F084 Doctors in digital health 4/4: Mediquo: Whatsapp for healthcare (Guillem Serra)

Guillem Serra comes from a family of doctors and studied medicine himself, but saw that everyday routine doctors operate under is too repetitive for his taste.

He decided against becoming a traditional doctor and created a platform connecting patients to doctors in a healthcare regulation-compliant way. MediQuo is a leading eHealth app in Spain and Latin America.

EHRs made medicine boring and frustrating

Guillem Serra.

Guillem is the 4th generation of doctors in his family. Although he trained as a regular medical doctor in Spain, he had the feeling that the traditional routine was not for him. Faced with the reality of the daily use of electronic health records (EHR), he noticed a lot of downsides in the daily medical practice, such as spending too much time doing accountability processes with no role division, resulting in the confusion around patient data. Time spent on writing and data entering shifts the focus away from the patient. "When I finished medicine, I started working as a medical doctor. In my first year, I was very bored. When I was faced with the idea of working every day with the same routine of the medical practice, seeing the same patients every day, I had the feeling that it was not what I wanted to do in my life".  

Electronic healthcare records were already in place when he was in his medical practice, "EHRs are built to record accountability, which means they record everything - invoicing, etc. They are not built for helping doctors. As a doctor, you end up doing many boring things that do not add value to the quality of care. More than half of the time in clinical practice is spent writing in the EHRs, which is why a new role entered healthcare - doctor's assistants that do the recording to the EHR, while the doctor is talking to the patient. This is a clear symptom that something is not working right." 

Besides medicine, he also studied math, and his strive for innovation was so strong that he decided to change his profession: "I started working as a C++ developer in a MedTech startup. This was when I changed my career path".

Easing communication in healthcare

Guillem decided to fix the problem of traditional time-consuming practice by implementing more communication and less tradition. "I started as a developer in a MedTech company. In eight years, I never thought about creating a company or business. I didn't think about being a businessman or an entrepreneur. But when I saw in my sector that all my colleagues were using WhatsApp or instant messaging apps to talk to patients informally, I realized I have never seen anything like that in the startup world".

The Creation of MediQuo is one of the easiest solutions in healthcare both for the patient and the doctor. Also called "the Whatsapp for medicine" or "the hospital in your pocket," MediQuo is a 24/7 chat with doctors and specialists, where a patient can directly talk to doctors, as well as join health groups and seek medical help validated by specialists and the team of health advisors. The service offers a wide choice of doctors: "You can click on any doctor, and you can talk as long as you want, as many times as you want, with as many doctors you want at once," explains Guillem Serra. Doctors have to answer in less than two minutes: "It's like Whatsapp, but instead of having friends, you have doctors. These doctors have a green button on the bottom left of their pictures. If they are green, it means they are available, and they have to answer in less than two minutes. And then you just need to click on them and start talking". Serra also emphasizes that while MediQuo supports video calls, it's the main feature is that it is a chat. It is more practical in some instances and requires less infrastructure. While video chats and conferences have increased lately, especially because of the global COVID-19 pandemic, a large portion of communication is done through emails and messaging applications. 

With no time limitation and favorite doctor selection, the doctor-patient relationship is boosted. Additionally, MediQuo allows doctors to earn extra income. Although the advantage of MediQuo of being used both in Spain and South America, the MediQuo team needs to deal with cultural issues based on different healthcare systems. Differences include different levels of engagement between Latin American and Spanish users, different public healthcare policies, different languages spoken, and different willingness to pay since MediQuo works on a subscription basis. "We need to separate the Latin American groups to the U.S. and Spanish groups because the difference is massive in terms of engagement from Latin American users instead of Spanish users. Also, the different languages are spoken, different cultures, and different practice hours allowed to make a difference in this. Furthermore, we have seen that Spanish and Americans are more likely to pay than South American countries. Spanish people convert to premium easier than South Americans or Mexicans". Surprisingly, the reason for that is access to credit cards - in some countries in South America, access to credit cards is restricted, making it harder for patients to pay in that matter.  

The future is digital

COVID-19 shed light on the use of telemedicine for the future. MediQuo saw a great increase in people downloading the app worldwide, as well as an increase in medical consultations. From 3000 daily consultations in April 2019, the number grew to 15.000 in December 2019, when the pandemic began. 

Serra is not worried about competition, or WhatsApp entering healthcare in a more serious manner. "If everyone worried about WhatsApp, we wouldn't have any more startups. An important difference is that WhatsApp is catching communication markets, but it is still a general solution. WhatsApp doesn't keep the data or have your medical record, which is a legal compliance issue in healthcare. In some countries, you are required to store data for 5 or 10 years, which is not what WhatsApp does."  

The Spanish healthcare and the future of healthcare 

In the podcast discussion, Serra also talks about his perception of the Spanish healthcare system, which he perceives as very advanced in terms of digitization. As he explains, about 20 years ago Spain introduced electronic medical records that were connected and integrated with all the GPs in Catalonia. In the past years, there has been a lot of digitalization in the Spanish healthcare system in Spain, especially in the private sector. "Insurance companies offer forms of telemedicine and hospitals are acquiring and adding telehealth solutions to their service. MediQuo is now working with the second biggest medical hospital group in Spain and private corporations," describes Serra. The use of telemedicine has increased exponentially in the past years, and especially now after COVID-19: "Telemedicine to talk to patients and health insurance companies paying for these public services offering this kind of solution to the to the population is something that was a trend. Now I've seen that the trend has spiked, and I believe telemedicine is here to stay." 

Asked about his expectations and plans regarding the future development of MediQuo, he predicts there could be an even greater connection between online and offline services. He believes hospitals will increasingly need to adopt an online-first mentality and provide as many services as possible online, while still sustaining physical space for procedures and exams that cannot be done online: "This is further in the future, but more specifically for MediQuo, I believe we have a lot of space for optimizing instant messaging. With the help of AI, we could do more to help doctors respond faster through auto.complete and auto-reply options. The opportunity here is much bigger than in video consultations."