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Milagros Ureña

DOMINICAN REPUBLIC - Health & Education

Technology Graft

General Director, CEDIMAT

Bio

Milagros Ureña has a degree in Biochemistry from Pedro Henrí­quez Ureña National University and has also studied Business Administration, Industrial Psychology, and Human Resource Management at both the undergraduate and post-graduate level. Having had a long career in the health and education sectors, as well as being an advisor on projects with the Finance and Tourism ministries and the Dominican Social Security Institute, she has been in charge of CEDIMAT since 2001.

"CEDIMAT performs about 30% of the nuclear medicine studies carried out in the Dominican Republic."

In 2012 the first heart transplant was performed in the Dominican Republic. How important a milestone is this for the country’s health system?

Completion of the first heart transplant in the country represents proof of the evolution of the ability of Dominican cardiovascular medicine to provide medical care. On the one hand, this fact proves the technological development that has been achieved, but on the other hand it reveals the lack of national policy regarding the sustainability and implementation of an enduring heart transplant program. A successful transplant program in emerging economies requires government involvement to ensure its continuity.

When will CEDIMAT’s cardiovascular medicine center be operational and what means will it have?

The center will be operational in January 2014. The construction and installation of equipment will be completed between November and December 2013, and thereafter a training program for all personnel who will be working with the high-tech equipment for cardiovascular medicine will be conducted. We expect the training to take two months, so that the personnel are knowledgeable of the center’s existing technology when it opens its doors. It is an advanced medical center where the simplest to the most complex cardiovascular specialty procedures will be performed. The center will consist of seven floors, 150 beds, and diagnostic, therapeutic, and chirurgical procedures will be performed there. The center is already considered one of the most advanced in Latin America in this specialty and others, and the blueprints have been certified to international standards. We will perform a type of medicine that will give the country a great boost to assert itself in the medical tourism field.

“CEDIMAT performs about 30% of the nuclear medicine studies carried out in the Dominican Republic.”

In fact, CEDIMAT already has special treatment services for international patients. What does providing such treatment services entail?

CEDIMAT has an International Patient Unit that coordinates everything from appointments, either through its website, call center, or walk-ins—as well as an efficient medical and administrative process—from the moment the patient is admitted until the discharge or delivery of the studies or procedure results. The personalized service also includes translation services into multiple languages. Some international patients come from specific contracts with foreign missions that have relied exclusively on the center’s medical services for the treatment of their members, as well as international medical insurance companies, including the social security administrations of some neighboring islands.

How has it been sourcing specialists for the center?

In terms of human resources, we already have a good team of medical specialists, but we are also training personnel in France, Spain, and the US. They will be joining the center once it starts operations. We also have proposals from foreign doctors who want to work at the center, and we will also have them working with us. The most important thing, which is something that has been going on for some years, is that CEDIMAT has served as a magnet so that Dominican professionals abroad choose to return to the Dominican Republic to practice their professions. The main reason is that in CEDIMAT they find the same technology, the same working conditions, and the same scientific environment to develop their specialties as they have been doing in developed countries.

What is the importance of investing in nuclear medicine?

We have made a significant investment in nuclear medicine. In fact, CEDIMAT performs about 30% of the nuclear medicine studies carried out in the Dominican Republic. We perform between 500 and 600 nuclear medicine procedures per month, a significant amount for any center in Latin America. It is the only center in the Dominican Republic with two gamma chambers and a specialized unit dedicated to treating patients needing iodine therapy. Right now we are working with the IAEA, at which CEDIMAT represents the Dominican Republic, to develop a Cyclotron PET/CT project, which is positron emission tomography, as it is the one diagnostic method lacking in the Dominican Republic preventing us from stating that we possess all the advanced technological means to perform a complete diagnosis at the highest level.

What is CEDIMAT doing to improve its international profile?

CEDIMAT is undergoing a certification process with Joint Commission International, the entity in charge of certifying hospitals in the US and other countries, to provide medical services conforming to international standards, focusing on quality of care and patient safety. This will open a spectrum of possibilities for CEDIMAT and the Dominican Republic with respect to medical tourism. On the other hand, it also opens the door for more interaction, information exchange, and brings our medical personnel up to date with foreign experts. Our doctors are being invited to hospitals and international conferences to present their research and practices, and to pass on their experiences at CEDIMAT. We have also received proposals and visits from international universities interested in developing research projects and exchanging information with CEDIMAT.

CEDIMAT has a telemedicine system permanently linked to Massachusetts General Hospital. How important is it for CEDIMAT to have an open line of communication with such a prestigious US institution?

It is extremely important because our doctors can teleconference regarding a patient and take advantage of this medium as a means of training. Our operating rooms have a telemedicine system that allows us to consult with doctors from other hospitals located around the world. For example, a doctor from the Massachusetts General Hospital can participate live in a surgery being performed in CEDIMAT. Similarly, we do teleconferences with other medical centers in the country, during which personnel can interact, discuss medical cases, and even participate remotely in a surgery. This system is extremely important to keep doctors up to date, and it benefits patients as several specialists may be intervening simultaneously in a medical procedure from different locations.

What potential do you see for the development of medical tourism in the Dominican Republic?

The Dominican Republic has great potential to develop medical tourism, but so far it is in its early stages because there is no state policy to develop it. The initiative should have its origin in breakthrough policies in this new tourism model coming from the Ministry of Tourism. Medical tourism is a new opportunity for the Dominican Republic because we have great comparative advantages, such as our proximity to developed countries like the US and Canada, with the former having a large number of uninsured citizens and high medical costs. It is estimated that in the US there are about 40 million people without insurance, and medical service costs are among the highest in the world. The proximity to the Dominican Republic would allow us to capture a percentage of this market, who could come here instead of going to India, for example, which is much farther away. In addition, the country has extraordinary access infrastructure with seven international airports and sophisticated communication systems, as well as a high-quality hotel industry.

How would you rate the government’s support of the healthcare sector in recent years and what role does the private health sector play in the country?

In recent years the government has made some progress with the sector and social security reform, but much remains to be done. Social security coverage is still insufficient and limited; there are many exclusions and little coverage for serious illnesses. Many procedures are beyond the scope of services, resulting in stagnation in the health sector, and the population cannot benefit from innovative procedures, such as laparoscopic surgery, which is a great breakthrough because it is minimally invasive and has great benefits for patients. The non-coverage of new procedures and technologies limits the investment capacity of the private sector. However, the private sector continues to make significant investments in medical technology, as well as in improving the quality of care.

© The Business Year – November 2012

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