State-of-the-art cardiology in rural Portugal

Holm oaks and olive trees as far as the eye can see. Black bulls and sheep graze in the rolling hills that stretch to the horizon. In the center of the landscape rises Évora with its whitewashed houses, churches, and monasteries. The medieval town in the rural Alentejo province of southern Portugal has been a UNESCO World Heritage Site since 1986. It seems like time has stood still in Évora.

The board of HESE and Patrício finally found the right partner in Siemens Healthineers. In 2018 they entered into a Value Partnership with the company for a period of eight years. But this long-term cooperation goes far beyond the simple provision of medical technology devices and imaging systems, explains Ivan França, CEO of Siemens Healthineers Portugal: “We maintain the devices, update them with the latest software, and train employees in the use of the systems. In addition, we help to optimize clinical operations and make them more efficient through spatial planning and by standardizing and digitalizing work processes.”

Siemens Healthineers is also supporting research activities and collaboration between the cardiovascular innovation center and the University of Évora to train future specialists, a collaboration which did not exist to this extent before. It is not only the patients who benefit from this: Hospital board also hopes to attract young talents to HESE through the advanced training and research projects.

The Value Partnership also includes an efficient financial model that made it possible to set up and equip a second cath lab. The cardiovascular department of HESE now has totally new treatment options, twice the capacity, and an extended service portfolio at its disposal. 


Value Partnerships encompass individually tailored services. In Évora, for example, the workflow has been optimized to improve the patient experience.

Research, training, and the latest innovation technologies – these were all important factors for Patrício in realizing his vision of the future of cardiovascular interventions in Évora. In modern interventional cardiology, in particular, there are areas of overlap in which specialists from different departments can work together and learn from one another, says Patrício. “So as well as using the latest technology, we also take an innovative approach to our work – one that’s unique in Portugal. In our center, physicians from various fields, such as cardiology, vascular surgery, and neuroradiology form a multidisciplinary team.”

His goal was to soon have teams from different disciplines working together on specific cases. These synergies allow them to develop completely new treatment and surgical methods. Patrício admits that this multidisciplinary work is a challenge for everyone but says it has great appeal too. He has already managed to attract renowned medical specialists to Évora – mainly from Lisbon – who wanted to take part in the “pioneering project.” Thanks to this combination of innovative technologies and eminent specialists, the collaboration with Siemens Healthineers is helping HESE to establish itself as a leading hospital for cardiovascular treatment in Portugal.

Upon entering into the partnership with Siemens Healthineers, Prof. Patrício stressed the need to develop a telemedical care. Remote monitoring allows hospital staff to care for patients in their homes before and after an intervention. For instance, Francisco Antonio Rosa from Lisbon was eager to be treated at HESE. He suffered from a heart valve defect, and in Évora he had a new aortic heart valve implanted through transcatheter aortic valve implantation (TAVI). In addition, the waiting lists for surgery were much shorter here than in urban centers such as Lisbon or Porto. The 84-year-old Portuguese says that the distance to Évora was not an issue.

Every day for many weeks, Rosa used the devices he had been loaned to record his weight, blood pressure, blood SpO2 levels, and heart rate. He then sent the data using a smartphone app to HESE, where three clinical staff members are assigned exclusively to evaluating patients’ vital signs using the telehealth software.

Remote monitoring of patients in their homes has significantly improved the quality of medical care, especially in a sparsely populated region like the Alentejo, explains Sandra Nunes, radiology technician and responsible for data analysis. Alentejo occupies a third of the area of Portugal, but just 700,000 people live here – 22 people per square kilometer. Many older heart patients are not mobile. “But we are in constant contact with them via the exchange of data and we call them as soon as we notice changes in the parameters,” says Nunes.