ConsejoSano translates to “Healthy Advice” in English and that nicely sums up the mission, tailored to Spanish speakers in the US, of this Los Angeles-based digital health startup. Its twist on helping non-English speakers navigate the healthcare system is to link US patients to doctors who are based in their native land. This out-of-the-box, cross-border thinking is catching on. Last month health benefits consulting firm Mercer announced an alliance with ConsejoSano to help employers simplify care, increase engagement, and lower costs related to Spanish-speaking employees. Earlier ConsejoSano was recognized by the Commonwealth Fund as a “healthcare innovation worth adopting” for its health and wellness mobile app offering access to native Spanish-speaking doctors, text-based behavior change programs, and a YouTube wellness channel. Founder and CEO Abner Mason spent years on the frontlines of the nation’s HIV/AIDS crisis, establishing the first business councils on HIV/AIDS in Mexico and Jamaica and serving on the Presidential Advisory Council on HIV/AIDS under President George W. Bush. We caught up with Mason, who also leads the Workplace Wellness Council of Mexico, to find out more about his current mission to help Spanish speakers improve their overall healthcare experience:
Oliver Wyman Health: What have you learned from your employee wellness work in Mexico?
Abner Mason: I have been working in Mexico building another part of our business, the Workplace Wellness Council of Mexico. We help companies in Mexico improve employee health with wellness programs. We noticed there were some healthcare solutions that were growing faster in Mexico than in the US. In particular, telehealth is taking off there due to the economic stratification in the society. The higher income people go to expensive options in Mexico or to the US or Europe for healthcare and lower income patients use government services, while the middle class is looking for high-quality, affordable, and convenient care. Telehealth has become a really attractive solution.
OWH: What problem are you trying to solve in the US?
AM: The current healthcare system is not designed for Spanish speakers, and even for English speakers it is very complicated and very hard to navigate. The US has a large and growing Hispanic population of which one-third are speaking only Spanish and another one-third can speak enough English to get by but have trouble on topics like healthcare that require more nuance. Some 18% of the US population is Hispanic today and this percentage will grow to 30% by 2050. In addition, Hispanics make up one of the most underinsured populations so they are going to benefit disproportionately under the Affordable Care Act. That equates to some $62 billion in new premium revenues over the next seven years. Insurance companies and other providers are looking to attract these folks and professionals in the healthcare system are looking to better serve them. And the industry as a whole is moving to consumerism and consumer choice in health plans and treatments. There’s opportunity to provide a solution for the US market that takes into account what we’ve learned across the border as well as these trends in the US.
OWH: What was the lightbulb moment when you realized cross-border connectivity could be the possible solution?
AM: The very first time I visited a telehealth call center in Mexico. I saw doctors in white jackets with headsets on sitting at computers, following Cleveland Clinic protocols and helping people all across Mexico. It struck me that they could be taking calls from anywhere. There are tens of millions of people in the US delaying healthcare because they can’t find a native language speaker. If we kept our eyes narrowly focused on old approaches, we would never find a solution. We had to look outside the box and across the border. This would not have been as effective 10 years ago but now patients have access with the mobile phone, and a large percentage of Hispanics have mobile phones. This has put the power in the hands of our customers. There is no reason that a border has to prevent a person on the US side from getting culturally appropriate advice. They have the capability in their hands.
OWH: How did you get started? What are your recent milestones?
AM: Our first service to begin with was access to a native Spanish speaking doctor 24/7. We partnered with a large, established high-quality physician telehealth service in Mexico that could scale and meet our volume needs. We launched some small direct to consumer projects to get feedback from users. We weren’t sure if health plans and corporations in the US would be willing to do this. We give a lot of credit to David Kaplan at Mercer for seeing long before others did how valuable this service could be. He saw the opportunity for his clients to solve this challenge. In addition to our alliance with Mercer, we have signed up our first health plan and we are talking to four or five others. As a result of our partnership with the physician call center in Mexico, we did not have to recreate this operation, allowing me as an entrepreneur to focus on building the business in the US and designing mobile apps and platforms. In the future, we will offer other services in addition to telehealth and partner with best-in-class providers. We want to be most trusted portal to the Hispanic community in the US.
OWH: Have you run into special regulatory concerns working cross-border?
AM: We continue to be sensitive to how each state regulates the practice of medicine. We have to be careful that we don’t practice medicine, that we don’t create a doctor-patient relationship, that we don’t write prescriptions. There are bright lines between clinical advice and functioning as a triage service. As soon as we determine that the caller needs a physician consultation, we can transfer them to a US provider. We navigate the caller to an in-network provider, for example, or to a US telemedicine provider. We serve as an entry point to the system in situations where a person might not have ever entered the system at all. We help solve immediate questions but also try to engage this person in their healthcare, asking about prevention and immunizations. We have nutritionists and mental health experts on staff to provide a broad range of services.
OWH: What does the future of healthcare look like to you?
AM: The future has to be built around information. Big data is powerful but it’s not meaningful unless it is presented to people in a way that can help them change their behavior. Historically a person’s health record was written in a way that they couldn’t understand it and it was maintained in a way that they couldn’t access it. People know more about the tire pressure in their cars than they do about their own blood pressure. We’ve created a society where that information isn’t considered valuable or meaningful. And it hasn’t been because it’s not actionable. Wearables are early steps to giving people the first steps to monitor their own health. If we can get to the point where the health information is ubiquitous, like wearable clothing, then we will get to the point where people can understand the information and use it to change their behavior and health.
OWH: What advice do you have for other entrepreneurs?
AM: You have to stick to your guns. Investors initially laughed at me when I talked about cross-border doctors. You have to believe enough in what you are doing. We created a market. We had to convince people that there was a market. You have to convince people that your idea makes sense. It’s important to think like an end user. We didn’t listen to the healthcare plan executive. We listened to the people who told us that they needed to speak to a real doctor who understood them. If you look at the product development from the point of view of the people you are trying to help, it will force you to come up with innovative ideas. Necessity is the mother of invention. Be willing to go where that path leads, even if it is to a new place. It can be lonely but there are people out there who get it and will join and support you.