Tec-Doc

In 2019, 77% of the Peruvian population had public or private insurance, while 23% (i.e., over 7.5 million people) did not have health insurance. After instituting a policy to strengthen universal health insurance, the Peruvian government reduced this gap significantly, and today, over 95% of the population is covered by some type of insurance. However, this rapid growth in coverage did not go hand-in-hand with the much-needed improvement in infrastructure and the supply of health services.

Thus, the Peruvian Ministry of Health (MINSA) reported in 2020 that 78% of healthcare facilities at the first level of care have inadequate installed capacity. In the same year, 1 out of 4 people who required medical assistance in the last 12 months did not receive care because they had to wait a long time to get an appointment or because of financial problems. Therefore, only the wealthiest population can get the care they need when they need it; meanwhile, a high proportion of the people cannot access proper care services and are left alone with their health issues. 

 On the other hand, rural areas of Peru represent an underserved community in terms of health and education. According to government regulations, recent medical school graduates must spend one year in rural areas (SERUM) to serve this population. However, 100% coverage is not achieved (geographical limitations), and low volumes in the different locations induce an underutilization of these physicians.

 Therefore, this gap could be decreased by providing a technological bridge between the underserved population and underutilized physicians, expanding the access exponentially.

Tec-Doc is a telehealth platform for primary care for all age groups, bridging the gap between underserved populations and physicians, leverage on the power of A.I, health data, and Blockchain. 

Tec-Doc optimizes the physician's work by digitizing all the workflow and closing the loop in care, creating a culture of continuous improvement in quality and safety.

Our solution covers two fronts: 

The patient: Our model guarantees a social price or is provided free of charge for patients,  working with large retail chains and / or telecommunications companies through their established customer loyalty programs. Their users can access Tec-Doc services,  using points towards telehealth services.

Labor force: The solution is converted into a hub for physicians enrolled in the social service year. It allows them to service large populations in rural areas and gain clinical experience in a supervised environment.

 The solution has the following characteristics:

• Matchmaking platform between medicine interns in rural areas and people in need of health services; these physicians gain documented experience within a quality and safe environment thanks to all the interventions and interactions converted into actionable data with the embedded A.I. engine.

• Triage through AI to differentiate between emergency and non-emergency cases.

• Video consultation (by appointment) through the web platform (duration: 20min)

• Registration of encounters in the EHR system.

• Adaptability to any equipment: Progressive web apps (PWA)

• Patient follow-up by text message between 48-72 hours post tele-consultation

• Closed-loop service: We work with different stakeholders to complete the patients’ attention, including pharmacy and complex health services.

• Patients as owners of their data: The patient is the owner of their medical records using blockchain technology. Tec-Doc guarantees the portability and security of the patient's data allowing them to share their medical data with other health facilities.

Tec-Doc will serve the Peruvian and Colombian populations of low socioeconomic levels of all age groups with low or no access to health services. 

Currently, this population has an insufficient supply of health services in primary care, often having to spend money to obtain private healthcare or wait a long time for a medical appointment or opt for self-medication. Tec-Doc allows people to easily have a high-quality medical consultation without having long waiting lists or traveling significant distances.

Auna Ideas is a health-tech-focused innovation hub that has crafted this solution based on two of our core values: empathy and innovation. We are well aware of the population's current socio-economic and health status in which we want to develop the pilot. We point the solution towards communities close to large cities that lack proper access to health services. 

Our team comprises medical doctors, biomedical engineers, and tech specialists who have ample experience developing and scaling health-tech products and services to the Latin-American market. Therefore, we feel prepared for the challenge and convinced that our solution could be deployed if we gather the necessary resources and support.

We are convinced that with the support of the MIT SOLVE program, our solution will have the necessary recognition and enrichment, increasing the access to quality health services for underserved populations. We also believe that the partnerships and alliances that we will be able to close through MIT Solve will help us become self-sustainable in the short term.

In addition, the strategic guidance and mentoring will surely help us reach product-market fit and scale our solution to other populations and geographies. It will also allow us to explore new business models for Tec doc with the support of a network of leaders in various fields, receiving advice and continuous monitoring, learning from their experience with solutions that have already been proven to work.

Although tele-health is an already known concept and has rapidly expanded during the pandemic, it has not successfully reached the most vulnerable and remote populations. In a pre-Covid19 scenario,  this population already lacked access to quality healthcare, and this gap has only expanded since. 

The existing market solutions looked to replace in-person appointments and health consults with tele-consultations in their great majority. Our proposal is aimed at populations that never had access to in-person health services due to location or the costs associated with them and have been stranded even more recently. Tec-Doc includes synchronous and asynchronous telemedicine services,  health education, and orientation for those who need it the most. 

 Tele-health and the provision of health services in the form of telemedicine offer the following advantages:

• Continuity and comprehensive care, focused on the patient's environment, applying concepts of globality and interoperability to health organizations

• improvement of patient quality of life due to lower mobilization for care.

• Immediacy of care and constant monitoring

• More equity in access to health services regardless of geographic location

• Reduced possibility of cross-infection between users of health services and health personnel.

• Decongestion of emergency and outpatient services.

We strongly believe that with a successful implementation of a pilot project, we could catalyze the impact on a much broader population and export the solution to other countries and healthcare systems with similar problems. 

Finally, we empower patients as the owner of their data using blockchain technology. Therefore, Tec-Doc ensures the portability and security of the patients’ medical data.

Our main goal is to improve health and wellbeing in our target populations by ensuring:

• Access to medical consultation and health care with better outcomes.

• A better quality of life for the patient.

• Timely and adequate medical attention.

• Democratization of health data.

In one year, we plan to conduct 25,000 tele-consultations with an ecosystem of 150 associate physicians and a response rate above 90%, robust patient-reported outcome measures (PROMs), and patient-reported experience measures (PREMs) systems.

In five years, our goal is to be the first option in tele-health in underserved populations and the largest provider of clinical follow-up for noncritical patients with chronic conditions.

To achieve these goals, we consider measuring the following key indicators:

1. Percentage of referrals to emergencies generated by tele-consultations: Measures the rate of referrals to an emergency service as a result of the presence of warning signs evidenced during the tele-consultation.

2. The percentage of accessibility to medical care by telemedicine measures the rate or number of patients who would not have attended a medical center or consultation.

3. Perception of health well-being and better quality of life: Measures the percentage of patients treated through Tec-Doc who perceive an improvement in health well-being and quality of life because of our platform. 

The need we are addressing is the lack of access to proper healthcare in Peru's vulnerable or remote population. We know that this sample population has a demand for a supporting healthcare system but cannot access it due to distance or lack of financial needs. We also know that the public healthcare system in the country is saturated, leading to long waits and self-medication. The desired end state would be a population with immediate and full access to a healthcare system that supports them in preventing and treating their illnesses. 

The inputs or levers in our system are the technological solutions and the availability of medical staff for tele-consultations. Connectivity is another lever, but it will not be in our control during the pilot project. Once the pilot project is successful, we might be able to affect policy to improve the connectivity of rural areas.

The outputs of these levers are a confident population to access and use the technological platform and feel at ease consulting with the medical staff. Another output would be a self-sustainable model, where we can give limitless access to the population and reward our doctors and maintain the platform. Finally, another output might relate to the public in general, who might become aware of the value of this solution and want to implement it nationwide. 

The system will have short-term effects or outcomes and longer-term effects. Short-term outcomes might include increased and faster access to a health professional for people needing a consultation. This outcome could be measured very easily if we had a baseline measurement. Long-term outcomes might be a healthier population since our medical staff will also focus on prevention. Therefore, the well-being of the people should also increase with time, even though this might take longer to notice and accomplish. 

Another short-term outcome could be a less saturated health system, with fewer events leading people to show up at the ER. Our triage system will help weed out those cases that can be easily treated remotely from those that need an in-person consult at a well-equipped health facility. 

The longer term outcome of this could be a more organized healthcare system in general, since the population will know that their first option is readily available and they will be able to, with time, discern between an urgent health issue vs. a non-urgent one. 

Finally, the technological platform could have a long-term impact on the population's education level since it will also provide important information, tutorials, and easily understandable bits of medical knowledge that should raise the general awareness and preparedness of the population.

Our solution is a digital cloud-based platform that allows patients to connect with doctors in real-time and will provide the user with a prescription document and medical recommendations. Our system includes a digital EHR with structured data for mining, prediction, and automatization of workflows connected to a blockchain database allowing patients to own and share his/her medical information in a secure way.

Our solution incorporates diversity through the scope of medical care and the medical specialty of family and community medicine. It is intended to serve all family members in all age groups regardless of their gender and geographic location with physicians involved without conditions, just the need for help and adequate qualifications. On the other hand, our solution has equity as part of its DNA, generating more access to high-quality health services for the most underserved populations.

Our value proposition is to offer timely and quality medical care to those who have difficult access to the health system due to geographic and/or socioeconomic barriers.  We deploy a state-of-the-art platform that uses AI, structured data, and blockchain, allowing physicians enrolled in the year of social service to join the initiative as providers, obtaining clinical experience that enhances their professional future. 

We can reach financial sustainability through partnerships with large retail chains and/or telecommunications companies allowing their clients to redeem the points of their loyalty programs in services on Tec-Doc,  having a social price, and partnering with different stakeholders, including government and companies and their social programs.

 Our cost structure includes the improvement of the platform, the costs of architecture, and the maintenance of the human administrative team.

We can reach financial sustainability through partnerships with large retail chains and/or telecommunications companies allowing their clients to redeem the points of their loyalty programs in services on Tec-Doc,  having a social price, and partnering with different stakeholders, including government and companies and their social programs. The physicians would give these tele-consults for free or low cost in return for more supervised “flight hours,” adding experience and access to a recognized ranking system that could help them get graduation or job opportunities at other networks.

To date, we have received funds from AUNA company as an initial investment for the development of this first MVP.