Bitmec Telemedicine Booth

According to the World Health Organization, around 50% of the world's population does not have access to quality medical care. Latin America, with its culturally and ethnically diverse populations, high levels of violence, growing political instability, and staggering levels of inequality, is quite a difficult region to tackle. Due to this, Latin American health systems are fragmented and segmented, limiting the region's ability to provide equitable access to public health services and quality medical care and guarantee the right to health of its populations. In the Latin American region alone, it is estimated that there are more than 165 million people without access to health services and the vast majority live in rural areas with high rates of poverty.

Although all employed Guatemalan citizens and their families are entitled to social security, the actual coverage provided by the Guatemalan Social Security Institute (IGSS) in 2016 was only around 20%. Additionally, while the Ministry of Health (MOH) is responsible for offering free services to the remainder of the Guatemalan population, the combined effective coverage of IGSS and MOH only reached around 50% of the total population. Private insurance penetration remains low, at less than 10%.

The Pan American Health Organization (PAHO) recently reported that over 50% of medical expenses in Guatemala are paid out of pocket. This indicates that approximately 9 million Guatemalans must seek alternative healthcare solutions in the private sector, often at a significant distance from their place of residence and at a high cost. This situation is particularly challenging for individuals residing in rural areas, where healthcare resources are even scarcer, with a ratio of only 1.2 doctors per 10,000 inhabitants compared to 4.2 doctors per 10,000 in more affluent urban areas.

Some of the consequences of this situation are reflected in the elevated rates of chronic malnutrition (49.8%), infant mortality (23.3/1000 live births), and maternal mortality (88 per 100,000 live births). In addition, Guatemala is undergoing a rapid epidemiological transition where chronic non-communicable diseases such as diabetes and hypertension are becoming more prevalent, especially among underserved communities. 

Considering the above, innovative solutions are needed to counter this situation and improve the well-being of the population, particularly among those historically underserved. Bitmec Health Technologies is a Guatemala-based startup that strives to improve access to healthcare services in Guatemala and abroad by developing and introducing scalable and affordable technological solutions within underserved populations.

Bitmec has developed an IoT telemedicine booth that facilitates access to high-quality primary care in underserved areas. The booth provides an enclosed, secure, and private space within a compact footprint of 14 square feet. This design allows for installation in virtually any indoor or outdoor setting, including community pharmacies, plazas, community centers, microfinance organization branches, and more.

The booth can be wirelessly operated either by a POS terminal, which unlocks it at the point of care, or by utilizing a self-service kiosk embedded in the outer panel of the booth. Before granting access, the booth undergoes a disinfection process and conducts a self-diagnostic sequence to verify the optimal functioning of all its systems.

Once inside, patients engage with a primary care physician via a high-resolution camera, a screen, speakers, and medical-grade sensors embedded throughout the booth. These sensors gather heart rate, oxygen saturation, height, weight, blood pressure, and body temperature. In addition, the boot includes a digital stethoscope that picks up heart and lung sounds. On the other end of the screen, remote primary care professionals guide patients through the entire process in real-time, record the measurements captured by sensors, and document the interaction using a proprietary telemedicine platform equipped with an embedded EMR module.

Upon concluding the consultation, prescriptions, lab orders, and referrals can be printed if necessary or sent electronically. Additionally, follow-up visits can be scheduled as needed.

The booth can access the internet via an embedded SIM card or a direct Ethernet port. This technology only requires access to a standard 110v power outlet and is equipped with a voltage regulator and a battery pack to withstand power surges and adapt to unreliable grid connectivity.

Leveraging its IoT capabilities, the booth is remotely monitored from Bitmec's headquarters. Through its network operations center, Bitmec can continuously track a range of parameters, such as internet speed, consumable levels, and sensor health, in real time. This monitoring process is aimed at maximizing booth uptime and ensuring seamless operation.

The integration of hardware and software in Bitmec's telemedicine booth ensures that patients can conveniently and reliably receive comprehensive remote care, offering an experience closely resembling an in-person visit. This versatility makes the booth applicable to a wide range of settings, particularly benefiting underserved populations.

Our solution serves a wide range of individuals, including:

Underserved Populations: Those residing in rural or remote areas with limited access to healthcare facilities can benefit greatly from our telemedicine booths. By bringing virtual consultations directly to their communities, we bridge the gap in access to medical services and provide timely healthcare assistance where it is needed the most.

Urban Dwellers: This is especially beneficial for individuals who work long hours for modest wages, as they may find it challenging to take time off for traditional medical appointments. Patients can receive quality medical care without the need to commute or wait for extended times, enhancing accessibility and efficiency.

Patients with Mobility Issues: For individuals with mobility challenges or disabilities, accessing traditional healthcare facilities can be particularly burdensome. Our solution eliminates the need for physical travel, allowing these patients to receive necessary medical attention in nearby community spaces, such as pharmacies, community centers, and convenience stores.

The impact of our solution on the lives of the target population includes:

Increased Access to Care: By bringing healthcare directly to communities, we ensure that individuals who previously faced barriers to access can now receive timely medical assistance.

Enhanced Productivity: Our telemedicine booths offer convenient access to medical consultations, reducing the time employees or self-employed individuals need to spend away from work for healthcare appointments.

Improved Health Outcomes: Early detection and treatment of medical conditions such as hypertension and diabetes can lead to better health outcomes and reduced healthcare costs in the long run.

Cost Savings: By reducing the need for physical travel and eliminating unnecessary emergency room visits, our telemedicine booths can help patients reduce the financial burden of an illness.

Bitmec boasts a multidisciplinary team with a wealth of expertise spanning engineering, public health, economics, product design, and venture capital management. Our founders, José Ordóñez, David Barac, Alvaro Rivera, and Lorena Chacón, collectively bring decades of experience and a deep understanding of Guatemala's socio-economic landscape.

• José Ordóñez, JD, MBA (Co-founder and CEO): With over 20 years of experience leading impact-driven companies, José is a prominent figure in Guatemala's entrepreneurship ecosystem. He has a proven track record of success with impactful startups such as Kingo Energy and HYBRICO.

• David Barac, BA (Co-Founder and President): As a serial entrepreneur specializing in international economics, David brings over 10 years of experience in the technology and impact sectors across low to middle-income countries.

• Alvaro Rivera, MD, MPH, MBA (Co-founder and Head of Product): With more than a decade of experience in community medicine, public health, and innovation, Alvaro has spearheaded numerous healthcare initiatives in Central America, collaborating with governments, NGOs, and the private sector.

• Lorena Chacón, BSc, MS (Co-founder and Director of Strategic Partnerships): With over 20 years of experience leading projects for international development agencies, Lorena has overseen projects related to healthcare and human resource development in vulnerable areas.

In addition to the founders, the team comprises over 10 highly talented software and hardware engineers from diverse backgrounds, along with experienced product managers. Together, they have played a pivotal role in developing Bitmec's technological solutions. Additionally, our team includes personnel with extensive experience in implementing projects focused on community development and healthcare services in Guatemala and other countries in the region.

Our team is uniquely positioned to deliver this solution due to several key factors:

1. Expertise in Telemedicine: We have a dedicated team with extensive experience in telemedicine technologies and healthcare delivery systems. 

2. Technological Proficiency: With a strong background in technology development and implementation, our team of engineers and field personnel is well-equipped to design, build, and deploy innovative telemedicine solutions. 

3. Commitment to Accessibility: Bitmec is deeply committed to making healthcare accessible to all, regardless of geographic location, socioeconomic status, or physical ability. 

4. Collaborative Approach: the company believes in the power of collaboration with key stakeholders and actively seeks partnerships with healthcare providers, community organizations, and government agencies to maximize the impact of our solutions. 

Our process began with a deep dive into the healthcare landscape of Guatemala. We engaged with healthcare professionals, community leaders, and government officials to gain insights into the prevailing challenges and unmet needs in urban and rural settings. Through interviews and surveys, we gathered qualitative and quantitative data to understand our target audience's preferences, pain points, and expectations.

As we refined our product concept, we initiated pilot tests in five communities across Guatemala. These on-the-ground experiences allowed us to observe firsthand how patients and healthcare providers interacted with our telemedicine booth, providing invaluable feedback on usability, functionality, and overall user experience.

Through these pilots, we also identified key features and functionalities that resonated most strongly with users, such as vital signs measurements, privacy during the medical encounter, and data safety. This also allowed us to fine-tune our solution to address the specific needs and preferences of the end user. Throughout this process, we prioritized affordability, accessibility, and reliability to ensure that our telemedicine booth could effectively serve underserved populations across Guatemala and other countries in the region.

In addition, the field experience allowed us to validate the demand for our telemedicine solution and assess the willingness to pay. Finally, these experiences also enabled us to develop and validate our business model. 

We've delivered services to over 20 communities, serving more than 5000 patients in Guatemala, and have already established a presence in several countries across the region. Our goal for the upcoming year is to extend our reach even further. We consider this program to be a vital catalyst in propelling our expansion objectives forward.

We are applying to Solve because we believe in the power of collaboration to overcome challenges and drive meaningful change. One of the significant hurdles facing Bitmec is navigating the complex regulatory landscape as we aim to expand our telemedicine solution to more regulated markets such as Mexico and Colombia, as well as other regions globally.

To scale our solution effectively, we need to attain international certifications, starting with the ISO13485-2016 certification for medical devices. Subsequently, we will pursue a CE mark and FDA clearance, which are essential for market entry in many countries worldwide. However, obtaining these certifications entails significant costs and may result in delays that impede our company's growth trajectory.

If selected to participate in the Solve program, we hope to receive support in navigating the regulatory landscape. Specifically, we seek assistance in mapping out regulatory requirements across different countries, connecting us with regulatory experts who can provide guidance and advice, and potentially securing funding, whether through grants, loans, or investment, to cover the expenses associated with obtaining certifications.

Furthermore, while not directly related to regulatory affairs, we are also interested in receiving advice from intellectual property (IP) experts. We aim to explore opportunities for patenting components of our telemedicine solution, understand the timeline and costs involved, and identify funding sources to cover these expenses, whether through grants or investment.

Another area where Solve can help Bitmec is in exploring ways to reduce the cost of our telemedicine booths. By identifying opportunities for cost optimization and efficiency improvements in the manufacturing process, sourcing of materials, or technology components, we can significantly lower the production costs of our booths. This, in turn, would enable us to scale our solution more rapidly as less capital would be required for expansion. Reducing the cost of the booths would directly benefit end-users by making access to healthcare even more affordable and convenient. Lower costs would make our telemedicine services accessible to a broader segment of the population, particularly those in underserved communities who may face financial barriers to healthcare. By leveraging Solve's network of experts and partners in manufacturing, supply chain management, and technology, we can identify innovative solutions to drive down costs while maintaining the quality and effectiveness of our telemedicine booths.

Overall, we believe that the resources and connections offered through Solve can help us overcome these barriers and accelerate the growth and impact of our telemedicine solution, ultimately enabling us to reach more underserved communities and improve access to healthcare globally.

Our solution provides accessible and comprehensive primary care services through telemedicine booths for underserved populations. Below are the most relevant areas where our telemedicine booths are innovating in healthcare delivery:

Technology: Our booths are equipped with advanced telemedicine technology, including high-resolution cameras and medical-grade sensors. This allows patients to engage in remote consultations with healthcare providers with a close to in-person experience. Moreover, we are harnessing the IoT capabilities of the booth to monitor them in real time, ensuring maximum uptime and operational efficiency.

Convenience and Accessibility: Our booths can be deployed in a variety of settings including community pharmacies, community centers, plazas, convenience stores, and workplaces. The flexibility provided by our booths makes healthcare more accessible and convenient for individuals who may face barriers to traditional healthcare services. Our solution brings healthcare directly to the community, reducing the need for travel and wait times.

Safety and Hygiene Features: To address concerns about safety and hygiene, our booths are equipped with automatic disinfection systems, security locks, and safety protocols to ensure a safe and private healthcare environment for patients.

The inputs, outputs, and outcomes of the telemedicine booth solution are outlined as follows:

Inputs:

• Capital:  capital required for the development, manufacturing, and deployment of the telemedicine booths.
• Human resources: Skilled professionals are needed for designing, manufacturing, installing, and maintaining the booths, as well as for providing medical services remotely.
• Technology infrastructure: hardware, software, internet connectivity, and electricity

Outputs:

• Deployed telemedicine booths: The physical installation of the booths in various locations, such as pharmacies, community centers, or rural areas.
• Remote consultations: The provision of medical consultations to patients through the telemedicine booths, facilitated by healthcare professionals.
• Health data collection: Gathering and recording vital signs and other relevant health information from patients during the consultations.
• Prescription and referrals: Issuing prescriptions, laboratory orders, and referrals as needed based on the outcomes of the consultations.

Outcomes:

• Improved access to healthcare: The telemedicine booths enable individuals, especially those in underserved or remote areas, to access medical services conveniently and affordably.
• Enhanced population health: The increased availability of services can contribute to better overall health outcomes at the community and population levels by facilitating preventive care, early detection, and management of health conditions.

Our impact goals for Bitmec's telemedicine solution are centered around improving access to quality healthcare, reducing healthcare disparities, and enhancing health outcomes for underserved populations.

Specifically, our impact goals include:

Increase Access to Healthcare: Our primary goal is to expand access to healthcare services for individuals living in remote or underserved areas where traditional healthcare facilities are scarce. We aim to measure our progress by tracking the number of telemedicine consultations conducted in these communities over time.

Reduce Healthcare Disparities: We strive to address healthcare disparities by providing equitable access to medical consultations and services, regardless of geographic location, socioeconomic status, or other demographic factors. We will measure our progress by monitoring the demographic diversity of individuals utilizing our telemedicine booths and assessing the extent to which our solution reaches marginalized populations.

Improve Health Outcomes: Our ultimate goal is to improve health outcomes by facilitating early detection, diagnosis, and treatment of medical conditions through timely telemedicine consultations. We will measure our progress by tracking key health indicators, such as the prevalence of chronic diseases, rates of preventable hospitalizations, and overall patient satisfaction with telemedicine services.

To measure our progress towards these impact goals, we utilize a combination of quantitative and qualitative indicators, including:

• Number of telemedicine consultations conducted
• Geographic distribution of telemedicine users
• Demographic diversity of telemedicine users
• Health outcomes indicators (e.g., improvement in health status)
• Patient satisfaction surveys and feedback

Our IoT telemedicine booths rely on a blend of hardware and software components to facilitate remote medical consultations and deliver essential healthcare services. The hardware comprises high-resolution cameras for clear visual communication, interactive screens for patient engagement, medical-grade sensors to measure vital signs, automatic disinfection systems for hygiene, and security features to ensure patient confidentiality and safety. The software platform enables audio-video communication, stores electronic medical records securely, analyzes patient data for insights, and provides a user-friendly interface. Additionally, we are developing our own artificial intelligence and machine learning algorithms, which will assist clinicians in making informed decisions. Finally, connectivity options include internet access via SIM cards, ethernet ports, or Wi-Fi, ensuring reliable communication with remote healthcare providers in almost any setting. 

4 Co-founders

23 Full time on payroll

2  Part-time on payroll

5 Contractors

Bitmec has been dedicated to developing its telemedicine solution for over three years, with the concept commencing during the onset of the pandemic in 2020. Following extensive periods of customer discovery, design refinement, and iterative improvements, we successfully launched the first version of the booth in 2021. Subsequently, the booth has undergone several updates and enhancements, informed by valuable insights gained throughout its implementation phase.

Bitmec has embraced diversity and inclusion principles from its inception. We uphold a strict non-discrimination policy, ensuring that individuals are judged solely on their abilities and contributions, rather than factors such as race, color, religion, gender, age, national origin, disability, marital status, or sexual orientation.

We invest in training and education programs on diverse topics, including enhancing awareness and understanding of diversity and inclusion issues among our team members.

At Bitmec we cultivate a supportive and welcoming environment where all team members feel valued and respected. This includes facilitating open communication, encouraging collaboration and teamwork, and providing opportunities for mentorship and professional development.

Finally, we proactively reach out to our team members for feedback to assess the effectiveness of our diversity and inclusion efforts. This feedback helps us identify areas for improvement and implement initiatives to address any gaps or challenges

Bitmec operates primarily on a PAAS (Platform as a Service) business model, wherein our telemedicine booths are strategically installed at key access points for a monthly fee. These booths are then managed and operated by third-party entities such as medical call centers, insurance companies, and government agencies. While healthcare providers deliver the medical services, Bitmec takes on the responsibility of ensuring that the telemedicine booths maintain over 90% uptime, thus guaranteeing continuous access to healthcare services for the communities we serve. Healthcare providers commonly deliver services to end consumers through our booths, either on a fee-for-service basis or as part of a membership or insurance plan.

Furthermore, Bitmec offers a B2C (Business to Consumer) model through partnerships with healthcare providers and community pharmacies. Under this model, patients have the option to pay out of pocket for consultations, or a sponsoring organization or insurance plan can cover the consultation fee on their behalf. The revenue generated monthly is then distributed among our partners, fostering mutually beneficial relationships and expanding access to healthcare services.

Bitmec's financing stems from Angel Investors, Family Offices, and early-stage venture capital funds (i.e., Magma Partners). Additionally, the company has secured grants from local (i.e., SENACYT) and international organizations (i.e., Inter-American Development Bank)  to support product development and booth manufacturing. Currently, Bitmec has raised more than 70% of its seed round and expects to close it in the following months.

Bitmec foresees reaching a break-even point within the next two years as it continues to expand its presence in Guatemala and other countries across the region. This projection is in line with the growth trajectory and revenue generation potential of its existing business models.