Lyptus Medical Geriatric Care

Among all segments of society, seniors (60+ adults) are the ones affected the most by rare diseases in two ways. 

First, there is a prevalence of rare diseases such as dementia (e.g. Alzheimers, Lewy Body, Vascular, Frontotemporal, Multiple System Atrophy, Supranuclear Palsy), as well as other neurodegenerative diseases that don’t primarily affect cognition, but nevertheless cause a great deal of disability and suffering (e.g. Parkinson’s, Multiple Sclerosis, Polyneuropathy, rare forms of epilepsy and stroke) affecting seniors disproportionally. When you compare young adults to seniors, proportions of such disease increase steadily from less than 1% to over 40% for dementia, from less than 0.5% to more than 4% for Parkinson’s disease, and from approximately 1% to nearly 10% for stroke. 

Second, common diseases in young adults turn into rare diseases in the elderly, because they manifest in atypical ways, respond in an atypical fashion to common treatments and can have very different outcomes. All of these factors make timely diagnosis of these common ailments much less likely, as well as cause important impairments in prognosis. 

Additionally, when patients suffer from multiple ailments that interact with each other this can also change the natural history of each individual disease, all because of the normal changes in bodily dynamics that are characteristic of an aging body.

In each of these cases, most physicians are simply not trained to diagnose and treat senior patients correctly. 

As an example we can start with one of the most common diagnostic errors seen by Geriatricians, which is when patients are diagnosed with dementia (generally Alzheimer’s) and started on complex and costly medications, when what they are actually presenting is inattention caused by major depression or generalized anxiety disorder. In young adults, this usually presents as a mildly irritating sense of “forgetfulness”, but in seniors it is so prominent that it causes a short term memory deficit that is very similar to early stages of dementia. These patients could experience full recovery of their symptoms with a 3 to 6 month treatment of inexpensive antidepressants, but instead have progressive worsening of their symptoms and can even become suicidal o simply experience a slow and devastating progression because they begin to eat less, move less and sleep more, until they eventually pass away from either malnutrition, infection or some combination of both.

An almost identical scenario occurs when physicians misdiagnose Essential Tremor, an extremely rare condition in young adults, but comparatively frequent disease in seniors, with Parkinson’s Disease, a rare disease in any age group. They are started on anti-Parkinsonian medications and only experience the progressive side-effects, which can become physically and mentally cripalling in a matter of months, instead of experiencing full symptomatic relief with a low dose of a very inexpensive medication that can be taken once or twice daily.

And finally, it is worth describing the differences in treatment and progression of two of the most common diseases in middle-aged adults in the Western world; Diabetes and Hypertension. In young adults both of these conditions are treated with one or two medications at progressively higher doses. However, in elderly patients, the correct strategy is the exact opposite. Patients require many more than one medication (typically three or four) using the lowest possible dose of each. Treating eldery patients the way you would treat a young adult causes an unacceptably high rate of side-effects, but also worsens disease progression because patients are rarely within the optimal parameters of blood-glucose levels and blood pressure.

Once again, in each of these examples, a licensed geriatrician is the only physician that can properly oversee the treatment for these patients, especially if the complexity or degree of progression of the disease calls for consultations with other specialists.

Unfortunately, geriatric infrastructure, and especially the number of licensed geriatricians, has not been growing at the same rate as the population is aging and life expectancy is increasing. 

For instance, in Mexico there is a fast growing 15.5 million senior population, but only 742 licensed geriatricians. That is, one geriatrician for every 21,000 seniors (as reference, an accepted standard from American Geriatrics Society is one geriatrician for every 4,000 seniors.)

Consequently, seniors receive either no-care or unqualified care that provokes poor health outcomes, among them, disability (1 in 2 seniors) and dependency (1 in 4 seniors). Families carry most of the burden, performing unpaid caregiving and suffering from caregiver burnout and collapse. Unpaid senior caregiving is so massive that it accounts for 19% of GDP, a figure like the 22% of GDP allocated every year to operate all public hospitals. With smaller families, an aging population, and longer life expectancies, this method of care will be soon unsustainable. 

Mexican health authorities have made efforts to increase the number of new geriatricians. Unfortunately, the country will potentially reach the 1:4,000 ratio milestone towards the year 2090. 

Unfortunately, this is a global challenge. For instance, in Colombia the geriatrician-to-senior ratio is 1:35,000, in Chile 1:38,000, in Nigeria 1:42,000, in Canada 1:14,600 and in the US 1:8,200. 

It is imperative to increase the access of seniors to licensed geriatricians TODAY.

Lyptus Medical combines the power of telemedicine, with the warmth and empathy of in-person care, to give seniors unprecedented access to house calls with licensed geriatricians in four easy steps: 

1. A patient receives the visit of their personal general practitioner (GP) at home. 

2. Analog to a resident in a teaching hospital, the GP performs a physician examination and a medical intake guided by our telemedicine software. 

3. A licensed geriatrician has access to the information registered by the GP and joins the consultation through a video call to reach a diagnosis and to offer a treatment plan. 

4. The patient and/or primary caregiver receive an electronic prescription and a summary of the doctor visit.  

To follow their treatments, patients purchase a yearly membership that includes all the necessary house calls with geriatricians and specialized physicians. Their GP provides programmed follow-up and is available 24/7 for medical orientations. The assistance of relatives is not required, however they receive a notification after every interaction. All of this for US$25 per month, on average. 

To offer these services, we use our proprietary cloud-based telemedicine software and basic hardware. 

Our cloud-based telehealth platform helps us perform house calls and patient follow-up. For house calls, it includes an electronic health record, medical note for the in-person physicians, medical note for the off-site geriatricians or specialists, video call and electronic prescription.   For patient follow-up, it includes reminders for follow-up calls, for scheduling follow-up house calls, and for renewing annual memberships. It also includes notifications for relatives and the capacity to register each interaction. 

In a few weeks, we will launch our app that will help patients and relatives access medical records, communicate with their physicians, receive notifications, as well as to set medicine intake reminders. 

The hardware that our physicians take into our patients homes are touch screen laptops, mobile internet modems, and essential medical equipment for physical examinations. Shortly we will include digital medical peripherals that will connect to our telemedicine platform such as stethoscopes, cameras, electrocardiographs, and ultrasound. 

Our target population are seniors (60-year old+) that require corrective and preventive care from geriatricians. Today, we are focusing on seniors located in large and medium cities in Mexico, starting in Mexico City, Monterrey, and Guadalajara. Initially, we are focusing on middle-to-high income seniors.  

With only 742 geriatricians in the country, 170 of them in the public health sector, most of these seniors do not receive geriatric care. Some of them do not receive care at all, and the rest receive care from unqualified physicians that, despite their best efforts and good intentions, do not understand how the human body works after 60-years of age nor how to treat geriatric syndromes. Therefore seniors are subject to wrong diagnosis and treatments, that leads to avoidable hospitalizations, disability, and dependency. 

For those seniors that have had access to a licensed geriatrician, the story is not good either. On the one hand, many seniors visit a geriatrician as a ‘last resource’, after visiting a myriad of physicians that have not solved their health issues. In the majority of these cases, the damage has been done leaving geriatricians with minimal alternatives to improve the well-being of patients. On the other hand, to achieve healthy aging, the American Geriatrics Society recommends seniors to visit their geriatrician at least three times per year. In reality, only three out of ten patients come back for a second visit. This happens because of three main reasons: First, inexistent follow-up to patients, second, many seniors need the support of a relative to visit a physician, and third, there is a lack of preventive culture in Mexico. Patients usually visit the doctor when they are feeling really ill. 

In summary, seniors are underserved because they have a lack of access to geriatricians, and when they do, it is often too late and they do not have the means to adhere to geriatric visits. 

Our solution impacts their lives because they have access to the right physician in the comfort of their own home, they receive the optimal number of geriatric house calls per year and they have open channels of communication to address any issue between house calls. 

We strongly believe, that we have assembled the best team to deliver this solution: 

Dr. Alberto Palacios, co-founder and medical director, is a board-certified geriatrician, a zealous medical educator, and a college professor. Dr. Palacios loves his chosen profession because it goes beyond medicine and includes the psychosocial aspects that can truly impact quality of life for patients, caregivers, and even other medical professionals. He firmly believes in the Health 3.0 revolution, which combines the technological and evidence-based approach of modern medicine, with the compassionate, patient-centered, and tailored approach of more traditional medicine. After experiencing first-hand the challenges of a geriatrician and his patients, he is deeply motivated to offer the best and most comprehensive geriatric care to as many people as possible.

Miguel Briones, co-founder and customer experience officer, is an industrial engineer, entrepreneur, and customer experience guru in Mexico. Miguel fervently enjoys designing and implementing memorable customer experiences for his clients, including fortune 500 companies and unicorns. After experiencing the archaic customer journey of patients and physicians in the traditional healthcare system, Miguel became obsessed with creating an enjoyable experience for patients and physicians, that improves their health outcomes and passion for care, respectively. 

Jorge Hinojosa, co-founder and CEO, is an industrial engineer, Yale MBA and entrepreneur. Jorge co-founded and led the national and international expansion of Impulsa Business Accelerator in Mexico. He is now using this experience to spearhead the expansion of Lyptus Medical to reach as many families as possible. Jorge’s drive comes from this personal experience as sole caregiver of his dependent parents for more than 15 years. 

The three of us are deeply committed and each of us brings essential experiences and talents required to grow Lyptus Medical exponentially. 

On one hand, becoming a winner of this challenge would give Lyptus Medical tremendous credibility and validation, that can open many doors, but particularly the following three: 

First, it’s a perfect opportunity to jump start a public relations campaign with media in Mexico and in the US.  

Second, it’s a powerful reason to believe for Mexican expats living in the US with senior relatives in Mexico and for B2B2C channels in Mexico. Both are key to the massive expansion of our services. 

Third, it’s a great achievement to showcase to potential investors in our seed round.  

On the other hand, the grants we could access can help us finance our growth and be less dependent on capital raises. 

That’s why we believe that Becoming a Solver would be an inflection point for Lyptus Medical. 

Our solution is disruptive because it allows geriatricians to increase their reach and capacity in an unprecedented way. In addition, it substantially increases the adherence to treatments and visits from patients. These two elements are the key to achieving optimal health outcomes.  

Presently, the great majority of geriatricians are in three cities: Mexico City, Monterrey and Guadalajara. At the same time, a traditional geriatric consultation lasts one hour. With our approach, geriatricians can see patients nationally and can perform three high-quality consultations in one hour. 

Currently, only three out of ten patients come back to a second geriatric visit and only 50% of patients take their treatment correctly. With our approach, there is 80% adherence to doctor visits and to treatments. 

We believe our solution will change the market entirely. Having real access to healthy aging creates an incentive for informative campaigns that promote visits to geriatricians. This will create more demand for geriatric care and, in turn, will incentivize more physicians to become geriatricians. With our business model, geriatricians will finally be able to see as many patients as their peers, increasing their income substantially. This will further incentivize physicians to become geriatricians.  

At the end of 2022, we have the following impact goals: 

1. Give 5,000 seniors from five different cities access to certified geriatricians at their home. 

2. Minimize the probability of suffering caregiver burden or collapse for the families of these 5,000 patients. 

3. Reduce healthcare expenses of these 5,000 patients by eliminating polypharmacy and by reducing the probability of hospitalizations through preventive care. 

4. Ensure that one geriatrician has the capacity to perform 4,000+ house calls and can follow-up on every patient comfortably. 

 In five years, we will at least expand our footprint in Mexico and in Latin America with the following impact goals: 

1. Give access to licensed geriatricians to at least 500,000 patients in 5 countries. 

2. Through independent research, demonstrate that mobile telemedicine reduces healthcare expenses, while increasing optimal health outcomes for patients and for their families.  

Our plan to achieve these goals mostly relies on our B2B2C expansion strategies: 

1. Through Marsh McLennan, the leading global insurance broker, we will access the collaborators of large corporations (e.g. IBM, HP, Siemens, DHL) to offer memberships for their senior relatives. 

2. Through pharmacies and pharmaceuticals (e.g. Farmacias Especializadas and Bayer) we will execute patient adherence programs, where our allies will buy memberships for their clients to increase their adherence to treatments. 

3. Through leading remittance players (e.g. Transnetwork) we will be able to offer Mexican expats living in the US and Canada, the possibility to purchase memberships for their senior relatives living in Mexico. 

Most of these B2B2C expansion opportunities imply relationships with companies with a LATAM/Global footprint, that will be key to expand outside of Mexico. 

To consider that a patient is active, they need to receive at least one geriatric house call per year and twelve successful follow-up calls. 

To make sure that patients are receiving appropriate treatment and follow-up, we measure the following variables: 

● Net Promoter Score: After each house call, we ask for a quick survey to assess customer satisfactions and to make sure we are meeting their expectations. Any deviance is addressed immediately. 

●      Adherence to treatments: By connecting electronic prescriptions with online pharmacies, patients and caregivers can access medications and have them delivered at home with competitive prices on an ongoing basis. Therefore, we can indirectly monitor if a patient is taking its medication regularly. 

●      Adherence to visits: By receiving programmed house calls as planned, we understand that patients are enjoying the experience and are being monitored by the right physicians in a preventive fashion. 

These indicators are levers generate our impact goals: 

●      Lower health expenses

●      Reduce disability

●      Reduce dependency 

●      Lower hospitalizations

●      Minimize caregiver collapse

ACTIVITES 

Seniors have access to annual treatments at home that include house calls with licensed geriatricians and specialized physicians, personalized follow-up, 24/7 medical orientations and notifications to authorized relatives. 

OUTPUTS

Seniors receive care from the right physicians and have the means to adhere to treatments and follow-up visits. Meanwhile, their relatives are kept abreast of their progress. 

SHORT-TERM OUTCOMES

 Seniors and their families feel at ease knowing that they are being treated, receive follow-up and have 24/7 access to the right team of physicians. They have a treatment plan with objectives and activities that will lead them to healthy aging. 

 Seniors eliminate polypharmacy and its side effects. 

Relatives lower their stress levels and reduce the probability of caregiver collapse. 

MEDIUM-TERM OUTCOMES

 Regular geriatric house calls help refine treatments and diligent follow-up increases adherence to treatments, making preventive care a reality. Preventive care minimizes the risk of hospitalizations. Seniors and their families don’t spend their time, energy and financial resources on health issues unnecessarily. 

LONG-TERM OUTCOMES

Happier and stronger seniors with no disabilities contribute actively to a better society

Our core technology is our proprietary cloud-based telemedicine system and app. They allow physicians to perform geriatric house calls and control our entire operation. Our technology works as follows: 

●      Our general practitioners carry a touchscreen laptop, a modem with a dedicated internet connection, and medical peripherals to the patient’s home. 

●      Guided by our telemedicine system, General Practitioners (GPs) perform a physician examination and medical intake of the patient, registering the results in their medical note. 

●      In a different location, a licensed geriatrician or other specialized physician, logs in into the house call, initially to review the patient’s EHR and the medical note from the GP.  Then, they join the consultation through a video call to reach a diagnosis and treatment plan. 

●      When the housecall ends, the patient and her primary caregiver receive a clinical summary of the visit as well as an electronic prescription. 

●      Notified by our system, GPs perform programmed follow-up with patients, registering the results of the interaction in the patient's EHR and notifying the primary caregiver through our app. 

●      Patients can access their personal GP through the app for 24/7 medical orientations. Likewise, the result of every interaction is recorded in the EHR and the primary caregiver is notified. 

●      According to each patient's treatment plan, house calls are scheduled and confirmed.  

●      Physicians, patients, and authorized relatives have access to all the information. 

Lyptus Medical is a mission-driven organization with core values that guide our every action. 

Our mission encompasses four key groups of people: Patients (Seniors), Primary Caregivers (Relatives), Collaborators and our Community. Our reason to exist as an organization relies on each one of these groups: 

1. For our patients, we want to provide them with the means to achieve healthy aging and to genuinely believe that they can live the happiest days of their lives after 65. 

2. For primary caregivers, we become a trusted advisor and sidekick they can lean on to take care of their loved ones while they make a living. 

3. For our collaborators, we want to attract and develop the most extraordinary talent. Without them, we cannot possibly accomplish our mission.  

4. Finally, for our community we want to actively contribute to creating a culture of healthy aging, a culture that repositions seniors as a valuable and aspirational role in society and, as such, deserves access to all the elements they require to thrive, from health services and education, to working opportunities and leisure. As a silver lining, when we promote healthy aging, we reduce dependency levels, which in turn free women from the burden of unpaid caregiving for disabled relatives. 

We have seven core values that are our compass to make daily decisiones:  Trust, Excellence, Assertive Communication, Integrity, Sense of Community, and Continuous Improvement. Whoever identifies with these values, regardless of their age, gender, sexual orientation and race will be encouraged to join us in our journey.

Presently, almost 60 percent of our team are women. However, only 40 percent have leadership positions in our organization. We have made the firm commitment of changing this situation, by encouraging women to apply for leadership positions and by purposely developing them to succeed in these positions. 

KEY RESOURCES

Our key resources are physicians (Licensed Geriatricians, Specialized Physicians, and General Practitioners) and technology (our mobile telemedicine system)

KEY ACTIVITIES 

Our key activities are the development of personalized treatment plans, the execution of house calls and follow-up, the access to geriatric products and services and the ongoing communication with relatives. 

PARTNERS + KEY STAKEHOLDERS

Our key partners and stakeholders are the following: 

Medikit - electronic prescription provider.

Prixz - online pharmacy with home delivery.

Chopo - national medical test laboratory with home-based sample collection.

AIG - provider of accident and fracture insurance for seniors between 55 and 89 years of age.

IKE - provider of ambulance and nursing assistance.

 TYPE OF INTERVENTION

Our intervention is a geriatric service at home that includes house calls and follow-up by a team of physicians led by licensed geriatricians. 

CHANNELS

 We are offering our services through B2C and B2B2C channels: 

B2C channels are mainly web marketing efforts through google adwords and facebook campaigns. 

B2B2C (starting march 2022) is divided into four groups of partner channels: 

• Insurance Brokers - Initially through Marsh McLennan that has a relationship with 2,000+ large corporations in Mexico. 
• Pharmacies and Pharmaceuticals - Initially with FESA and Bayer, we are starting loyalty and patient adherence programs. 
• Banks - Banks in Mexico have an independent retirement healthcare package for their retirees. Initially through Grupo Banorte, we plan to serve their retirees to lower hospitalizations and polypharmacy. 
• Remittance players - Mexico’s main source of income are remittances sent by expats living in the US. Through Transnetwork, we will offer our annual memberships in their recently created marketplace.

SEGMENTS

 Our beneficiaries are 65+ year-old adults and their families. 

 Our customers are divided into two groups. First, family members, typically sons and daughters of our patients, make out-of-pocket payments for our yearly memberships. Second, large companies like pharmacies and pharmaceuticals as patient adherence programs. 

VALUE PROPOSITION

For Patients, we give easy and affordable access to geriatric treatment plans at home to prevent illness and dependency. 

For Primary Caregivers, we alleviate the burden of care by assuring that their loved ones are treated by the right team of physicians in the right frequency.   

For Geriatricians, we give them unprecedented reach and capacity. They can see more patients in more places. 

 For General Practitioners, we give them the opportunity of working close to their home, interact daily with complex patients and specialized physicians, and have higher incomes than their peers. 

COST STRUCTURE, REVENUE AND SURPLUS

 Our business model is built in such a way that it creates value for every stakeholder. 

 A normal follow-up visit at a geriatrician’s office costs US$50 on average, plus the associated time, transportation, and parking expenses. A regular house call by a geriatrician costs between US$125 on average. Lyptus Medical provides geriatric house calls for seniors at an average price of US$45 per housecall, plus follow-up and 24/7 medical orientation. Our patients and their families receive much more value at an even lower cost than traditional alternatives. 

 As mentioned, a Geriatrician earns US$50 on average per consultation at their office. An average follow-up consultation lasts one hour. At Lyptus, Geriatricians earn US$25 per house call and they can perform three per hour. Therefore, they earn US$75 per hour, 50% more than their regular income. In addition, they do not have to pay for rent or for an assistant. Furthermore, patients increase their adherence to visits 3x. Therefore, geriatricians earn more and have less expenses through Lyptus Medical. 

 General Practitioners at Lyptus medical earn US$12 per house call. They can perform 80 housecalls per month working part-time. This is an income of $960/month, almost twice as much as an average full-time general practitioner earns per month. Our GPs earn more, work less and learn more through Lyptus Medical. Furthermore, 90% of our GPs have passed the ENARM exam to become specialized physicians. 

We generate revenue selling memberships to customers. We also help our allies upsell geriatric services (e.g. insurance, ambulance, caregivers, nurses) and products (medicines). In addition, we will generate additional revenue through healthcare analytics with monetizable research and marketing opportunities. 

Presently, we are generating US$5K in revenue per month, we have raised US$450K from friends and family, and have won $3K in grants. 

 We plan to increase our revenue, raise more capital, and receive more grants to finance our growth. To increase our growth, we are partnering with large corporations to start B2B2C growth opportunities. To raise more capital, we are currently working with Expert Dojo, a california-based business accelerator specialized in growth and financing. To win grants, we are applying to MIT Solve.