Summary: Enhancing Access to Health Care in Latin America through Technology and Innovation

Speakers:

• David Fox, Vice President, Head of Business Development (Former Head of Life Sciences, Healthcare, and Chemicals), DHL Global Forwarding Americas
• James Hogan, President, Medtronic Latin America
• Gustavo Menendez-Bernales, Managing Director, Internet Business Solutions, Cisco Systems
• Scott C. Simmons, Director of TeleHealth, University of Miami Miller School of Medicine (moderator)

Summary

On June 13, AS/COA and the University of Miami’s Center for Latin American Studies held an expert panel on health care in Latin America, focusing on the role of technology and innovation in broadening access to care and the quality of services. Panelists discussed innovative solutions being implemented in the region, how new technologies are empowering individuals, and the need for cross-sector collaboration.

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Today’s Health Care Innovations

Scott Simmons of the University of Miami’s TeleHealth initiative opened the program with a description of telemedicine as a technology that allows skilled physicians, nurses, and other health care practitioners to efficiently distribute their services across populations that may not otherwise have access. Gustavo Menendez-Bernales of Cisco Systems noted that his company is developing telemedicine projects that enable patient-physician interactions in real time, via videoconference. In Latin America, where 70 percent of all heath-care specialists are located in urban areas, access to necessary health care services among rural populations traditionally comes with the burden of traveling hours or days and great financial hardship. Allowing for remote consultations via video technology can have an important impact in remote areas. Menendez-Bernales argued that there is great growth potential for these technologies in Latin America, given the alignment of several factors: affordability and accessibility of equipment, consumers’ increasing familiarity and ease with videoconferencing, and improved broadband connections throughout the region.

James Hogan of Medtronic outlined the remote monitoring technologies in which his company has invested, and added another benefit to their use: allowing physicians to treat patients in real time. He described the all-too-familiar situation in which a patient feels an alarming symptom one day, and visits his or her physician the next day—when the symptoms have inevitably subsided—to see what it might be. The visit becomes a waste of time and resources on both ends. Hogan described how Medtronic medical devices, namely the pacemaker, tackle this problem. Pacemakers traditionally regulate heart rate by delivering electrical impulses to the heart, but now they can also monitor and record heart performance over time. This allows physicians to download patient data remotely, look for anomalous behavior, and alter treatment accordingly. Patients are thereby treated with greater precision and almost instantaneously, resonating with Menedez-Bernales’ argument that current health care innovations not only focus on ensuring equal access, but also timely access.

Health care innovations are also optimizing the delivery and distribution of medical equipment and medicines. David Fox of DHL Global Forwarding explained that about 25 percent of life science products, such as vaccines and drugs, are moved using cold-shipping solutions; this figure is likely to double over the next five years. DHL recently launched a new cold-shipping freight called Thermonet, which keeps the temperature of a product at an appropriate level throughout the life of its shipment through the use of monitoring devices. This is a revolutionary solution for patients that require temperature-sensitive drugs such as insulin, but live in remote areas. According to Fox, these patients can now receive “the right drug at the right time and in the proper condition.” 

Empowering Individuals through Telemedicine

Whenever a new technology is implemented in a service sector, the main concern involves the experience of the beneficiary. In the case of telemedicine, Menendez-Bernales noted that Cisco reports over 90 percent patient satisfaction, because the patient generally incurs the main benefits of convenience: saving time, avoiding extensive travel, etc. But he cautioned that there is room for improvement, notably an ever-changing point of care. Currently, Cisco technology is connecting institutions, such as specialists in the capital with clinics in rural areas. In the future, though, patients might not even need to visit clinics—they might be able to interact with physicians over videoconference from the comfort of their own homes.

In addition, an audience member suggested that in the near future, patients might be able to track their own medical data, such as blood-sugar levels and heart rate, through applications on their cell phones or other electronic devices. Regardless of when these technologies become available, skilled physicians and nurses remain invaluable in the analysis of medical data. Simmons stated that over 85 percent of health care transactions are cognitive, meaning that specialists continue to be the cornerstones in any health care system. Technology is facilitating the gathering of patient information and the speed at which physicians can access such data, but analysis and judgments will always require the mind of a medical expert. As Hogan put it, without trained individuals, “technology is just technology.”

Cross-Sector Collaboration

Speakers agreed that efficiently enhancing health care in Latin America requires collaboration among governments, corporations, philanthropy groups, and non-governmental organizations. To date, multilaterals have assisted with infrastructure projects such as broadband expansion in the region. Menendez-Bernales noted that the World Bank and Inter-American Development Bank are increasingly interested in funding telemedicine initiatives and other successful partnerships with governments. Speakers acknowledged that corporations also play a critical role, not only as economic drivers but also as philanthropic agents. Hogan argued that profitable companies “have a moral obligation to do substantial philanthropy.”

Ultimately, the overall sentiment was that governments are not doing enough to ensure adequate delivery of primary health care services in Latin America. An audience member brought up the subject of Haiti, which faces development challenges and instability. Menendez-Bernales noted that in Haiti, telemedicine has had a positive impact following the 2010 earthquake, but the true challenge lies is designing a public model that can transition from disaster relief to a long-term health plan. On a broader scale, Hogan argued that governments should focus more on preventive care, which will prove more cost efficient in the long run. He noted that a healthy individual can work and contribute to society without pulling significant resources for treatment of preventable ailments, concluding that “a healthy population is a wealthy population.”