Prever o futuro na saúde? Com gestão de dados, você pode

Dr. Diogenes Silva, médico anestesista e CEO da Anestech Innovation Rising

Assista ao vídeo desta palestra em nosso canal no YouTube

Vivemos a era do big data e os dados são o novo ouro, é deles que estão atrás as grandes corporações. Sozinhos, porém, dados não são nada. É na análise desses dados e no que eles nos dizem, principalmente sua capacidade preditiva, que está seu valor. E é nessa análise que trabalha a Anestech Innovation Rising, do médico anestesista Diogenes Silva, com a entrada (input) massiva de dados de saúde que recebe de seus aplicativos: tratamento e desfecho com análise. “O volume de dados inseridos precisa ser tratado com significância estatística”, afirmou o Dr. Diogenes Silva na palestra “Registro Digital do Procedimento Anestésico (AxReg): Maior Impacto na Segurança e Economia Hospitalar”, no AnestEdu. “Então podemos usá-los para tomar decisões inclusive de negócios com business intelligence.” Ele falou no painel  “Quarta Revolução Industrial: Tecnologias a Serviço da Segurança do Paciente Cirúrgico e da Sustentabilidade Hospitalar” e citou a frase de William Edwards Deming, um conhecido estatístico, professor universitário e autor: “Não se gerencia o que não se mede. Não se mede o que não se define. Não se define o que não se entende. Não há sucesso no que não se gerencia.”

Veja também: Aplicativo que estará no 8º AnestEdu – AxReg – promove cirurgias 10 a 50% mais seguras e 36% mais econômicas

O Dr. Diogenes Silva citou os seguintes objetivos da análise de dados na saúde (fonte: Optum):

  • Compreender os fatores de custos e a tendência de utilização – “gestão hospitalar”;
  • Identificar membros que necessitam de intervenção clínica – “profissionais, pacientes, farmas e outros players que precisem de uma intervenção precoce melhora toda a cadeia”;
  • Melhorar distribuição de recursos para benefício máximo;
  • Analisar o comportamento do cliente para modelar o engajamento – “que as pessoas se sintam encantadas em prestar a assistência, porque é isso que qualquer paciente quer, que a assistência seja encantadora, porque o Facebook faz isso com ele, o Big Brother faz isso com ele”.

Prever o futuro na saúde com a gestão de dados do centro cirúrgico

Para o Dr. Diogenes Silva, colher e gerir dados é importante porque é impossível fazer gestão sem medir nada,  no “achômetro”. E se um hospital não tem sucesso no melhor centro de atendimento que pode ter, que é o centro cirúrgico, duas coisas acontecem: primeiro, o hospital está sempre em necessidade e segundo, o trabalho do profissional de saúde nunca é valorizado: “Você não consegue que o hospital se sinta empoderado por ter, além de uma boa assistência, um bom negócio, porque você não está medindo, não está fazendo gestão”.

Segundo ele, acabou o tempo de conflitos de interesse, é preciso ter confluência de interesses, ou seja, todos os players do mercado, da cadeia de saúde, têm de estar confluentes no mesmo objetivo: melhorar a experiência do paciente, o resultado, o desfecho. E lembrou que o protocolo Eras – Projeto Acerto, com o qual trabalha e que a WMC Anestesia recomenda, preconiza que o sucesso ao tratar o paciente se alcança com a interdisciplinaridade: anestesia, enfermagem, fisioterapia, nutrição trabalhando juntas.

Veja também: Afinal, o que querem os gestores hospitalares? Engajamento da equipe médica para oferecer valor em saúde ao paciente

E a confluência, o ápice dos problemas de saúde das pessoas, passou a ser cirúrgico. As técnicas cirúrgicas e anestésicas menos invasivas, as novas drogas, passaram a permitir que hoje sejam levados ao centro cirúrgico uma série de problemas que agora podem ser abordados.

O Dr. Diogenes Silva trouxe alguns dados que demonstram a importância do centro cirúrgico em um hospital e esclarecem a situação do mercado no Brasil:

  • 52% dos pacientes internados no hospital são cirúrgicos (Fonte: Benchmarking Anestech). “Mais da metade das pessoas que estão no hospital estão lá para fazer uma cirurgia. Veja a importância disso para o mercado.”
  • A média de cirurgia por paciente em um hospital é de 1,4 (Fonte: Benchmarking Anestech). “De todos os pacientes de um hospital, cada um deles vai fazer quase uma cirurgia e meia.”
  • 30 milhões de procedimentos anestésicos por ano – todos sem uma central de apoio com revisão de dados (Fonte: Benchmarking Anestech).
  • 8 mil cirurgias por hora somente nos hospitais da Associação Nacional dos Hospitais Privados (Anahp). Em 2017, foram 948.944 cirurgias.
  • 40% do custo do hospital vem do centro cirúrgico, que representa 70% da renovação de leitos do hospital. O custo de uma sala cirúrgica é de 10 a 30 dólares por minuto (Fonte: Macario A., Vitez T. S., Dunn B., et al – Where are the costs in perioperative care? Anesthesiology). “E não acontece nada no centro cirúrgico se o anestesista não fizer. O Dr. Prof. Florentino Mendes pesquisou isso no Rio Grande do Sul e concluiu que o custo/minuto de uma sala cirúrgica, operando ou não, é de 10 a 30 dólares nos Estados Unidos, 10 a 30 euros na Europa e 10 a 30 reais no Brasil.”
  • 1 a cada 200 pacientes irá morrer na mesa cirúrgica (cirurgias de grande porte) de um evento completamente adverso ao qual será operado. (Fonte: Renato Camargo Couto, segundo o Instituto de Estudos de Saúde Suplementar).

Por que prever o futuro na saúde pensando no mercado? Respostas na coluna “Baseado em Performance”:

Para o Dr. Diogenes Silva, outro motivo primordial para pensarmos no mercado, é porque estamos entrando na era da abundância na saúde, e isso ocorre também por causa dos dados. “Quando fizermos o tratamento de dados adequadamente, saberemos tão bem como tudo funciona, como é, como fazer bem feito, que vai sobrar. É assim que devemos pensar”, afirmou.

Ele trouxe exemplos de evolução, como a aprovação pelo Food and Drug Administration (FDA), a agência federal do Departamento de Saúde e Serviços Humanos dos Estados Unidos, há não muito tempo, da primeira solução de aprendizado clínico baseada em deep learning para laudos de ressonâncias magnéticas cardíacas. São dez milhões de algoritmos testados produzindo resultados em 15 minutos, trabalho que um ser humano levaria o dobro do tempo para fazer. O Dr. Diogenes Silva disse que aprovações como essa acontecem todos os dias.

Veja também: Tempestade na saúde: saiba quais são os ventos que podem trazer um mundo de oportunidades

Outro exemplo é a análise de Sebastian Thrun, cientista do Google e da Universidade de Stanford, de quatorze mil imagens de melanomas. A máquina acertou 72% dos diagnósticos e o homem – dermatologistas especializados – acertou 66%. Além disso, Geoffrey Hinton, psicólogo cognitivo e cientista da computação, disse: “Nós devemos parar imediatamente de formar médicos radiologistas!” A radiologia é a arte de comparar padrões de imagem, e a máquina faz isso pixel a pixel. “É impossível competir com ela”, disse o Dr. Diogenes Silva.

Ele lembrou ainda da máquina de anestesia que trabalha sem a presença de um anestesista e contou que quando ela foi retirada do mercado, em 2016, e viu colegas anestesistas comemorando, perguntou a eles se andavam no mesmo carro que foi inventado em 1886 ou em um carro um pouco melhor. “Já está sendo feita outra máquina com deep learning para sedação em colonoscopia e endoscopia sem a presença de um anestesista”, afirmou. “Mas a máquina nunca vai conseguir ter pelos pacientes algo que nós temos, chamado empatia. Ela nunca vai sentir pelo paciente o que nós nos esquecemos de sentir porque estamos usando plataformas de computador. Ela nunca vai tocar um paciente como nós tocamos.”

Prever o futuro na saúde com os dados no AxReg

Sobre o AxReg, o aplicativo da Anestech para gestão de dados no perioperatório, o Dr. Diogenes Silva explicou que não se trata de prontuário eletrônico, o que já existe há vinte anos no Brasil, nem de ficha anestésica, pois o que a gestão de dados oferece é a capacidade de prever o que vai acontecer: “É muito bom saber o que aconteceu, mas precisamos começar a prever o que vai acontecer e, com isso, mudar nossa relação e nosso protagonismo dentro do centro cirúrgico. E se hoje o dado não traz conhecimento, não é resgatável, não serve para nada, está desperdiçado.”

Ele explicou ainda que o AxReg é uma ferramenta mobile friendly, ou seja, um aplicativo para ser usado em um dispositivo móvel, o tablet, conectada com a nuvem (internet) em que, em tempo real, podem-se gerar indicadores para a gestão hospitalar, para o grupo de anestesistas, para o trabalho do fluxo do processo no centro cirúrgico, integrando, rastreando e analisando dados perioperatórios para melhorar três pilares: a segurança do paciente, a gestão hospitalar e a proteção legal de todos: “Acredito piamente que a segurança do paciente passa por um profissional valorizado, atualizado, descansado e de posse de ferramentas tecnológicas que expandam a sua capacidade assistencial, sua capacidade cognitiva e melhorem seu posicionamento dentro da instituição.”

E citou uma frase do Mount Sinai Journal of Medicine: “Não há outra configuração clínica ou registro de prontuário médico que concentre tal abundância de dados fisiológicos e farmacológicos do paciente, coletados minuto a minuto, como o Registro de Anestesia.” Isso significa, segundo o Dr. Diogenes Silva, que se o paciente ficar internado uma semana em um hospital e fizer uma cirurgia de uma hora, nessa uma hora cirúrgica terá o prontuário mais completo, com dados anotados minuto a minuto pelo anestesista.

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  73. Apple now has Rhapsody as an app, which is a great start, but it is currently hampered by the inability to store locally on your iPod, and has a dismal 64kbps bit rate. If this changes, then it will somewhat negate this advantage for the Zune, but the 10 songs per month will still be a big plus in Zune Pass’ favor.

  74. The Zune concentrates on being a Portable Media Player. Not a web browser. Not a game machine. Maybe in the future it’ll do even better in those areas, but for now it’s a fantastic way to organize and listen to your music and videos, and is without peer in that regard. The iPod’s strengths are its web browsing and apps. If those sound more compelling, perhaps it is your best choice.

  75. The new Zune browser is surprisingly good, but not as good as the iPod’s. It works well, but isn’t as fast as Safari, and has a clunkier interface. If you occasionally plan on using the web browser that’s not an issue, but if you’re planning to browse the web alot from your PMP then the iPod’s larger screen and better browser may be important.

  76. This is getting a bit more subjective, but I much prefer the Zune Marketplace. The interface is colorful, has more flair, and some cool features like ‘Mixview’ that let you quickly see related albums, songs, or other users related to what you’re listening to. Clicking on one of those will center on that item, and another set of “neighbors” will come into view, allowing you to navigate around exploring by similar artists, songs, or users. Speaking of users, the Zune “Social” is also great fun, letting you find others with shared tastes and becoming friends with them. You then can listen to a playlist created based on an amalgamation of what all your friends are listening to, which is also enjoyable. Those concerned with privacy will be relieved to know you can prevent the public from seeing your personal listening habits if you so choose.

  77. Hands down, Apple’s app store wins by a mile. It’s a huge selection of all sorts of apps vs a rather sad selection of a handful for Zune. Microsoft has plans, especially in the realm of games, but I’m not sure I’d want to bet on the future if this aspect is important to you. The iPod is a much better choice in that case.

  78. Between me and my husband we’ve owned more MP3 players over the years than I can count, including Sansas, iRivers, iPods (classic & touch), the Ibiza Rhapsody, etc. But, the last few years I’ve settled down to one line of players. Why? Because I was happy to discover how well-designed and fun to use the underappreciated (and widely mocked) Zunes are.

  79. Apple now has Rhapsody as an app, which is a great start, but it is currently hampered by the inability to store locally on your iPod, and has a dismal 64kbps bit rate. If this changes, then it will somewhat negate this advantage for the Zune, but the 10 songs per month will still be a big plus in Zune Pass’ favor.

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  81. The new Zune browser is surprisingly good, but not as good as the iPod’s. It works well, but isn’t as fast as Safari, and has a clunkier interface. If you occasionally plan on using the web browser that’s not an issue, but if you’re planning to browse the web alot from your PMP then the iPod’s larger screen and better browser may be important.

  82. Apple now has Rhapsody as an app, which is a great start, but it is currently hampered by the inability to store locally on your iPod, and has a dismal 64kbps bit rate. If this changes, then it will somewhat negate this advantage for the Zune, but the 10 songs per month will still be a big plus in Zune Pass’ favor.

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  85. Apple now has Rhapsody as an app, which is a great start, but it is currently hampered by the inability to store locally on your iPod, and has a dismal 64kbps bit rate. If this changes, then it will somewhat negate this advantage for the Zune, but the 10 songs per month will still be a big plus in Zune Pass’ favor.

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