MiSalud Health Brings Spanish-Language Virtual Care Rooted in Mexican Culture to the United States
A team of co-founders are building on their Silicon Valley experience and a tech surge in Guadalajara, Mexico, to create a new virtual care offering for Spanish-speakers in America. It’s a holistic, culturally-responsive approach to health that’s a breath of fresh air for an often under-treated community.
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Challenge
It’s payday at a medium-sized onion farm in Southern California. The workers, the majority of whom are seasonal migrants from Mexico, gather in the break room waiting for their checks. The HR representative enters the room, hands out the paychecks and then attempts to tell the employees about some health benefits. The problem is, he speaks no Spanish. And even if he could, chances are that the healthcare providers available might not speak Spanish either — less than 5% of doctors and nurse practitioners in the US do.
Now, imagine instead that at this same payday, a team of Spanish-speaking doctors and healthcare providers are on site. They give a presentation to the employees in Spanish and provide health screenings then and there. The employees have their blood pressure checked, height and weight recorded, and blood drawn for routine labs. As a result of these screenings, it’s discovered that more than 74% of employees have severe unmanaged chronic health conditions, like diabetes, hypertension, and high cholesterol.
But it doesn’t end there. Communication with the same healthcare provider continues using a mobile app. The workers get follow-up care and a health plan from someone they’ve met and trust. If they don’t respond to letters or notifications on the app, they get a phone call to walk them through what steps they need to take for their health. It’s a relationship — a relationship with someone who understands their culture, who can, for example, talk someone with diabetes through lowering their carb intake while taking into account that a tortilla is a staple food of their diet.
Origin Story
The scenario above isn’t just an exercise in imagination. It’s a real case study from MiSalud Health, a fast-growing Spanish-first bilingual digital health platform. It’s the brainchild of three co-founders — Cindy Blanco, Wendy Johansson, and Bismarck Lepe — who’ve known and worked together on different companies for the past 15 years, brought together by a shared vision and passion to champion equity and access in tech for underrepresented people and communities.
For instance, over the past ten years or so, the trio has worked towards establishing a thriving tech hub in Guadalajara, Mexico. In 2016, Blanco co-founded StartupGDL, an organization dedicated to attracting global high-growth tech startups to the area, contributing to education, economic development, and equity in the IT ecosystem there. StartupGDL is a sister organization to Wizeline, a technology services provider of digital solutions, co-founded by Johansson and Lepe. Together with other innovators, they’ve created opportunities for growth in the region, connecting Mexican tech workers to the global economy and changing the lives of families through access to better paying jobs.
The impetus to address health concerns for Latinos in the US came when the pandemic exposed the dramatic healthcare inequalities for the population. For instance, Latinos in California were three times more likely to get COVID and then three times more likely to die from it. These statistics hit close to home for Lepe. His parents were migrant workers who spent May through December of each year while he grew up working on the Pacific Coast. He knew firsthand how difficult it was for them to access healthcare in these jobs.
The trio found themselves asking what impact they could make to create access to healthcare for the 42.5 million people in the US who speak Spanish as their native tongue, especially those with limited resources. They brought together some of the best technologists and thinkers they’d worked with before to problem solve on how to close the health equity gap in the Latino immigrant population, and create impact for their families back at home in Mexico. They envisioned a way to connect laborers and migrant workers to Spanish-speaking healthcare workers, using the same model they used to connect Mexican IT specialists and software engineers to the world. In 2021, they launched MiSalud Health.
Under the Hood
The MiSalud Health digital platform provides both physical and mental health services to the global Latinx population, starting with the states in the US with the highest Spanish speaking populations: California, Texas, and Florida. It’s Spanish-first, bilingual virtual care, so that families with varying fluencies can utilize the same app.
“Everyone on our team is fully bilingual and lives the same culture of our patients so they can deliver quality, culturally-appropriate care,” explains Johansson. “We know that when someone feels heard and understood, there are better health outcomes.”
While available directly to consumers as a subscription app, the majority of their business comes through employers who offer MiSalud Health to their Spanish-speaking employees. A key component and differentiator of the business is their hands-on approach to enrolling new users. As seen in the case study at the top, MiSalud Health comes to work sites, meets with the employees, and invests the time in establishing a relationship with them. It builds a level of trust that is necessary for real health interventions to happen.
Once enrolled, employees can access a “health coach,” who is a fully licensed Latin American physician or psychologist. 80–85% of the consultations are focused on employees receiving preventive healthcare, managing chronic diseases or mental health issues, and preventing emergency department visits and unmet health needs. The other 15% or so of cases that require prescriptions, labs, or imaging, get passed onto Spanish-speaking US doctors. Either way, a core component of the care model is taking time with the patients and helping them navigate the healthcare system. It’s a high-touch service that walks with patients through their lifestyle and ecosystem, helping them make the behavioral changes and even the mindset shift they need to impact their health.
For example, MiSalud Health offers a chronic condition program for people with diabetes, hypertension, and high cholesterol. It is collaborative care that includes sessions with a counselor to fuel the kind of thinking that leads to lifestyle change. Johansson recalls one patient early on who was coming in and telling the MiSalud Health team she was having trouble with her vision. She had lived with unmanaged diabetes so long that it was impacting her life. MiSalud Health coordinated care for her, finding her an urgent care clinic, calling them to tell them she was coming, then helping her navigate the care plan.
“She came back to us and let us know this was something she had never experienced before. She said, ‘You saw me all the way through.’”
In the year ahead, MiSalud Health looks to expand their services into other states with a large percentage of Spanish speakers — targeting employers in the agriculture, construction, and hospitality services primarily — while also creating new partnerships that offer their services. They’ve already started building relationships with remittance firms who transfer money from workers in America to their families in their home countries and offer small loans. For an additional fee, these workers can have a Spanish-speaking doctor at their fingertips, enabling them to stay healthy and continue to work.
The success of their initial rollout offers many possible avenues to grow the business. They plan to develop relationships with other Spanish-speaking countries like Cuba, Columbia, and the DR, and they see the possibility of offering other language capabilities. Another route would be to offer adjacent services to their customers, providing a Spanish-first bilingual tool to navigate insurance, mortgages, or bank loans.
For now, their eyes are locked on their mission: to provide affordable and culturally-authentic medical care for underserved communities in the US. It’s a rewarding endeavor, Johansson says, as you get to see the people you serve day to day and know the impact of your work. “We get to serve a population in the US in a way they haven’t been before, helping them navigate the system, and addressing the health equity gap in the Latino population.”
Our Take
Run by startup veterans with proven track records as changemakers, MiSalud Health provides a meaningful way to address the health disparities that exist for the global Latinx population. Their servant leader mentality comes through in the high bar they set for bedside manner and the time they take to review cases week by week, making sure their solution does what it is intended to do: rebuild trust in the healthcare system through excellent, culturally-appropriate care.
Please join us in welcoming Cindy Blanco, Wendy Johansson, Bismarck Lepe, and the rest of the MiSalud Health team to the StartUp Health global army of Health Transformers.
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Published: May 11, 2023