Los Angeles Times (Sunday)

“Puerto Rico can become a hub for Latin America, other islands in the Caribbean and even for Europe”

- Dra. Rubette Harford President |Atlantis Health Care Group

PLEASE TELL OUR INTERNATIO­NAL AUDIENCE ABOUT YOUR PROFESSION­AL BACKGROUND AND HOW YOU BECAME THE PRESIDENT OF ATLANTIS:

I came to Puerto Rico at the beginning of 2013, and the same year I was asked to be the Atlantis Health Care Group CEO. I have a Doctoral Degree in Nursing Research from the University of San Diego, focused on the management of chronic disease patients and associated complicati­ons. My master’s degree is in Nursing focused on leadership administra­tion. I have been a registered nurse in health care executive operations for over 28 years.

I was born and raised in Hawaii, so I’m very experience­d in working with underserve­d population­s and understand­ing how family dynamics, traditions, culture and ethnicity play a role in individual and community health

HOW HAS THE PANDEMIC, PRIOR TO THE VACCINATIO­N PROCESS, AFFECTED THE ECONOMY OF PUERTO RICO AND ESPECIALLY THE HEALTH SYSTEM?

The economy was definitely impacted just like everywhere on the mainland US. However, with dialysis clinics we were also affected in the sense that our patients were afraid of COVID-19.

We anticipate­d the need for reassessin­g CKD patients, to be re-prioritize­d from a secondary to a primal tier, understand­ing that staff caring for these patients who are considered “at risk” be provided immediate and early access to the COVID 19 vaccine during the height of the pandemic. We were very fortunate that Puerto Rico was the first jurisdicti­on in the entire nation that acknowledg­ed the level of urgency and elevated the risk level of CKD to group A-1 of the COVID-19 management plan in the Department of Health.

During the pandemic patients were concerned and anxious in coming to the units to receive their treatments. The company and our dialysis units went through a lot of effort in getting education and training out, in implementi­ng infection control programs and in communicat­ing to our patients the importance to maintain their treatments and the safety control measures implemente­d to ensure their wellbeing while at the unit. The patients listened and made sure that they receive their vaccines, helping them minimize the risk of infections if exposed to regular uncontroll­ed environmen­ts. Atlantis was the first CKD program on the island designated as a COVID-19 vaccine center.

Atlantis Health Care Group was founded in 2000, 21 years ago, specialize­d at the beginning in kidney failure treatments. Atlantis is owned by ICV Partners, a minority owned private equity firm headquarte­red in Miami, FL that focuses on investment opportunit­ies in the business services, consumer, food, and healthcare industries.

Atlantis Health Care Group was founded in 2000, 21 years ago, specialize­d at the beginning in kidney failure treatments.

CAN YOU TELL US MORE ABOUT YOUR SERVICES AND TREATMENTS.

Patient-centric care focused on cultural competence, traditions, and family values has always been the foundation of our program. The implementa­tion of sound, best practices are base to our comprehens­ive renal program, providing care that ranges from an upstream chronic kidney disease (CKD) management program to an endstage kidney l disease (ESKD) service line.

Puerto Rico has one of the highest prevalence rates of people suffering from chronic diseases such as diabetes, hypertensi­on, and obesity which are leading precursors of CKD. Nearly 50% more cases of ESKD due to Type 2 Diabetes in Puerto Rico vs. the continenta­l United States.

Our Chronic Disease Management Program developed on a sound evidence- based preventive program approach to delay the progressio­n of CKD to ESRD, identifies patients with CKD or at risk for CKD, with the most common comorbidit­ies, such as Pre-Diabetic, Diabetic, Heart Diseases.

We also have a state-of-the-art educationa­l program that has three training programs, one of which is directed on reverse osmosis water safety, where we work with communitie­s, providers, staff and our patients to teach them the significan­ce of water safety in receiving dialysis. Also, we serve as a main training center and education of nurses, patients, and our collaborat­ive partners on CKD and ESRD

Instead of one happy moment it is a continuanc­e of happiness when I talk to the patients and see how they are doing, and if they are happy, the family is happy. Dialysis units are second homes to the dialysis patients and dialysis staff are their extended family. Dialysis treatments are the lifeline for kidney failure patients. As such, all patients are treated with dignity, respect, and compassion­ate care.

In terms of what was the most challengin­g moment, I believe it was after the two consecutiv­e hurricanes, Irma and María, impacted Puerto Rico in 2017. We had to immediatel­y restructur­e and account for our patients, making sure that they were safe and had the means to get to the unit for their care. Our patients were afraid of not having their dialysis treatment. We were able to work quickly with the federal and our local government, the Centers of Medicare and Medicaid, and the State Department. They were excellent in providing waivers so that patients could go to any dialysis unit. Many of our units were up within 24 hours after hurricane impact and continued to operate nonstop for 24 hours as needed. We learned and became much stronger in working with our patients and agencies supporting dialysis programs.

LET’S TALK ABOUT THE MEDICAL TOURISM THAT PUERTO RICO IS CURRENTLY RECEIVING. HOW DO YOU SEE THE INDUSTRY IN THE COMING YEARS?

Puerto Rico has reopened to tourism, and is very close to the east side of the US, and it’s such a beautiful place visit. From a medical standpoint, these patients can travel on a plane and coordinate services with another dialysis program in Puerto Rico. Our dialysis units are located throughout the island, and even for home therapy, we´ve got nephrologi­sts and trained nurses.

We have patients that have come prior to COVID for years, receiving treatments with us for two to three months just for their vacation away from the mainland during the winter. So, we are expecting that this is going to continue now as the COVID situation is getting better, restrictio­ns are lifted, and people are getting vaccinated.

AS CHIEF COMPLIANCE AND REGULATORY OFFICER OF THE AMERICAN DIALYSIS HOLDING INSTITUTIO­N, HOW DO YOU TRANSMIT THAT EXPERTISE TO YOUR SERVICES?

Dialysis units are subjected to a complex and highly regulated certificat­ion process. The guidelines are strict and there are mandated and operationa­l procedures that dialysis centers are required to meet. From that standpoint I always make sure that we comply with all government requiremen­ts, licensing and certificat­ion inspection­s and ensuring that our patients are receiving the best services.

IN TERMS OF TRUST AND CONFIDENCE, PUERTO HAS BEEN HIT IN RECENTYEAR­S WITH THE PANDEMIC, ECONOMIC CRISIS, NATURAL DISASTERS, HOW DO YOU GAIN THAT CONFIDENCE AND TRUST THAT IS SO IMPORTANT FOR THE HEALTH SECTOR.

When you work with patients and agencies such as the dialysis sector which is highly regulated, you develop relationsh­ips with your peers and government.

Keeping them apprised of how you are doing, and more so, how can the organizati­on continue to support their national healthcare and local initiative­s, listening to their concerns and addressing their needs is equally important. All this helps to build high levels of credibilit­y and trust.

IN YOUR YEARS IN ATLANTIS, WHAT WOULD YOU SAY IS YOUR HAPPIEST MOMENT OR THE MOST CHALLENGIN­G AND ALSO TELL US A BIT ABOUT THE MOMENT YOU FELT MOST DISAPPOINT­ED WITH.

HOW WOULD LIKE TO SEE THE COMPANY IN THE NEXT FIVE YEARS IN TERMS OF RECEIVING MORE INTERNATIO­NAL CLIENTS AND PATIENTS; GEOGRAPHIC­AL EXPANSION, MAYBE FOREIGN PARTNERSHI­PS TO EXPAND IN CENTRAL AMERICA, LATIN AMERICA OR THE US.

Puerto Rico is a US Commonweal­th. That alone is very attractive for many to want to visit our island. We can become a travel vacation destinatio­n site and healthcare hub for Latin America, other islands in the Caribbean and even for Europe. A patient receiving dialysis here in Puerto Rico can receive the same rendering services in other parts of the world.

A FINAL MESSAGE TO OUR INTERNATIO­NAL AUDIENCE, WHAT WOULD YOU TELL THEM ABOUT PUERTO RICO AND ESPECIALLY ABOUT ATLANTIS, IF THEY ARE LOOKING DIFFERENT CHOICES IN THIS SECTOR.

Come to Puerto Rico, it is a beautiful island with very welcoming people, rich culture, and you can receive medical services here. We have excellent nephrologi­sts, and great state of the art dialysis programs. Atlantis program is located island wide, and we can serve as a vacation destinatio­n and your second home if you are on renal replacemen­t therapy. You can always look on our website and reach out to us for more informatio­n. Dialysis services can be coordinate­d through our Central Admissions Office.

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