Felipe Maqueda wears a white coat and has a stethoscope draped around his neck, but only out of habit. He’s not actually examining anyone. Instead, Maqueda is diagnosing and treating patients through a laptop. His screen is divided between videos, chats and medical records.
Maqueda, a specialist at the Autonomous National University of Mexico, works with Mediconecta, a distance medicine -- or “telemedicine” -- network, which serves more than two million people with on-demand medical consultations from internists over video. During sessions that last between 20 minutes and an hour, he hears about all manner of ailments.
“One patient was bit by a dog and was afraid of getting rabies ... he’d read that [rabies] was fatal,” Maqueda told Univision News over video conference. “And there was a young man who was afraid to go to the doctor. I suspected he had colon cancer and in the end, studies confirmed the diagnosis.”
Mediconecta, which launched in 2011, serves patients across Latin America, including in Costa Rica, Venezuela, Chile, Ecuador, Peru and Mexico, often covered through those patients’ insurance. But since early this year, doctors from the network have also been attending Hispanic patients in the United States. It’s part of an effort to serve Latin American immigrants who can’t afford the high costs of U.S. healthcare or simply prefer to see a doctor from their home country. Each conversation costs $25. Most doctors are general practitioners, but pediatricians, psychologists, nutritionists and family planning and sexual health specialists are also available.
"For many people, especially for first-generation Hispanics, the possibility of having a doctor from your home country is attractive,” says Daniel Silberman, who co-founded the network in Miami. “Accessing healthcare is a complex issue, especially if you don’t have the resources or are uninsured. But almost everyone has internet.” Silberman and co-founder Salomon Simkins are engineers from Venezuela who received MBAs from top U.S. universities, and longtime friends.
If a patient in Miami signs onto Mediconecta’s website today, an ad appears in Spanish, which reads: “Are you a Venezuelan living abroad? Speak with a doctor in Venezuela face-to-face via video-conference. No appointment required, no wait time. Just $15 per month.”
When it comes to accessing health services in the U.S., Hispanics face many challenges: one out of every four do not have health insurance. Access is poor. And studies show that hospitals often don’t have interpreters.
Maqueda says Hispanics also have trouble adjusting to cultural differences in care. "Medicine in the United States is very tech-driven, which means it often treats diseases, not patients,” he tells Univision News through video chat. “In Mexico we learn empathy and patients recognize that. You want a doctor who treats you well when you are vulnerable and uncomfortable.”
Silberman says the majority of U.S. users so far are in Florida, but would not say how many people are currently using the service in the United States. Doctors are only authorized to give U.S. patients advice and to converse with them.
For patients in Latin America, doctors can also write orders for additional exams and lab tests, as well as prescribe medications (only in the countries where they work). In some cases patients are referred to physicians for in-person follow-up.
Each doctor in the network -- there are about 50 -- uses his/her own computer for video conversations. The system, similar to Skype, can be downloaded on smartphones, tablets and computers. Patients usually wait an average of five minutes to be seen by a doctor, who begins by asking questions about symptoms.
"Every disease has distinguishing elements,” Maqueda says. “So remote diagnosis begins with questioning. With patient consent, sometimes we also ask the patient to show us things through the camera -- dermatological diseases, sexually transmitted diseases, traumatic injuries."
Telemedicine is not a new concept -- its beginnings in the United States date back to the early days of space exploration -- but greater application is now possible thanks to technological advances like mobile phones with internet, higher resolution video and electronic medical histories.
Though Mediconecta is a pioneer in the field in Latin America, it’s still a small operation. So far, it’s raised just $4.1 million in angel funding. Mediconecta plans to continue expanding throughout Latin America and Spain. It also plans to expand into wellness and specialty areas.
A small number of U.S. doctors and specialists are also treating patients in Latin America and other parts of the world through Mediconecta, Silberman says. The company is also working to offer “common plans” that reflect the reality of many Latin American families, where people live in different countries and not everyone has access to health insurance or health services.
Mediconecta, which was selected this month as one of the world’s most innovative companies in the health sector by Startupbootcamp, Europe’s largest business accelerator operating in eight countries, has grown over 300% in the last two years.
People in some of the most rural areas of the world, including in the Amazon and Alaska, are currently being treated through telemedicine, which lowers costs and facilitates monitoring after consultations. Plus, the Affordable Care Act, also known as Obamacare, made telemedicine a priority in 2010. As a result, telemedicine consultations are now covered by Medicare in some states.
Maqueda believes that U.S. Hispanics, in particular, appreciate the system’s anonymity.
"It's very easy to just click and ask,” he says. “It’s easier to tell a doctor who’s far away what’s going on. Sometimes I think it is just a matter of not being stigmatized.”
Jessica Weiss contributed to this report.