Setting the Scene
Today I am with Henrique Dias, founder and CEO of NoHarm, a nonprofit startup that develops AI-based tools to improve patient safety in Brazil’s public healthcare system. NoHarm has received awards and project grants from Google, the Bill and Melinda Gates Foundation, and a number of other organizations. What they’ve done is really innovative, and I think you’ll be very interested.
Henrique, thank you so much for joining me. I am really eager to hear about NoHarm.
HENRIQUE
Yeah. Thank you so much, Jane, to be interested about us, and I’m glad to answer your questions.
How NoHarm works
Great. I think maybe the first question is a pretty practical one, which is very simply, can you tell me how it works? Not in detail, but in general how the whole thing works? It’s a little hard for me to imagine.
HENRIQUE
Yeah. NoHarm, it’s a nonprofit organization here in Brazil, so this is our start. And we developed systems, AI systems to improve the overall quality of healthcare system in Brazil, mainly in the hospital. And how we do that, we deploy systems in the hospitals, in the primary care facilities that are going to evaluate all the information of the patients, like exams, prescriptions, clinical notes, laboratory results. And our system is going to assess all this information regarding the patient disease and the patient condition, and is going to highlight to the healthcare professional if there is any misleading or inconsistency about the patient’s drug treatment, or some suggestion of exams that should be done. Some of this information is crossed by the information of the patient using literature. So it’s not like an AI that’s going to understand magically something. It’s things that come from literature because the reference exams, the maximum dosage of a drug are things that come from industry, things that were defined by literature. So this is not AI, it’s just crossing information. So this is what we do, and this is what we deliver for the healthcare in Brazil.
AI in NoHarm
Well, that’s very, very interesting. I had, had this sort of vague notion that it was sort of AI, but I mean I know that AI is not what people really think it is. And it very often it’s a question of information that’s collected and analyzed. And it sounds to me like that’s what you’re talking about.
HENRIQUE
Yeah. Because sometimes people think AI is something magical that’s going to understand about the world so fast and better than humans. But there are some things that need to be based on literature. In health, this is very important. We keep that in mind.
JANE
What inspired this idea? Because my podcast is about imagination, and I wondered if you imagined something that then you were able to build.
The birth of NoHarm
Yeah. So you can heard in other stories about the startups, that people really build a successful startup after fail several times. So before NoHarm I already had creates another startups that failed. And so I began in my PhD scholarship. And during my PhD, my sister Anelena, she’s a clinical pharmacist, and she evaluated every day all the patients about the drug treatment, about laboratory exams, reading clinical notes. And during my PhD I was studying about AI and natural allegory* processing. And I wondered, “Well, I think I can help you in your problem, so maybe we can start doing a research project inside the hospital, and see what we can do.” So this was the seed of our idea come from, is from Anelena’s problem that she faced in hospital, and my PhD, the ideas of how to automatize that comes from. So is basically when we are chatting in a lunch in our family, when we’re gathering everyone, we come up with some ideas of how to improve Ana Elena’s job daily life.
JANE
You know what I think is really interesting about that is you started with something very practical, and you created something that’s obviously recognized around the world as being amazing.
Starting with a practical problem
Yeah. Yeah. It comes from that, from a practical problem. So usually the guys from IT, they imagine a solution without a problem, and they get passionate about the solution. And here we got passionate about the problem, Ana Elena’s problem. So when you got passionate about the problematic of some job, or the healthcare industry, you need to really carefully think about the solution, and not build a solution for something that you imagine there is a problem.
JANE
So how would you describe the people who use your solution? Are they medical personnel? Are they patients themselves?
Healthcare professionals
Everyone that use our solution are healthcare professional. Most of them, like 90% of them are clinical pharmacists. Clinical pharmacists is specialization of the pharmaceutical or chemistry people that is going to work mainly to evaluate the drug treatment, and the drug adherence of a treatment that the physician assesses to a patient. So this is the one that use our tool. So our tool is not for dummies, should I say, it’s for someone that is very specialized, that is the clinical pharmacist. Someone that made pharmacist or chemistry in the graduation, and is under graduation. And in the graduation they made a specialization like clinical pharmacy or hospital. So it’s someone with very, very, good understanding about health.
JANE
How does it work financially?
Business model
We have a mixed business model. So as a nonprofit we believe that we should have a good impact in Brazil mainly. So as a nonprofit, we give our system for free for the public health system, for the public hospital, and public primary care facilities. But where the money come from? So in the beginning of our journey, we have some money to start, but then we start charging as a monthly fee for the private hospitals. So this is where our money come from, mainly from private hospital. You can see in my screen that we have other supporters like Bill and Melinda Gates Foundation, we have Google, Amazon that gave us credits for cloud computing. But our mainly income comes from the private sector. As a Robin Hood tech, we give our solution for free for the public ones.
JANE
Well, that sounds like a very smart way of doing it.
HENRIQUE
Yes.
JANE
Is that working well?
Unique startup in the world
Yes, it’s working very well. And this is where our most imaginative ideas come from. So it’s very unique startup in Brazil, and very unique startup in the world that is a nonprofit startup. And these come because our family are mainly public employee in Brazil, and we have public school, public university. So we wonder how we can give back. We are not a wealthy and rich family, but even so we wonder how we can give back everything that we have gained for free by the government. So this is the idea come from. So we build a nonprofit organization to ensure that even after we pass away, our purpose keep going. Because as a nonprofit you are not able to sell the company, you are not able to sell the patient data. So we have a lot of restriction about that. We are not able to earn profits of your work. So there’s a lot of restrictions that keep our purpose in our direction.
And it’s working very well because in Brazil we have a mixed health system. So one-third of our health system is private, and two thirds is public. So with this balance, we are able to, from each hospital that we have private, we are able to give for two hostels for free. And as far we are a scalable solution that run in the cloud, we are able to give for free for them. So this is another thing that allowed us to do that because scale-wise startup is very easy.
JANE
Have you been approached by other countries who are interested?
HENRIQUE
Yes, yes, yes. We already do some demos for Argentina, Colombia, Peru, Ecuador, United States, Portugal, and Spain.
JANE
Sorry, did you say United States?
HENRIQUE
Yeah, United States. We already do some demos.
JANE
The United States invited you? That’s fantastic.
HENRIQUE
Yeah. Yeah. Because our tool, our system is very unique worldwide because there is no other tool for clinical pharmacists, specialized for clinical pharmacists. Most of the tools was design and built for physicians, and the clinical pharmacists, nutrition, nurses have no tool to understand about a patient, and to AI techniques. So this is a pretty unique tool. You can search, you’re not going to find no tool for clinical pharmacy.
JANE
That’s really something. Congratulations on such-
HENRIQUE
Thank you. Thank you so much.
The future of NoHarm
… an amazing creation. How do you see the future of NoHarm?
HENRIQUE
We nowadays are mainly focused to help Brazil because to go in other countries, you need to spend a lot of effort or a lot of time and money to open to new markets. We need partners to do that, but we are not find no partner in US, not find partners in Mexico, in Colombia, in Europe yet. So when we find some partners, we are very willing to expand our business to other countries. But nowadays, we are very focused as a nonprofit to solve Brazilian problems, and we are scaling very well here, we are in traction. Every year we grow twice in the numbers of patients, in the number of hospitals, in the number of head revenue. So we are doing very well here, and we don’t want to lost focus in Brazil at this point.
JANE
It might be too early, it might be too risky to expand.
HENRIQUE
Partners like Gates Foundation can help us to reach Africa, an example. But we still need partners in Africa to deploy NoHarm in Africa hospitals.
JANE
Yes. Well, my instinctive feeling is that you will find partners.
Looking for partners
Yeah, my feeling too, for sure. I believe so that we are going to find partners that understand our purpose, understand our delivery solution, how we can improve the overall quality of the healthcare system in other countries. And I also believe that we’re going to find partners that will be willing to deploy NoHarm in other countries and impact other lives than Brazil, for sure. We believe so.
JANE
How many years ago did you start NoHarm?
HENRIQUE
We start in the beginning of pandemic in March of 2020.
JANE
Really? So it’s not been that long.
HENRIQUE
No five years, yeah. But did it help us a lot because everything we do is remote, so we don’t have an office, we don’t do demos inside. Everything we do is online, remote. And this help us a lot to keep our budget low. So it help us a lot. Because in Brazil, most hospitals did not accept do some demos, and capacitation of the team remote. But during pandemic they was obligated, it’s mandatory. So it helped us a lot.
JANE
I see. Yes. In fact, you’re a very modern, I don’t want to say company, organization. You’re a very modern organization.
HENRIQUE
We are. We are. We do AI, data-driven solution and also remote.
Evolving
Yeah. How do you see yourself personally evolving, if I may ask such a personal question, say over the next 5 or 10 years?
HENRIQUE
Yeah. I think the main and important skills that I should have and should learn more is how to manage a bigger team. Manage people are a very challenging task for a CEO or manager. So I think I should understand better about how to manage a bigger team because we’re still small right now, we have 20 people. And also I think we should improve our skills about getting funds from donators, and companies, and wealth families and rich companies that we still not did that yet. We got some funds from Gates Foundation, but here in Brazil we have other philanthropic people and companies that we are able to reach, and we need to learn how to reach them to improve our outcomes.
JANE
That’s very interesting. You see yourself continuing in the same direction that you’re going now, but expanding and maybe going higher in the organization?
HENRIQUE
For sure.
JANE
By higher, I mean taking a leadership position of a larger group of people. And if you have distributed people in different parts of Brazil, that will take special leadership skills also.
HENRIQUE
Yeah. Yeah. I think we are doing well right now, but I think we got more challenged when we increase our team size.
Challenging future
Yeah. Overall sort of beyond NoHarm, do you feel positive about the future of the world, the way things are going? And I don’t mean just AI, I mean governments, countries, and technology. What do you think?
HENRIQUE
I think we have a very challenging world to live, a very challenging governments to run. But as I’m in NoHarm, in a nonprofit organization, I still believe that we can do some good with our tiny possibilities as a person, as a people, or a group, or a small company. We still can make some benefits in our society in Brazil and all around the world. It’s a challenge, but is the world that we lived, we need to face this reality. The reality is that we have a challenging world, so what we are going to do with that? Well, we choose to do good, and to improve the others’ daily lives, the healthcare system because it keep us in a better mood when we do good for the people.
JANE
In this conversation, I have a feeling that I’ve had when talking to other people and reading in general., I think the young generation growing up now may be more likely to do things in the direction that you’re talking about. Do you have a feeling about that?
HENRIQUE
Yeah, I believe so.
JANE
I mean, young people who are 10, 12 years old, 15 years old, I think they will, from what people tell me, they are concerned about the future at a much earlier age than say I was, for example. I don’t know, I don’t know what your age is, but I don’t know how soon you became concerned about the future of healthcare, for example.
HENRIQUE
Yeah.
The next generation
Do you think young people will be more likely to move in that direction?
HENRIQUE
I believe we have a new generation that are able to understand better the challenge of the world, and how to manage it and to find solutions for that, to be less prejudiced, to be more conscious about the nature, the environment, the animals. So I think we still have challenge, we still have people that do not concern about others. We have this kind of people, but we also have a young generation that’s come to bring benefits to the world, and change this reality. With the challenge that we have, they will change our reality.
JANE
Well, I’m glad you feel that way. I think that’s a good sign.
HENRIQUE
Yeah, thanks.
Equitable AI supports humans
Are there any other things that you would like to say, or messages that you would like to communicate?
HENRIQUE
Yeah, sure. I am a computer scientist, and we have this big wave and hype about AI. And I think NoHarm brings to the world very fresh and new insights of how to use and how to deploy AI. So NoHarm develop AI, but we do that as an open source company. Everything we do is open source because we believe that open source can spread the word, and spread the benefits of AI. Also, we deploy in poor environments for free, so it’s our equitable AI.
And also we are very concerned on where and how this AI is going to be used. So we never deploy AI in a healthcare environment without a support decision system. We always do that as a support decision system. AI never are able to make the final decision, AI should be in the healthcare system as a decision support system. So I think our ways to deploy AI, to develop AI, to deliver AI are fresh and new that people could be motivated to do the same, and understand the benefits to do that. So as a computer science, this is what I want to give to the people. So do equitable AI and a better AI for the world.
JANE
So can I tell anyone who contacts me and wants to get in touch with you, can I give them your email?
HENRIQUE
Yeah, for sure. We are very willing. We do partnership all around the world, we do partnership with everyone that reach us. We always like to understand more how we can benefit the other societies and other peoples with our knowledge. So we are very willing to do partnerships. So anyone that hear this podcast, reach us by our email, that is someone somewhere here.
JANE
Great. Well, thank you very much, Henrique. This has been, for me, a very enlightening conversation.
HENRIQUE
Thank you, Jane. Thank you for the opportunity to spread the word about NoHarm and AI.
JANE
Well, you certainly deserve having the word spread far and wide.
HENRIQUE
Thank you. Thank you so much.
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