Giuseppe Recchi, CEO Affidea, in HBI about the company's plans for growth

Healthcare Europa speaks to Giuseppe Recchi, CEO of pan-European advanced diagnostic imaging provider Affidea, to find out about the company’s foray into outpatient care, the state of AI, and plans for the future.

Healthcare Europa (HE): Affidea is moving more into outpatient care. How does that fit into Affidea’s business model?

Integration matters. Offering more high-quality services to our customers adds more value to our proposition, as it would in any industry. We see a lot of synergies by adding more subspecialty expertise to our current diagnostic imaging capacity, matching specific know-how to local demand.

HE: And this is what you are doing in Ireland at the moment?

GR: Yes. We found an opportunity to enter into Express Care, which is part of a wider three-year, €20 million investment in the country. People can enter our facilities without an appointment, which is good for them and relieves the burden placed on A&E departments. Our centres are open 12 hours a day, 365 days a year. They provide services to all patients who attend on a fee-for-service basis, irrespective of private health insurance status. We feel there’s a demand for easy access, fast care, which is synergetic with our core diagnostic business.

Our Express Care centres are based on a polyclinic vision, offering a one-stop-shop of healthcare services. So, for example, if you break your wrist playing football, you can attend the Express Care and our team of doctors will diagnose and stabilise you, offer an X-Ray or MRI scan, treat your injury accordingly, all of this can be arranged within an hour. They can also ensure you have the correct aftercare – an appointment with a consultant orthopaedic surgeon and follow up care with a physiotherapist. This means patients only need to visit one provider.

We believe the wider our footprint, the better we can position ourselves as the healthcare supplier of reference for a wider group of patients. We also aim to be the best partner for insurers.

HE: Does your Irish experience mean you’d be interested in building a pan-European outpatient network?

GR: We are always expanding and looking for opportunities for future growth but we do this on a market by market, location by location decision. Every country has a different model. Some countries are more focused on private business, some B2B, some are fully public. Affidea is uniquely positioned to offer a tailored service that matches demand – whether that is express care, outpatient, or sub-specialty expertise. There’s no one-size-fits-all approach in a cross-country strategy given the diverse healthcare business models and regulations.

HE: So every market requires a different approach which makes building a joined up network more difficult?

GR: I believe that the healthcare industry is a local game that needs a global mindset. We have a strong network of centres in advanced diagnostic imaging and already a quarter of them have added outpatient capabilities.

Each country has its own business approach but there are trends across markets, such as a shortage of radiologists creating a pressure to increase salaries which is squeezing the operators’ business sustainability. In Greece there are 31 radiologists for every 100,000 people but in Spain there are 12 and in Italy, there are just 3.

AI technology will empower us and will support radiologists become more productive, efficient and focused on their patients.

So we want to be able to move (human) resources between countries but the biggest barrier is currently regulations. Most of the radiologists cannot work outside where they are qualified – but it’s not a different job there are just different regulations.

They had this problem in the US 15 years go, they solved it with teleradiology but there, there was one system of regulation and one language. Language will be addressed probably through AI, but this regulation is a self-created burden that Europe needs to look at. And it’s not just in healthcare. It’s a recurrent issue in any industry.

HE: We know you’ve been talking to IBM Watson and Microsoft – what is the current state of AI as a diagnostic tool, and is it a threat to the radiologist profession or a tool to assist it?

GR: We are the only healthcare operator in Europe to sit on the Imaging Advisory Boards of IBM Watson Health, and we also sit on the board of Microsoft Cloud. This is in part due to the richness of the datasets we produce – 13 million scans every year in our 246 centres, located in 16 countries across the continent.

AI-powered medical imaging systems can produce scans that help radiologists identify patterns – and help them treat patients with serious conditions more quickly. The result is clear, more accurate, quality care. Some studies have demonstrated differences in interpretation between radiologists reading the same scan as high as 30%. Some AI has an accuracy of around 90-95% which is very high. Some are already certified in Europe or the US which is the threshold to make a project bankable.

Will it be possible to get to 100%? Probably. But it doesn’t mean human radiologists will disappear. We will never let a machine operate on its own.

I compare it to autopilots in planes. What I see happening is all the most advanced centres will have radiologists plus AI.

AI can help radiologists identify patterns. When you take a scan you get about 2,000 tones of grey. The human eye can only detect about 20 therefore we should do everything we can to increase the capacity of the radiologist to read all the available data. That’s where AI will improve things – it will read through a lot more data than is physically available to radiologists. For me, it’s about speeding up diagnostic processes, enabling doctors to automate routine procedures and processes, allowing them to focus on the most complex and critically ill patients and more efficiently and effectively diagnose and treat, minimising mistakes. It’s an instrument of precision.

HE: Where do you see Affidea’s growth coming from? Is the focus consolidating where you are, or expanding abroad?

GR: We’ve got a lot of capital to invest in our M&A strategy. We’re going to play as a consolidator.

Industry core growth plays between 2-4%, it’s good compared to other industries. But if you want to stay in double digits that’s achieved through strategic growth.

HE: And which countries are most interesting to you at the moment?

GR: We want to strengthen our position in existing markets – Italy, Poland, Romania, even Turkey – despite the exchange rate. Europe is our sweet spot but we are also looking to expand outside – in the Middle East and Africa rather than Asia.

Source: Healthcare Business International