Jhonatan Bringas Dimitriades, MD is a Medical Doctor and executive who works with technologists, developers, medical professionals, and patients to deliver the right digital and technical solutions to enhance the diagnosis, treatment, recovery, and quality of life of patients around the globe.
Dr. Bringas believes in the democratization and digitalization of medicine. He Bringas has worked in the implementation of medical technologies in some of the top medical centers worldwide, such as the Mayo Clinic, the Cleveland Clinic, the Panama Clinic, the Hong Kong University Hospital, the AMC UMC Amsterdam, and many others. His work is related to the medical implementation of technologies, digital health, and innovation in the medical devices area.
Jhonatan is a certified Occupational Physician, with postgraduate education in Public Health, Business Strategy, and Digital Healthcare solutions. Jhonatan holds a Medical Degree, recertified in 3 continents and has held the positions of Medical Director, Chief Medical Officer, and is currently the Chief Communications Officer of Finnish MedTech NUKUTE, a respiratory / sleep medicine wearable company with a deep development in diagnostics and digital health tools.
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Episode Transcript
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Speaker 1 (00:02):
Welcome to the Latin Med Tech Leaders podcast, a
conversation with med techleaders who have succeeded or
plan to succeed in LatinAmerica. Please subscribe on
your favorite podcastingplatform. Apple Podcast,
Spotify, Google Podcast. AmazonMusic is teacher Tune in iHeart
Radio , Pandora or Deser .
(00:27):
Welcome to the Lata Mex LeadersPodcast. Today our guest is Dr.
Jonathan Briga from theNetherlands. Dr. Briga is a
physician who has worked in theimplementation of medical
technologies, digital health,and medical devices in some of
the top medical centersworldwide, such as the Mayo
(00:47):
Clinic, the Cleveland Clinic,the Panama Clinic, the Hong
Kong University Hospital, theA-M-C-U-M-C, Amsterdam and
Meridia . Others, his health ,Cheryl leadership positions,
including medical director,chief medical officer, and is
currently the ChiefCommunications officer of a
Finnish MedTech company callednte . How do you pronounce that
(01:10):
name? Uh, Jonathan
Speaker 2 (01:12):
In Finnish is supposed to say Kuta .
Speaker 1 (01:13):
Oh , Kuta . Okay.
. So Kuta is arespiratory sleep medicine
wearable company developingdiagnostics and digital health
tools. Dr. Briga haspostgraduate education in
public health, businessstrategy, and digital
healthcare solutions. So,Jonathan, it's great to have
you here today. Welcome to theshow.
Speaker 2 (01:33):
Thank you, Julio , very much. I'm very happy to be
here.
Speaker 1 (01:36):
Awesome. All right , let's start, Jonathan, with
your personal and professionallink to Latin America. You have
a very fascinating personalstory, so I'm sure listeners
wanna hear about it.
Speaker 2 (01:51):
Well, just really fast to make it short, I am
Peruvian, originally born andraised in Peru. I did have a
little time of my life that Ispent between the US and Peru.
I did my medical education inthe Caribbean, and I went back
to Peru to do my specialty. Andit was until then that I was
basically working on essentialmedicine as a provider. And uh,
(02:11):
at some point I started to worktowards more the business side.
And I , uh, when I moved to theNetherlands, I went completely
on the medical technology side.
So I've been working fordifferent companies already
from an early stage in 2014when I moved to the
Netherlands, companies that didhematology, I did some
genetical solutions, and it wasuntil the company called Lodi
(02:31):
that I held already a positionthat was global, where I
focused my attention , uh,pretty much in Latin America. I
already knew and met manydoctors from Latin America. I
already had many connectionsthere, and it was just natural
for me to go and use all thatnetwork and those connections.
And of course, my knowledge ofLatin America to implement
technology in those countries.
(02:51):
Since then, I've been workingalready for more than five
years in implementation of ,uh, medical technology in
different countries , uh, fromChile to Mexico. And of course
I've also been working in theUS and Canada. But for the sake
of this interview, let's, Iwill just discuss Latin
America.
Speaker 1 (03:07):
Excellent, Yan .
Thank you for that. All right .
So what trends do you seehappening in Latin America that
are relevant to our discussiontoday from the epidemiological
political, socioeconomic , uh,view?
Speaker 2 (03:20):
So I think that COVID-19 pandemic has opened
the eyes of many countries inthe political side. Um, I think
they realized that availabilityof medical services in Latin
America was not the best. Itwas very centralized. So that
centralization has played avery, let's say, impactful
factor in how the infection hasspread and the amount of
(03:41):
casualties that have arose inthe countries in Latin America.
So I think in that case, seeingthis situation in the last year
and a half and , and also alittle bit prospecting, how
it's gonna happen or what'sgoing to happen in the next two
or three years. I think thecountries in Latin America will
shift a little bit towardsdigital solutions. And in the
case of med tech , probablythey will start to implement
(04:03):
more technologically advanceddevices that can help them
prevent, I think preventionwill be a key , uh, in many
countries in Latin America, ifwe want to keep sustainable in
the case of medical services.
Also, because thesocioeconomic, as you said,
situation has been impacted byCOVID-19 , very much so. When
we use our resources, we haveto be smart. So how do we use
(04:23):
our resources to lower ourcosts per year? That's
something that many governmentswill consider and ask
themselves in the moment thatthey implement medical
technology. I'm hearingalready, like the door is
knocking all the time here ,um, embassies from Latin
America asking me questions.
And I think it's just becauseof that. I'm very hopeful for
this new type of thinking,let's say.
Speaker 1 (04:45):
Okay, very good . So what's your perception of Latin
America as a place tocommercialize medical
technologies? Uh , Jonathan
Speaker 2 (04:53):
As a place of commercialized, you said?
Speaker 1 (04:55):
Yeah.
Commercializing medicaltechnologies , selling medical
devices in the region. Yeah.
Speaker 2 (05:00):
Um, I think it's, it has been a very tough region. I
think the medical culture thatcomes from university, you
know, just medicalprofessionals, they are very
keen on keeping theirtraditions, and it's something
that creates a little bit of anobstacle in the case of
developing or implementing newtechnologies. And I think
adoption of these technologiesare key in these countries. But
(05:23):
because of the COVID-19 ,again, I see that that's going
to shift. Many doctors thatdidn't believe in digital
health now are doingtelemedicine in all these
countries, from Costa Rica,Mexico, to Peru, Chile , uh,
Bolivia. So I don't doubt thatthis will change. In the case
of how it has been so far, whatI just said, they putting a lot
of barriers. And then there'salso the national bureaucracy
(05:44):
from these countries that aremaking it very difficult.
There's, and every country hasa different regulatory aspect,
and so if you are a companythat wants to implement
technologies or expand in LatinAmerica, you can't see us as a
block. Chile has one regulatory, uh, system, and Peru has
another one. Ecuador hasanother one. You know, some of
them are very easy to navigate,like Chile. Some of them are
(06:06):
super complicated like Brazil.
So we have to be very smart inthe case of the companies, and
I think that that's also onelimitation for the
implementation of technologiesin latam .
Speaker 1 (06:16):
Yeah, well said.
Yeah, reimbursement is also anissue, which is really key for
the adoption of newertechnologies. I mean, if the
system doesn't have a code forthe product, then you have to
convince the , the system tojustify the use of that
technology on a patient, or youhave to get into the private
insurance sector. Yeah . Whichis a sliver of the whole big
(06:40):
pie. Yeah. So let's , um, talkus about Latin America as a
place to do business. I mean,what's your overall perception
as a region to , um, to dobusiness in general? I mean, is
it fun? Is it boring? Is it, isit nice? I mean, as how , how
does it compare to Europe, tothe United States , uh, people
and meetings , uh, things ofthat nature?
Speaker 2 (07:01):
I think that I've had really good experiences in
Latin America. I can tell youthe countries where I've been
very successful in the shortterm and the ones that I've had
to really work very hard andput a lot of attention to have
some success. For instance,Chile and Colombia and Panama,
they are countries that arereally early adopters of
technology. They love to knowwhat's next. So when you go
there and you go to aconference or a congress in
(07:23):
these countries and you meetall these doctors, they're very
eager to know what's next. Eventhe people in national systems
and of course the people thatwork in private sector. So it's
really cool to go there. It'sreally a breath of fresh air to
go to these countries forcongresses conferences and be
able to discuss with theproviders, but also with the
insurance people, with thebusiness people in these
countries. I've had somedifferent experiences in other
(07:44):
ones. For instance, I've hadsome frustrating experiences in
my own country in Peru where Ithink the situation, it has a
very big barrier on adoption ofnew technologies, but I think
that the Covid is changingtheir minds as well. But before
that, it was kind of difficultto justify implementing
technologies. I remember aconversation, it was very
(08:04):
harsh, where cardiologists inone of the biggest cardiac
centers in Lima, where I wasexplaining them why it is
important to do cardiacrehabilitation, implementing
ECG to it. And , um, theydidn't believe in that until
then . So I think it wassomething that I had to really
like be an advocate of this.
But , um, in general, I thinkLatin America is a challenging
(08:24):
place for the people that loveinternational business. It is
no different than doingbusiness in the Middle East or
in Southeast Asia. It's thechallenging region, but it can
give you really great successif you do it strategically.
Speaker 1 (08:37):
Okay, good. So let's go country by country where you
have the most experience. Um,Jonathan, let's start with Peru
because I guess , uh, you know,to me, I've been to Peru a few
times and I love the countryand the food and the people. It
is , it is just nice, but it'snot a country that I hear from
my clients as a first place toenter Latin America. They
(09:00):
usually want to start in Mexicoor in Columbia . Once in a
while. I hear Argentina,Brazil, of course, everyone
that wants to be in Brazil. Butonce they learn about the
regulatory hurdles and theprice of getting the
registration and the time ittakes , they're like, no, let's
start somewhere else. But , uh,Peru, I almost never get an
inquiry for Peru. So let's talkabout Peru. What do you think
(09:21):
about the country? What do youthink about the medical
business , uh, sector in thecountry, et cetera ?
Speaker 2 (09:28):
So Peru is , um, very difficult place to start
business with new technology.
There is a regulation thatreally is a little bit of a old
fashioned regulation. So if youwant to import in Peru, you
need to have a company called , which is like a
pharmacy. Although you'reimporting medical technology,
your company has to beregistered as it was in
(09:51):
pharmacy. Then you have to havea , actually a chemist that has
to be the medical director ofthis pharmacy in order to
import medical technology,which makes no sense, you know?
So , uh, that's just the firststep. You have to have a place
where you do storage of yourmedical technology and you have
to put them there so they caninspect it. Even though you
(10:11):
could probably bring it fromthe airport directly to
location or from the portdirectly to location. You have
to have this place and it hasto stay on a closet or like a
place of storage for some time.
And this storage place has tohave a registration as well. So
it's a very complicated way ofplaying this. It has supported
a monopoly for some time. Andthen after that, you still need
(10:31):
to register your devices thatit's according to the class. So
that's basically according tothe class in the us . So class
one plus two, plus three , uh,and then it costs an amount of
time. Uh , they ask you formany questions, and usually
that process is very tediousand challenging. When that
finishes, then you can finallyimport your product and you can
sell it in a market. Theproblem with the market is that
(10:52):
the market wants very cheapprices, but by the time that
you can already import yourproduct, you already made a
huge expense that you have toprobably justify in the matter
of, you know , adding a plus tothe price or a margin, which
they don't want. So that makesit extremely difficult. You
know, you have to have really,really very experienced
partners in Peru in order tomake your product succeed. Um,
(11:16):
there are companies that createtheir own companies in Peru,
for instance, Phillips hastheir own Phillips , uh,
Peruvian Phillips , uh, which Ithink is an , it's a
distributor, I'm not reallysure, but I think it's a
distributor that has beenacquired. And in that way, then
they can pretty much controlthe importation. Also, their
devices are extremelyexpensive, and it's just a
market, so it , it's not verydifficult for them to succeed.
(11:37):
But for small companies thathave innovative medical
technologies and they are justtrying to risk free , go to
Latin America and expand in astrategical way, Peru is not
gonna be the place of choice,unfortunately, because I think
they would pretty much profitfrom new technologies.
Speaker 1 (11:55):
Yeah, that's unfortunate. So , um, how long
does it take to register amedical device , uh, in Peru ?
Speaker 2 (12:04):
If it's class one , it probably will take you
around three months. Class two,probably around six months, and
class three, probably ninemonths. But that's , um,
optimistic calculation. So it'sprobably a little bit more than
that
Speaker 1 (12:16):
For , yeah, yeah, yeah. Wow. And the population
is fairly significant, right?
It's like 40 something millionpeople?
Speaker 2 (12:23):
Yes. It's uh , 38 million. It's almost almost
arriving to the 40. Yes. Youhave centralized places. So
Lima has , uh, I think around10 million people in the
capital .
Speaker 1 (12:34):
What's the second largest city?
Speaker 2 (12:36):
I think? rpa .
Speaker 1 (12:37):
Rpa , yeah. So what's the medical, I'm sorry,
the healthcare system in Peru,like ,
Speaker 2 (12:43):
Uh, so you have three systems, the Universal
Healthcare System, which iscontrolled by the Ministry of
Health, and that one is calledmea . So that is basically free
for everyone. And , um,everyone in Peru can go, of
course, it has its flaws. It's,it's not a lot of hospitals,
there's not a lot of beds. Uh ,there's a very big amount of
people. So if you are going tobe seeing a doctorate mea ,
(13:05):
you're probably going to bewaiting for a long time for
consultation. Now, there's alsoother system which is called ,
uh, alute , and that one is ainsurance that you pay when you
are employed. Uh, so it's stillnational, but it's only for
people that are employed. Andthen that one , uh, you pay for
and it's a little bit betterthan Mesa , it's semi-private
(13:28):
because it's subsidizing,you're paying yourself.
However, it's not a privateinsurance.
Speaker 1 (13:33):
So it's controlled by the government. It is re
regulated by the government.
But you go to a privatehospital, not a , a government
owned hospital.
Speaker 2 (13:40):
Yes, exactly. But these are hospitals that are
also from this system, which iscalled salute . So you still
get a lot of people becausepeople that let's say , uh, are
fishermen to the people thatare , uh, CEOs, everyone has
salute if they have a contract.
And then you have the thirdone, and the third one is a
completely private one. And youhave different private
(14:01):
healthcare insurance companies.
Some of the biggest ones areReac , uh, Pacifico. And then
you have private hospitals thatsome of them belong to the
insurance companies, and someof them are just a network of
private hospitals. And in thecase of private hospitals, you
can have the most amazing topof the shelf hospital that is
(14:22):
comparable to a Swiss privatehospital, or you can have the
lowest of the lowest,you know. So basically it's a
very big and broad spectrum ofprivate hospitals that Peru has
been finding challenging tocontrol and to audit. And they
always find new centers thatare maybe going a little bit
out of the legality and theyclose them. So it's a very
(14:44):
difficult position, but I thinkthey're developing the way they
do their healthcareaccessibility, and they have
been developing their economyas well. So I don't doubt that
in a couple of years, maybethree to five years, they will
have this a little bit betterin control and they will have
better , uh, rules of the gamefor these three systems.
Speaker 1 (15:03):
Sure, yeah. So is there another system for
government employees, like themilitary teachers?
Speaker 2 (15:11):
The military, they have their own system . So each
military branch has their ownsystem . So the military has
theirs. So Army , uh, the AirForce has their hospitals, the
police has theirs. So the threemilitary branches have their
three systems.
Speaker 1 (15:27):
. Oh my God .
We're talking about almost 10systems, if you really
count those little ones.
Speaker 2 (15:34):
Yeah. Yeah. I don't count them, but I think I
should probably. Yes.
Speaker 1 (15:37):
Yeah, exactly.
Exactly. And I guess the , um,oil company has another system
and the teacher's union hasanother system or something.
?
Speaker 2 (15:47):
Uh , no, no. The teachers unit don't have
another system, but I thinkthat there are some small
systems of the miningcompanies, but those are not
really systems. Yes, those arenot really systems, but they
have their own medical centers,the places where they do
mining.
Speaker 1 (16:00):
Yeah. The , the reason I call them systems is
that , um, from themanufacturer's perspective,
Jonathan, you have to navigateeach , uh, vertical to get
reimbursement, right? So that'sthe challenge.
Speaker 2 (16:16):
Yes. This is why a manufacturer should probably
find , uh, distribution partnerin the country and not navigate
it himself. It will beextremely difficult. You will
spend a lot of resources andyou might never win them back.
Speaker 1 (16:30):
Yeah, yeah, yeah .
And it is a lobbying effort. Itis a political effort. It is ,
uh, who, you know, friends? Uh,I guess, so my thinking will be
that if a company that has aproduct that wants to be
introduced in Peru, thelowanger fruit is the private
(16:50):
insurance system, because thereare more open to newer
technologies. As long as thedoctor justifies the procedure
with this specific device willprobably be , uh, reimbursed.
Speaker 2 (17:04):
That depends on the insurance company. So the
lowest hanging fruit is in theindeed. Uh , for instance,
let's , let's put an example.
If I wanted to bring , uh, theproduct of the company where I
work kuta , if I wanna bringone of those respiratory
monitors to Peru, I have tolobby this at different levels.
So yes, I have to do it in atthe private sector, private
hospitals, and show it toneurologists or respiratory
(17:25):
doctors, sleep doctors. Butthen I also need to talk to the
insurances. They have to agreebecause one private hospital is
receiving patients that arecoming from different
insurances. So they all have toagree that they will reimburse
my product or the hospital willbuy it, and then they will just
(17:47):
build the insurance companiesas a treatment. So that's
another possibility. But Ithink that the best one is to
come in the market with theinsurance companies.
Speaker 1 (17:57):
Yeah. Yeah. Wow, interesting. So I guess I don't
know what your thoughts are onthis , uh, Unitan that , um,
the Pacific Alliance and theOECD will make Peru a more
competitive country in theregulatory framework, in the
adoption of newer technologies.
(18:17):
You know what I mean?
Speaker 2 (18:19):
Yes. I think the Pacific Alliance , uh, if you
think about right now,countries that are easy to
navigate and countries that aredifficult to navigate in Latin
America, you basically aremapping the Pacific Alliance
versus Mercosur . So thedifficult countries are Brazil
and Argentina , uh, you know,and then the countries that are
(18:39):
easy to navigate are Chile andPanama, Colombia, Mexico, which
are the countries that are inthe Pacific Alliance. I think
it has to do a lot with thevision of each region
separately. Uh, they have adifferent vision. While the
Pacific Alliance is trying tobe very open , uh, the ME sewer
is putting a lot of regulatorydisruptions, let's say, in the
process of commerce, ization ,maybe to protect their own
(19:00):
markets.
Speaker 1 (19:01):
Yes. That's the key word , protectionism. Yeah,
Speaker 2 (19:04):
Yeah, yeah. So that's how I see it. So I think
Peru can profit from thePacific Alliance in many
things. Probably one of thethings will come into
healthcare very soon, becauseafter this Covid pandemic, I
think the Pacific Alliance hasthe responsibility to address
the situation with theirmembers and find a common
ground in a new global way ofpublic health.
Speaker 1 (19:25):
Yeah. The Pacific Alliance is a big trend in
Latin America, Jonathan. And itwill make countries behave in a
new way, in a more open way,more competitive, more business
friendly. And also the OECD isputting a lot of pressures in
all these countries. Andcoincidentally, Peru is the
(19:48):
only country in the PacificAlliance today defining the
Pacific Alliance as membercountries and candidate
countries. I mean, membercountries are Mexico, Colombia
, Peru, and Chile. Andcandidate countries are Panama
and Costa Rica. But Peru is theonly member country that is not
(20:11):
part of the OECD yet it hasalready submitted its
application for the OECD . AndI can't wait to see Peru being
, uh, accepted as a memberbecause it will really
transform the country as it hasbeen happening in Colombia ,
for example, my own country.
Speaker 2 (20:28):
I agree it's going to be a great thing for Peru.
They probably will start , uh,mirroring a little bit more the
developed economies in thePacific Alliance, like and
Chile. And um, we're lookingforward to that as well. It's
also gonna help them a lot inthe case of how to regulate and
navigate their own regulatoryaspects, which probably they
don't really understand or knowhow yet.
Speaker 1 (20:49):
Hmm . Yeah. Yeah.
And eventually the PacificAlliance will create a single
regulatory market.
Speaker 2 (20:54):
That'll be amazing.
Speaker 1 (20:56):
Yeah, it'll be amazing. That would be like in
Europe somehow. Yeah, I mean,they will first homogenize the
requirements, which will makeit easier. I mean, just one do
ca for countries or five or sixcountries , whatever member
countries they have at thattime. Fantastic. And the second
step, I guess is the mutualrecognition. If I get approval
in Columbia , the membercountries will recognize my
(21:17):
approval. So that's the way itshould be.
Speaker 2 (21:19):
I agree. I think that they've been doing this
already with three tradeagreements. The Pacific
Alliance has been doing that.
If they recognized in Chile,then they are using the free to
trade agreements in anothercountry. I think that they
should do the same in the caseof regulatory. It's gonna help
them to acquire newtechnologies, but it's also
gonna help them in the case ofpharma, it will help them in
the case of clinical trials,you know, it will be easier for
(21:40):
the region to access onclinical trials at different
pharma levels, which is neededto test in the populations of
our region as well.
Speaker 1 (21:49):
Yeah, well said.
That's a good point. Yeah. TheAndan region, Columbia , Peru ,
uh, well let's get Venezuelaout of the picture for now. KU
and Bolivia, the Andan Pact , Ithink that's the official name.
They already have whateventually the Pacific Alliance
will have. They have um,homogenization of the
(22:10):
requirements of the documentedrequirements, but for, I think
it's for cosmetics and somefood products or something like
that. But , uh, they , I'm sureit is for cosmetics, which is a
good step. I mean, it's a ,it's an issue step and there's
already free movement of peopleand there's a lot of trade of
course, and all that. Anyway,so let's move on to other
(22:31):
countries. I mean, what othercountry you feel comfortable
talking about? Um, Jonathan ,
Speaker 2 (22:36):
Anyone? Um , I've been very happy doing business
in Chile. You know, the thingabout Chile is that you
basically bring your device, itenters and you have an onsite ,
uh, permission, which is yourentire regulatory process. So
when you have a partner thatalready can navigate , uh,
national system, which is youcompletely universal, and the
(22:57):
private system, then the rest,which is regulatory, that's
actually pretty easy. And thatallows your partner as well to
just bring some demos to thecountry without having to deal
with all these regulatoryissues. They can probably leave
a demo at a client and just forthem to test it. I think the
way of doing marketing of yourdevices is way easier as well,
(23:18):
than if you just do it throughbrochures or pictures. You can
actually implement a device andtell them like, Hey, use it for
a couple of weeks and then I'llcome back and you let me know
how it went. Because you don'tneed any regulatory process.
You can just do that. So Ithink I've loved to work in
Chile 'cause we can just putthings really fast into place
and, and say, let's just figureit out and if you guys like it,
(23:39):
we're just gonna implement it.
And, and it's a sale. It's asale being done very easy, very
fast.
Speaker 1 (23:45):
Yeah. I think it's a self-regulated market in the
way that the quality of yourproduct, the stamp of approval
from the FDA or the EuropeanUnion, the CA is really what
sets the product apart from thecompetition. The Chinese or
Indian or Pakistanian productsor Turkish products that
sometimes get it to these freemarkets.
Speaker 2 (24:06):
Exactly. It's enough that if FDA and the ce , it's
enough. But you know, if youthink about Chile, they are so
open to new technologies.
They're so open to innovationthat, for instance, during this
pandemic, they have been alsoin the lead of absolutely
everything. They have been thelead of testing. They've been a
lead of vaccinating like Chile.
Right now, of course they havetheir third wave because they
(24:28):
haven't really been able tovaccinate the amount of the
population that they need tovaccinate to be more free. And
they have given maybe too manyfreedoms to people, but they
already vaccinated around morethan 25% of the population,
which is something extremelysuccessful for countries in
Latin America. And they do itbecause they implement
technologies to be able to dothat related to digital
healthcare. They are earlyadopting new trends. While
(24:51):
Latin America in its entiretywas discussing what we're gonna
do with vaccines, Chile said,which is gonna buy them. And
that made a big difference. AndI think it's the way they do
business as well. They're notworried about risking in Chile
and that really has made a bigdifference in the case of
implementing medicaltechnology.
Speaker 1 (25:10):
Good, good. Yeah.
Yeah . I love Chile too. I I ,I've been to Chile , uh, two or
three times and I love thecountry. I love the mentality.
It's considered a second worldcountry, not a third world
country using allterminology. But that's a good
way to relate to or to compareChile with other countries in
Latin America. Yeah, veryforward thinking. It's like
Costa Rica in a way. It's kindof a different from the rest.
(25:32):
, it's a Switzerland ofLatin America,
Speaker 2 (25:35):
And you can see it in the amount of hospitals from
this region that are in the, inthe American economy list
ranking.
Speaker 1 (25:43):
Yes. Yeah, ranking.
Yeah, exactly. Yeah, yeah,yeah. Alright . Ah , we're
close to the end of the show,Jonathan, but I'd like you to
talk about Kuta . Tell us aboutyour plans in Latin America.
What do you have? Um ,
Speaker 2 (25:55):
So we, we basically developed a , this really cool
product that is a path product,but it's not only a path , it
is also a respiratory breathingsounds monitor that is a color
combined with an SPO twodevice. And what it does is at
the moment, we are doing , uh,apnea , uh, a diagnostics,
whether it is central apnea orobstructive apnea, but we're
(26:16):
going to be adding moretechnology in the future. So
the cool thing of our device isthat our device is basically a
hardware device that iscontrolled by digital health
solutions. And by doing that,we basically can update our
device constantly and, and giveit more functions. And because
of its capacity of listening to, um, respiratory sounds and
analyzing them in analgorithmic way, we can
(26:37):
actually be able to diagnose,or let's not call it diagnose,
but point and give the adviceto doctors on specific
respiratory conditions. Andthat's something very powerful
right now in this world ofautomatization and doctors
doing telehealth because we cando it remotely. So I think that
our plans in Latin America is,right now we are , um, starting
(26:58):
to think about distributors. Imean already discussing some of
these things with my networkand I'm always open to hear
more companies that are relatedinto the sleep medicine, but
also respiratory medicine. Weare open to first do some
interviews with possibledistributors and after that we
would like probably to go to acouple of congresses in Latin
America to show up our device,but also to just get into
(27:18):
workshops and discuss thesethings together. And we wanna
do this in a very scientificway at the beginning. And then
we want to expand commerciallywhen we have , uh, created a
validation in Latin America.
Speaker 1 (27:28):
Very good. And what countries have you gotten the
most interest , uh, so far?
Speaker 2 (27:33):
Um, yeah , so I've been speaking with people in
Panama. We have a really gooddistribution partner in Panama
, uh, and Costa Rica. So Panamaand Costa Rica are, as , as we
just said, they are innovative.
They are the candidates of thePacific Alliance. Of course,
I'm discussing things withthem. I have a really , uh, uh,
amazing partner in Chile thatis just a very good company
(27:54):
that have been , uh, led byyoung people that have , uh,
innovation in their minds. SoChile, Panama, Costa Rica, and
maybe Colombia will be thefirst countries to enter. And
of course we are applying forFDA. So after that, probably
the United States, before we goto Mexico, Mexico usually
follows the trends of the us .
(28:15):
So once we have , uh, createdadoption in the US then Mexico
will be our next , uh, target.
Speaker 1 (28:21):
Fantastic Jonathan thing . All right . So before
we close, what would you say tothe CEO of a company that is
just looking or doesn'tunderstand? Latin America has
never been to Latin Americans.
Just looking to expand to theregion. What will be your words
of wisdom to him?
Speaker 2 (28:38):
I would say see a , a good event where you can go,
there are really interestingevents in the Americas where
you can find many distributionpartners like Hospital R or FMI
in Florida. I will tell them aswell that if your product is
very niche, then you probablywant to go to the Latin
American society of something.
If it's cardiology, cardiology,if it's respiratory,
(28:58):
respiratory, see how the marketreacts to your products and
find a distribution partner,especially in the countries
that are regulatory chaos,because they are the only ones
that will be able to implementyour product unless you have
millions of dollars toto spend in that. That's my
advice.
Speaker 1 (29:17):
Excellent, Jonathan.
Alright . It was great havingyou here and , uh, I look
forward to being in touch. I'msure listeners got good , some
good wisdom from yourexperiencing Latin Americans
specific Peru. I was so glad tohear your take on Peru because
you're my first guest to everspeak about Peru, so I love the
conversation. All right ,Jonathan , thank you.
Speaker 2 (29:37):
Thank you, Julio.
.
Welcome to the Latin Med Tech Leaders podcast, a
conversation with med techleaders who have succeeded or
plan to succeed in LatinAmerica. Please subscribe on
your favorite podcastingplatform. Apple Podcast,
Spotify, Google Podcast. AmazonMusic is teacher Tune in iHeart
Radio , Pandora or Deser .
(00:27):
Welcome to the Lata Mex LeadersPodcast. Today our guest is Dr.
Jonathan Briga from theNetherlands. Dr. Briga is a
physician who has worked in theimplementation of medical
technologies, digital health,and medical devices in some of
the top medical centersworldwide, such as the Mayo
(00:47):
Clinic, the Cleveland Clinic,the Panama Clinic, the Hong
Kong University Hospital, theA-M-C-U-M-C, Amsterdam and
Meridia . Others, his health ,Cheryl leadership positions,
including medical director,chief medical officer, and is
currently the ChiefCommunications officer of a
Finnish MedTech company callednte . How do you pronounce that
(01:10):
name? Uh, Jonathan
Speaker 2 (01:12):
In Finnish is supposed to say Kuta .
Speaker 1 (01:13):
Oh , Kuta . Okay.
wearable company developingdiagnostics and digital health
tools. Dr. Briga haspostgraduate education in
public health, businessstrategy, and digital
healthcare solutions. So,Jonathan, it's great to have
you here today. Welcome to theshow.
Speaker 2 (01:33):
Thank you, Julio , very much. I'm very happy to be
here.
Speaker 1 (01:36):
Awesome. All right , let's start, Jonathan, with
your personal and professionallink to Latin America. You have
a very fascinating personalstory, so I'm sure listeners
wanna hear about it.
Speaker 2 (01:51):
Well, just really fast to make it short, I am
Peruvian, originally born andraised in Peru. I did have a
little time of my life that Ispent between the US and Peru.
I did my medical education inthe Caribbean, and I went back
to Peru to do my specialty. Andit was until then that I was
basically working on essentialmedicine as a provider. And uh,
(02:11):
at some point I started to worktowards more the business side.
And I , uh, when I moved to theNetherlands, I went completely
on the medical technology side.
So I've been working fordifferent companies already
from an early stage in 2014when I moved to the
Netherlands, companies that didhematology, I did some
genetical solutions, and it wasuntil the company called Lodi
(02:31):
that I held already a positionthat was global, where I
focused my attention , uh,pretty much in Latin America. I
already knew and met manydoctors from Latin America. I
already had many connectionsthere, and it was just natural
for me to go and use all thatnetwork and those connections.
And of course, my knowledge ofLatin America to implement
technology in those countries.
(02:51):
Since then, I've been workingalready for more than five
years in implementation of ,uh, medical technology in
different countries , uh, fromChile to Mexico. And of course
I've also been working in theUS and Canada. But for the sake
of this interview, let's, Iwill just discuss Latin
America.
Speaker 1 (03:07):
Excellent, Yan .
Thank you for that. All right .
So what trends do you seehappening in Latin America that
are relevant to our discussiontoday from the epidemiological
political, socioeconomic , uh,view?
Speaker 2 (03:20):
So I think that COVID-19 pandemic has opened
the eyes of many countries inthe political side. Um, I think
they realized that availabilityof medical services in Latin
America was not the best. Itwas very centralized. So that
centralization has played avery, let's say, impactful
factor in how the infection hasspread and the amount of
(03:41):
casualties that have arose inthe countries in Latin America.
So I think in that case, seeingthis situation in the last year
and a half and , and also alittle bit prospecting, how
it's gonna happen or what'sgoing to happen in the next two
or three years. I think thecountries in Latin America will
shift a little bit towardsdigital solutions. And in the
case of med tech , probablythey will start to implement
(04:03):
more technologically advanceddevices that can help them
prevent, I think preventionwill be a key , uh, in many
countries in Latin America, ifwe want to keep sustainable in
the case of medical services.
Also, because thesocioeconomic, as you said,
situation has been impacted byCOVID-19 , very much so. When
we use our resources, we haveto be smart. So how do we use
(04:23):
our resources to lower ourcosts per year? That's
something that many governmentswill consider and ask
themselves in the moment thatthey implement medical
technology. I'm hearingalready, like the door is
knocking all the time here ,um, embassies from Latin
America asking me questions.
And I think it's just becauseof that. I'm very hopeful for
this new type of thinking,let's say.
Speaker 1 (04:45):
Okay, very good . So what's your perception of Latin
America as a place tocommercialize medical
technologies? Uh , Jonathan
Speaker 2 (04:53):
As a place of commercialized, you said?
Speaker 1 (04:55):
Yeah.
Commercializing medicaltechnologies , selling medical
devices in the region. Yeah.
Speaker 2 (05:00):
Um, I think it's, it has been a very tough region. I
think the medical culture thatcomes from university, you
know, just medicalprofessionals, they are very
keen on keeping theirtraditions, and it's something
that creates a little bit of anobstacle in the case of
developing or implementing newtechnologies. And I think
adoption of these technologiesare key in these countries. But
(05:23):
because of the COVID-19 ,again, I see that that's going
to shift. Many doctors thatdidn't believe in digital
health now are doingtelemedicine in all these
countries, from Costa Rica,Mexico, to Peru, Chile , uh,
Bolivia. So I don't doubt thatthis will change. In the case
of how it has been so far, whatI just said, they putting a lot
of barriers. And then there'salso the national bureaucracy
(05:44):
from these countries that aremaking it very difficult.
There's, and every country hasa different regulatory aspect,
and so if you are a companythat wants to implement
technologies or expand in LatinAmerica, you can't see us as a
block. Chile has one regulatory, uh, system, and Peru has
another one. Ecuador hasanother one. You know, some of
them are very easy to navigate,like Chile. Some of them are
(06:06):
super complicated like Brazil.
So we have to be very smart inthe case of the companies, and
I think that that's also onelimitation for the
implementation of technologiesin latam .
Speaker 1 (06:16):
Yeah, well said.
Yeah, reimbursement is also anissue, which is really key for
the adoption of newertechnologies. I mean, if the
system doesn't have a code forthe product, then you have to
convince the , the system tojustify the use of that
technology on a patient, or youhave to get into the private
insurance sector. Yeah . Whichis a sliver of the whole big
(06:40):
pie. Yeah. So let's , um, talkus about Latin America as a
place to do business. I mean,what's your overall perception
as a region to , um, to dobusiness in general? I mean, is
it fun? Is it boring? Is it, isit nice? I mean, as how , how
does it compare to Europe, tothe United States , uh, people
and meetings , uh, things ofthat nature?
Speaker 2 (07:01):
I think that I've had really good experiences in
Latin America. I can tell youthe countries where I've been
very successful in the shortterm and the ones that I've had
to really work very hard andput a lot of attention to have
some success. For instance,Chile and Colombia and Panama,
they are countries that arereally early adopters of
technology. They love to knowwhat's next. So when you go
there and you go to aconference or a congress in
(07:23):
these countries and you meetall these doctors, they're very
eager to know what's next. Eventhe people in national systems
and of course the people thatwork in private sector. So it's
really cool to go there. It'sreally a breath of fresh air to
go to these countries forcongresses conferences and be
able to discuss with theproviders, but also with the
insurance people, with thebusiness people in these
countries. I've had somedifferent experiences in other
(07:44):
ones. For instance, I've hadsome frustrating experiences in
my own country in Peru where Ithink the situation, it has a
very big barrier on adoption ofnew technologies, but I think
that the Covid is changingtheir minds as well. But before
that, it was kind of difficultto justify implementing
technologies. I remember aconversation, it was very
(08:04):
harsh, where cardiologists inone of the biggest cardiac
centers in Lima, where I wasexplaining them why it is
important to do cardiacrehabilitation, implementing
ECG to it. And , um, theydidn't believe in that until
then . So I think it wassomething that I had to really
like be an advocate of this.
But , um, in general, I thinkLatin America is a challenging
(08:24):
place for the people that loveinternational business. It is
no different than doingbusiness in the Middle East or
in Southeast Asia. It's thechallenging region, but it can
give you really great successif you do it strategically.
Speaker 1 (08:37):
Okay, good. So let's go country by country where you
have the most experience. Um,Jonathan, let's start with Peru
because I guess , uh, you know,to me, I've been to Peru a few
times and I love the countryand the food and the people. It
is , it is just nice, but it'snot a country that I hear from
my clients as a first place toenter Latin America. They
(09:00):
usually want to start in Mexicoor in Columbia . Once in a
while. I hear Argentina,Brazil, of course, everyone
that wants to be in Brazil. Butonce they learn about the
regulatory hurdles and theprice of getting the
registration and the time ittakes , they're like, no, let's
start somewhere else. But , uh,Peru, I almost never get an
inquiry for Peru. So let's talkabout Peru. What do you think
(09:21):
about the country? What do youthink about the medical
business , uh, sector in thecountry, et cetera ?
Speaker 2 (09:28):
So Peru is , um, very difficult place to start
business with new technology.
There is a regulation thatreally is a little bit of a old
fashioned regulation. So if youwant to import in Peru, you
need to have a company called
pharmacy. Although you'reimporting medical technology,
your company has to beregistered as it was in
(09:51):
pharmacy. Then you have to havea , actually a chemist that has
to be the medical director ofthis pharmacy in order to
import medical technology,which makes no sense, you know?
So , uh, that's just the firststep. You have to have a place
where you do storage of yourmedical technology and you have
to put them there so they caninspect it. Even though you
(10:11):
could probably bring it fromthe airport directly to
location or from the portdirectly to location. You have
to have this place and it hasto stay on a closet or like a
place of storage for some time.
And this storage place has tohave a registration as well. So
it's a very complicated way ofplaying this. It has supported
a monopoly for some time. Andthen after that, you still need
(10:31):
to register your devices thatit's according to the class. So
that's basically according tothe class in the us . So class
one plus two, plus three , uh,and then it costs an amount of
time. Uh , they ask you formany questions, and usually
that process is very tediousand challenging. When that
finishes, then you can finallyimport your product and you can
sell it in a market. Theproblem with the market is that
(10:52):
the market wants very cheapprices, but by the time that
you can already import yourproduct, you already made a
huge expense that you have toprobably justify in the matter
of, you know , adding a plus tothe price or a margin, which
they don't want. So that makesit extremely difficult. You
know, you have to have really,really very experienced
partners in Peru in order tomake your product succeed. Um,
(11:16):
there are companies that createtheir own companies in Peru,
for instance, Phillips hastheir own Phillips , uh,
Peruvian Phillips , uh, which Ithink is an , it's a
distributor, I'm not reallysure, but I think it's a
distributor that has beenacquired. And in that way, then
they can pretty much controlthe importation. Also, their
devices are extremelyexpensive, and it's just a
market, so it , it's not verydifficult for them to succeed.
(11:37):
But for small companies thathave innovative medical
technologies and they are justtrying to risk free , go to
Latin America and expand in astrategical way, Peru is not
gonna be the place of choice,unfortunately, because I think
they would pretty much profitfrom new technologies.
Speaker 1 (11:55):
Yeah, that's unfortunate. So , um, how long
does it take to register amedical device , uh, in Peru ?
Speaker 2 (12:04):
If it's class one , it probably will take you
around three months. Class two,probably around six months, and
class three, probably ninemonths. But that's , um,
optimistic calculation. So it'sprobably a little bit more than
that
Speaker 1 (12:16):
For , yeah, yeah, yeah. Wow. And the population
is fairly significant, right?
It's like 40 something millionpeople?
Speaker 2 (12:23):
Yes. It's uh , 38 million. It's almost almost
arriving to the 40. Yes. Youhave centralized places. So
Lima has , uh, I think around10 million people in the
capital .
Speaker 1 (12:34):
What's the second largest city?
Speaker 2 (12:36):
I think? rpa .
Speaker 1 (12:37):
Rpa , yeah. So what's the medical, I'm sorry,
the healthcare system in Peru,like ,
Speaker 2 (12:43):
Uh, so you have three systems, the Universal
Healthcare System, which iscontrolled by the Ministry of
Health, and that one is calledmea . So that is basically free
for everyone. And , um,everyone in Peru can go, of
course, it has its flaws. It's,it's not a lot of hospitals,
there's not a lot of beds. Uh ,there's a very big amount of
people. So if you are going tobe seeing a doctorate mea ,
(13:05):
you're probably going to bewaiting for a long time for
consultation. Now, there's alsoother system which is called ,
uh, alute , and that one is ainsurance that you pay when you
are employed. Uh, so it's stillnational, but it's only for
people that are employed. Andthen that one , uh, you pay for
and it's a little bit betterthan Mesa , it's semi-private
(13:28):
because it's subsidizing,you're paying yourself.
However, it's not a privateinsurance.
Speaker 1 (13:33):
So it's controlled by the government. It is re
regulated by the government.
But you go to a privatehospital, not a , a government
owned hospital.
Speaker 2 (13:40):
Yes, exactly. But these are hospitals that are
also from this system, which iscalled salute . So you still
get a lot of people becausepeople that let's say , uh, are
fishermen to the people thatare , uh, CEOs, everyone has
salute if they have a contract.
And then you have the thirdone, and the third one is a
completely private one. And youhave different private
(14:01):
healthcare insurance companies.
Some of the biggest ones areReac , uh, Pacifico. And then
you have private hospitals thatsome of them belong to the
insurance companies, and someof them are just a network of
private hospitals. And in thecase of private hospitals, you
can have the most amazing topof the shelf hospital that is
(14:22):
comparable to a Swiss privatehospital, or you can have the
lowest of the lowest
very big and broad spectrum ofprivate hospitals that Peru has
been finding challenging tocontrol and to audit. And they
always find new centers thatare maybe going a little bit
out of the legality and theyclose them. So it's a very
(14:44):
difficult position, but I thinkthey're developing the way they
do their healthcareaccessibility, and they have
been developing their economyas well. So I don't doubt that
in a couple of years, maybethree to five years, they will
have this a little bit betterin control and they will have
better , uh, rules of the gamefor these three systems.
Speaker 1 (15:03):
Sure, yeah. So is there another system for
government employees, like themilitary teachers?
Speaker 2 (15:11):
The military, they have their own system . So each
military branch has their ownsystem . So the military has
theirs. So Army , uh, the AirForce has their hospitals, the
police has theirs. So the threemilitary branches have their
three systems.
Speaker 1 (15:27):
We're talking about almost 10systems
count those little ones.
Speaker 2 (15:34):
Yeah. Yeah. I don't count them, but I think I
should probably. Yes.
Speaker 1 (15:37):
Yeah, exactly.
Exactly. And I guess the , um,oil company has another system
and the teacher's union hasanother system or something.
Speaker 2 (15:47):
Uh , no, no. The teachers unit don't have
another system, but I thinkthat there are some small
systems of the miningcompanies, but those are not
really systems. Yes, those arenot really systems, but they
have their own medical centers,the places where they do
mining.
Speaker 1 (16:00):
Yeah. The , the reason I call them systems is
that , um, from themanufacturer's perspective,
Jonathan, you have to navigateeach , uh, vertical to get
reimbursement, right? So that'sthe challenge.
Speaker 2 (16:16):
Yes. This is why a manufacturer should probably
find , uh, distribution partnerin the country and not navigate
it himself. It will beextremely difficult. You will
spend a lot of resources andyou might never win them back.
Speaker 1 (16:30):
Yeah, yeah, yeah .
And it is a lobbying effort. Itis a political effort. It is ,
uh, who, you know, friends? Uh,I guess, so my thinking will be
that if a company that has aproduct that wants to be
introduced in Peru, thelowanger fruit is the private
(16:50):
insurance system, because thereare more open to newer
technologies. As long as thedoctor justifies the procedure
with this specific device willprobably be , uh, reimbursed.
Speaker 2 (17:04):
That depends on the insurance company. So the
lowest hanging fruit is in theindeed. Uh , for instance,
let's , let's put an example.
If I wanted to bring , uh, theproduct of the company where I
work kuta , if I wanna bringone of those respiratory
monitors to Peru, I have tolobby this at different levels.
So yes, I have to do it in atthe private sector, private
hospitals, and show it toneurologists or respiratory
(17:25):
doctors, sleep doctors. Butthen I also need to talk to the
insurances. They have to agreebecause one private hospital is
receiving patients that arecoming from different
insurances. So they all have toagree that they will reimburse
my product or the hospital willbuy it, and then they will just
(17:47):
build the insurance companiesas a treatment. So that's
another possibility. But Ithink that the best one is to
come in the market with theinsurance companies.
Speaker 1 (17:57):
Yeah. Yeah. Wow, interesting. So I guess I don't
know what your thoughts are onthis , uh, Unitan that , um,
the Pacific Alliance and theOECD will make Peru a more
competitive country in theregulatory framework, in the
adoption of newer technologies.
(18:17):
You know what I mean?
Speaker 2 (18:19):
Yes. I think the Pacific Alliance , uh, if you
think about right now,countries that are easy to
navigate and countries that aredifficult to navigate in Latin
America, you basically aremapping the Pacific Alliance
versus Mercosur . So thedifficult countries are Brazil
and Argentina , uh, you know,and then the countries that are
(18:39):
easy to navigate are Chile andPanama, Colombia, Mexico, which
are the countries that are inthe Pacific Alliance. I think
it has to do a lot with thevision of each region
separately. Uh, they have adifferent vision. While the
Pacific Alliance is trying tobe very open , uh, the ME sewer
is putting a lot of regulatorydisruptions, let's say, in the
process of commerce, ization ,maybe to protect their own
(19:00):
markets.
Speaker 1 (19:01):
Yes. That's the key word , protectionism. Yeah,
Speaker 2 (19:04):
Yeah, yeah. So that's how I see it. So I think
Peru can profit from thePacific Alliance in many
things. Probably one of thethings will come into
healthcare very soon, becauseafter this Covid pandemic, I
think the Pacific Alliance hasthe responsibility to address
the situation with theirmembers and find a common
ground in a new global way ofpublic health.
Speaker 1 (19:25):
Yeah. The Pacific Alliance is a big trend in
Latin America, Jonathan. And itwill make countries behave in a
new way, in a more open way,more competitive, more business
friendly. And also the OECD isputting a lot of pressures in
all these countries. Andcoincidentally, Peru is the
(19:48):
only country in the PacificAlliance today defining the
Pacific Alliance as membercountries and candidate
countries. I mean, membercountries are Mexico, Colombia
, Peru, and Chile. Andcandidate countries are Panama
and Costa Rica. But Peru is theonly member country that is not
(20:11):
part of the OECD yet it hasalready submitted its
application for the OECD . AndI can't wait to see Peru being
, uh, accepted as a memberbecause it will really
transform the country as it hasbeen happening in Colombia ,
for example, my own country.
Speaker 2 (20:28):
I agree it's going to be a great thing for Peru.
They probably will start , uh,mirroring a little bit more the
developed economies in thePacific Alliance, like and
Chile. And um, we're lookingforward to that as well. It's
also gonna help them a lot inthe case of how to regulate and
navigate their own regulatoryaspects, which probably they
don't really understand or knowhow yet.
Speaker 1 (20:49):
Hmm . Yeah. Yeah.
And eventually the PacificAlliance will create a single
regulatory market.
Speaker 2 (20:54):
That'll be amazing.
Speaker 1 (20:56):
Yeah, it'll be amazing. That would be like in
Europe somehow. Yeah, I mean,they will first homogenize the
requirements, which will makeit easier. I mean, just one do
ca for countries or five or sixcountries , whatever member
countries they have at thattime. Fantastic. And the second
step, I guess is the mutualrecognition. If I get approval
in Columbia , the membercountries will recognize my
(21:17):
approval. So that's the way itshould be.
Speaker 2 (21:19):
I agree. I think that they've been doing this
already with three tradeagreements. The Pacific
Alliance has been doing that.
If they recognized in Chile,then they are using the free to
trade agreements in anothercountry. I think that they
should do the same in the caseof regulatory. It's gonna help
them to acquire newtechnologies, but it's also
gonna help them in the case ofpharma, it will help them in
the case of clinical trials,you know, it will be easier for
(21:40):
the region to access onclinical trials at different
pharma levels, which is neededto test in the populations of
our region as well.
Speaker 1 (21:49):
Yeah, well said.
That's a good point. Yeah. TheAndan region, Columbia , Peru ,
uh, well let's get Venezuelaout of the picture for now. KU
and Bolivia, the Andan Pact , Ithink that's the official name.
They already have whateventually the Pacific Alliance
will have. They have um,homogenization of the
(22:10):
requirements of the documentedrequirements, but for, I think
it's for cosmetics and somefood products or something like
that. But , uh, they , I'm sureit is for cosmetics, which is a
good step. I mean, it's a ,it's an issue step and there's
already free movement of peopleand there's a lot of trade of
course, and all that. Anyway,so let's move on to other
(22:31):
countries. I mean, what othercountry you feel comfortable
talking about? Um, Jonathan ,
Speaker 2 (22:36):
Anyone? Um , I've been very happy doing business
in Chile. You know, the thingabout Chile is that you
basically bring your device, itenters and you have an onsite ,
uh, permission, which is yourentire regulatory process. So
when you have a partner thatalready can navigate , uh,
national system, which is youcompletely universal, and the
(22:57):
private system, then the rest,which is regulatory, that's
actually pretty easy. And thatallows your partner as well to
just bring some demos to thecountry without having to deal
with all these regulatoryissues. They can probably leave
a demo at a client and just forthem to test it. I think the
way of doing marketing of yourdevices is way easier as well,
(23:18):
than if you just do it throughbrochures or pictures. You can
actually implement a device andtell them like, Hey, use it for
a couple of weeks and then I'llcome back and you let me know
how it went. Because you don'tneed any regulatory process.
You can just do that. So Ithink I've loved to work in
Chile 'cause we can just putthings really fast into place
and, and say, let's just figureit out and if you guys like it,
(23:39):
we're just gonna implement it.
And, and it's a sale. It's asale being done very easy, very
fast.
Speaker 1 (23:45):
Yeah. I think it's a self-regulated market in the
way that the quality of yourproduct, the stamp of approval
from the FDA or the EuropeanUnion, the CA is really what
sets the product apart from thecompetition. The Chinese or
Indian or Pakistanian productsor Turkish products that
sometimes get it to these freemarkets.
Speaker 2 (24:06):
Exactly. It's enough that if FDA and the ce , it's
enough. But you know, if youthink about Chile, they are so
open to new technologies.
They're so open to innovationthat, for instance, during this
pandemic, they have been alsoin the lead of absolutely
everything. They have been thelead of testing. They've been a
lead of vaccinating like Chile.
Right now, of course they havetheir third wave because they
(24:28):
haven't really been able tovaccinate the amount of the
population that they need tovaccinate to be more free. And
they have given maybe too manyfreedoms to people, but they
already vaccinated around morethan 25% of the population,
which is something extremelysuccessful for countries in
Latin America. And they do itbecause they implement
technologies to be able to dothat related to digital
healthcare. They are earlyadopting new trends. While
(24:51):
Latin America in its entiretywas discussing what we're gonna
do with vaccines, Chile said,which is gonna buy them. And
that made a big difference. AndI think it's the way they do
business as well. They're notworried about risking in Chile
and that really has made a bigdifference in the case of
implementing medicaltechnology.
Speaker 1 (25:10):
Good, good. Yeah.
Yeah . I love Chile too. I I ,I've been to Chile , uh, two or
three times and I love thecountry. I love the mentality.
It's considered a second worldcountry, not a third world
country
way to relate to or to compareChile with other countries in
Latin America. Yeah, veryforward thinking. It's like
Costa Rica in a way. It's kindof a different from the rest.
(25:32):
Speaker 2 (25:35):
And you can see it in the amount of hospitals from
this region that are in the, inthe American economy list
ranking.
Speaker 1 (25:43):
Yes. Yeah, ranking.
Yeah, exactly. Yeah, yeah,yeah. Alright . Ah , we're
close to the end of the show,Jonathan, but I'd like you to
talk about Kuta . Tell us aboutyour plans in Latin America.
What do you have? Um ,
Speaker 2 (25:55):
So we, we basically developed a , this really cool
product that is a path product,but it's not only a path , it
is also a respiratory breathingsounds monitor that is a color
combined with an SPO twodevice. And what it does is at
the moment, we are doing , uh,apnea , uh, a diagnostics,
whether it is central apnea orobstructive apnea, but we're
(26:16):
going to be adding moretechnology in the future. So
the cool thing of our device isthat our device is basically a
hardware device that iscontrolled by digital health
solutions. And by doing that,we basically can update our
device constantly and, and giveit more functions. And because
of its capacity of listening to, um, respiratory sounds and
analyzing them in analgorithmic way, we can
(26:37):
actually be able to diagnose,or let's not call it diagnose,
but point and give the adviceto doctors on specific
respiratory conditions. Andthat's something very powerful
right now in this world ofautomatization and doctors
doing telehealth because we cando it remotely. So I think that
our plans in Latin America is,right now we are , um, starting
(26:58):
to think about distributors. Imean already discussing some of
these things with my networkand I'm always open to hear
more companies that are relatedinto the sleep medicine, but
also respiratory medicine. Weare open to first do some
interviews with possibledistributors and after that we
would like probably to go to acouple of congresses in Latin
America to show up our device,but also to just get into
(27:18):
workshops and discuss thesethings together. And we wanna
do this in a very scientificway at the beginning. And then
we want to expand commerciallywhen we have , uh, created a
validation in Latin America.
Speaker 1 (27:28):
Very good. And what countries have you gotten the
most interest , uh, so far?
Speaker 2 (27:33):
Um, yeah , so I've been speaking with people in
Panama. We have a really gooddistribution partner in Panama
, uh, and Costa Rica. So Panamaand Costa Rica are, as , as we
just said, they are innovative.
They are the candidates of thePacific Alliance. Of course,
I'm discussing things withthem. I have a really , uh, uh,
amazing partner in Chile thatis just a very good company
(27:54):
that have been , uh, led byyoung people that have , uh,
innovation in their minds. SoChile, Panama, Costa Rica, and
maybe Colombia will be thefirst countries to enter. And
of course we are applying forFDA. So after that, probably
the United States, before we goto Mexico, Mexico usually
follows the trends of the us .
(28:15):
So once we have , uh, createdadoption in the US then Mexico
will be our next , uh, target.
Speaker 1 (28:21):
Fantastic Jonathan thing . All right . So before
we close, what would you say tothe CEO of a company that is
just looking or doesn'tunderstand? Latin America has
never been to Latin Americans.
Just looking to expand to theregion. What will be your words
of wisdom to him?
Speaker 2 (28:38):
I would say see a , a good event where you can go,
there are really interestingevents in the Americas where
you can find many distributionpartners like Hospital R or FMI
in Florida. I will tell them aswell that if your product is
very niche, then you probablywant to go to the Latin
American society of something.
If it's cardiology, cardiology,if it's respiratory,
(28:58):
respiratory, see how the marketreacts to your products and
find a distribution partner,especially in the countries
that are regulatory chaos,because they are the only ones
that will be able to implementyour product unless you have
millions of dollars to
advice.
Speaker 1 (29:17):
Excellent, Jonathan.
Alright . It was great havingyou here and , uh, I look
forward to being in touch. I'msure listeners got good , some
good wisdom from yourexperiencing Latin Americans
specific Peru. I was so glad tohear your take on Peru because
you're my first guest to everspeak about Peru, so I love the
conversation. All right ,Jonathan , thank you.
Speaker 2 (29:37):
Thank you, Julio.
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