The waste healthcare (still) tolerates

By Ricardo Bueno, journalist and writer

For anyone who pays attention to detail, a routine experience like the one I had on October 15 exposes some of the invisible, and unnecessary, pain points of Brazilian healthcare.

Everyone knows the most common and most discussed gaps, such as lines at public clinics and hospitals, long waits for care, surgery or admission and the shortage of physicians in some specialties. What rarely comes up, however, is the waste of people, resources, energy and paper, which causes a financial erosion the system does not always notice. These are pain points that open the door to automation in hospitals and clinics, making way for artificial intelligence.

At first, all was well

A few weeks ago, the physician who follows me at the public primary care unit closest to my home, in the south of Porto Alegre, ordered a mammogram because of pain I had reported around my left nipple. Once the exam was done, everything suggested there was nothing to worry about.

Because the image was not conclusive, I was referred for an additional bilateral ultrasound, more detailed and thorough, so that we could rule out any doubts. Through SUS (Brazil’s public health system), the exam would probably take a long time.

So I decided to go to a private clinic.

First, I did a quick search for places with better wheelchair accessibility, since I am what I call a #neoPCD (a person with a recently acquired disability), due to Post-Polio Syndrome, diagnosed about three years ago. I contacted the private clinic via WhatsApp. The appointment was booked, and confirmation of the exam came 48 hours in advance.

Wasted resources

Anticipating delays from paperwork and registration, my wife and I went to the clinic, located inside a hospital, almost an hour early. After identifying ourselves on the ground floor, we went up to the second floor. We took a number, waited a few minutes and, right at the start of the visit, the clinic employee made a copy of the medical order, a document that should have taken up no more than half a sheet of A4 paper. The image of the order, by the way, had already been sent via WhatsApp when the appointment was booked. It was supposed to be in the system – but it was not.

The young employee then printed another A4 sheet, with the exam number, the date, my name and date of birth, headed “Pick up your exam here.” This content takes up only a third of the sheet. I did not quite understand what this paper was for, since he also handed me another document, a labeled strip of paper 8 cm wide, showing the same data: exam number, date, name and date of birth - with only the addition of a barcode next to the exam number and the information that the result could be picked up in 48 hours. A duplication that seemed unnecessary to me.

Wasted time

In a nearby room, where we were told to wait, I remembered that I had not paid for the exam. My wife went back to the counter, where the young man thanked her and admitted he had forgotten to charge us. Once the payment was made, he handed over the receipt on yet another A4 sheet, this time with the printing taking up a twelfth of the page. My concern grew over the waste of paper and the steps that seemed to have no end.

After waiting 30 minutes, we decided to ask an employee nearby whether the exam would take long, since the scheduled time had passed. She explained that the physician was in another procedure. When a young woman who was also waiting for an exam asked whether a mammogram needed to be performed by a physician, another employee said that mammograms and other exams of the same modality were actually performed in another room...

Instead of being seen at 8:20 a.m., as scheduled, I was called at 10:10 a.m. Both I and the young woman waiting next to me had to be squeezed into the line with everyone else, in the correct room, one delay causing another. I lost a whole morning of work because of the clinic’s lack of processes and visible operational confusion.

How AI can help

Because I work with AI companies and see the technology’s advances in my daily routine, I made a point of counting the number of moments when automation would have made a simple visit faster, reducing the time lost by both staff and patients.

I was also struck by the waste of paper at various stages of the visit and by the errors employees are exposed to: if it were not for our honesty, I would have had an exam without paying, even though the booking said otherwise.

When I read or write about the strengths of AI technology and the model of support for hospital and clinic management, I find myself imagining the leap in quality we are going to make in an area as sensitive to human beings as healthcare.

Welcome, artificial intelligence.

Combined with human intelligence, it will bring countless benefits, allow more investment in what is essential and save time and lives.