HMi meets… Giuseppe Recchi

Giuseppe Recchi, chief executive officer, Affidea

Giuseppe Recchi believes that the healthcare industry is still under-consolidated. The chief executive officer of Affidea Group talks expansion, data and putting patients first. 

Affidea is Europe’s largest medical services provider. It has 245 diagnostic imaging, outpatient and cancer-care centres in 16 countries and continues to grow rapidly, in particular in Ireland and Hungary. Here, chief executive officer Giuseppe Recchi talks with Healthcare Markets international about how Affidea is grasping the new challenges of technology with both hands, about European legislation and about the skills he has brought to healthcare from his experience in the energy and telecoms sectors.

HMi Affidea has and manages a vast amount of data from images. Is your strategy on how to monetise that the biggest challenge and opportunity facing the company?

GR We are not monetising the data. Data belongs to the patients and our unique scale of operations is rather an opportunity to support the development and implementation of AI,
aiming to develop the most advanced technologies for a more accurate diagnostic.

Our vision for Affidea is to become the premier digital healthcare provider with the most extensive network of medical centres powered by AI. Across our network, we produce every year 13 million examinations so there is a huge amount of data generated. The
capabilities of the new algorithms and machines are an unprecedented support to doctors, radiologists and to the medical practice.

The more scans the artificial intelligence algorithms can review, the more patterns they find and the more precisely they can help radiologists in offering a better, more accurate diagnosis. This, in turn, will enable the delivery of more timely, higher quality care. For
sure, the analysis of big data with AI techniques will have an enormous impact on disease prevention, cures, and on achieving precision health and optimised treatments.

We, as Affidea, are already playing a huge role in supporting the digitisation of healthcare systems across Europe, and this will be increasingly important for the quality of our services as we continue to grow and expand.

THE MORE SCANS
THE AI CAN
REVIEW, THE MORE
PATTERNS THEY
FIND AND THE
MORE PRECISELY
THEY CAN HELP
IN OFFERING A
MORE ACCURATE
DIAGNOSIS

We are the only European operator to sit on the Imaging Advisory board of both IBM Watson Health and Microsoft Cloud.

HMi How significant are your AI partnerships? Are AI and digital the future?

GR No doubt the future of AI and digital healthcare is already here. It’s just a matter of understanding their position in the value chain of the service. I think there has been too much analysis on how AI could disrupt the industry. I rather see AI as a very useful tool that adds to the continuous development of medical know-how.

We have already implemented AI into our operations and we are developing our first AI clinical product – Affidea neuroInsight in collaboration with icometrix – for patients with multiple sclerosis. We are piloting the project in four countries; Italy, Portugal, Switzerland
and Serbia.

The second AI partnership announced is for breast cancer screening which we will launch at the beginning of July in another three countries across our group – Greece, Hungary and Spain, in a partnership with Screen-Point.

These developments will equip our doctors with highly accurate tools to detect diseases and will help clinicians better understand the disease development and in turn, optimise patient
treatment.

The result is clear – more accurate, quality care, in this way enhancing patients’ treatment altogether.

HMi Is European privacy legislation a hindrance or a help?

GR I’ve worked in several regulated industries like energy or telecoms, and regulations have generally delayed the adoption of the new technologies or the consolidation at a larger scale. As much as it is necessary to define standards to avoid the Wild West of
new practices, regulations should be carefully managed to try to favour new developments.

In healthcare it’s even truer: where we speak about people’s lives – here, regulations should focus on supporting the developments faster than what we see today.

Teleradiology is one of the examples. The shortage of radiologists is a burning issue in many European countries – three radiologists per 100,000 people in Italy, 12 in Spain and Portugal and 31 in Greece. Both the shortage in radiologists and the growing need for
sub-specialisation are some of the main reasons for the usage of teleradiology. But in many European countries, regulations require the doctor to be physically present in the centre by the equipment, which places a limitation for the expansion of teleradiology; some countries
even totally forbid this practice, which is a clear disadvantage for patients.

HMi Two of your most high-profile moves over the past year have been into outpatient care with Fonix- Med in Hungary and ExpressCare in Ireland. Is the aim to own more of the healthcare chain?

GR We are recognised at European level for our excellent diagnostic and cancer care services. Expanding our portfolio of services is complementing our leading network of diagnostic imaging services.

Both Fonix-Med which is an important corporate healthcare and retail outpatient service provider, along with the three Express Care for minor injuries and minor illnesses are part of our ambitious expansion plan into the outpatient sector, strengthening our position in the existing markets, by adding new medical capabilities which can allow us to deliver a coordinated care for patients.

These two additions plus the new Affidea for Men outpatient clinic that we opened this year along with the acquisition of IMI, a reputed imaging provider in Portugal recognised for its teleradiology services, are adding to our growth journey and are bringing a great benefit
to patients, PHIs and National Health Systems.

IN MANY
EUROPEAN
COUNTRIES,
REGULATIONS
REQUIRE A
DOCTOR TO
BE PRESENT
WHICH PLACES
LIMITATIONS ON
THE EXPANSION OF
TELERADIOLOGY

HMi You have talked in the past about maintaining double-digit growth. How do you balance M&A with organic growth?

GR We have a long track record in integrating new centres, organically or through acquisitions, with 50% growth in the number of centres only in the last five years.

Our business model is based on long-term patient needs and industry trends and we have ambitious plans to further grow in the markets where we are present and where there is market demand for specialised services.

The healthcare industry is heavily under-consolidated, while scale is an important factor to sustain technology developments, investments and leadership in the medical know-how. The business in which we are requires a constant investment in capital and an ability to deal with NHS budget constraints.

All of these things are a challenge even for a large healthcare network as Affidea.

The need to reduce costs and, at the same time, maintain the high standards of quality expected from medical imaging equipment will further influence the trend towards consolidation.

HMi Where and on what within Europe are you focused on the moment?

GR We are a pan-European healthcare leader and every country for us is an opportunity, especially if we can create local synergies.

We are constantly looking to add new complementary and innovative capabilities, like teleradiology or expanding medical services across geographies like moving towards vertical integration. In the same time, we see an increasing demand for sub-specialisation. We have already built a network of sub-speciality radiology experts in different areas across our network and this highly specialised network that we manage allows us to offer the best competencies for any patient.

The direction we go is towards being recognised as a truly advanced and digital healthcare provider.

HMi What are the management challenges that come with a larger geographical footprint not just within Europe, but globally too?

GR It is not important how many pins you put over a map but rather the way a company can develop a strategic position in each country in a way that can offer a premium service for local stakeholders from patients, doctors, PHIs, national health systems and employees.

Standardisation and managing operational standards across every department across a network of 245 centres in 16 different geographies, is an operation where very few companies in Europe succeed and we are proud that Affidea is leading this pathway.

Just to give you an example from the clinical side, we have connected our MRI scanners through a cross-border digital platform and built the program called MRI Excellence which allows us to standardise scanning protocols and to monitor image quality, time of each scan, idle time, and protocol adherence.

We can see that the digitisation across our network can drive care standardisation and protocols unification, resulting not only in increased quality of our scans and reduced reading time but also in improved patient experience.

HMi Every growing healthcare company talks about its patient-centric approach. What does it mean for Affidea?

GR As simple as constantly asking our patients and doctors about their satisfaction and recommendations for improvements in each of the 245 centres.

We correct and modify what’s needed based on patients and doctors feedback. We must remember that patients are individuals, each of us is a patient somewhere and not statistics.

Having at the heart of everything we do a culture of continuous improvement we also keep our people’s engagement and satisfaction.

This approach has already shown its results during the company-wide Staff Engagement Survey where Affidea score was above the industry European average. One outstanding example is Affidea Lithuania which has been awarded two times already, in 2018 and 2019, as the Best Employer Baltics.

This is proof of our long-standing commitment for patients and staff satisfaction.

HMi You came to healthcare with experience from both the telecoms sector and the oil & gas sector. What skills were useful there that you have been able to bring to healthcare?

GR In telecoms, I was executive chairman of Telecom Italy. This sector – like energy where I was chairman of ENI – is heavily related to building infrastructure on the upstream but widely consumer-oriented on downstream.

Everything is around deploying properly the capex but focusing on consumers’ perception and satisfaction. Both energy and telecoms services are crucial in people’s lives, but healthcare impacts on patient’s health expectations that determine the providers to be more dependent on the reputation of their services.

PATIENTS ARE
INDIVIDUALS, EACH
OF US IS A PATIENT
SOMEWHERE AND
NOT A STATISTIC

It is true that infrastructure and technology investments need to be sustained by a proper business model and market predictability.

It is paramount that national health systems across Europe understand that if private business does not invest because regulations become uncertain or, even worse, payments get cut or clawed back (this is happening now in Greece), the negative impact on the servicing capacity will be felt by the end user which, in healthcare, it is the patient.

Affidea’s statement of belief is that ‘nothing is more important than health’, and I strongly believe there should be more sensitivity and caution from regulators in protecting investments in healthcare and consequently the quality of service.