A Best Practice for Innovative, High-Tech Affordable Health Services

Manufacturing the Preventive Medicine Program (PMP) Container in the São Paulo, Brazil


Editor’s note: This is part two of the two part series  on Thinking Inside the Health Box:  Brazil’s Center for Integrated Education and Health, Going Global. Here’s Part 1 entitled, Thinking Inside of Brazil’s Health In a Box 

Starting in 2015, the Council Board of CIES Brazil initiated serious discussions and strategic planning for a “scaling” phase and expansion of CIES Global via globalization programs such as Ashoka-Mckinsey’s Globalizer.  These discussions were fueled by several invitations for implementing CIES in aside from the US, in multiple Latin American, Asian and African countries including Haiti, Mexico, Colombia and Peru, and Africa as Mozambique and Angola.

The result of the Strategic Planning discussions evolved into a “Duplication Project” that was defined by the Board as a primary strategic goal for CIES Brazil.    

The intent was the establishment of a strong United States presence and “hub” and the formation of “CIES Global” a subsidiary organization of CIES Brazil to serve as a major world reference center. 

This new U.S. based “hub” and reference center would serve for demonstration of the CIES brand, philosophy and health service model for interested parties and countries that desired to duplicate and disseminate the service on a global scale. 

With the Advent of CIES GLOBAL, CIES Brazil has taken its innovative mobile healthcare delivery model truly “on the road” and chose as its first ever site outside Brazil, Atlanta Georgia USA.  

Atlanta was chosen because of the cities world recognition as an internationally diverse and globally minded business region, its high standard of living and vast metropolitan area with a recognized International Airport and as a region known for innovation and excellence in academic health sciences, healthcare delivery, public health, and heath information technology and biomedical sciences. 

Mini Hybrid Hospital Joinville Brazil

Mini Hybrid Hospital Joinville Brazil

Growth Strategy:  CIES – Global having now introduced the world´s first self-contained, highly adaptable and customizable Health Container to the US is now contracting with its Brazil manufacturing partners Fleximedical Inc. and Engemet Inc. to initiate large scale manufacturing of its showcase product (The Health Box) in the US, has its sights set high. 

The CIES Global Council Board has identified 4 priority areas for development, growth and financing opportunities:

  1. Manufacturing in the US and Brazil 20-30 “Hybrid Day Hospitals” at $1 M USD each.
  2. Manufacturing 2 large “Secondary Care Hospitals” with container technology at a cost of approximately $25 M USD each.  
  3. Manufacturing in Atlanta GA USA 20 retrofitted container “Health Boxes” per year for 5 years at approximately $150K each. 
  4. Total Expected Capital needs over 5 year period for CIES Global expansion  $95-100 M USD

While the current CIES Global – Atlanta clinic model has begun with “PMP” container Heatlh Box units, the strategic growth plan is to proceed with constructing “Hybrid Day Hospitals” and secondary care hospitals which are unique configurations of retrofitted, refurbished and retooled shipping containers into fully connected,  highly efficient, highly adaptable structures that redefine the way healthcare can be delivered. 

Unique and cutting edge health technology and informatics are an integral part of this “new patient health experience” that they conveniently schedule, engage and monitor in real time on mobile application.  CIES GLOBAL core mission is to put the control in the hands of humans allowing us to understand and engage more completely in how we manage our health care and optimize our health and wellness.  

Ultimately, as has occurred in Brazil, the connected network of Health Boxes, Hybrid Hospitals and Secondary Care Hospitals will reach critical mass and reach a greater proportion of a population for basic needed health services in a “Hub and Spoke” Model.   

This model allows geographically and sometimes culturally disparate populations access health care via multiple mobile clinics through a “virtual triage” process feed patients needing a higher level of care into secondary and tertiary care facilities, thus efficiently controlling cost and outcomes in a process driven by “Big Data”.   The resulting social impact is that many more people receive much needed basic and critical preventive care services and procedures and the effects of chronic disease are prevented or eliminated altogether. 

The model is not hypothetical and has a demonstrable track record and outcome metrics of almost 10 years in one of the largest and most complex urban areas in the world, São Paulo Brazil.

This successful model in CIES Brazil currently provides needed minor vascular procedures such as hernia repairs and removal of varicose veins, Pharyno-Laryngoscopy, GI Endoscopy and Colonoscopy, Cataract removal, Vascular Doppler Ultrasound, Transvaginal US, Abdominal US, Electro-Myography, Echocardiography and Mammography at some site. 

These are the most common traditionally clinic or hospital based procedures that most people regardless of social class or type of insurance can wait for months due to overcrowded urban hospitals and limited procedure – surgical room time for physicians.

Most CIES sites provide some medical consultation that may lead to a procedure or referral to a tertiary care center when needed for advanced specialty care. 

Next- CIES – Global Business Model- Tiered Moibile Health Screening and services 

Eduardo Montana
Eduardo Montana
Dr. Eduardo Montaña is a Preventive Pediatric Cardiologists and Lipidologist who in 2001 founded Children’s Cardiovascular Medicine, a private practice in the Metropolitan Atlanta area covering the needs of the infants, children and adolescents throughout the State Georgia. He currently serves as a National Hispanic Medical Association (NHMA)/National Hispanic Medical Foundation (NHMF) Physician Leadership Fellow in Washington DC where he participates in developing policy initiatives related to Culturally and Linguistically Appropriate healthcare Services (CLAS) for Latino Communities. He serves as Chair of the Board of Directors of the Hispanic Health Care Coalition of Georgia (HHCCG) supporting initiatives at addressing Obesity and Diabetes in Latino Communities through Health Education and Promotion Services. Dr. Montaña completed both his training in Preventive Medicine and Pediatric Cardiology at the Emory University School of Medicine as well as his Masters of Public Health at the Rollins School of Public Health. In the early nineties, Dr. Montaña was awarded and completed an appointment at the Centers for Disease Control and Prevention, Center for Environmental Health and Health Promotion in the Epidemiology Intelligence Service in Birth Defects Surveillance. He later served on faculty at Emory University School of Medicine, Department of Pediatrics and Pediatric Cardiology. Dr. Montaña earned his MBA in Healthcare Administration and Management from University of Colorado Executive Health Care Business School. He remains committed to positively impacting educational and health care disparities in Latin American youth.

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