Startup uses technology and starts bringing health to those in the SUS queue

That was after watching the documentary who cares?who tells stories social entrepreneurthat Adriana Mallet and Sabine Zink have decided to contribute to improving Access to health in Brazil. We attended the same college, a public university, we are from privileged families and we wanted to give back that privilege. I think that desire was latent,” says Sabine, who graduated in physical education with a master’s degree in pedagogy.

They walked out of the cinema, hugged and cried for an hour. This feeling resurfaced and they had to do something. In the course of Adriana, who is now a physician, access to health care is an age-old problem. Of the four aunts with breast cancer, three received a late diagnosis due to a lack of specialized care. When she was ten years old, she saw someone die of illness. “I went to medicine a lot with this access vision, because if my aunts found out earlier, they might be alive.”

With a newly purchased SUV and a desire to travel through the Brazilian countryside, the two were inspired by the Saúde e Alegria project, one of the cases featured in the documentary, operating in the Amazon region, and founded SAS Brasil in 2013. I project the best of all in one: Health by Adriana and Joy by Sabine. “I spent a few months in anesthesia and joked that I was leaving the hospital. I left the operating room for the emergency room, from the emergency room to Samo and from Samo to expeditions,” the doctor recalls.

Today, the social startup provides free access to specialized, mostly volunteer doctors, such as ophthalmologists and gynecologists, to people on the Unified Health System’s waiting list, easing the saturation of the network. In partnership with health departments, the institution provides virtual or face-to-face services, offering more than 20 medical specialties in six areas. It also has an online service platform that can be used from anywhere in Brazil.

“We understood that lack of access is often more of a geography issue than an income issue,” Adriana says. “In this predicament, we knew our performance would be more impactful,” Sabine continues. Through a model called Health 1.5, the entity operates between primary care, which provides consultations with general practitioners, for example, and secondary care, which focuses on outpatients that refer patients to more complex tertiary-level procedures.

company models

Many people find the term “social startup” strange, says Adriana, but she ignores the NGO label and justifies that the idea of ​​a startup is to learn quickly and adapt to a purpose. “We know we have to start small, because it is a huge problem that we cannot solve with old solutions. No new solution is born ready-made and at scale. So the mentality was to test models.”

The company began by making expeditions with tents erected and dismantled every day in the cities they passed through, initially in the Northeast. People were informed about care back in the day, whose focus was on identifying and treating skin cancer, but not all of them had a real need. To improve work, the entity sought health departments to find out who was already on the SUS waiting list for expert advice. The efficacy extended to the chassis and they adopted containers and then carts to house doctor-patient meetings.

Another step has been to test telemedicine, since 2018, to identify in advance people who need minor surgeries, which will be performed during the expedition period. Prior to this resource, out of every 100 patients preselected for care, about 12 had a serious problem that required surgical procedure. Subsequently, the examination became more accurate, and of the 100 selected, 67 required surgeries. This improved the structure required for each expedition.

technology for innovation

To not be exact, Sabine explains that cities are selected according to needs to receive Advanced Telemedicine Units (ATUs), another product tested. Currently, four have been installed in the cities of Cavalcante (GO), Santo Amaro (MA), Cruz and Acaraú (CE). “I stayed in the city for at least a year so that we could have a greater continuity process within the municipal model. The expedition is the first assessment of the cities that will receive.”

The startup has invested in technology and also has its own platform to serve anyone, and the first contact can be made by WhatsApp number. For those without a cell phone or internet connection, SAS Brasil works with call centers, where a health professional with a phone can mediate a consultation.

These structures, equipped with monitoring devices, an automated disinfection system and devices to measure vital signs, were used in the first year of the epidemic in communities in Rio de Janeiro and São Paulo and were awarded the Dasa & Abril Medical Innovation Award in 2020, in the category of innovation in social medicine.

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Another resource is software that allows image tests to be performed with remote monitoring in real time. For example: a pregnant woman who lives in rural Ceara can go to UTA for an ultrasound, which will be seen on the screen by a gynecologist in Rio de Janeiro. The tool is used in cervical screening and should soon be augmented with another innovation: an algorithm that analyzes the results and indicates which ones are most likely to indicate cancer.

“Only a woman who, in fact, has a change will travel. We run over 300,000 tests. It has to do three times more for early diagnosis of women, who wait a year in line just to see their laps and 60% of them have nothing. The idea won.

Financial resources are the biggest challenge

For the first two years, SAS Brasil sustained itself by crowdfunding on an online platform and investing out of its own pocket (staff and volunteers) when necessary. In the third year, Roche entered the pharmaceutical field as the number one sponsor and has survived to this day, with the proposal to involve the company’s employees as volunteers in the startup’s business.

“We believe that the partnership with SAS Brasil advances our mission to provide greater health and quality of life for the community. We recognize the enormous challenges that Brazil faces in serving the population, which become even more complex given the geographical difficulties of our country,” says Sarah Chaya, Director of Legal, Sustainable Partnerships and Responsibility Social and Sustainability and Compliance Officer. From Roche Pharma Brazil.

In 2017, Albert Einstein Hospital joined as a supporter, and since then, other companies have joined the list of financial service providers, allowing the startup to hire doctors to coordinate fields and other professionals for different functions. “Maintaining a team of 50 people with donations is not easy,” Sabine says, as she realizes that having large donors as a major source of funding is not sustainable. In addition, she stated that the operational cost of transporting teams through Brazil is very high and it would be effective to get support from airlines or car rental companies, for example.

“Today, we work with individuals. Having a base of 50,000 people who donate R$100 and that goes to R$5 million is more sustainable than having five big supporters worth R$1 million. If a backer cancels from year to year, that’s a budget leak. “.

Because the founders understood that income isn’t always the biggest issue for those who don’t have access to health care, one of the SAS’s plans is to create a format in which some people pay for care and, in turn, pay for those consultations or screenings. Who can not invest in this care.

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