🇧🇷 Português 🇩🇪 Deutsch 🇺🇸 English

Economic Analysis

Cost reduction and process optimization

⏰ TIME SAVED

270.9h

Per physician/year

💰 ANNUAL SAVINGS

$8.9k

Per physician

💸 TOTAL SAVINGS

$436k

10 physicians/5 years

✅ EXPERIENCE

4 years

Tested in practice

Brazilian Healthcare System Context

LME (Laudo para Solicitação de Medicamento de Componente Especializado) = Prescription form for high-cost medications in the Brazilian public health system (SUS).

High-cost pharmacies: Specialized government pharmacies that dispense expensive medications (often $1,000+ per month) for chronic conditions like Multiple Sclerosis, Epilepsy, and rare diseases at no cost to patients.

The bureaucratic problem: Each LME form takes 17 minutes to complete manually and can extend over 10+ pages with extensive medical documentation requirements. Small errors in diagnosis codes, patient data, or medication details result in prescription rejection, forcing patients to return for new consultations.

Critical impact: Manual completion creates significant administrative burden, reduces direct patient care time, and increases the risk of medication access delays due to bureaucratic errors.

Executive Summary

CliqueReceita eliminates 270.9 annual hours of medical bureaucracy, generating $8,866 in savings per physician/year. Open-source system with 4 years of proven clinical practice.

Real data: Collected from January 2019 to September 2023 in outpatient practice. Especially effective for specialties with high prescription volume (Neurology, Psychiatry, Endocrinology).
Option 1: Direct Savings

Complete conversion to operational cost reduction

Option 2: Reinvestment

Care improvement: more professionals, shorter hours, longer consultations

1. Operational Context

The data below culminates in the 270.9 annual hours saved per physician presented in this analysis.
Item Before After
Time to fill LME 17 min 2 min (signature time only)
Time savings per LME – 15 min
Total LMEs filled/year 1,000 1,000
Total time saved – 250 hours
(15 min × 1,000 ÷ 60)
Additional time saved: Administrative time (20.9h) = 20.9 extra hours
Physician hourly wage: $32.7/hour
  • Number of regular patients: 400
  • Annual prescriptions: 1,000 (due to polypharmacy)
  • Incorrect prescription rate: 5% (50 per year)
    • Rate based on observed data. Example: CID G40 instead of G40.0 results in dispensing refusal.
    • Eliminates additional consultations just to reissue already completed prescriptions.
  • Additional administrative time saved:
    • Extra consultations: 50 consultations × 20 min = 16.7 hours
    • Rescheduling: 50 reschedules × 5 min = 4.2 hours
    • Administrative total: 16.7h + 4.2h = 20.9 hours/year

2. Annual Financial Summary

$44,330

Savings in 5 years (1 physician)

$443,300

Savings in 5 years (10 physicians)

Conservative Scenario (50% of values)
1 physician: $22,165 (5 years)
10 physicians: $221,650 (5 years)

Process Demonstration

Demonstration video of automated LME filling

3. Reduction of Patient Burden

Clinical Risk Mitigation
Critical situations avoided:
  • Abrupt discontinuation of antiepileptics (status epilepticus risk)
  • Interruption of antipsychotics (psychiatric decompensation)
  • Discontinuity of cardiac medications (cardiovascular events)
Reduction of Patient Disruptions
Incorrect prescriptions avoided: 50/year
Time saved per patient: 1h
Unnecessary extra consultations: 50 avoided
Total hours saved: 50h/year

Eliminates unnecessary trips and pharmacy waiting times

4. Flexibility in Benefits Application

Direct Benefits:
  • Improvement in care quality - physicians less burdened with bureaucracy can achieve greater focus and attention during consultations
  • Reduction of stress and burnout among professionals
  • More mental energy for complex clinical decisions
Option A - Financial Savings
  • Conversion to direct savings of $8,866/year per physician
  • Ideal for institutions seeking budget optimization
Option B - Quality Investment
  • Extended consultation time
  • Reduced workload while maintaining compensation
  • Hiring additional team support
  • Investment in training and infrastructure

5. Clinical Impact

Bureaucratic Barrier: Excessive bureaucracy creates barriers for prescribing high-cost medications, even when clinically indicated. Physicians often choose less effective alternatives to avoid complex bureaucratic processes, harming optimal patient care.
Current Scenario
  • 17 minutes for each LME
  • Avoidance of high-cost medications
  • Suboptimal prescriptions for convenience
  • Professional frustration
With CliqueReceita
  • 2 minutes (signature only)
  • Evidence-based prescriptions
  • Better therapeutic adherence
  • Focus on patient care

6. Security

Periodic security analysis with audit systems and AI tools.

Implemented measures:

Hardened OS (custom kernel modifications)
Firewall and SSH access only with cryptographic key
Rate limiting and other protective measures
Data transmission exclusively encrypted
Security logs sent to external servers
Ephemeral PDFs generated in RAM with access control
Security testing during updates to ensure data isolation
Compliance with GDPR and HIPAA.

7. Competitive Differentials

Similar systems exist, however they don't have the comparable level of granularity and such efficient user interface - based on direct practical experience → CliqueReceita is designed to have all conditional forms for each process, which will allow an administrative employee to issue reports without errors and without needing help.

It's free software, open source (https://github.com/lcsavb/autocusto), with GPL-3 license (which allows commercial use, with the caveat that if integrated into another application, it must also have publicly available code). The in-house IT can perform local deployment of the app, considering the team works with the technology stack used (Django/Python/JS/Containers). Thus, data can be contained within the institution itself and the code modified for specific needs.

8. Roadmap

Next implementations: integrated electronic health record, AI patient intake system (pre-anamnesis), prescription system similar to MEMED/MEVO, as well as the possibility of digital signature of LMEs (enabling telemedicine).

Lucas Amorim Vieira de Barros
CRM 150494