Tooling Up for the Future

Konstantinos Deligiannis, General Manager South Eastern Europe at GE Healthcare, talks to Business Partners magazine about medical technologies and healthcare innovation in Greece, pointing to the sector’s shortcomings—but also to the untapped potential that could very well redraw the future of the sector and of Greece itself.

Tell us a bit about GE Healthcare and about its activities in Greece.

GE Healthcare is part of the General Electric group and has been operating in Greece since 1976. Since 2009, GE Healthcare Hellas S.A. has functioned as the administrative and regional center for the whole Southeast Europe region, which covers 14 countries including Hungary, Romania, Serbia, Bulgaria, etc. Based in Marousi, Athens, the company occupies approximately 130 employees and commercializes high-end medical technology and pharmaceutical products, while also providing high quality maintenance and support services.

The company manufactures pioneering medical technologies and systems for every stage of patient care, from diagnostic imaging for routine examinations to life-critical care systems and specialized pharmaceutical agents. To name a few: molecular imaging, magnetic resonance, computed tomography, X-ray, mammography, ultrasound systems, vascular imaging systems (cath-labs), electrocardiograms, bone densitometry, surgical C-arms, contrast media and radiopharmaceuticals. At the same time, GE provides technical and scientific support for a great variety of applications, including cellular science and pharma R&D. Finally, in the healthcare IT sector, GE Healthcare offers integrated solutions and information systems for the interconnection of healthcare infrastructures, aiming at the most effective management of patient data.

Based on this strong innovative portfolio, GE Healthcare has partnered with almost all public and university hospitals in Greece, as well as with private health centers, clinics, medical centers and pharmaceutical/biotechnology companies. Overall, we have an installed base in the Greek healthcare system numbering close to 5,000 systems.

What is the level of high technology imaging equipment in the country?

Greece has been the first country in Southeast Europe to develop significant healthcare infrastructure, both in the private and public sectors. Even at a global level, the country exhibits several unique features: the highest number of doctors proportionally to its population; a patient mentality of ensuring the best possible treatment at any cost, which leads to strong out-of-pocket contribution to healthcare spending and revenues; and one of the highest densities of hospitals and diagnostic centers, followed by a similarly high density of imaging equipment (e.g. magnetic resonance systems, computed tomography systems, and mammography systems).

However, the average level of quality and age of these critical systems is rather disappointing. Most of these machines, both in the public and private sectors, are dated and have long exceeded their useful life as per European standards. This has multiple consequences. As concerns patients, aged diagnostic equipment can result in poor diagnoses that may be inconclusive—meaning that exams must be repeated—or may miss critical findings. Such equipment offers limited or no access to newer techniques and clinical applications and, most importantly, can emit an excess of radiation to the patient, compared to newer models. Furthermore, even routine tests in older equipment take a longer time, which can have a severe effect when it comes to elderly people or children. Another significant issue with using dated diagnostic equipment is the elevated cost of operation, which is a result of maintenance difficulties (due to the scarcity of spare parts) and their higher energy consumption. Any way you look at it, at the end of the day the National Organization for Healthcare Provision (EOPYY) is taking a hit by funding equipment that operates contrary to the promotion of the high quality of healthcare that all Greek governments aim for. Equipment that should have long ago been replaced.

So what does that mean for healthcare innovation in the country? What’s the current climate and what do you think the future holds for companies innovating in this sector in Greece?

I can answer this by describing what the status is abroad. Medical imaging technology is rejuvenated every three to four years. Internationally, a substantial amount of R&D funds goes toward developing new generations of diagnostic equipment, systems that can give earlier and more accurate diagnoses while reducing examination times and lowering patient radiation dose. The vision of personalized medicine drives the international medical community, academic institutions, industrial manufacturers, patient organizations—every possible stakeholder in the healthcare industry—to make every possible effort in improving the level of diagnosis by establishing new techniques and methods.

Following this strategic orientation, social security organizations across Europe—even those in our proximity in Southeast Europe and the Balkans—have opted to encourage investments in modern healthcare technologies. Reimbursement is higher for exams done using new systems, and conversely there is no reimbursement for private healthcare providers who use imaging equipment beyond their useful lifespan of 7-10 years. This way social security organizations ensure that (a) the population of the country is served by a best in class of safety and quality medical technology, (b) the private healthcare sector is attractive only to serious providers that respect their business mission and keep up to date with developments in medical technology, and (c) the social security system itself achieves savings while simultaneously directing its limited funds to the best healthcare providers.

None of this is happening in Greece. EOPYY continues to be the most generous national healthcare provider in Europe, one that refunds any type, age and quality of medical equipment as long as said equipment can run an exam—any exam. There are no strict quality and age criteria. And this is the reason why Greece is one of a handful of countries in the developed world still using diagnostic systems (e.g. MRs, CTs, and mammographs) that were installed in the previous century. It is also the reason why our country is the main destination for old systems that are being de-installed in other European countries due to their age.

How transparent is the procurement system in Greece? What are the qualitative and object criteria and how these are assessed?

For a number of years now, Greece has been evaluated by international organizations such as Transparency International as one of the worse countries not in Europe but in the Balkans, in terms of corruption and lack of transparency. This is something that is rarely discussed or even mentioned in the news or at conferences. We take it for granted, or perhaps it’s no longer an issue for us. It is a pity, but it seems that we all have adjusted to living and working in such a counter-productive environment and see no benefit in changing it. Personally, I believe that we Greeks, as a nation, we have resigned from any ambitious vision for our country.

In a funny way, corruption is based on short-sighted belief that by decreasing competition and denying market access to quality healthcare companies, business growth and profit will be easier and better for the few who manage to stay in the race. However, what is actually happening is that healthcare costs are increasing, the public sector is sinking deeper into debt, and the toxic business environment drives away companies and investments. A drier economy will lead to increased taxation, unemployment and shrinking markets. So, we are essentially sawing off the branch we are sitting on.

I really wish that Greeks could see and understand the Romanian miracle. How an infamously corrupt country transformed itself into a transparent and fair business oasis, attracting all types of serious investments. The economy is annually growing at +7%, unemployment is less than 4%, salaries are continually increasing, taxation is one level for all, businesses and physical persons, at 16%, VAT is continually decreasing one point per year. They have solved all these issues that have plagued us for decades. And they started by targeting corruption.

From the impact of tax reform to the availability of necessary infrastructure and the existence of a suitable workforce, what’s it like doing business Greece?

It is a land of contradictions. Predictable unpredictability. A routine of surprises. Continually changing rules. Short-lived strategic priorities, especially in healthcare. Lack of transparency. Excess of arrogance. And excess of ignorance in positions of power. Lack of accountability and responsibility. Few opportunities for dialogue. Even fewer for constructive dialogue.

At the same time, we have an extraordinary workforce, with a remarkably high level of skills and credentials. There are talented doctors, charismatic entrepreneurs, and world-class medical physicists. The anonymous heroes in the public system working far beyond their job descriptions for the benefit of the country. Makes you wonder, if all these vector forces pointed in the same direction, pointed toward a national vision, what Greece could achieve.

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