TBY talks to Mehmet Ali Aydınlar, President of the Board of Directors of Acıbadem Healthcare Group, on digitizing patient information, international acquisitions, and educating doctors in Turkey and beyond.

Acıbadem digitized its patient information systems across all of its group hospitals. How did this improve patient care services, and how do you ensure the security of this system?

Acıbadem follows and applies the latest innovations in the digital world. In addition, Acıbadem transforms the know-how in this field into the products. We have Turkey's first and only integrated system on digital pathology. We are the first healthcare group to provide digital radiology and paperless processes. These are only a few of the firsts we provided in this field of work. Our doctors can record all the treatment processes relating to their patients on the system. With this, we create a faultless and traceable digital process between the physician, the nurse, and the pharmacy. Thanks to our digital recording system, all healthcare professionals, especially our physicians, can manage the diagnosis and treatment processes more quickly and efficiently. This helps increase the satisfaction of patients and their relatives. With this digital system, protecting the privacy of patients is of the utmost importance. For this purpose, we have developed advanced security systems. On the other hand we have developed the practices that have received prestigious awards in the international arena such as arranging appointments from digital media and accessing health records via our online system. In addition our own digital medicine management system, Astore is a computer operated drawer structure works integrated with our hospital software. In this way it prevents confusion for the patients which are staying in the hospital by providing them with the correct drug to be taken out of the store and applied to the patient.

Acıbadem also operates internationally. What are the greatest challenges in operating in countries that have different legal arrangements and health systems?

Acıbadem has been serving outpatients from 21 hospitals in four countries; we have a total of 14 medical centers and 30 representation offices in 18 different countries. We provide direct health services in Bulgaria, Macedonia, and the Netherlands other than Turkey. Each of these has different systems and dynamics in relation to each other. An interesting aspect of the health sector is that although one may operate in different regions, the fundamental problems they face are similar around the world. For example, we operate in 10 countries as IHH, though the problems we discuss on our board of directors are usually the same. We encounter the lack of qualified health personnel, growing costs, ways of using efficient work models against raising costs, as well as the impact of health policy and practices on the private sector. When making investments in a country, it is important to understand the relationship between the private and public sectors, as well as the payment system in the country. In some countries, we have a strong and sound foundation of general health insurance, while in another country we have the exact opposite. In addition, the health sector is subject to a high degree of regulation from many different angles. Because of that, one has to provide the best service by prioritizing both patient safety and patient health. In the meantime, you plan and expect to earn the return you desire. This is not an easy task.

Acıbadem's entry into Bulgarian and Macedonian markets was through acquisition, whereas in the Netherlands it began its operations independently. Why were these separate models selected? Which model will Acıbadem use in its international growth in the coming future?

When you enter a country, you evaluate market entry options from many different angles, and many different factors can play an important role. For example, both Bulgaria's and Macedonia's health sectors are among the growing countries and are way behind in terms of regulations in comparison to Turkey. In such cases, the fact that there are already profitable elements within a certain quality of service makes it a reason for buying. Besides, it is crucial to have local partners, especially in acquisitions, that understand both the country and the health sector well. The presence of partners who live there and are familiar with the dynamics of the country is an important catalyst for one's goals. The Netherlands has a relatively highly developed socioeconomic structure, and its health insurance system is fairly developed. Using this structure in the Netherlands as a guide, we wanted to test ourselves by investing in an already developed country for the first time. In summary, we took our model to both Bulgaria and Macedonia. Within the framework of our growth strategy, we prefer to move forward with both new hospital construction projects and possible acquisition projects. I foresee that our growth strategy abroad will continue on these foundations. This will vary slightly depending on the country and the conditions in which we aim to enter into. Our growth strategy focuses on regions close to the areas where Acıbadem operates, rather than focusing on certain countries. In this context we can count the Balkans, Central and Eastern Europe, Middle East, and North Africa.

In addition to technology, Acıbadem's employment policy and working culture have played important roles in the establishment of the same standard of service in all of its group hospitals. How has Acıbadem University contributed to the group's employment policy?

Acıbadem is working very hard to provide the best, the highest quality service with the best managers in the field of healthcare. We are a group which does not deny the importance of teamwork is behind success; so we have worked to build our team with the spirit of teamwork in every aspect of our company. This enabled all our employees to feel part of a whole and it strengthened their sense that they belong with us. As a result, today we are training our own managers. Some of our nurses that we trained during 2000 are now working directors in our largest hospitals. Similarly our employees who come from different functions such as quality management, patient services, budget planning and internal audit are currently working as hospital directors. This shows that an employee who starts at the lowest level in an institution can work on the highest level of management positions. This creates role models in the organization and ultimately increases the motivation of the staff. There are no “turnovers” in the senior management and we do not lose managers. In this way we transfer the history and the traditions of the institute to the new generations and emphasize the importance of corporate culture that we show to our employees. Acıbadem University, which provides education in the field of health sciences and reflects our pioneering and holistic perspective in the health sector, is my social responsibility project. With a capacity of more than 4,000 students and with a 100.000 square meters of indoor space, it operates only as a health sciences oriented university. It educates health professionals of the future with its world class academic and technological infrastructure. In this sense, Acıbadem University has a very important function in the terms of training qualified human resources which can race against rest of the world. Young people that are graduated from different faculties are not only doctors, but they are also nurses, health technicians and administrators. As a result, individuals blended with Acıbadem culture at the start of their educational lives continue to be a part of our family. In this respect, I can say that Acıbadem University has a serious complementary power.

What is the role of Acıbadem University in educating doctors in the region and in Turkey?

Acıbadem University is one of the best health science universities in the whole world. In addition to our strong academic staff, we also have our CASE Clinical Simulation and Advanced Endoscopic and Robotic Surgery Training Center, one of the most advanced medical simulation training centers in the world. We demonstrate our difference with our advanced technology student laboratories that offer practical training in the associate and undergraduate programs. CASE, our center of clinical simulation, is accredited by Europe and the US. It is also one of the two centers in the world that has a certificate of excellence. One of them is Acıbadem University and the other one is University of Toledo in US. In four years, more than 15,000 specialists from abroad have been trained in this simulation center. Acıbadem University's School of Medicine is the medical school you need the highest test scores to apply to.

Over the next 12 months, what are Acıbadem's primary objectives?

2018 was a difficult year for our country as a result of the economic fluctuation and the devaluation of the lira in the second half of the year. Nevertheless, we managed to increase our revenues by 32%. The volatility in foreign exchange had a negative impact on our foreign currency debt. Nevertheless, Acıbadem has always been succeeded in getting out of crisis. In 2019, we are taking important steps to reduce our foreign currency debt and strengthen our balance. Probably in a short period of time, through the refinancing of our loans and through capital increase in the company, we plan to minimize our risks by reducing both our foreign currency debts and our remaining debts in more favorable conditions. Thus, Acıbadem will be ready to make significant progress in the near future as a strong balance sheet and cash generating company. We have two hospital investments in Istanbul, and we continue to work on them. We are doing it slowly to see what is ahead.