Ribera uses AI technology to help patients and doctors

Two women in blue scrub suits look at screens while, through a glass wall, a scanner with a patient’s feet sticking out is visible in the next room.

AI Digital Transformation

Ribera uses AI technology to help patients and doctors

03 Sept 2025, written by Catherine Bolgar

Healthcare is squeezed on all sides, in nearly every country. The number of new doctors and nurses isn’t keeping up with the greater demand for healthcare that comes with an aging population that has more chronic diseases. Budgets are tight. Healthcare professionals are overworked.

“In Spain, we have the same problems as everywhere,” says Manuel Bosch Arcos, chief transformation officer of Ribera, a private healthcare operator of 16 hospitals and 74 medical centers in Spain, Portugal and Central Europe, serving more than two million patients a year. To deal with higher demand and the costs that go with it, Ribera is counting on data and technology to help improve healthcare systems for their patients.

“A key part of the company is technology,” Bosch says. “We are not a traditional healthcare company. We have contracts with the government based on the quality of care, so we can be more innovative. We need strong data to ensure that what we do is good for patients, the company and the healthcare system.”

A man in a blue suit jacket and khaki pants sits on a desk with his arms crossed, looking directly at the camera and smiling broadly.

Ribera sees technology and data as the way to transform the healthcare system. “What we are doing is rethinking data and rethinking the way healthcare could be tailored – and doing that in real time,” he says.

Manuel Bosch Arcos, chief transformation officer of Ribera. Photo by Miguel Vizcaíno for Microsoft.

A small percentage of patients accounts for a large portion of healthcare spending because they have chronic conditions, usually several simultaneously. Improving these patients’ health is a boon to the system – and to themselves, of course.

Ribera’s technology subsidiary, Futurs, created the Cynara Citizen portal to do the things hospital portals do – let patients make appointments, upload lab results, ask questions or do tele-consultations with their providers through Microsoft Teams – but also to coordinate a hub management approach to patient care where the providers involved in each patient’s care can get together to develop a personalized digital health plan for the patient and monitor it.

The many layers of Cynara technology

The name Cynara is the genus for artichokes, which are highly prized in the southern part of Alicante, where the initial development team is located. But the name is also symbolic of the way the portal’s many functionalities, sometimes layered and overlapping, are like petals of an artichoke, Bosch says. Ribera’s use of Microsoft tools is similarly layered. It employs Dynamics 365 Contact Center, OpenAI models for generative AI projects, Azure Machine Learning tools for non-generative AI applications, Microsoft Fabric, Dynamics Business Central and Microsoft 365 Copilot.

Through Cynara Citizen, Ribera health professionals can track health indicators from patients – with particular focus on those with chronic diseases – to quickly address problems without waiting until the patients’ next appointment. Some chronically ill patients might tend to do nothing until their condition worsens to the point that they have to go to the emergency room; through Cynara Citizen, health professionals can check key health indicators remotely and proactively tell the patient what to do to avoid a health emergency.

“We have linked the app with clinical results,” Bosch says. “Patients are getting better blood glucose control and not going to the emergency room as often.” Level 3 patients, those with the most complex cases of chronic conditions, who were enrolled in the Cynara Citizen Population Health Management Program showed a 23 percent drop in emergency room visits and an 18 percent decrease in readmissions within 30 days, compared with a year earlier, which was before Cynara Citizen launched, according to Ribera. The patients had been in the clinical program enhanced with technology for at least 12 months. Ribera compared the level of use of the services of patients before and after being included in the program.

More broadly, Cynara Citizen, which Ribera developed with Microsoft technology, can reduce care gaps, helping patients follow their health plans so they are less likely to have to go to the emergency room. By seeing in real time whether, for example, a diabetic patient has a drop in glucose levels, Ribera health professionals can call the patient and get them to react before the glucose levels fall to the point that an ambulance has to be called, or that the patient falls into a coma. Because patients know who the professionals are on their care team and can message them in addition to making appointments, Ribera believes patients feel they are getting good care and good access, Bosch says. Since the app runs on Microsoft Azure, it can be easily and securely accessed from nearly anywhere.

Two women in blue scrub suits sit at a table with computer screens. They are talking to each other.

Marina Sánchez Grau, a diagnostic radiographer, left, and María Isabel Pérez Zaragoza, nuclear medicine technologist, discuss a scan at Ribera’s Hospital Universitario del Vinalopó in Spain’s Alicante region. Photo by Miguel Vizcaíno for Microsoft. 1 of 4

A woman in a blue scrub suit puts on blue latex gloves.

Claudia Coves Martínez, a nurse at Ribera’s Hospital Universitario del Vinalopó in Spain’s Alicante region, speaks to a colleague. Photo by Miguel Vizcaíno for Microsoft. 2 of 4

A woman in a white lab coat works at a computer.

Gladys Figueroa Ardila, a nuclear medicine physician with Ribera, works at a computer. Nuclear medicine is used to diagnose a range of conditions, including cancer and cardiovascular diseases that are the kinds of chronic conditions that Cynara Citizen aims to improve. Photo by Miguel Vizcaíno for Microsoft. 3 of 4

Manuel Bosch Arcos, chief transformation officer of Ribera. Photo by Miguel Vizcaíno for Microsoft. 4 of 4

Ribera’s active investment in AI

A woman in a red top smiles and looks directly at the camera.

“The advantage is that you can collect much more information. Not just five items but maybe 30, using variables that are not easy to find – maybe they are in the labs and if a person has to collect them manually, it’s impossible.”

Mireia Ladios Martin, head of quality at Ribera and product manager for Futurs. Photo by Miguel Vizcaíno for Microsoft.

Cynara Citizen is just one way Ribera is using technology. For more than four years, Ribera has been actively investing in AI with three goals in mind – sorting data, refining that into better insights and predicting. It expects machine learning to classify information and doctors and patients better understanding of cases, such as spotting patterns that signal a patient has a high probability of being readmitted to the hospital, so care can be adjusted accordingly. For example, it developed a model using Azure Machine Learning to identify patients at risk of developing pressure ulcers, a huge concern in hospitals. Another model can predict the risk of patients falling.

“The advantage is that you can collect much more information. Not just five items but maybe 30, using variables that are not easy to find – maybe they are in the labs and if a person has to collect them manually, it’s impossible,” says Mireia Ladios Martin, head of quality at Ribera and product manager for Futurs. The AI tools complement the traditional risk assessment scales.

For example, Ribera wants to identify patients who have infections at their surgical site after their operation. A team of physicians reviewed every patient who had surgery and noted whether they had an infection after 30 or 60 days. Then Ribera used data mining to identify everything related to infection. The resulting model delivers a score for each patient, so those with high scores can be flagged for closer looks.

Generative AI can create content; in that realm, Ribera is exploring several projects to lighten the administrative burden on doctors. One uses AI to generate discharge papers for some routine procedures, such as cataract surgery, to relieve doctors of certain administrative tasks so they can devote more time to actual patient care.

Ribera fully anonymizes data and works with Microsoft to ensure safeguards around data security and the ethical and legal rationales of AI in the healthcare setting. “We need to be very cautious about patient privacy, about which kind of information we send, where and how,” Bosch says, adding that Ribera also carefully examines the rationale for using AI in corporate and health applications, to ensure it is ethical and legal.

Bosch compares Ribera’s use of AI to a taxi driver using GPS – the driver, or in Ribera’s case the doctor, is still in charge and making decisions, but the technology can help speed the process and reduce stress.

“There’s more demand than the current system can provide,” Bosch says, “so we need to do more and better with the same resources. We need to be more efficient and provide more value.”

Header image: Marina Sánchez Grau, a diagnostic radiographer, left, and María Isabel Pérez Zaragoza, nuclear medicine technologist, conduct a scan at Ribera’s Hospital Universitario del Vinalopó in Spain’s Alicante region. Photo by Miguel Vizcaíno for Microsoft.