They are two great friends, talking to them is a star in total synergy, in the midst of a movement of energy flowing, moving, that creates. They’ve known each other for only two and a half years, but they seem to have been friends for a lifetime. We present to you two great professionals, who believe in the power that each of us has, so that we can change the reality of our health, of our economy, of our country.
Dr. Víctor Oliveras Deulofeu, recently awarded the National Prize for Medicine 2021, Graduated in General Medicine from the University of Barcelona, MBA at IESE (University of Navarra) and Doctorate in Medicine from the Autonomous University of Barcelona) and Lluís Solanell Banegas a renowned Telecommunications Engineer, and Lic. in Medicine, Robotics, IA, Big Data. Participation in medical research projects at Hospital Clinic (Linkare, BioBridge, Nexes, Renewing Health, Synergy). Collaboration with the U.S. Navy, in the development of Telemedicine in emergency equipment, tested in the wars in Syria and Iraq.
Today together leading a powerful project, using the latest technology based on Artificial Intelligence and Blockchain.
But let’s not get ahead of ourselves, let’s start at the beginning.
Good morning Victor, good morning Lluís, it is a pleasure to be with you today.
V and L: The liking is all ours.
Ruge Magazine (N): From your point of view, how do you see the situation happening today in Spain, in the world?
Dr. Víctor Oliveras (V): I can’t deny that you think, that we might be doing things so differently, but there are many factors, attached to health, that are deciding today for all of us. It’s up to each of us to keep it that way or change. The question we should ask ourselves is, do we have enough? As historians used to say, how are we going to change, if we’ve been like this for three centuries? And I mean, is three centuries enough as a learning period, or do we need three more centuries?
N: It is interesting this point that you raise, because each path is full of decisions and multiple options, that life presents to you. We have absolute freedom. In the face of more adverse situations, knowing how to see and hear becomes the greatest of wisdom. During the development of each magazine, for example, we have a plan, a strategy, but we feel, and life moves us, sometimes puts people in front of us and we begin to realize that everything is changing. We’re adapting. Many times the original idea was one and, we ended up materializing something absolutely different, but it is completely aligned. We flow.
V: You know what that means? That you found out there’s a screenwriter. I often say there’s a screenwriter, I don’t know exactly who he is, but if there’s a script, I know there’s going to be a screenwriter (we smile).
N: How does a Telecommunications Engineer get to work hand in hand with a doctor?
V: Do you know what matter and anti-matter are? Well, I’m the anti-matter. Lluís is global and I’m local. I was finishing my PhD, imagine a poor doctor of the Catalan health service, wasted, exhausted. My goal was to work on cardiovascular prevention in middle age.
Lluís Solanell (L): And I was looking to launch the proximity model, I was looking for support in health professionals, doctors. And I met one, who introduced me to Victor.
V: Divine paths are inscrutable. We are both very different, Lluís is a Telecommunications Engineer, I am a Physician. And one day, I’m introduced, just like the screenwriter put it in front of me, and then I say:
«Oh! You look like you’re out of «Silicon Valley,» and he says, «No, I’m from «Vilanova i la Geltrú.» And, at that very moment, the ice breaks.
He starts telling me all his life, he’s a telecommunications engineer, but he studied medicine for 6 years, and he doesn’t end up with those things that he has 4 or 5 subjects left. Well, we know he studied it so he could understand doctors so he could communicate in his «language.»
And then, he tells me that he was working in a hospital in Barcelona, for many years and, that he developed the whole new health model of proximity, and I said: «But if that hospital, is the main level 3 hospital center in Barcelona, and is not usually the most open to carry out these kinds of plans?
L: Well, indeed it was, after having it all developed, the hospital did not find it fit to be implemented and, it tossed the project.
At that very moment, I decided to leave Spain for a few years, and went to work in Ukraine, Russia, Georgia. In fact, when the war started in Ukraine I was there. Then I spent a month in Iraq and Syria, collaborating on a telemedicine project with the American army, where I learned what the real war is, which has nothing to do with what’s in movies, video games, and above all, I learned, how people worked in more extreme situations, mainly on health issues.
I realized that, when we were experimenting with medicine, we saw that if you take a technological device and leave it in the hands, for example, of a paramedic, with minimal notions to handle that equipment, when it comes time to use it, because it no longer works.
The problem is not that the equipment has been damaged, but that it is the mind of the person who is there, who has to attend to many shattered people, in the face of absolute chaos and at the same time, to attend the orders, which he receives remotely, from the technical advisor, who is in another country. The paramedic didn’t listen, he didn’t pay attention to him, they didn’t finally communicate. And at that very moment, that is when I propose that the way we work should be changed, so that the synergy of a team is generated.
V: This is fundamental to what comes next.
L: I proposed an entire system, and the change was brutal. They developed it at the world-class field hospital, where surgeons are operating 24 hrs. up-todate, non-stop.
N: They take the physical body to its maximum.
L: That’s right. When they all began working with the proposed system, paramedics on the front line better organized the wounded. The choice was more selective. They ordered the helicopters to take the wounded to the first, second and third line hospitals, lowering their pressure. In addition, the diagnosis of the patient was known, before reaching the hospital area, saving more lives and, of course, from a military point of view, they had more resources to keep fighting. After traveling for so long, I ruined myself, and had to go back to Spain.
This is where the new Proximity Model is born. Which is, to identify a new class of professionals, whom we call «Health Coach», who are very empathetic people, who listen, as if they were the former family doctor, who are in no hurry, able to do chemical tests, but who at the same time do not require making any medical decisions.
That is, it asks the questions, performs the tests, captures the data and if a decision-diagnosis is required, it connects with the specialist remotely. And this specialist, is who will analyze the data collected, the information collected and, through a videoconference with the «Health Coach», will advise and care for the patient.
During the taking of measurements and data, the system analyzes almost all the information it collects, the physical, chemical, psychosocial and socioeconomic data, where, according to the partial conclusions, they obtain the final conclusions. Gives a differential diagnosis, so that the specialist (doctor) can then analyze.
When we started running the whole system, we encountered information privacy issues, which in the military zone was not limiting.
This led us to develop an adaptation of the system, based on Blockchain technology. Finally, the new structure of the Proximity Care Model, called MAP, consists of:
Health Coach: Delivers service to the user, maintains direct contact with the patient. It can be a doctor, nurse, university student, physical therapist, nutritionist, among others. Present everywhere of the world. Face-to-face contact.
CRP (Competent Remote Professional): He’s the specialist physician, with competences, trained to give Diagnostics. Serves remote to the Health Coach.
Blockchain: Give security legal and legal to the specialist doctor and patient. In addition protects the privacy of Users. NEOS (Neural Operating System): Artificial Intelligence System that supports the model. The Intelligence Operating System Artificial (NEOS) works on scientific and medical research, with data captured from all users. With Blockchain technology, traceability is allowed protecting the privacy of its users. That is, your data is known, but it is not known to those who belong. We don’t have the data stored in any database. Only by means of the match that is performed with the encrypted key of each user, the system is able to connect that person with their medical history.
To access the system by the user, it is accessed through an application on the mobile, or an encrypted card. Being who will confirm, that the user is who he claims to be, making the data readable at that time. Health Coaches and RPPs also have special tools (tablets or mobiles), with their own operating system, with sensors, that captures data in an orderly manner.
N: What if there were any malicious intentions to access each user’s information?
L: A few years ago, I went to Moscow, Russia, invited by the president of NBC (National Broadcasting Company) to handle an humanitarian aid issue. Through NBC I was contacted by the president of CSKA Moscow (Tsentralniy Sportivniy Klub Armii, «Central Army Sports Club”). When I got to the sports center, to me: —We introduced the Minister of Defense of Russia,— and I was very surprised.
The Minister asked me to explain to him what was the project he was working on. It should be noted, that at the time, data privacy was not so developed as now and, he said: —This is a much more dangerous than the atomic bomb,— I can access the public data of a country, know what its riskiest area is and threaten it with a biological weapon. Also, attacks can be made through social networks, sowing fear in one area or another, which weakens the countries that are interested in weakening.
Well, to avoid it, everything is encrypted. There is no data, on any server, that links it to a person. The only one who knows about your information is the user himself. It is based on the same Bitcoin technology, it works much like the «Wallet».
One of the factors I would most like to highlight is that the system we have designed is created to empower society. That is, people have to know what they have and participate in decisions that affect their own health, their lives, without fear.
N: ¿Why do you feel that this solution would empower the patient, society?
L: Sorry, and we’ve experienced it. It is a system that we already have in place through the ArvilaMagna Clinic. Barcelona.
For example, we are working with patients who are sick with COVID-19, who after becoming PCR at the CAP (Primary Care Center, Catalonia), come to visit us.
Why does this happen? Because in cases where they’ve had the positive test, CAP sends you home and tells you when you really feel bad, you have to go to the hospital. At that moment, we meet a frightened person, who does not understand what is happening, his mind begins to think the worst.
With the «MAP» system, first of all, the patient is cared for by the Health Coach who will interview him, it will review its levels, and on that basis, it will act. The patient’s viral load is very likely to be detected to be very low and not contagious. Viral load is an important indicator, it determines whether you’re someone who can spread or not. It will examine its entire environment, demonstrating that there is no one else infected. They will be monitored every 15 days, for approximately two months. This produces peace of mind in the patient. He feels accompanied, understood.
And this follow-up of the Proximity Assistance Model, is what generates the empowerment of the patient, because it understands what it is, realizes the real impact and also has someone with whom to interact, who answers the times that are necessary, so that the patient calms down. A peace of mind that the public or private system cannot give.
There are DPOs (Goal Management, based on economic standards), which force you to meet certain standards in terms of treatments and dosages, based on generic tables that define that a person of age, weight, defined height, corresponds a certain specific dose and does not look, nor watches over anything else. So a professional, thinks, if I modify the treatment, and a patient dies (which is a probability in any such treatment), they can report me because I have not followed the guidance.
On the Proximity Model this is resolved, since with the role of Blockchain, it is reported what treatment has been carried out, a criterion that supports such treatment, specifies follow-up, and has the authorization of the patient. In this way, one ceases to be afraid, and begins the process of daring to break old rigid rules, which do not serve all patients and that can only be determined, when it is treated patient to patient, when you really know who is in front of you.
N: With the Proximity Assistance Model, how do you solve the problem, of time/resource limitation, that exists today in public/private health, for patient care?
V: Proximity medicine is primarily oriented towards early and preventive detection medicine. In contrast, in current health models, they are rather reactive.
With the steps they are taking to treat COVID-19, it can be clearly seen. The patient should go to the hospital when he feels really bad and, in fact, there are cases of people waiting to be very serious to justify his or her return to the emergency room. The problem is that when they arrive at the hospital, they enter the ICU directly.
As we know, during of COVID-19 period, the emergencies only focused on the virus, and the rest of diseases were not prioritized. Many patients had to contact specialists outside the system. And this is the point, but in the day-to-day life it’s worse, a thousand times worse.
The reality is that raw. And finally, why is there so little time to care for a patient? Because of the economy? There is less and less time to care for a patient, because it is a system of brutal but totally inefficient efficacy. Because it is not dedicated to caring for the patient, the individual is not cared for, prevention is underestimated, and we are dedicated only to extending the lifespan. Where the quality of life decreases, and thus we have a weak population and an incremental consumption of health and social welfare resources, especially here in Spain.
This system implemented today, in Spanish health, was sold as a system that would have no co-payment, so it would help the economy. The situation is that the co-payment does exist, but it was transferred to doctors, nurses and patients. Strenuous days, very tight workforce, and fair remuneration. It is a perverse system, as it gives no room for manoeuvre. The system is not dedicated to healing, just to remove pain.
N: ¿How do we prevent a hostile environment from being created in the areas most at risk of contagion?
V: We know, the worst thing about the whole process is not the disease, it’s such. It’s the message of fear, the management, the knowledge, the emotional instrumentalization. We focus directly on treating emotion, because we know it scores very high within a patient’s health. For example, the first cardiovascular health treatment we use is precisely working with the patient’s emotion.
For me, freedom and responsibility are inseparable, we need a healthier society. And that’s associated with the impossible of us having a healthy economy with a sick society. Which leads us, that we must focus on healing and healing.
L: We are deploying the model in England, in London, as a treatment for COVID-19. And they want to replicate, exactly, the professional structure that we have defined. Our partners there are working directly with NHS UK (United Kingdom National Health Service) and PC (Imperial College). And its focus is the medium- and long-term effects that the virus can cause.
This is because the virus can cause damage to microcirculation, in the brain, in the heart, in lungs, kidneys, and are damage that is not seen with the naked eye and immediately. They are beginning to prepare, for the possible onset of chronically ill patients, that may come in the near future. And you know, it requires an operating system, tested and standardized, in advance.
Benefits of the Proximity Assistance Model
L: Patients can be treated at home optimally, without having to go to the doctor, except for severe cases. In this way, it takes all the time that is really required per patient, and we are not focused on meeting time and cost saving standards, but we have the focus on preventive medicine.This means for us the Proximity Model.
In addition, it is a new offer of work, with a more social focus, better quality of health, more humanized. Another added value is the reduction of possible human errors, in data analysis.
V: We are proposing a disruptive change to the current health system. We always said that the global economy is highly vulnerable to a pandemic effect/threat. We were treated as crazy, pessimistic, because the Spanish economy was robust, and COVID-19 has brought us credibility.
Current solutions are: we need more ambulances, we need more drones, all confined, without selective actions, the healthy are treated as sick. If we focus only on heart attacks, we will always be late. It’s proven that we have an old concept regarding health treatment.
When it is diagnosed in time, the contagion is stopped, in addition, with an early detection, it helps to treat according to the clinical history, what does not happen today. Working in advance with people at higher risk, this implies personalized treatment, close monitoring, genetic inheritance studies.
A cardiovascular fact: we could avoid 80% of heart attacks, with early detection. And heart attack is the main cause of professional death.
And thanks to the research I’ve been doing for years, it was that I met Bemer, who is a high-tech machine that works precisely in the prevention of problems in microcirculation. Which has allowed me over the years to get even more effective and faster results with my patients.
All chronic degenerative diseases are related to cardiovascular problems, including problems with brainvascular, stroke, dementia, Alzheimer’s (the main factor that causes it is high blood pressure), microcirculation disorders, osteoarthritis, premature aging.
The Proximity Assistance Model positions the patient in the center. It is 4P Medicine: Preventive, Personalized, Participatory, Predictive.
Promoting new technologies, collaborating with a wide network of professionals, helping the patient modify their unhealthy lifestyle habits, increasing physical exercise, giving emotional support.
Technology generates a rejection, because it’s scary, because it’s something unknown. But it’s also true that it helps us. And it will never replace the human being. I’ve always believed that the higher the technology, the greater the need for contact. The model seeks to generate change, promote more jobs, seek to oxygenate the Health System.
N: What a powerful and instructive conversation we’ve had, I’d stay many more hours. A lot of success, it’s been a pleasure meeting you.
L and V: Equally, delighted.
How does the system work, at the user level?
The Health Coach is quickly accessible, it is in a gym, in a pharmacy, in offices of different companies, on our own website. The patient first communicates with us through this Health Coach.
The Health Coach sits next to the patient, talks to him for a while, is performing the questionnaire during the conversation, being able to preventively detect other problems that the same patient does not dare to say, such as fears, cases of addictions, depression, loss of work, among others. The health look is comprehensive, not just clinical.
Dr. Víctor Oliveras D.
Lluís Solanell B.
Clínica Arvila Magna. Barcelona: https://arvilamagna.com/