Distance concierge medicine: telemedicine connects US doctors to Chinese patients

October 25, 2017 | by

Another ‘burden shift’ in medical care. As we in the US wrestle with the issues of telemedicine, cross-state consults, and payment parity, companies are finding a niche in cross-border international virtual consults. A startup in NYC, Docflight, now connects Chinese patients to a claimed several hundred US doctors from prestigious medical centers: Dana-Farber Cancer Center, NYU Langone, Brigham and Women’s Hospital, Massachusetts General, New York-Presbyterian, and others. Founded by Sally Wang, an attorney with a MPH, she developed the idea after negotiating the US healthcare system for her mother with breast cancer and considering how difficult it would be in China to do the same.

The patients pay an upfront fee of about $2,000 in what is essentially long-distance concierge medicine. Docflight first screens the patient, then recommends an appropriate specialist. Once matched, Docflight collects the patient’s medical records (machine translated then human reviewed) and schedules the consult time. The US doctor then advises their Chinese patient on health issues and performs a virtual visit, often with an attending Chinese doctor, and offers recommendations for treatment in an average 45 minute session. The doctors cannot prescribe, perform treatments or procedures. 

China has a burgeoning middle class and an aging population, which in combination with the hospital-based system of care in China means that individual patients receive little time with a physician, don’t have a personal relationship with one or more doctors, and don’t expect much of a personal relationship with their doctor. Their government is trying to swing the balance to a primary care model, but with 1.4 bn people that will take awhile. Telehealth and remote patient monitoring is one avenue being explored [TTA 12 Oct 16] but for acute care, a different model is needed. For the Chinese middle class, Docflight is an alternative to medical tourism, a time-tested safety valve for the affluent commonplace for patients from Canada, Latin America, the Middle East, and Asia to international medical centers, though Docflight will arrange such trips to the US.

It’s reasonable that healthcare crosses borders to increase access and overcome language barriers. We’ve previously profiled Mexico’s Salud Interactiva, which provides telephonic consults within the country plus select services through partners ConsejoSano (US) and Konsulta MD (Philippines) [TTA 16 Aug]. Dictum Health, an early-stage health tech company dual-headquartered in Dubai and Oakland, Calif., provides telehealth/telemedicine services long-distance to clinics in Costa Rica, refugee camps in Jordan, and oil rigs [TTA 19 Sep]. Crossing borders to burden-shift care and using technology to facilitate it is a trend to watch for in 2018. NBC News (video), Bold Global Media (video), Crunchbase  Hat tip to reader Jeanmarie Tenuto of Healthcare Technical Solutions.

Commonwealth Fund case study on Spanish-speaking telemedicine services (MX, PH, US)

August 16, 2017 | by

Recently released by the New York-based Commonwealth Fund health policy foundation is a case study of a new model for extending medical care in Mexico and with a variant in the US for the Spanish-speaking population. In Mexico, MedicallHome (not a typo) connects subscribers by phone and mobile app to a 24/7 national network of physicians and discounted health resources such as clinics, labs, pharmacies, in-person medical services, and hospitals. The 60-person Healthcare Contact Center, staffed by primary care doctors, psychologists, and nutritionists,  triage emergencies (press 1) to medical advice (press 2) to referrals (press 3). They also arrange in-person visits and emergency services.

MedicallHome’s model is targeted to low and middle-income Mexicans. It is primarily a direct-to-consumer offering, with subscriptions from $2 to $5/month, including travel health (60 cents for a bus trip) and low-cost insurance for students, but they also partner with private insurance, companies, and employers.  With an average of 500,000 calls per year, MedicallHome staff resolve 62 percent of cases by phone and refer the remaining cases for in-person treatment. Prescribing medications without an in-person consult is illegal in Mexico.  

The profitable MedicallHome complements the free (but overwhelmed and with long waits) national health service Seguro Popular. It also benefits from the oversupply of primary care physicians who work at multiple hospitals, clinics and private practices, and find the shift work in a call center convenient. Their parent, Salud Interactiva, built the infrastructure, IT, EHR, and worked with Telmex, the largest phone company in Mexico. They have also extended it to the Philippines as of July 2015 as Konsulta MD, a joint venture between Salud Interactiva and Globe Telecom, the Philippines’ primary telecommunications provider. 

Salud’s joint venture in the US, ConsejoSano (healthy advice) is also profiled in the case study. Since ConsejoSano connects to the Mexico-based call center and not to US doctors, (more…)

Is ‘telehealth lite’ good enough for the Spanish-speaking market? (US)

February 3, 2016 | by

Pioneering or inadequate? Mercer LLC, a major employee benefits consulting company that is part of business consulting giant Marsh & McLennan, and digital health platform developer ConsejoSano (Health Advice) recently announced a partnership where Mercer will market the ConsejoSano platform to its large base of US employers and also to the wider US Hispanic market of 54 million with at least 22 million in the workforce. Their pitch is to the group most comfortable communicating in Spanish as a primary language. The service is via phone or mobile app, and connects employees to native Spanish-speaking doctors. However, you won’t be able to visit that doctor unless you go to Mexico; they are provided via Salud Interactiva S.A. de C.V., a Mexico City-based medical services/telehealth company. Because the doctors are ex-US, they cannot refer or write a prescription, and only address questions on general health needs, mental health, nutrition and chronic disease management. Still, ConsejoSano claims a 60 percent resolution of medical needs upon the first call.

This Editor asks: What about that other 40 percent? This conceivably is a ‘first turn’ service for that Spanish-speaking person, and after you’ve built up that trust, the consult isn’t completed. Why isn’t this built with warm transfer capability to US-based assistance which can refer the person to either local in-network doctors, a telehealth doctor in their employee insurance network or other assistive services? Is this a good-looking glass-half-full for the Spanish-primary speaking population? Mobile Strategies 360, Mercer release