“A SUCCESSFUL DIGITAL TRANSFORMATION STRATEGY REQUIRES BUY-IN ACROSS OPERATIONS, IT, AND CLINICAL LEADERSHIP. COMMON SENSE IS NOT ENOUGH”

Interview with Javier Contreras, CEO, Grupo Conclina, Quito, Ecuador

Healthcare organizations want to provide high-quality services to patients. But if patients can’t easily access or afford health services, the system has not been properly designed to meet patient needs, suggests Javier Contreras, CEO of Grupo Conclina, an Ecuadorian healthcare firm that owns Hospital Metropolitano, the largest private hospital in the country; Humana, a pre-paid health insurance plan; and Metroambulat, which provides ambulatory services. Grupo Conclina, which is an IFC investment client, recently partnered with IFC’s DigiHealth team to draw up and implement a digital transformation strategy, enabling the company to increase access, boost quality, and provide cost savings. In an interview, Contreras explains why the pandemic made the company rethink its digital strategy, how it secured internal buy-in, and which three things hospitals should consider when planning for digital changes.


How did you decide to make digitalization a priority?

Our mission is to provide the highest quality health services in the country. We knew well before the pandemic that a digital transformation was essential to maintaining the highest standards, and we always intended to lead the charge in Ecuador.

In our country, the public and private health sectors operate entirely independently of each other. Not all Ecuadorians have access to public health services, while 45 percent of our private hospital beds are empty. I believe that digital solutions can help us strengthen our position and deliver greater access to healthcare services and reach more people. In the current system, doctors work in their consultation offices, and patients have to come to them and wait their turn. This system may be more efficient for physicians, but it places doctors as the driver of the system versus patients. There is a lot of room for improvement in making services more efficient and cost-effective for the patient, which also benefits our bottom line. And digitalization can help us do this successfully.

Getting buy-in from senior leadership is only part of the process for successful change. How did you build buy-in across the institution?

As you know, people are resistant to change. And even more so when they don’t understand why they need to do something different. Take our doctors as an example. They are the best doctors in Ecuador, trained overseas in places like the U.S. and Europe, but they don’t necessarily appreciate the need to change. With this in mind, we have been very clear in communications across the organization that we are not turning to digital solutions for the sake of it. We have engaged teams across finance, operations, clinical practices, and of course, IT in discussions around digitalization and provided support and resources to anyone navigating the more challenging aspects of implementation. Taking the time to have these important conversations from the very beginning has helped build enthusiasm for what we are doing.

A study by Boston Consulting Group found that 70 percent of digital change initiatives fall short of their objectives. What do you think helps ensure success?

Digitalization isn’t easy. We looked into digital solutions several years ago and found ourselves trying to run before walking. Take artificial intelligence or data analytics as examples. These are novel technologies that everyone is talking about, but they are not necessarily going to improve efficiencies and enable a higher level of care if these solutions are not part of a bigger-picture, forward-looking strategic plan.

A successful digital transformation requires buy-in across operations, IT, and clinical leadership. Common sense is not enough. We saw that we needed help devising a plan that considered global trends and initiatives. We also needed an objective evaluation of our strengths and weaknesses. IFC’s DigiHealth program and consultants checked all the boxes. IFC’s team started its work by conducting a thorough assessment of where we were on the digital transformation path and helped us identify a realistic starting point. From there, the DigiHealth team gave us a structure and a detailed plan based on a multinational point of view of how to achieve our long-term goals.

Identifying technology solutions that will have the greatest impact can be daunting. What are you prioritizing?

In our experience, it was very important not to take on too much too fast. IFC helped us identify technology solutions like enterprise resource planning (ERP) that would improve our transactional systems [like admitting and discharging patients and billing them]. ERP tools enable us to lower operating costs while making our back-office functions work more efficiently. The next priority has been convenience and making more information available to patients, doctors, family members, and other stakeholders through an online and mobile app. If a former hospital patient needs his or her medical records, they shouldn’t have to come in to get them. That person should be able to access a web portal that contains images, lab results, billing history, and all medical records. Electronic health records tools have brought up the level of convenience our patients deserve.

Is there one thing that really pushed forward your digital transformation?

The pandemic was a key enabler of our digital transformation. During peak COVID, most Ecuadorians were afraid to seek in-person medical care, and even our most experienced doctors were reluctant to see patients. As a result, digital tools like telehealth consultations were embraced by even the biggest skeptics, who found themselves open to doing things differently out of necessity, giving us an opportunity to execute a plan. Once isolation ended, telemedicine did decline because some patients preferred to see doctors face-to-face. However, I believe this is a generational preference. Young people are much more resilient to new ways of doing things, and remote care is the wave of the future.

I have always thought every crisis allows one to find ways to get through it and emerge stronger than ever. This is true for Conclina; we are stronger now than ever before.

How should companies evaluate the effectiveness of their digital transformation strategy?

For us, pursuing a digital transformation strategy is an investment project. Of course, we care about our patients and delivering a better experience. But there must be an economic return and several key performance indicators that allow us to evaluate initiatives against our objectives. These measures of success need to be incorporated into the planning process and not an afterthought. If we don’t see an increase in patients returning to our hospital or a clear return on our investment, something isn’t working. The other less tangible measure of success is being prepared for future uncertainties and not being paralyzed when the unexpected happens.

What are the three things you would advise other hospitals to focus on when planning digital changes?

Since failure statistics are so high for companies pursuing a digital transformation, the first step is to lower the probability of failure. This means having the support of a knowledgeable, global-minded, and experienced advisor. I also believe it is important to look beyond what is happening locally. For example, IFC provided examples of what was happening in other parts of the world, and that perspective informed many of our decisions. Second, be sure the project pursues a clear economic objective. Ultimately, if we can provide patients with more access to quality services, that will help grow the volume of the business. Third, involve management and staff until the digital transformation priorities are clearly understood, and supports are in place to help them effectively execute their tasks. Since leaders are not involved in the day-to-day implementation and adoption of various solutions, key players within the organization must clearly understand what is happening and why.

This interview has been edited for length and clarity.
Published in October 2022


Javier Contreras is a senior executive with over 31 years of international experience. He is currently the CEO of Conclina Group, which includes Hospital Metropolitano, the largest private hospital in Ecuador; Humana S.A., third largest player in the prepaid medical services market and Metrored S.A., fifth largest player in the diagnosis and ambulatory services market. Contreras is an Electronic Systems Engineer (Monterrey TEC, Mexico), with an MBA (Universidad de Belgrano, Argentina), a master’s degree in digital marketing (EUDE, Spain) and a master’s in data analytics (INCAE, Costa Rica). He has also completed post graduate coursework in health care delivery (Harvard Business School, USA).