasive marker of intestinal inflammation.

1

Now available, an FDA cleared assay that delivers the results physicians need for patients with symptoms of IBD • A new fecal ELISA test kit offering expanded dynamic range of 15.6-500mg/kg1 • High sensitivity helps guide decision-making when selecting patients for endoscopy2

For more information visit www.inovadx.com Scan this QR code or go to www.inovadx.com/calprotectin to learn more about this important marker

INOVA Diagnostics, Inc., San Diego, CA 92131 858-586-9900 www.inovadx.com References: 1. QUANTA Lite Calprotectin directional insert.

2. Bunn, S. et al. Fecal calprotectin: validation as a noninvasive measure of bowel inflammation in childhood inflammatory bowel disease. J Pediatric Gastroenterology Nutrition 2001;33:14-22.

QUANTA Lite is a trademark of Inova Diagnostics, Inc. © 2015 Inova Diagnostics, Inc. All rights reserved.

690416 August 2014 Rev. 1

H E A LT H C A R E

Company Information INDUSTRY

PAML HEADQUARTERS

Healthcare FOUNDED

1957 EMPLOYEES

1000

succeed. We’re focused on quality and service in terms of providing for those that work with us.”

As a value-driven organization, PAML looks to enhance the skills and abilities of its clients all while remaining community-centric.

Mindful of its presence in the community, PAML is constantly looking to locally brand joint ventures for the benefit of its partners and the community as a whole.

“Our goal is to do upwards of 90 percent of the volume generated in a particular region locally,” explained Dr. Velázquez. “That way we can increase the efficiency of our local partners, provide them with a revenue stream they didn’t previously have, and maintain the continuity of information for the region of delivered care.”

REVENUE

$250 M PRODUCTS/ SERVICES

www.paml.com

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Healthe Care:

The Leading Private Hospit Provider for Southeast Victo

With The Valley Private Hospital and South Eastern Pr its portfolio of 16 medical facilities, Healthe Care has private hospital with state-of-the-art technology, spe and a driving vision.

Written by: Stephanie C. Ocano Produced by: Rob Benson

tal oria

rivate Hospital in transformed this cialist services

H E A LT H E C A R E

O

ur vision for The Valley and South Eastern private hospitals is to become the major private hospital provider for southeastern Melbourne and Victoria.

Formed in 2005 with the intention to lead individuals to health, Healthe Care has become a reputable source across Australia for private healthcare.

With a philosophy rooted in empowerment and well-being, Healthe Care takes pride in 42

June 2015

delivering premium care to all its valued clients and patients through specialist services, facilities and innovations.

We recently spoke with CEO of The Valley and South Eastern private hospitals, Neil Henderson, who offered his insight into the success of the company as well as its plans for the future.

A Success Story When Henderson joined Healthe Care there was a lot of room for

H E A LT H C A R E

improvement in The Valley and South Eastern private hospitals.

But rather than fearing the challenge, he took it on headfirst.

“I really wanted to contribute to the greater common good and develop something that I could sit back on and be proud of in years to come,” said Henderson of the early days. “What contributed [to the recent paramount success] was the recognition that the fundamentals were there for the two hospitals to transform into

major players.”

And transform they did.

“The basic infrastructure of the buildings was there,” said Henderson, “but the spark that became the difference between mediocrity and rapid success was vision, leadership and belief.”

“Basically, what I did in 2012 was to determine that these two hospitals could develop and grow rapidly and I needed to build myself a team that would believe and be inspired by the vision w w w. h e a l t h e c a r e . c o m . a u /

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H E A LT H E C A R E to lead and motivate others to follow,” added Henderson.

The “others” Henderson referenced included doctors and staff, as well as stakeholders.

By recruiting and training a team of managers who were committed to said vision and culture, this inspiration was spread to each department where the managers imparted good leadership. In order to continue this spread of positivity, the “Love Your Work” program was instituted to

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recognize individuals that were doing something above and beyond their line of duty.

“At the end of the day, if people are being recognised for their hard work, they are likely to be more motivated to do their job,” reiterated Henderson.

Exclusive, World-First Technology There are four aspects of Healthe Care that make it distinct from other private hospital care

“We are a vibrant, growing and excited organization with a big future—which creates lots of opportunities to participate in.”

– Neil Henderson, CEO

www.adcoconstruct.com.au

H E A LT H C A R E

providers: a strong emphasis on strategic visioning, a strong team with a strong bond to one another and the hospitals’ vision, a high level of delegation from corporate to local decisions and some hightech equipment that is rarely seen in competitor hospitals.

Investing $4 million, The Valley Private Hospital built the world’s first fully hybrid operating theatre integrated with a Siemens Zeego 3D imaging system, a Maquet theatre system and a Magnus table. The move was so groundbreaking that teams from both Siemens and Maquet in Germany traveled to the hospital to admire and marvel at the world first.

Additionally, the hospital also recently built a brand new 10-bed, state-of-the-art intensive care unit with the latest technologies, built a new ward, four new operating theaters, and then added an EOS, Nobel Prize winning, spinal imaging system from France.

Storz in Germany were the first to develop a 3D camera for laparascopic surgery and The Valley Private Hospital acquired this as well.

When asked what it felt like to own such impactful technology that no one else has yet, Henderson replied with three words full of enthusiasm: “I love it!”

“It [the technology] has enabled us to do a few things,” he added.

“For one, it has been critical to change the perception of the hospital from where it was to where it is. It has made people sit up and notice that we are serious and do what we say we will do. It also enables us to attract top specialists in the field because they want to use that technology—which adds to the reputation and prestige.”

Looking to the Year 2020 “We are a vibrant, growing and excited organization with a big future—which creates lots of opportunities to participate in,” said Henderson.

Healthe Care’s vision for The Valley and South Eastern private hospitals is to grow overall, but its goal for the year 2020 is to own 50 per cent of the market of the 1.2 million people living in southeastern Melbourne and Victoria. This exponential growth w w w. h e a l t h e c a r e . c o m . a u /

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would require going from the current 260 hospital beds to 560 by said year across 3 campuses.

Currently, 60 beds are being built at The Valley Private Hospital and the following 60 beds will be built at South Eastern Private Hospital—which will take the current total to 380 hospital beds by 2016, well on track to realize the 2020 vision.

Healthe Care has committed significant funds to redevelopment projects. Undertaking extensive refurbishment of patient accommodation and adding additional services, Healthe Care’s aim is to build facilities with strong partnerships and service integration that deliver innovative programs, provide flexible care options and support patients well beyond their hospital stay.

For those after the best private hospital care there is in Australia, the choice is Healthe Care.

“[The technology we use] enables us to attract top specialists in the field.”

– Neil Henderson, CEO

Company Information INDUSTRY

Healthcare HEADQUARTERS

Sydney NSW, Australia FOUNDED

2005 EMPLOYEES

Healthe Care: 5,000; Valley / South Eastern: 1,000 PRODUCTS/ SERVICES Healthe Care’s philosophy is simple: to make and keep people healthy. By providing the right tools and information alongside a range of health services and solutions, Healthe Care empowers its patients to take control of their health. With a portfolio of 16 hospitals, 5,000 employees and 1,600 hospital beds (for now), Healthe Care is the third largest commercial group in Australia.

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Fundacion Clinica Shaio:

Colombia’s Top Cardiologist Joining care, research and education to serve

Written by: Tomas H. Lucero, Editorial Assistant Produced by: Lucy Verde, Director of Projects at WDM Group - LATAM Interviewee: Gilberto Mejia, Scientific Director of Clínica Shaio Foundation 48 June 2015

t

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C L I N I C A S H A I O F O U N D AT I O N

F En route to Shaio

Inside Shaio

undacion Clinica Shaio is a non-profit organization devoted to the research and care of cardiovascular disease. It was founded in the heart of Colombia, the city of Bogota, in 1956. Its approach is to care for the patient as a team and to invade as least as possible when surgery is absolutely unavoidable.

The foundation differentiates itself by the high-complexity of the care with which it treats cardiovascular disease as well as the high complexity of the diseases it handles. Shaio uses state-of-the-art equipment to treat cardiovascular disease.

In addition to doing important medical research, the foundation also plays a role as educator of health care professionals.

By 2040, the foundation will have collaborated with the City of Bogota to transform the clinic and its surroundings into a holistic medical complex.

Clinic differentiators In its 60 years of existence, Shaio clinic has built a strong tradition in medicine. This tradition is one that clearly differentiates itself from the competition. The clinic’s differentiators are its specialization in cardiovascular procedures, its strength in education and research, and its “group” approach to treating patients suffering

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from cardiovascular disease.

“Since its origins the clinic devoted itself to all things cardiovascular and it has always sought, led by technological development, for our surgeries to be as least invasive as possible.

We may be characterized by how we’ve always sought to perform high-complexity surgeries with the least invasion possible,” explained Gilberto Mejia, Scientific Director of the Clínica Shaio Foundation The foundation understands that the practice of medicine and quality education go hand in hand.

This is why it has built strong relationships with the local academic community. “[The second differentiator] is also a foundational principle of the clinic. It is strength

Key People

Gilberto Mejia Scientific Director of the Fundacion Clínica Shaio Gilberto Mejia is a physician from Universidad del Bosque. After U of Bosque he specialized in general anesthesia at the Hospital Militar and then cardio anesthesia at Clinica Shaio. His first contact with the clinic was in 1986, as a student.

In 1990, educated as an anesthesiologist, he began as Surgery Room Chief and then as Clinica Shaio Anesthesia Department chief. He has been scientific director since 2005.

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Human resources of the Shaio Clinic Department of Haemodynamics

“Our patients don’t come to a single physician but they come to a group of specialists who follow a single operating procedure.””

in research and education. We have partnerships with more than 18 universities which we help educate a variety of health care professionals,” added the director.

– Gilberto Mejía, Scientific Director of Fundación Clínica Shaio

“Another differentiator is that the treatment of cardiovascular illness is treated as a group.

It’s not one specialist who cares for a patient.

Instead, a group does it. The group follows one standard operating procedure. Our patients don’t come to a single physician but they come to a

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June 2015

This institution is also innovative in how it cares for and relieves patients. While at a conventional clinic the patient faces his physician alone, and by turn, the physician faces her patient alone, at Shaio they practice a “group” medicine.

SECTOR

The new GAMMA KNIFE® PERFEXIONTM, crowning jewel of radio-surgery

group of specialists who follow a single operating procedure. It’s a group medicine and it has better results,” explained the scientific director.

Dialogue with the world In July of 2015 the 20th World Congress on Heart Disease will take place. Clinica Shaio’s goal for that event is to evaluate its national practice of cardio care through a dialogue with key global players and innovators.

“Considering the caliber of specialists that will attend the congress, we purport to compare Colombian cardiology with world cardiology,” asserted Mejia.

Tribute to doctor Jorge Reynolds Pombo

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C L I N I C A S H A I O F O U N D AT I O N

The new Cardio

In its relationship with health insurance companies, Shaio confronts the problem of the high cost of using state-of-the-art medical equipment. However, as a health organization, Shaio understands that in the long-term, using high technology costs less.

Prevention Gym

“The relationship with the insurers is always difficult because, as a first-tier institution, where high technology is deployed, they always associate this to high costs. Therefore, what we attempt to do in partnership, and what we’ve achieved, is to show the insurers that the use of high technology is not synonymous with high

L AT I N A M E R I C A

costs. We try to show that when high technology is used right it will ameliorate the disease, increase quality of life and decrease the cost of caring for the disease. True, using high technology is more expensive per event but caring for the disease costs less when tools are used properly and when the right tools are used,” stated Mejia.

Mejia asserted that the corollary of the digitalization of medicine is more effective treatments and interventions. An example of this digitalization is the integration of diagnostic images onto one computer. According to Mejia, this type of integration allows the physician to perform more objective and timely diagnoses, which express themselves as expedited and more appropriate surgeries. This is one way in which the clinic capitalizes on medical digital technologies.

Social commitment As a non-profit organization, the clinic reinvests all of its earnings in three areas: technology, training and social responsibility programs. One of these programs, Corazon Colombia, battles the problem of congenital heart disease.

Corazón Colombia is a foundation program that operates on children who have no resources or don’t have easy access to the social security health care system. The clinic operates on their

“The clinic managed to win a “Partial Plan for Urban Renovation.”

It’s an urban instrument furnished by the city, and it will transform the clinic and its surroundings into a comprehensive medical complex” – Gilberto Mejia, Scientific Director of Fundacion Clínica Shaio

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C L I N I C A S H A I O F O U N D AT I O N congenital cardio pathologies. It began in 2003.

To date, it has operated on more than 750 children and diagnosed more than 2,500.

“They bring children from all over the country, completely free. Their congenital heart diseases are treated and then they’re returned to their hometowns,” indicated the director.

Another program is Corazón Saludable and it is preventive medicine. The project aims to impart health education using a health event as the point of departure. This means that if a patient has had an event, their family is at risk. The people she

L AT I N A M E R I C A

lives with are at risk because, possibly, they have the same habits.

“Through the program we teach them which habits they must modify to achieve better cardiovascular health,” asserted Mejia.

Company Information NAME

Fundaciin Clinica Shaio INDUSTRY

The Partial Plan for Urban Renovation

Hospitals and clinics

The aforementioned programs show that Clinica Shaio’s interests go beyond its four walls.

In the far future—the next fifteen years—the clinic will participate in a partnership that will transform the entire neighborhood that surrounds it.

The clinic managed to win a “Partial Plan for Urban Renovation.” It’s an urban instrument furnished by the city, and it will transform the clinic and its surroundings into a comprehensive medical complex.

HEADQUARTERS

Bogota, Suba, Colombia FOUNDED

1956 EMPLOYEES

1.600 REVENUE

USD $100 million

“This will allow us to reform our entire infrastructure, creating larger, safer, more comfortable spaces. The clinic itself will not grow much but it will improve its services in regards to space and access,” added Mejia.

WEBSITE

www.shaio.org

This fifteen year plan is a completely new conceptualization to build a health center, on which will be a new clinic, including education, medical and research buildings, and even a hotel.

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The Experience of

175 years in Global Healthcare

Written by: Rebecca Castrejón, Editor Produced by: Lucy Verde, Director of Healthcare Projects at WDM Group Interviewee: Carlos Jiménez, CEO of B.Braun México 58

June 2015

B. Braun MĂŠxico has distinguished itself as an innovative firm in the health sector. Since setting up in Mexico it has won the trust of clients and medical institutions which have incorporated B. Braun devices to improve their surgical procedures.

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B. BRAUN MEXICO

B

. Braun Mexico is a subsidiary of the global company B. Braun Medical Inc. (B. Braun) which has more than 175 years of experience in the health market. B. Braun has devoted itself to health care and the advance of medicine through innovation in state-of-the-art medical and pharmaceutical devices.

Apps B. Braun

They develop products that range from surgical technologies to orthopedics to neurology to hemodyalisis therapy to regional anesthesia to infectious disease control, among others.

Operations in Mexico Even though B. Braun products have been sold in Mexico since the sixties, the multinational didn’t set up in the country until 1993 through a partnership with the Mexican Institute for Social Security (IMSS) to produce osteosynthesis, opening its production plant in Mexico State and corporate offices in Mexico City.

Traceability

The company supports the Mexican Aesculap Academy Foundation and has a subsidiary charged with supplying products and services for primary and holistic anesthetic care and intensive care; as well as devices for the mobile patient, named B. Braun Medical All the while, it’s a corporate member of chambers and associations like the National 60

June 2015

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Chamber of the Pharmaceutical Industry (CANIFARMA), the Mexican-German Chamber of Commerce and Industry (CAMEXA), the Mexican Association of Innovative Industries in Medical Devices (AMID), and the Association of Medical Device Companies (ASEMED.) Mexican Aesculap Academy Foundation: Specialized Medical Education B. Braun’s efforts in medical education arrived in Mexico in 2002, followed by the opening of the Aesculap Academy in 2004. The academy fosters the training and updating of the Mexican medical community through courses on the cutting edge of medicine, viewing of surgical procedures streamed in real-time, seminars led

B. Braun Mexico present at the regional Latin American

Key People

Carlos Jimenez CEO of B. Braun Mexico By 1986, the executive had joined the company after graduating with a bachelor’s degree in Dual Education Systems, specializing in Industrial Business Administration in which he expanded his knowledge of production, marketing and management.

He served in a variety of posts at B. Braun before becoming the subsidiary’s leader in Mexico. His last position was Marketing and Latin American Product Development Manager from 1998 to 2008.

Additionally, he’s president of the Mexican Aesculap Academy, a foundation in the education sector which supports the medical specialization of Mexican health professionals. The executive is also Vice President of the Mexican Association for the Innovative Medical Device Industries (AMID) and a member of the GermanMexican Chamber of Commerce and Industry (CAMEXA.)

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B. Braun Aesculap designs a device for the sealing of cups

“We are differentiated by the degree of innovation we are achieving, launching many new products and offering improvements to the Mexican health market” – Carlos Jimenez, CEO for B.Braun México

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June 2015

by international experts and events in one of the more than 50 countries where Aesculap Academy operates.

The courses are offered in a variety of specialties to physicians, surgeons, interdisciplinary personnel, nursing professionals, and medical, operating room and sterilization technicians.

“We are differentiated by the degree of innovation we are achieving, launching many new products and offering improvements to the Mexican health market,” stated Carlos Jimenez, CEO of B. Braun Mexico, who has been with the German medical company nearly 30 years.

Jimenez leads the Mexican subsidiary managing

Critical care with our infusion bombs

the financial, commercial and productive aspects of the company.

Distinctions in the competition market Innovation, efficiency and sustainability are B. Braun’s three pillars for solutions in the medical market. For the company, to innovate does not mean launching something more complicated. They realize that complicated innovations increase risk. In terms of efficiency with the client, the company seeks to offer technical assistance based on a shared interest through personalized tutorials. Finally, when it comes to sustainable development it is achieved by coexisting responsibly with clients, its community and the environment.

Hemodialysis equipment

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B. BRAUN MEXICO

L AT I N A M E R I C A

Digitalizing the Mexican health industry B. Braun has grown at the pace of the new technologies, implementing electronic applications for the global health market. Such innovations start within the company through its B. Braun Knowledge Center, an internal platform for disseminating strategic information from the German group.

In constant creation and improvement of medical devices with an eye to

“Our employees have access to our spending reports from their mobile phones or tablets through an internal mobile app, creating a culture of use of electronic media,” added the CEO.

the future

Furthermore, the company has applications for its clients and industry professionals, with

SUPPLIER PROFILE Employees: 750 Established: 2010 Industry: Medical & hospitable Services: Proyectos de Asociación Público Privada (APP), kidney patient care (including hemodialysis), integrated services: laboratory, minimally invasive hemodynamics, anesthesia, radiology, pharmacy and not care.

Recent Projects: Regional High Specialty Hospital of Zumpango, Proyecto de Asociación Público Privada (APP), Patient Care Center Renal, Huacho, Perú.

President/CEO: Javier Sanchez, General Director; Alfonso Arellano, Comercial Director

Webpage: www.igsamedical.com

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B. BRAUN MEXICO

Professionals committed to health

friendly mHealth technology tutorials which display a significant part of the B. Braun products selection, as well as user manuals and medical goals for each solution.

There is another type of medical applications that B. Braun offers the patient, that due to Federal Commission to Protect from Sanitary Risks (COFEPRIS) regulations, have not been launched in Mexico.

The company is also a pioneer in the use of hospital software to increase efficiency in access to medical resources and facilitate the clinical process.

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A transparent company As one of the most important suppliers of medical devices in the global market, B. Braun seeks to be closer to the medical community and its business partners. This is why corporate transparency is one of its main values. For example, B. Braun makes its annual corporate report public online. “Our brand is very close to its users, clients and partners. We are a multinational with a culture of transparency, that shares its data and is open with its associates,� said Jimenez.

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Aesculap Academy

B. BRAUN MEXICO

L AT I N A M E R I C A

successful recruitment of industry professionals thanks to the publicizing of its corporate culture on mediums like LinkedIn. Socially responsible and committed to the national well-being Instrumental

B. Braun Mexico is active in its social context.

Its commitment to the national well-being is such that they donate more than five percent of their annual sales to education programs and community service. They also donate medical devices to the Mexican Red Cross, sponsor teaching materials at neighboring schools and lend a hand in the many education programs offered by the Mexican Aesculap Academy Foundation.

One of its focuses is supporting the German Industry Board for Culture in Mexico which arranges cultural exchanges. “We want to build a bridge between two cultures and countries that are so different economically,” expressed Jimenez.

Through the Mexican Aesculap Academy Foundation, in 2014 B. Braun provided 115 educational programs reaching more than 1,600 health professionals, among them nurses, biomedical engineers, surgeons, specialists and other industry personnel.

“Our brand is very close to its users, clients and partners. We are a multinational with a culture of transparency, that shares its data and is open with its associates” – Carlos Jimenez, CEO for B.Braun México

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B. Braun Mexico sponsored the event “GROW 2015, Courage with Attitude� for its human

Progress in its Mexican product line By the end of 2015, B. Braun Mexico hopes to launch a variety of medical components as part of its efforts to consolidate its commerce in the country.

Dr. Andrea Gattolin sharing expertise, representing MĂŠxico at the 38th International General Surgery Congress 70

June 2015

Among the principal innovations awaited in for the mid-term are: 1. 3-D camera system: Provides sharper and wider vision for the surgeon, as well as ease-ofuse (less fatigue, more security) diminishing the margin of error in minor invasive surgery.

2. Pre-procedure surgery planning software in orthopedic implants: Planning the surgery allows for customization to patient foot specifications

SECTOR

resources

which protects tissues because access is optimized.

3. Semi-rigid system for column vertebrae: B. Braun’s new system achieves joint stability in dozens of local vertebrae without restricting their movement.

Supplying quality B. Braun’s supply chain is under constant quality control. This practice is part of the company’s “Sharing Expertise” policy. The company ensures the highest production quality since it makes 99 percent of the products it sells worldwide.

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B. BRAUN MEXICO

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The CEO emphasized that its suppliers play an important role in its innovations: “The suppliers play an essential role as far as supplying materials and electronic components. We understand that all of our final products, particularly our innovative devices and software have been a result of a successful synergy with them.”

Company Information NAME

B. Braun Mexico INDUSTRY

Medical devices and injectable pharmaceuticals

Growth projections B. Braun has grown annually by at least 20 percent. By the end of 2015 it’s actually projecting a growth of 30 percent. With this growth it also expects to double its number of employees to 600 in the next four years.

The parent company has observed the high growth the country has experienced as well as its manufacturing muscle. It’s considering future investments and the construction of a new industrial enterprise by 2018. The strategic vision is for the country to be an exclusive B. Braun manufacturer of global market products.

“We are looking to launch new products in osteosynthesis with titanium alloy, expand our portfolio with implant and column solutions, increase sales, our technical support and manufacturing,” concluded the CEO.

HEADQUARTERS

Toluca, Estado de Mexico y Ciudad de México, Mexico FOUNDED

1993 in Mexico 1839 global EMPLOYEES

300+ REVENUE

USD $80- $100 million WEBSITE

www.bbraun.com.mx

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Complete

coverage in specialized medical attention Colombian Cardiovascular Foundation’s available services and products are a result of a true calling to fulfill medical needs to the most patients possible.

Written by: Mateo Rafael Tablado, Associative Editor Produced by: Lucy Verde, Director of Latin American Projects at WDM Group Interviewee: Dr. Víctor Raúl Castillo, CEO of FCV of Colombia

F U N D A C I O N C A R D I O VA S C U L A R D E C O L O M B I A

T

Heart Institute

he origin of the Colombian Cardiovascular Foundation (FCV) goes back to early 1980s field trips, when doctors Franklin Quiroz and Raul Castillo would take foreign visitors to rural towns in the Santander Department, in northeast Colombia, and notice the necessity of providing attention for cardiovascular ailments, especially among children. The FCV non-profit was founded in 1986 and began operations in facilities lent by other hospitals until 1997, the year in which the first Instituto del Corazon opened in Floridablanca, near the city of Bucaramanga.

panoramic view

“With the consolidation of other medical specialties, Colombians will have a complete alternative in healthcare services quality and cost” – Dr. Victor R. Castillo, CEO for FCV Colombia

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The 1998-2002 Financial Crisis: The Catalyst for Expansion The turn of the century was a difficult time for Colombian economy, the financial crisis affected most government agencies, including the Institute of Social Security, FCV’s main supporter. This prompted the Foundation to offer the most services and products possible its resources could provide, in order to generate enough cash flow to maintain ongoing operations.

Strategic Business Units FCV’s Strategic Business Units income is reinvested in the Foundation; this way, new business units are created to satisfy patients’ demands. Current business units are: · FCV’s own hospitals · Hospital and surgery supplies · Bioengineering laboratory

L AT I N A M E R I C A

· Hospital management · Medical air transport · Telemedicine · Design and construction · Corporate University · Product sales · Event production and marketing Awards and Certifications In 2001, the FCV became the first Colombian hospital to earn ISO 9001 certifying, not long afterwards it was also certified by The Joint Commission, among other accolades and compliance certificates.

Outreach to the Community FCV works with children from low-income families, providing them access to healthcare; low-income patients from the inner country are

Surgical procedure

Key People

Víctor Raúl CEO Dr. Castillo is the current CEO at Colombia’s FCV. The surgeon attended the Juan N. Corpas University medical school, in Bogota. His postgraduate studies took place at del Valle University and specialized in cardiovascular surgery at Pontifical Bolivarian University, in Medellin. Besides Dr. Castillo’s practice as general surgeon at Ramon Gonzalez Valencia and Social Security Institute hospitals, his experience includes upper management positions at Bucaramanga Surgical Institute and the city’s Chamber of Commerce (of which he’s currently president). He has also worked for COLCIENCIAS (ministry for science and health-related technology); and besides performing as a surgeon at FCV, he is also the foundation’s CEO. Dr. Castillo has attended conferences, symposiums, courses and congresses worldwide as a speaker. His work has been awarded accolades such as the “Meritory Citizen Order” from the Government of the Santander Department, the Merit Honor from FCV and a special recognition award by the Colombian Cardiology Society.

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Patient rooms

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provided of lodging, feeding and transportation.

FCV also produces the yearly Bucaramanga Marathon, first ran on 2004.

Strategic Partnerships FCV works with other organizations specialized in different aspects of healthcare. Boston Scientific is their main supplier for therapy-related products.

Deployment of latest-generation technology arrives from partnerships with Colciencias government agency for science and technology, as well as from SENA (National Learning Service).

Under Construction: a Top Level Medical Center FCV’s most ambitious project up to date is already under construction, the FCV

SECTOR

Waiting hall at tomography unit

Medical and Dentistry Center and Colombia International Hospital. The center’s site has just been declared a tax-free zone, attractive for medical tourism; the project also includes a hotel and convention center.

These facilities are scheduled to open during 2015.

FCV CEO Victor Raul Castillo and Orlando

Dr. Victor R. Castillo, CEO for FCV Colombia shared some details in the following interview about the foundation’s assets and resources, which combined result in a top-notch, competitive health institution.

Sardi de Lima, Spain Ambassador to Colombia

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International, which could be -in your opinionthe three main factors for FCV’s leadership within the area?

Dr. Víctor Raul Castillo: A core value we share is being able at defining where exactly do we want to go, by planning ahead and working persistently in every goal; this attribute has resulted in important steps forward taken by our institution. Another factor is being open to initiatives in favor of the area’s health sector brings us recognition as successful organization and also as a trigger to other actions benefitting not only our institution, but rather our entire community. And the third one is counting with a committed human team, able to support our institutional development.

BRAL: As it happens with the partnership shared by FCV and Pharma, in which ways have other joint efforts improved the ability to provide medical attention, prescriptions, products and deploy latest-generation technology?

VRC: Partnerships with our suppliers have resulted in mutual benefits, consolidating efforts that go beyond financial profit. It’s not just about quality and costs; the best that comes out of these alliances are the multiple opportunities for developing research and continual improvement projects.

FCV Heart Institute main entrance

“We count with a committed human team, able to support our institutional development” – Dr. Victor R. Castillo, CEO for FCV Colombia

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First-born Intensive Care Unit

BRAL: Once the Colombia International Hospital project opens (projected for 2015), what other new services and developments await for Colombia’s population?

VRC: Our population will be able to rely on a world-class hospital without leaving the country.

Through the partnerships we could establish at our Oncology department, specially the one agreed with UPMC (University of Pittsburgh Medical Center), Colombian nationals will have access to services from one of the world’s leading institutions in oncology. In the same way, this will happen with other medical specialties

Trusted experts in global sourcing, supply chain, logistics, and inventory management for small production components.

Doing now what patients need next

L AT I N A M E R I C A

such as gynecology, neurosurgery, orthotics and others, as soon as upcoming alliances are set by FCV, bringing alternatives in service quality and cost.

BRAL: In your own projections, where do you see FCV five years from today? What plans do you have to accomplish such goals?

VRC: Five years from today, FCV is becoming Colombia’s most prominent health institution, not only because of the length of provided medical services and demographic reach, but rather by its activities’ social impact, benefitting the community in its entirety, specially population sectors scattered through hard-to-reach parts of the country’s geography, mainly people lacking access to decent medical attention. Five years from now, FCV must be our country’s most important social endeavor.

Within the next five years, we hope our University Foundation becomes fully operational, with a complete medical specialty program and our social security company underway. In this same period, the Tech Development Center should be patenting higher volumes of medical products and instruments along with other local initiatives, as part of Colombia’s most important healthcare cluster. Our services’ scale should be large enough to provide attention for children and adults separately. By then, we will have 12 own medical centers across the country, while managing 50 top-level hospitals.

Company Information NAME

Fundacion Cardiovascular de Colombia INDUSTRY

Healthcare, hospitals HEADQUARTERS

Bucaramanga, Departamento de Santander, Colombia FOUNDED

1986 EMPLOYEES

2,800 REVENUE

US $110 million WEBSITE

www.fcv.org

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Beneficência ortuguesa de São Paulo:

Bringing innovation to health for 155 years

nt of reference in various hospital care specialties, entity focuses igh quality assistance and investments to maintain its excellence Written by: Flávia Brancato Produced by: Karla Sohn 85

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W Beneficência Portuguesa de São Paulo inaugurated in June 16th 1957

Surgery Center of Beneficência Portuguesa de São Paulo in 1957

ith its 7,500 employees, 3,000 doctors and 1,100 beds, the three hospitals comprising the Beneficência Portuguesa de São Paulo (BP) are a point of reference in more than 50 hospital care specialties.

Considered the largest private hospital in Latin America since its founding in 1859, the organization is proud of its work based on quality, humanization, education and research, as well as having a renown team of experts from various fields.

“We currently serve more than 1.8 million people every year, which allows us to continuously develop the technical know-how necessary to handle high complexity cases. We are a point of reference in hospital medical care in various specialties such as cardiology, oncology, neurology, orthopedics and more,” says Manuel Coelho, BP’s executive superintendent of marketing and strategy.

In recognition of its quality and medical capacity, as well as its competence in the training of health professionals, this year Beneficência Portuguesa de São Paulo received the certificate of “Teaching Hospital” from the Ministries of Education and Health.

Hospital São Joaquim The institution’s first unit serves private patients, supplementary health patients and those from SUS – Sistema Único de Saúde (Unified Health System.)

In addition, for the last three years, Hospital São Joaquim has been accredited by the National

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Aerial view of the Hospital. Featured São Joaquim Hospital (white) and São José Hospital (blue)

Accreditation Organization (ONA) at the highest Level three, for management excellence.

Hospital São José Established in 2007, this unit stands out for oncology care with international standards, among other specialties, whether for private or complementary health patients. Three years after its opening, Hospital São José was accredited by the Joint Commission International (JCI)—considered the highest standard of comprehensive medical care.

Hospital Santo Antônio Focusing on social responsibility and the association’s charity efforts, Hospital Santo Antônio was created in 2012 to offer high quality service exclusively for SUS patients. w w w. b p s p . o r g . b r

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THE NEW DIRECTION FOR TOTAL DOCUMENT SOLUTIONS

Tel.: +55 (11) 5574-8677 | Fax: +55 (11) 5539-5767 | kitani@kitani.com.br

www.kitani.com.br

BRAZIL

Santo Antônio Hospital - Public hospital from Beneficência Portuguesa de São Paulo

Centro Oncológico Antônio Ermírio de Moraes In 2013, BP opened the Centro Oncológico Antônio Ermírio de Moraes, one of the most comprehensive centers for diagnosis and treatment of all types of cancer. Considered a one-stop-shop for oncology, their methodology involves multidisciplinary medical teams which enable greater accuracy in diagnosis, therapies and complementary treatments, and also provides a full monitoring of the patient’s health and support for family members.

In addition, the Oncological Center has advanced equipment and is constantly investing in innovation. Its care structure has two floors of clinics and dental medicine, 42 beds, 21 rapid infusions rooms, 20 chemotherapy rooms and four radiotherapy equipment which allow for the performance of more than 20,000 oncology procedures a year.

CHALLENGES AND STRATEGIES Ensuring high-quality care for all patients, the organization is always in pursuit of excellence in processes, controls and systems. According to the superintendent, “Since we are a service institution, our attention to the people is essential. Therefore, we adopt appropriate management w w w. b p s p . o r g . b r

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One of many ICUs from Beneficência Portuguesa de São Paulo

practices, allowing the development of a team of leaders focused on sustainability and positive results that allows for the growth of Beneficência Portuguesa.”

Strategically, the institution’s efforts are pooled in its “strategic fronts,” which concentrate the project planning. As an example, recently they adopted the Lean 6 Sigma and 5S practices to optimize patient flow.

“Beneficência Portuguesa is currently experiencing large changes and the biggest challenge of our management is to ensure that all actions are set and experienced by everybody in the institution, reinforcing our ‘ABC cause’ (Attention, Welfare and Caring),” said Coelho.

In addition, the ongoing focus on the training of professionals has proven to be one of the key strategic initiatives adopted to ensure the quality and excellence of service. Therefore, some actions have been implemented.

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Among many others, the Leadership Development Program, Program for Excellence in Service, training actions for staff and physicians, school of nursing and partnership with universities. According to Coelho, about 2,000 professionals participate in training programs per month.

SOCIAL RESPONSIBILITY About 60 percent of the services are directed to public patients, who have access to all the same modern infrastructure and excellence, with the same clinical staff and technology equipment.

“We currently serve more than 1.8 million people every year, which allows us to continuously develop the technical knowhow necessary to handle high complexity cases” – Manuel Coelho, BP’s executive superintendent of marketing and strategy

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Cutting edge technology in the Nuclear Medicine Center

“We understand philanthropy as the right that all people have. Regardless of economic and social level, they will all receive the very best in health. Our cause has always been a social responsibility,” says the superintendent.

The figures demonstrate the organization’s maturity in terms of volume and competence in service and treatment. Between 2010 and 2014 they processed 81,000 admissions, 54,000 surgeries, over 20,000 chemotherapies, 307,000 radiotherapies and over 2 million laboratory tests, all performed by SUS. During the same period, 355 transplants were performed.

FOCUS ON INVESTMENTS Over the past five years, Beneficência Portuguesa de São Paulo invested over USD $95 million in expansion and qualification of its hospital facilities.

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about USD $22million. Last year, an additional USD $45 million was invested in the construction of block two of Hospital São José—considered the premium hospital of the group. The project, which expands from 67 to 118 beds, will also include the implementation of an emergency service, 31 chemotherapy rooms, the latest radiation equipment, a floor dedicated to the care and welfare of cancer patients and a floor specialized in bone marrow transplants.

In 2014, BP started the “Projeto Conectar”.

A program to restructure and modernize the technology of all three hospitals. Launched in mid-2014 and planned to end in 2016, this project had USD $4 million as an initial investment.

Coelho states: “Our plans consider investments of around [USD] $44 million in 2015. The majority will be invested in Hospital São José and approximately [USD] $2.8 million in improvements to the diagnostic center.”

With so many projects and excellent prospects for the future, Coelho makes it clear that the entity will always maintain the strategic direction of working with dedication, ensuring high quality care for all patients. “We will keep the strength in our purpose to make Beneficência Portuguesa not only recognized for its expertise and assistance, but above all, for the same cause from 155 years ago: to provide quality health care for each and everyone,” he concludes.

Company Information NAME

Beneficência Portuguesa de São Paulo INDUSTRY

Healthcare HEADQUARTERS

São Paulo - SP, Brazil E S TA B L I S H E D

1859 EMPLOYEES

7,500 employees and 3,000 doctors MANAGEMENT

Board Directors President: Rubens Ermírio de Moraes CEO: Denise Santos

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Centroflora:

Partnerships for a Better World

Through practices that promote a sustainable growth, local development and biodiversity conservation, the group is a leader in the natural active pharmaceutical ingredients (APIs) market

Written by: Flรกvia Brancato | Produced by: Karla Sohn

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hrough practices that promote sustainable growth, in the tradition of the socio-environmental corporate program “Partnerships for a Better World,� Grupo Centroflora gathers in its portfolio around 200 products destined for the health, personal-care, and food and beverage markets.

Using technologies that isolate, extract, concentrate and dry differentiated natural ingredients and active ingredients of highly aggregated value, with assured quality and traceability, the company is a leader in its sector.

During its more than half a century operating in the botanical extract market, the goup has been a heavy hitter since its first product, artichoke extract, utilized in the production of a medication that treated digestive disturbances related to hepatic functions.

Pharmachemical unit - ParnaĂ­ba, PI

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Management President:

Peter Andersen Technical-Scientific Director:

Ricardo Dias FinacialAdministrative Director:

Plant Extracts unit

Mauro Tavares

Structure and Production Centroflora’s product line possesses diversity in its presentations and standardizations, covering items of the smallest technological complexity to what are known as pharmochemicals, which are considered active pharmaceutical ingredients (APIs) of high purity. Among the ones that stand out are the standardized botanic extract, for phytotherapeutic use in the nutrition segment, essential oils of pharmaceutical grade, dehydrated pulps, and isolated active natural ingredients, like pilocarpine salts and quercetin.

In order to manage production, the group relies on an ample distribution network present in more than 70 countries and a high volume of exportation. “More than 60% of our sales are exports to the most developed and demanding markets in the world,” said President of Grupo

Pharmachemical Unit Director:

Guillermo Perez Salicrup

“In Brazil, Centroflora takes the spotlight in the natural pharmaceutical API market” – Peter Martin Andersen, President of Grupo Centroflora

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Plant Extracts unit facade - Botucatu, SP

Centroflora, Peter Martin Andersen. In the international market, despite pilocarpine—for pharmaceutical use—being the top export, 80% of the exported volume is geared towards the nutraceutics segments, which showcase the Barbados cherry, guaraná berry, açaí berry, yerba mate and green coffee extracts.

At the national level, the company is considered mainstream. According to Andersen, some medicinal plants are responsible for the positive exposure. “In Brazil, Centroflora takes the spotlight in the natural pharmaceutical API market, featuring Passiflora incarnata—a medicinal plant traditionally used as a sedative and sleep aid—as well Cordia verbenacea, a Brazilian medicinal plant utilized as an antiseptic healing agent and natural anti-inflammatory.”

The production plants are divided into the Drying, and Vegetable Extraction, units, both located in Botucatu, São Paulo state, and the Pharmacochemistry Unit, located in Parnaíba, Piauí state. The company 98

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has also invested in agribusiness. In Parnaíba it grows Cordia verbenácea, a plant utilized in the production of a unique oil which is the ingredient of the Acheflan line, from the Brazilian laboratory Ache. The company’s steady growth is a reality and forecasts maintain a positive curve. “In 2008 we built an essential oils unit inside the farm and near the agricultural production area.

And last year we acquired, from Boehringer Ingelheim, the manufacturing technology of an API group which will result in important technological advancements for the company and for the country over the next years,” stated Andersen. These new molecules will be produced in the pharmacochemistry unit in Piauí, where the company has invested in overhauling and expanding production capacity to serve around 100 new clients who are located mainly in the U.S. and Europe.

Beyond unit expansion, Grupo Centroflora has been developing partnerships over the past years. In 2012, it acquired a 100% equity share in the company Phytobios from Natura, and Grupo Orsa, which facilitated the reconstruction of the company’s strategic innovation. “Phytobios is currently responsible for all small-scale research projects,” explained Andersen. Also, in 2014, Centroflora and CMS, a Swiss company, formed a joint venture called Centroflora CMS--operating out of Luxemburg--focused on the global distribution of APIs.

Yerba Mate harvest, Partnerships for a Better World

Essential Oils unit Parnaíba, PI

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Passiflora incarnata, Partnerships for a Better World

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“Partnerships for a Better World” Andersen clearly states: “The integration of a productive chain, through the Partnerships for a Better World program is, without a doubt, the biggest differential at Centroflora.” The program was created in 2002 and its main guidelines are: 1) To promote the conservation and sustainable use of biodiversity through partnerships that generate value to its stakeholders; 2) To facilitate industrial-scale supplies of vegetable raw material with traceability and sustainability; 3) To foster family agriculture, forestry stewardship, local development and ethical biocommerce.

Currently, there are more than 4,000 people involved in the culture, or harvest, processes of vegetable-origin raw material for Centroflora; spread out in the south, southeast, north and northeast regions. The purchase of planned crops is guaranteed through the Partnership Contracts established between Centroflora and its clients and producers.

The focus for partnerships with medicinal plants’ suppliers are rural communities, associations, cooperative societies and family farmers who are selected based on technical sustainability criteria. The species selected for cultivation go through botanical, agronomic and feasibility analyses ensuring the promotion of the desired species. The Partnership deal offers raw-material suppliers, not only technical support and technology transfers, but also training and strengthening of productive deals. All partners follow organic agriculture principles. “The Partnerships deals are

“The Partnerships deals are concluded with the benefits to all agents in the production chain in mind, which goes beyond financial aspects” – Peter Martin Andersen, President of Grupo Centroflora w w w. c e n t ro f l o r a . c o m . b r

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Agricultural unit - Parnaíba, PI

concluded with the benefits to all agents in the production chain in mind, which goes beyond financial aspects. The main benefits are the promotion of family farming, local development, biodiversity conservation, products’ traceability and mitigation of supply shortage risk,” Andersen concluded.

More projects Among many others, some projects developed by the company, especially in environmental accountability, are noteworthy. Created in 2002 by Grupo Centraflora, the Floravida Institute is a non-governmental organization whose mission is to expand crossover socio-environmental initiatives in the health, environmental and local development fields. With its headquarters located in Botucatu and a branch in Parnaíba, the Institute 102

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has a multidisciplinary staff working on the sustainability of the company’s active regions.

One of Floravida’s projects, dubbed “The School Goes to the Forest,” is part of an environmental education program aimed at sustainable development. On its dirt trails, the Institute hosts student groups who are touched by the experience.

Additionally, Centrofauna is a scientific regional unit for the handling, rehabilitation and triage of wild fauna. Its objective is to rehabilitate wild animals recovered from illegal captivity and trade, or through voluntary surrender, and release them back into their natural habitat. They also have a training program focused on animal cruelty and

“We try to invest between USD $3 to $4 million annually in our factories. The focus is always to improve the extraction, dehydration and controls process” – Peter Martin Andersen, President of Grupo Centroflora

Floravida Institute - Botucatu, SP

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wildlife captivity prevention.

Lastly, aiming at using biodiversity ethically, the Jaborandi Appreciation Program (Programa de Valorização do Jaborandi) is focused on generating income, environmental education and the social organization of the Jaborandi extracting communities. For this program, Grupo Centroflora received the 2013 Banco do Brasil Foundation’s Social Technology Award, among other acknowledgements in its five years of existence. The program’s methodology has been replicated by other productive chains, such as Guaraná and Fava D’Anta.

Trends and Challenges While the market tendencies are more focused on anxiolytics and natural laxatives derived from medicinal plants, the pharmaceutical and food sectors are focused on energy drinks made with Brazilian ingredients like 104

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Quality Control Laboratory - Botucatu, SP

Jaborandi Enhancement Project

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Peter Martin Andersen, President

yerba mate, guaraná or green coffee. The industry faces several hurdles.

The innovation with Brazilian biodiversity is still a big challenge, considering the current regulatory scenario of access to the genetic patrimony. “For over five years we have been actively participating in discussions on the theme, supporting the approval of a new milestone that will promote access and allocation of benefits, and development of intellectual property and national industry,” emphasized Andersen.

And the challenges continue. “Brazil has been an important API producer for the pharmaceutical industry in the past. Over the last 25 years, this industry has been decimated due to the lack of incentives, unfavorable currency exchange rates and a low corporate culture,” added Andersen.

In comparison, currently the country imports more than 95% of its pharmaceuticals’ active ingredients.

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Company Information INDUSTRY

Pharmachemical HEADQUARTERS

Botucatu, São Paulo E S TA B L I S H E D

1957 EMPLOYEES

270 PRODUCTS/

t of Grupo Centroflora

SERVICES

The national production of newly acquired molecules from Boehringer Ingelheim meets the need for a national political incentive towards modernizing the Brazilian factories and increasing the national competitivity.

Grupo Centroflora’s pharmachemical unit is one of the only national companies certified by FDA EDMQ (Electronic Document Management Quality ). To maintain open roads ahead, Andersen concludes, “We try to invest between USD $3 to $4 million annually in our factories.

The focus is always to improve the extraction, dehydration and controls process.”

Standardized vegetable extract, essential oils, dehydrated fruit pulps and isolated active ingredients of vegetable origin

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