25 years transforming healthcare: from GXSalud to K2BHealth

Where GXSalud began, and the first steps of digital transformation in healthcare

It was 1999 when we started GXSalud. There was no cloud, no smartphones, and nobody was talking about “interoperability”. What there was, was the will to solve a concrete problem: to stop health information living in papers, folders and individual memories, and start having it live in systems.

At the time, the sector’s technological ambition was simple to name, though enormous to execute: an integrated system. A single one, that did everything. Medical records, administration, billing, appointments. All inside the same box. And for years that was the value proposition: if we managed to bring every process into one system, we had transformed an organisation’s healthcare.

Experience in digital health, electronic health records and interoperability

I spent much of my career working with that logic. I worked on the evolution of solutions for private health insurers, where the complexity was not only clinical but financial and regulatory. I supported non-profit organisations — among them Teletón, a project that marked me deeply, not only for the technical challenge but for what it represents for thousands of families — in digitising processes that until then depended entirely on people’s willingness and memory. And I was part of transforming healthcare at national level, in a role that is seldom told outside the room: as technology partners to Salud.UY in building the National Electronic Health Record.

With a vision that was innovative for the region, that project became a reference and a guide for many countries, which looked to Uruguay as an example of how to build health interoperability at country scale. That last experience changed how I understand the problem. Because at country scale, “one system that does everything” stops being an option. I needed different systems, from different vendors, with different histories and technologies, to be able to talk to each other. I needed interoperability, not uniformity.

From the integrated system to the modular ecosystem

That is where the second great chapter of this story began for me: the move from integrated to modular. Organisations started to understand that there was no need — and no advantage — in tying themselves to a monolithic system claiming to solve everything. We began designing architectures where modules could be combined, replaced and updated independently. It was as big a shift in mindset as it was in technology: to stop thinking about “the system” and start thinking about “the ecosystem”.

K2BHealth and designing interoperable solutions for healthcare organisations

Today, more than 25 years after that beginning, now as K2BHealth, we are in a new chapter. Healthcare organisations no longer look for a monolithic system, nor simply for modules from a single vendor. Beyond interoperable systems, they look for the best niche solutions for each need — often world-class in their specific function — and above all for adaptable solutions, able to evolve quickly, because the sector changes faster than any closed system can keep up with.

Telemedicine, appointment management, clinical analytics, patient experience, cybersecurity for sensitive data, interoperability with national systems. Each piece built by whoever does it best, and designed so it can be swapped out tomorrow without breaking everything else. And our role, as a technology company and consultancy, has stopped being “building the system” and become something harder and more valuable: designing, integrating and supporting that whole, complex ecosystem.

Digital transformation in healthcare: people, processes and trust

Because that is what I have learned in these 25 years, professionally and personally: digital transformation in healthcare was never, at bottom, a technology problem. It was always a problem of people, processes and trust. I know the pain of these projects because I have lived them from the inside: management changes halfway through, teams having to learn new ways of working, data that must be migrated without losing a single clinical history, budgets renegotiated and deadlines pushed because the reality of a health system changes faster than any project plan.

Technological evolution in healthcare: from local systems to the cloud

Along the way I lived through several fundamental technology shifts. We started with systems using dbf tables sitting on network servers; we passed through client-server solutions, where each installation was almost a local engineering project. Then came web systems, which let us think about remote access, accessibility and scale in ways we had not imagined. Later the data moved to the cloud, and with it came architectures that were increasingly complex inside but that, paradoxically, simplified processes on the outside for the people using them every day.

Each of those leaps meant learning again, unlearning certainties again, convincing entire organisations again that the effort of change was worth it. But of all the changes I have lived through, none compares to the one we are living now: artificial intelligence is, without doubt, the technological revolution itself.

Artificial intelligence in healthcare: technology with sector knowledge

Today artificial intelligence occupies much of the conversation about the future of healthcare, and rightly so: its potential is enormous. But after 25 years in this sector, I hold one conviction I do not intend to qualify: AI on its own improves nothing. AI amplifies what we already know — what we have learned working shoulder to shoulder with doctors, nurses, administrators and patients over all these years.

Without that sector knowledge — without understanding how a hospital really moves, what an insurer needs, what matters to an organisation like Teletón, what it takes to build trust at national scale as with the national EHR — AI is just technology without direction. With that knowledge behind it, AI becomes a tool that multiplies what we already knew how to do well.

Electronic health records, data and responsible AI in healthcare

Fifteen years ago, if you asked me what “digitally transforming” a healthcare organisation meant, the answer was almost always the same: implement an electronic health record. Today that question is far richer, and far more complex. It means thinking about the whole patient experience, about interoperability between organisations, about intelligent use of data, about information security, about integration with national public policy, and increasingly about how to bring in AI responsibly on a solid base of processes and knowledge. Above all it means having a partner who understands that none of these projects is won with a product: it is won by walking alongside.

K2BHealth as a technology partner for healthcare

That is what we try to be at K2BHealth, heirs to that GXSalud of 1999: not just technology suppliers, but companions on the road for those who carry the enormous responsibility of caring for the health of people, organisations and the country. Through our digital transformation services, we continue to support organisations, teams and institutions along that path of technological evolution.

Twenty-five years on, I still believe what I believed at the start: technology in healthcare is not worth anything for how sophisticated it is, but for the life it improves on the other side.