PORTUGAL - Health & Education
Cardiologist at Centro Hospitalar de Gaia and Professor, University of Porto
Ricardo Fontes-Carvalho is currently Director of Cardiology at Centro Hospitalar de Gaia and Professor at Faculty of Medicine University of Porto, Portugal. He has been involved in both basic and clinical research, for which he has received 15 national and international awards and has authored more than 120 publications. At an international level he has served in several positions in different scientific societies. In 2017 he was distinguished as Fellow of the European Society of Cardiology (FESC) and as Fellow of the American College Cardiology (FACC). More recently he concluded a MsC in Health Economics and Management at the London School of Economics (LSE).â€¨
TBY talks to Ricardo Fontes-Carvalho, Cardiologist at Centro Hospitalar de Gaia and Professor at the Faculty of Medicine in the University of Porto, about the national healthcare system, digital technology application, and objectives for the year ahead.
What is your critical assessment of the quality of the national healthcare system and how is your department working to improve it?
The overall quality of the national healthcare system is good, as demonstrated in several national health indicators. In Portugal, there is a universal and equal access to healthcare and the Portuguese National Healthcare System is considered one of the essential pillars of the recent Portuguese democracy. Therefore, it is not surprising that Portugal has one of the highest life expectancies at birth and, for example, one of the lowest childhood mortalities. Nevertheless, more recently, the system is facing several important challenges due to important economic constrains and underfunding of the National Health System, need to implement organizational reforms to the system and increasing difficulties in motivating and attracting doctors and other healthcare personnel. Regarding the care for cardiovascular disease, the level of Portuguese Cardiology is very high and aligned with the best international practices. Portugal has one of the lowest mortality rates in Europe for coronary artery disease and, more importantly, in the last three decades we have seen a more than 20% decrease in the adjusted mortality due to cardiovascular disease. Knowing quite well the European and worldwide reality, I can state that cardiovascular care in Portugal is excellent, with very motivated and highly qualified professionals. In spite of this, there are some work to be done especially in the access to innovation and complex cardiovascular procedures, particularly for patients living in the interior of the country. The Cardiology Department of Centro Hospitalar the Gaia was founded about three decades ago. During these decades the Department has made major contributions to national and worldwide Cardiology, having a pioneering role in the development of several new technologies, especially in the field of intervention cardiology, cardiac imaging and arrythmias management. We also keep a strong focus in monitoring several healthcare quality indicators and patient satisfaction.
How are you aligning the activity of your department with the latest and best international practices?
Currently, the Department is completely aligned with the best international practices in terms of healthcare quality indicators and patient satisfaction. The department has a high volume of procedures to allow a good and timely access to cardiovascular care to our patients. Access to innovation is also a key concern because it allows us to provide access to the best cardiovascular care, improves quality indicators and motives workers to improve their practice.
How are the ongoing digital revolution and technology use influenced your daily operations and the ones of healthcare operators?
Digital revolution will completely change the way how we provide healthcare in the next decades, with the introduction of artificial intelligence, continuous monitoring devices, big-data analysis and other digital technologies. Currently, digital technologies are already helping doctors and patients to improve healthcare results, for example with the introduction of the common electronic healthcare process, new technologies of patient telemonitoring and the possibilities of teleconsultation.
What are your short term priorities and what are the main objectives set in your agenda?
The current priorities of the department are centered around four objectives: a) healthcare quality, b) continuous access to innovation; c) foster clinical research and d) provide the high-quality education to the younger generation. First, quality improvement should be a concern of every healthcare departments by providing patient-centric cardiovascular care. Although our quality indicators are already very good, the goal should be to provide excellence in cardiovascular care, which is a continuous and never-ending goal. Currently, to further improve the quality of healthcare we need to build new and larger facilities to provide “integrated” cardiovascular care and more comfort to the patient. Moreover, with population ageing we are living an era of “epidemiologic transition” in the type of patients and diseases that we take care of, which is demanding a significant adaption of hospital facilities. Access to innovation is also essencial in cardiovascular care, because Cardiology is a fasting moving medical specialty. Therefore, continuous access to new technologies and new devices is very important to improve the quality of care and to motive healthcare personnel to improve their practice. Clinical and translational research is also a short- and long-term priority of the Department. Not only it improves current knowledge about the disease but several data have shown that departments who have important clinical research usually provide higher quality standards of care. In this field, our department has developed a strong collaboration with Faculty of Medicine University of Porto. Finally, another strategic goal of a healthcare department should be to assure long term quality of care. Therefore, our department has a strong focus in providing high quality formation to the cardiologists of tomorrow and every year provides education to more than 30 fellows from all over the country.
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