Innovation
Committed to the Company’s future and understanding that data provide a universe of relevant information for its success, the Data & Innovation department has been developing two main and structural projects for the Company.
Data Lake is an area that enables us to store data from different sources, in different formats. This information can be used in artificial intelligence, prescriptions, hospital care or even to meet other needs, based on three important pillars: variety, volume and velocity with high data availability.
Other project of extreme importance is the clinical repository, a storage base with over five million patient information from the Company’s main units. We have data from electronic charts, exams, reports and images gathered and unified for health care uses, support to patient’s diagnosis, health history storage and their visits to Rede D’Or São Luiz’s units.
Given its importance and criticality, data is stored on cloud and encrypted with strict restrict access. This storage provides more security, high availability and full data privacy.
29 million views
in our digital platform in 2021, in which users can schedule in-person or virtual medical appointments, request a second medical opinion, schedule and access test results.
We are the lead sponsor of the D’Or Institute for Research and Education (IDOR), a non-profit organization intended to contribute to the evolution of science, in order to improve human life. Therefore, it combines cutting-edge research, professional qualification and technological development in the healthcare field.
Founded in the city of Rio de Janeiro, in 2021, IDOR brought important contributions to the Brazilian and international public health systems, e.g., understanding the role that the Zika virus plays in malformations of the nervous system and in research to fight the Covid-19 pandemic.
IDOR’s first research fields were neuroscience – which is until today one of the highlights of the Institute –, plus the intensive care and internal medicine. Over the years, other fields such as pediatrics, oncology, cardiology, pathology and hematology gained more room at IDOR. The Institute currently relies on a diversified team of scientists, who perform translational research, i.e., they corelate information obtained in the labs with clinical data referring to patient care.
The excellence of IDOR’s research makes possible several international partnerships and hundreds of publications in leading scientific journals. Moreover, the Institute also has significantly contributed to preparing health care professionals in different stages of education, including undergraduate and graduate programs, medical and multi-professional residency programs, upgrades and technical trainings, activities which enabled the creation of IDOR’s Medical Science College in 2017.
Together with the expansion of its operational fronts, IDOR has also been also expanding its geographic reach. In Rio de Janeiro (RJ), in addition to the headquarters in Botafogo, IDOR has a wide space at the Hospital Gloria D’Or dedicated to clinical research. Additionally, it has 2 units in São Paulo (SP), Salvador (BA) and Brasília (Federal District), which operate in the fields of research, education and innovation, in an integrated fashion. IDOR’s research reaches other Brazilian capital cities, leveraging Rede D’Or São Luiz’s structure in this process.
More them 100 researchers
comprising IDOR’s team have directly contributed to cientific advancements in Brazil.
More them 300 articles
were published in several international science journals in 2021, as the result of our esearchers’ and employees’ efforts. Almost 110 of them were related to Covid-19.
IDOR’s high commitment to science is evidenced by the overall number of publications, which reached almost 300 papers every year. Our team of more than 100 researchers has directly contributed to scientific dvancements in Brazil year after year.
The investments in the deployment of a technology hub to generate high quality images were also essential for developing neuroscience research, including studies on brain activity in different diseases, in substance abuse situations and in the moral judgment sphere. Moreover, at IDOR’s Applied Neuropsychology Center (CNA), a team of specialists in neurology, psychiatry, radiology, psychology and occupational therapy offer specialized multi-professional care to children and adolescents with learning disabilities, and adults and elders with memory impairment or dementia signs.
The IDOR develops research projects in other Medicine fields, such as Intensive Care, Cardiology, Pediatrics, Oncology, Hematology, Gastroenterology, Hepatology, Infectious Diseases, Vaccines, Pathology, Cellular Therapy and Data Science.
Coupled with scientific publications that are the basis for clinical practices and other health interventions, IDOR also operates in the education of skilled professionals. Part of the learning activities are operated by IDOR Medical Science College, whose creation was approved by Part of Ministry of Education (MEC, in Portuguese) in 2017. Currently, courses are offered at IDOR’s headquarters in Botafogo, city of Rio de Janeiro (RJ), with practical training at our Rede D'Or São Luiz’s hospitals. In 2022, the College will be moved to a historical architectural complex next to Hospital Gloria D’Or, in the heart of Rio de Janeiro.
IDOR’s reach in the learning segment encompasses several levels, from undergraduate to doctorate’s degrees, including extension courses, graduate programs, medical and multi- professional residency, among others.
The undergraduate Nursing program is expected to begin in 2022, which will add to the Technology Degree in Radiology already offered by the institution. Among the new program’s particularities are the intensive care, emergency care and oncology courses. Another innovation made by IDOR College is to prepare its students in management and leadership, in addition to presenting the nursing sector beyond hospital care e.g.: patient safety management, account audit, control of hospital infection, clinical research, outpatient service and home care.
One of IDOR’s 2021 highlights in terms of education was the start of a multi-professional residency program, with opportunities for graduates in Pharmacy, Nutrition and Nursing, focused on preparing professionals to work with oncology patients.
IDOR also offers academic internship programs, medical residency, robotassisted surgery training (learn more on Our technology) and doctorate’s degree in medical science.
After in-person classes have been suspended due to the pandemic, IDOR College responded quickly and began to offer virtual classes, creating a new expansion opportunity for its operation: Distance Learning (DL, or EAD in Portuguese). Distance learning will enable course expansion by increasing the number of students and involvement of Rede D’Or São Luiz’s units in different Brazilian states.
+30,000
CITATIONS IN SCIENTIFIC JOURNALS
+300 articles
ARTICLES IN SCIENTIFIC JOURNALS IN 2021
+1,700
PUBLICATIONS IN SCIENTIFIC JOURNALS
+90
events IN 2021
+100
rESEARCHERS
SCIENTIFIC
collaboration in 60 countries
+4,000
STUDENTS BETWEEN 2016 AND 2021
+30 medical residency
PROGRAMS IN THE STATES OF RIO DE JANEIRO, SÃO PAULO AND BAHIA
+100
RESIDENTS TAKING THE PROGRAM
doctorate
1 program
IDOR’s main strategic goals include the mission to innovate based on the scientific and technological discoveries of its research teams, working to develop new Pharmaceuticals; Biopharmaceuticals; Advanced Therapy; Digital Therapy; New solutions for personalized medicine; Supporting software for distance medicine; Software to help in diagnosis; Software to help making therapeutic decisions and Medical equipment.
IDOR was accredited as an Embrapii Unit Specialized in Medical Biotechnology, which was an important milestone achieved in 2021 that showcases its remarkable specialization in the following lines of research:
IDOR
is highly committed
to science, which is evidenced by studies published every year in the most important national and international science journals.
Open D’Or is the innovation branch responsible for supporting IDOR in its innovation process. Therefore, it is responsible for conducting market studies, identifying innovation opportunities, raising public and private investments, negotiating partnerships, managing projects and intellectual property assets as well as encouraging scientific entrepreneurship.
Moreover, Open D’Or devotes its efforts to fostering the innovation culture by holding the IDOR Science, Technology and Innovation Conference – currently in its second edition – , offering in-house training sessions and implementing policies to encourage innovation.
1,576
POTENTIAL PARTNERS MAPPED
10
MARKET STUDIES
3
TECHNICAL VISITS
13
IMPORTANT PARTNERSHIPS
with startups, companies, science and technology institutes
10
PRODUCTS UNDER DEVELOPMENT
3
SOFTWARE AND HARDWARE LICENSES
1
patente
1
spin-off
To fight the new coronavirus pandemic, IDOR rallied most of its researchers and employees to implement a broad research platform on Covid-19, with 10 study fronts. “IDOR Science against Covid-19” encompasses research about understanding the virus behavior in laboratory and its effects in different cells and tissues, drug trials to neutralize or reduce the virus’ effects, recognize the disease’s biological markers in order to predict its outcomes, clinical trials for patients with different comorbidities, cellular therapies, evaluation of fear and lockdown impacts and the use of artificial intelligence in radiologic image analysis. These efforts already have resulted in more than 110 studies published in several international science journals and caught the attention of several international scientific events.
IDOR became ready in just a few weeks to carry out the Oxford’s vaccine trials with 4,000 volunteers in two cities, Rio de Janeiro and Salvador. The preparation involved structural investments, selection and training of 100 people to recruit, administer the vaccine and monitor volunteers for 1 year (the period of the trial). Afterwards, other four studies with different vaccines (a total of five Covid-19 vaccines studies) became part of IDOR’s initiatives to fight Covid-19, amounting to 6,600 volunteers.
In addition to the concern about the disease’s physiological aspects and vaccines to prevent it, IDOR also acted to soften the negative impacts of the pandemic on the population’s mental health, creating an online and free-of-charge platform to periodically make tips and exercises available based on scientific evidence to improve anxiety and depression symptoms, as well as other wellness tips. IDOR Mental Health Portal is run by IDOR’s psychology and psychiatry professionals and recorded more than 60,000 hits in one single day.
In partnership with Zoox Smart Data, IDOR also developed “Dados do Bem” an app to analyze the geographic area infected by Covid-19. The tool was adopted by several municipal authorities to help devising strategic plans to fight the disease, providing guidance on exams and management of physical space. The app recorded more than 1.5 million downloads and was used by more than 1 million people to perform a self- evaluation and recommended to 250,000 people to go and get tested for the disease. The Dados do Bem app ended its main activities in March 2021, however it remains available for public authorities according to the pandemic needs.
From the left to the right: Dr. Ana Pittella, main researcher in the vaccine trials at IDOR-RJ, Dr. Sue Ann Costa Clemens, representative of Oxford’s vaccine trials in Brazil, Dr. Andrew Pollard, director of Oxford University’s Vaccine Group and Dr. Fernanda Tovar- Moll, president of IDOR.
Oncologia D’Or, our specialized oncology care structure, has more than 50 units in 8 states (Rio de Janeiro, São Paulo, Maranhão, Bahia, Pernambuco, Ceará , Sergipe and Paraná) and the Federal District. At the units, over 670 physicians and almost 1,100 employees with different backgrounds are dedicated to the diagnosis and treatment of all types of cancer, solid tumors and hematologic neoplasias, providing international-level services in patient care.
In 2021, D’Or Oncologia had on average 40,000 monthly appointments, using different antineoplastic treatments – chemotherapy, targeted therapy, immunotherapy, hormonal therapy, radiotherapy and bone marrow transplant - in around 9,000 patients.
1,100
employees
of different backgrounds are dedicated to the diagnosis and treatment of different types of cancer.
The integrated operation of clinic oncologists and hematologists, pathologists and other physicians in the treatment of our patients’ cancer in each one of our hospitals is one of Oncologia D’Or’s advantages. This work model allows for more agility in the diagnosis and a more assertive treatment strategy. The integrated operation model is eased by daily multi-disciplinary meetings (called Tumor Board) to discuss cases online, bringing together Rede D'Or São Luiz physicians for oncology patients care throughout Brazil. There are also weekly meetings at the different oncology areas, which bring Oncologia D’Or’s main leaderships together, improving decision-making and making easy the alignment of medical conducts at our units.
To further explore the synergy between Rede D’Or São Luiz’s different services for the benefit of oncology patients, we strengthened the Green Line, a pioneering oncology project in Brazil, which creates an integrated flow between oncology diagnosis, surgery and treatment units, making easy the scheduling of exams and surgeries. Supported by the Green Line, it is possible to reduce the wait time for diagnosis and procedures in patients with cancer, which, in many cases, may represent a better clinical outcome.
In 2021, we opened Oncologia D’Or units in different Brazilian regions. In Brasília, we opened the Taguatinga Unit, which is located in a 700-m² area and offers six oncology doctors’ offices, eight individual infusion boxes with television set, four individual infusion beds and cold cap services. In the state of Bahia, the Pituba unit, located in the city of Salvador, also began patient treatments.
In São Paulo, we opened 2 units: Oncologia D’Or Osasco and Hospital IFOR’s Infusion Center.
In addition, Oncologia D’Or invested in the modernization of the existing units Icaraí, in the city of Niterói (RJ) and Fujiday, in the city of Fortaleza (CE), which now have more modern infrastructures, plus wide and comfortable spaces to better serve patients.
Oncologia D’Or acquired 2 more units in 2021: Oncologia D’Or at Hospital Summer, in the city of Resende, in the countryside of the state of Rio de Janeiro, and Oncologia D’Or Hospital Santa Cruz, in the city of Curitiba (PR).
Oncology Pharmacies are key to ensure the quality of antineoplastic treatments, contributing to ensure safety, speed and savings to our medication preparation processes.
During 2021, the Pharmacy team implemented methods such as Data Matrix, Visual Compounding Inspection, Computer Standardized Fractioning and Labeling Center, which contribute to the process automation, providing more safety for the patient and reduction of printed material. To improve communication between our teams, the Shift Change tool was implemented, in which everyone shares a spreadsheet with detailed
Oncology D’Or’s Electronic Medical Record (EMR), set up in our entire oncology care network to record and manage patient information, is an important tool in aligning procedures and creating a unique quality care standard for the country.
In 2021, Oncologia D’Or’s information systems recognized more than 59 thousand patients whose data have been recorded in over 172 thousand appointments, creating nearly 250 thousand prescriptions and 97 thousand lab requests. Telemedicine was another important achievement in the period, providing more safety and comfort for oncology patient care during this new phase of the pandemic. In the period, over three thousand patients had remote appointments.
3,000 patients
used our telemedicine services with safety and comfort during the new stage of the pandemic.
The Patient App has been gradually used in several Brazilian regions and patients were informed to use the tool as an additional form to contact the nursing teams. In 2021, more than two thousand patients under treatment used the tool to report symptoms and control their schedules. Concerned about those who have restrictions to the use of digital tools, the Patient Schedule was fully reviewed to be used as a complement to the app.
At the beginning of 2021, we saw the number of Covid-19 cases raise once again. To reduce the risk of the virus spreading among our physicians, we kept most of our meetings as virtual ones, as well as our International Symposiums.
Repeating the model presented in 2020, Oncologia D’Or organized 5 online scientific symposiums: the 6th Oncologia D’Or International Hematology Symposium, in May; the 6th Oncologia D’Or International Urologic Oncology Symposium, in July; the 6th Oncologia D’Or International Lung Cancer Symposium, in August; the 8th Oncologia D’Or International Gastrointestinal Cancer Symposium, in September, and the 6th Oncologia D’Or International Breast Cancer Symposium, in October.
160 speakers of national and international renown have participated in the five events that recorded attendance of nearly 2,800 participants (mostly physicians) to partake in more than 40 hours of original scientific knowledge about the main advancements in oncology. The content presented online, and other groundbreaking material have been made available to participants on an exclusive website for future reference.
Since October 2020, we have adopted the Quali D’Or System to manage indicators that enable the optimization of technical quality data and is an excellent benchmarking opportunity among Rede D’Or São Luiz’s hospitals. The tool is available at 61 hospitals and brings benefits, such as improvements to data availability, quality and usage in decision-making; easier comparison between the performance of different units; learning from better results; encouragement to excelling, as a way to progressively improve our overall performance.
In October 2021, we added the Maternal & Infant profile to use the main features, totaling 62 indicators. Rede D’ Or São Luiz guarantees that the treatment of data input to the system complies with Law 13.709/2018 - Brazilian General Data Protection Act (LGPD in Portuguese).
| Technical quality indicators | 2019 | 2020 | 2021 |
|---|---|---|---|
| Average length of stay (Adult ICU) - days | 5.00 | 5.64 | 6.29 |
| 24-hour adult ICU readmission rate – % | 0.36 | 0.43 | 0.33 |
| Standardized hospital mortality rate (observed/expected) – Score (<1.00>) | 0.46 | 0.65 | 0.68 |
| Catheter-related bloodstream infection incidence density – per thousand | 0.88 | 1.43 | 1.56 |
| Catheter-associated urinary tract infection incidence density – ICU – per thousand | 0.79 | 0.65 | 0.73 |
| Ventilator-associated pneumonia incidence density – per thousand | 1.43 | 2.57 | 2.92 |
| Pressure ulcer incidence rate - per thousand | 0.45 | 0.73 | 0.64 |
The Patient App has been gradually used in several Brazilian regions and patients were informed to use the tool as an additional form to contact the nursing teams.
In order to share the practices developed at our hospitals, we held the 3rd Rede D’Or São Luiz Quality Showcase in 2021. The purpose is for each unit to encourage its professionals to show the results achieved with good practices implemented.
47 hospitals participated and submitted 462 papers (5.5% more than in 2020), about seven topics: clinical cases, safety culture, waste reduction, patient experience, process improvement, innovative practices and initiatives to fight the pandemic.
A panel with 90 professionals has evaluated the papers. The 40 best case studies have been selected for publication on the Rede D'Or São Luiz annals and the best 22 have been presented during an online event for all employees. In the final assessment, seven papers received prizes and three hospitals were praised for submitting the largest number of papers to the Showcase. Two of the papers that received prizes in the 2020 edition were published.
The creation of its own quality and safety evaluation standards at all our hospitals (the Rede D'Or São Luiz Care Practice Manual) stemmed from the expectation of going beyond accreditation. Our goal is to assess care practices at the Rede D’Or São Luiz’s hospitals, ensuring the minimum standard of technical quality and identify good practices to be shared among the units.
The program includes good safety and quality practices for the patients, legal requirements and guidance on several accreditation models. At the end of each technical visit with evaluation based on the Care Practices Manual requirements, a report indicates the service score in compliance with the required safety criteria.
In order to decentralize and develop, we have kicked off the Rede D’Or São Luiz Quality Development Project, in which we have invited office employees to join in a training process and included them in the technical visits to the units that did not imply conflicts of interest. Currently, 38 employees have already participated in the program and seven are part of the evaluation team, expanding the team of professionals eligible to perform technical visits and bring knowledge back to their units.
Through the implementation of Rede D’Or São Luiz Care Practices Manual, our goal is to assess care practices at the Company’s hospitals, ensuring the minimum standards of service, technical quality and identifying good practices.
So that all acquired hospitals have the same Rede D'Or São Luiz standard, the acquired units go through an integration process with the Corporate Quality team, when the Service Quality corporate office present their actions and those that will be developed jointly to foster patient-centered care and ensure patient safety.
Integration has three different stages: guideline alignment, integration checklist and technical visit from the corporate service quality team to prepare an organizational diagnosis.
In 2021, we integrated 12 acquired hospital units: Balbino, Cárdio Pulmonar, Santa Emília, Nossa Senhora das Neves, Clim, Guaianases, Serra Mayor, Antônio Afonso, América, Biocor, Proncor and Novo Atibaia. In 2021 we incorporated 55% more than the six new units in 2020.
The average score of the evaluation of mandatory documents from new hospitals was 54% adequate to the checklist.
In 2015, we created D’Or Consultoria to offer operational management as well as risk and health management, consulting services, market diagnosis and assessment, marketing and communication specialized services in corporate health care and benefits. The Company is currently responsible for more than R$3.5 million in insurance premium, 2.2 million lives and over 1.7 thousand clients in the states of São Paulo, Rio de Janeiro, Bahia, Pernambuco, Minas Gerais, the Federal District and Paraná.
Based on technology used for integrating every health information (patient care, occupational, out-patient care, medicines and other) of the company and, through a behavioral analysis of the users, D’Or Consultoria develops customized programs according to the profile of each client, with assertiveness and proactiveness. Being the only specialized player in the segment, D’Or Consultoria offers services and content that effectively contribute for the education and awareness-raising with regard to the importance of health prevention, in a mild and customized manner. Moreover, clients rely on the follow-up and support of the Health Management and Employee Life Quality teams.
Through D’Or Soluções, occupational health and safety management is unified. A multidisciplinary team, cutting-edge equipment and distinguished partners guarantee that to customers compliance with the Ministry of Labor’s requirements and laws. D’Or PME makes available health and dental care insurance to small and mid-sized companies, with specialized professionals and customized service. To make access easier, a single system requests a quote for an insurance plan and sends it online in a few minutes.
Individual insurance is another service offered, with a simple and affordable structure, as well as corporate insurance: Liability Insurance (essential to guarantee liabilities with third parties), Property & Casualty (insurance against losses, damages and liability on properties, objects and even people) and Financial Lines (protection against liability, frauds, errors and omissions).
D’Or Consultoria has AceleraD’Or to accelerate the growth of partner brokers, which is a distinguished and innovative acceleration program for small- and mid-sized insurance and benefits broker companies operating in Brazil. Along with that, the AceleraD’Or Mentoring Program, whose first edition began in the last quarter of 2021, has gathered more than 100 brokers interested in being accelerated by D’Or Consultoria. We selected ten of them who will go through the complete program in 2022, enjoying guidance, growth, visibility, networking and D’Or Consultoria’s entire technology.
