We dream of Bulgaria becoming an European IT hub for digital healthcare

Interview by Eneya Georgieva / DHI Cluster Bulgaria

Ivan Lekushev is the co-founder and CEO of the technology company BGO Software, which offers digital transformation of organizations in the healthcare sector in Europe, the United Kingdom, and the United States. BGO registered an entity in Switzerland two months ago and now is announcing the opening of its office in Basel. The new workspace of the Bulgarian company is on the campus of Novartis in the innovative park Basel Area – a center for innovative solutions in healthcare.

– Mr Lekushev, in February BGO entered a new market and two months later opened an office with a strategic location. Why did you and your team choose Switzerland to grow the company?

– The government there appreciates and places high importance on healthcare and the pharmaceutical industry, so there are policies that support innovations, centers for the exchange of knowledge. Moreover, individual businesses communicate united by the cause of the state in an open ecosystem, therefore this environment provides a good opportunity for companies like BGO to reach people with different expertise and common vision.

However, the state strictly follows its rules and requires patience to meet all its conditions. Fortunately, the established relationships are stable over time and there are no unpleasant surprises. All this makes me think that the Swiss market for digital healthcare solutions will grow at an ever faster pace. An additional impetus will come from the health crisis, which has exacerbated our need to part with the ineffective methods of the past.

– Working with companies from the prestigious Fortune 500 Pharma ranking allows you to follow the development of global leaders in healthcare. What difficulties do they face on the path to excellence?

– The truth is that healthcare is a very conservative industry and the global digitization index The Industry Digitization Index has begun to tendentiously assign it the last places in its ranking. If we compare it with the financial sector, there will be a huge gap between the results. The COVID-19 pandemic has opened our eyes to all the changes we need to make. For example, access to health facilities is limited due to anti-epidemic measures, but through technology we can contact our GP without worrying about infection. If we had relied on telemedicine earlier, we would now be using a developed and familiar system and accordingly to go through the crisis much easier and more effectively to deal with the spread of the virus.

The extraordinary circumstances brought purely administrative relief. It takes between 7 to 10 years for a pill to make it from an idea to the market. Much of this time is spent waiting for the transfer of documents from the company to the regulator and vice versa. Much of this process can be digitized, and one of the reason why COVID-19 vaccines made it to the market so quickly is the active digital communication deprived of its inefficiencies. The political will of the organizations to reduce or eliminate the administrative burden of filling in endless piles of paper brought results because of the situation and the people demanded so.

It makes no sense, in the 21st century to still use physical paper, that can be easily damaged. Needless to say, completing the forms and documents is very difficult and time consuming. This proves once again, that we need digitalisation and the use of more technical means to facilitate the processes in the sector and enable us to focus on prevention, treatment, innovation, and science, rather than fire fighting.

Some countries are already ahead in the digital transformation of the health sector. For example, the electronic health record has been officially approved in United States since 2004, during the presidency of  George W. Bush. In terms of the digital development of medicine, the US is still a world leader. Their market is larger than those of the next four economies combined. In Europe, Germany is doing very well thanks to government policies to fully digitize healthcare sector and there are government subsidies to support this process, both at national level and at various levels of the sector.

The other countries will soon be left without a choice and will follow the example of the largest economy in the world and the country with the largest GDP in the European Union.

– What needs to happen to make the accelerated COVID-19 vaccine pathway an official drug launch practice?

– The optimization of the process is delayed for several reasons. First, companies have little incentive because the current system still works. The drug development life cycle is a slow and clumsy process, but the drugs still reach the patients and bring profits along the value chain. Digitally transforming the value chain means digitizing some components and completely replacing or removing others. This will take a significant amount of financial and human resources. It will take a lot of motivation to get out of it the illusion of the comfort zone that the industry still believes in. Unfortunately, in this case the phrase – “If it isn’t broke, don’t fix it”, has turned into a strategy for the industry.

On the other hand, the illusion that we have a lot of time is a fact and many companies pospone the digital transformation of their systems to next year, every year. Fortunately, the pandemic put an end to this delay and left opponents of digital medicine without much arguments.

– How the digitalization of the health sector has become a corporate cause for BGO and why did you decide to join forces with the Bulgarian Cluster for Digital Solutions and Innovations in Healthcare (DHI)?

– For a long time BGO worked as a company for outsourced services. However, we believe that the future of thr IT business in the region lays in building a particular competence and creating value for clients, that is much more than affordable resources.  Subsequently, given the considerable experience that we gained over the last years, while working with some of the most significant players in the clinical research, pharma and healthtech fields globally, made it an easy choice for us. We want to leave a mark in the industry and use technology to improve and save lives today. This transition happened very naturally, as did the partnership with DHI.

The reason we became part of DHI is its mission. During our first meeting, it became clear that we had similar goals and ambitions, and that speaks for itself. The cluster brings together people with the clear awareness that technology can contribute to better health and improving the quality of life.

– How does the Bulgarian market for digital solutions in healthcare look like in your boldest forecasts?

Bulgaria has the potential to become a Digital Health hub in Europe and my dream is for this to happen. Currently, the software industry is responsible for 3.3% of the country’s gross domestic product, according to data for 2019 of the Bulgarian Association of Software Companies (BASCOM). My prediction is that without implementing policies supported by the government and the business, the opportunities for our country to benefit of those incredible times of global digital transformation will start diminishing in 2-3 years. Soon we will not be competitive compared to other countries, because the salaries of our specialists grow disproportionately to the rates that the industry can afford to charge its clients.

We are in direct competition with destinations such as Ukraine, Moldova, Romania, and others in Central and Eastern Europe, Africa, Latin America and Asia, but unless we don’t change our approach, we are doomed to lose the race. Let’s imagine that the image of Bulgaria abroad is built on expertise in the field of digital healthcare. Then investors will recognize us for our expertise, skilled and trained IT talent and the solutions that IT companies in Bulgaria have built for a rapidly growing industry.

– Would under-digitalization of the public sector be a show stopper for this transformation of Bulgaria into a Digital Health Hub of Europe?

– The truth is that there is a long way ahead of us, before we can catch up with the more digitized countries in the West. Naturally, digitalization would have many benefits for the people, for the business and the overall image of us as a business destination.

The process of digitalization is not easy, but I believe that Bulgarian business are the main driver of this transformation, while putting pressure on the governement to take further action. We have companies that are recognised globally for the tools and technology that they create, but that potential is left unused at home. Speaking from our experience – we at BGO have built solutions for the government in the United Kingdom, that have digitally transformed the complete mechanism used to approve and manage clinical trial applications by the state. We have the know how, the people and the resources to do the same for our country, but… Have in mind that there are tens of other IT companies that can share similar experiences.

However there is a good side to it, sooner or later, our country will realize that it is time to catch up with the others. When that time comes, the IT sector will have gained the required experience on the foreign markets and the process will be significantly faster and more efficient. Hopefully soon!