Telemedicine Platform for Unattented Populations
Telemedicine Platform for Unattented Populations
Business Model Description
Remote medical care for underserved populations, through user-friendly platforms that allow for external consultations, first aid questions and answers, remote medical appointment scheduling, and more, with coordinated information from insurance providers, health services, and the Ministry of Health.
Expected Impact
Having a healthcare system that is universally accessible and innovative, adaptable to social changes
How is this information gathered?
Investment opportunities with potential to contribute to sustainable development are based on country-level SDG Investor Maps.
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Country & Regions
- Macroregion Norte
- Macroregion Selva
- Macroregion Centro
Sector Classification
Health Care
Development need
- 76% of the population has chronic health problems, and 33.6% have caloric deficits (3).
- 97.65% of the healthcare facilities in the National Health Plan (PNA) are inadequate (4).
- The rate of potentially avoidable premature mortality is 32.2%, with 418.4 deaths per million inhabitants due to COVID (5).
- Between 10% and 20% of Peruvians are excluded from access to the healthcare system (11).
Policy priority
- The National Plan includes measures to strengthen interventions for the prevention and control of chronic malnutrition, anemia, and preventable diseases.
- The National Multisectoral Health Policy 2030 establishes healthcare and health interventions, addressing the social determinants of health.
- The Multisectoral Strategic Plan for 2030 focuses on making Peru a healthy country.
Gender inequalities and marginalization issues
- 44.3% of women reported suffering from a permanent ailment, which is 9.7 percentage points higher than men (6).
- Deaths due to central nervous system diseases accounted for 6.3% in women and 5.5% in men (6).
- 16% of Peruvians living in urban areas and 5% in rural areas had access to high-complexity and quality medical centers (11).
Investment opportunities introduction
- Peru has a multi-year investment program in the health sector, amounting to S/ 24,769 million for 2023 (7).
- Between 2009 and 2022, S/ 6,732.7 million has been invested in health through the Oxi modality (8).
- There are 6 health investment projects for an approximate sum of US$ 827 million (9).
- Ensuring access to quality healthcare and services is an objective of the Ministry of Health (MINSA).
Key bottlenecks introduction
- It is estimated that there is one doctor for every 390 inhabitants and one nurse for every 368 people in the entire country, with the majority of doctors located in Lima.
- There are only two ICU beds for every 100,000 people and 700 intensive care doctors. The WHO recommends 45 healthcare workers for every 10,000 people (10).
Health Care Providers
Development need
- On average, a Peruvian spends S/ 31 soles on an outpatient medical consultation, which includes the cost of care, transportation, and waiting time to be attended to. This amount is equivalent to 10% of the basic cost of living (13).
- Out of every 100 people experiencing chronic illnesses or discomfort, 30 sought medical attention, while 70 did not seek care (43).
Policy priority
- National Telehealth Plan for the years 2020 to 2023. Institutional Strategic Plan of the Ministry of Health 2019 to 2024.
Gender inequalities and marginalization issues
- Peruvian women have a GDP of 87 dollars, while men have only 66 dollars (14).
- Callao, Ica, Lambayeque, Madre de Dios, Tacna, and Ucayali have 100% of their First-Level Health Establishments with inadequate installed capacity (22).
- In rural areas, 17.8% sought care in MINSA (Ministry of Health) establishments, and 13.9% in pharmacies or drugstores (43).
Investment opportunities introduction
- Telemedicine has provided more than 2 million consultations (15).
- From 2020 to November 2022, 155,248,052 outpatient consultations were conducted (16).
- Healthtech investments in Latin America reached $99 million (19), and in Peru, HRtech, proptech, healthtech, and agtech accounted for approximately 2% of the total investment in startups in 2021 (18).
Health Care Distributors
Pipeline Opportunity
Telemedicine Platform for Unattented Populations
Remote medical care for underserved populations, through user-friendly platforms that allow for external consultations, first aid questions and answers, remote medical appointment scheduling, and more, with coordinated information from insurance providers, health services, and the Ministry of Health.
Business Case
Market Size and Environment
> USD 1 billion
> 25%
Essalud reports that, within a year and a half of implementing the National Telemedicine Center (Cenate), they have provided over 2 million virtual consultations. In its first year of service alone, online healthcare through Cenate grew 14 times (25). The per capita health expenditure in 2021 was 1,333 euros (44).
In Peru, a single clinic conducted 17,000 teleconsultations per month (25).
The telemedicine market was valued at approximately USD 104,437.92 million in 2021, and it is expected to generate revenues of USD 272,756.3 million in 2027, with a CAGR of 20.5% during the forecast period, 2022-2027 (24).
Indicative Return
> 25%
20% - 25%
The French firm Idinvest Partners sold TeleClinic, a telemedicine platform in Germany, to the Swiss pharmaceutical group Zur Rose, generating an internal rate of return of 40% (26).
The implementation of telemedicine in the management of Chronic Kidney Disease (CKD) in Peru can generate up to US$167 per year in significant cost savings in healthcare (29).
Investment Timeframe
Medium Term (5–10 years)
The investment timelines can vary depending on the specific company and each funding round. However, in general, investments in telemedicine tend to be medium to long-term because it's a growing sector that is constantly evolving.
Ticket Size
USD 500,000 - USD 1 million
Market Risks & Scale Obstacles
Market - Highly Regulated
Capital - CapEx Intensive
Impact Case
Sustainable Development Need
The average duration of a medical appointment in Peru was 17.27 minutes, and the average duration of counseling was 1.72 minutes, which represents only 10% of the time dedicated to counseling and is less than the recommended duration of 3-5 minutes (30).
In Peru, in-person medical appointments can take up to 2 weeks to schedule in Medical Centers and Polyclinics (13), with an average cost of S/ 31 for an outpatient medical consultation (31).
Between July and September of 2018, the average appointment scheduling time for healthcare was 56 hours and 1 minute, while in the same period in 2019, this time increased to 63 hours and 19 minutes. (32)
Gender & Marginalisation
In Peru, 11 women die every day due to breast and cervical cancer, primarily because of the lack of timely diagnoses and access to innovative treatments, as healthcare services are centralized in the capital (33).
The Ombudsman's Office of Peru warns that the exercise of the right to health has been particularly limited, especially in rural areas and among individuals with fewer resources (35).
Only 5% of Peruvians in rural areas had access to high-complexity medical facilities (11).
Expected Development Outcome
Universalize healthcare through the implementation of telehealth services, ensuring access for women and men in their diversity, under equal conditions, and without discrimination (21).
Peruvians should be able to save up to S/ 15 in public healthcare centers. Based on estimates made using 2019 ENAHO figures, these savings would come from avoiding S/ 6 in transportation costs, S/ 4 in waiting time, and potentially a reduction of up to S/ 5 in the cost of care (13).
The indigenous population with limited access to healthcare facilities should benefit. 2,316 healthcare establishments integrated into the National Telehealth Network provide telemedicine services to indigenous communities in the Amazonas, Junín, Loreto, Madre de Dios, Pasco, and San Martin regions (36).
Gender & Marginalisation
One of the objectives of the National Telemedicine Plan by 2023 is to ensure that communities and vulnerable groups have access to eHealth services.
Reduction of out-of-pocket healthcare expenses, especially for women.
Primary SDGs addressed
3.2.2 Neonatal mortality rate
3.9.2 Mortality rate attributed to unsafe water, unsafe sanitation and lack of hygiene (exposure to unsafe Water, Sanitation and Hygiene for All (WASH) services)
3.c.1 Health worker density and distribution
3.3.2 Tuberculosis incidence per 100,000 population
3.8.1 Coverage of essential health services
Between 2000 and 2018, the neonatal mortality rate decreased by more than 50%, while the childhood mortality rate decreased by almost two-thirds in the same period (20).
Indigenous peoples are particularly vulnerable to HIV/AIDS and syphilis. In 2004, a seroprevalence of 7.5% for HIV and 6.3% for syphilis was recorded in the Shiwilu native community in Datem del Marañón (21).
Peru has 32 doctors per 10,000 people, with the majority located in urban areas, especially in Lima. It is estimated that there is one doctor for every 390 inhabitants and one nurse for every 368 (10).
In 2019, Peru diagnosed 32,970 cases of TB, achieving a detection coverage of 89.1% compared to the WHO's estimate (21).
Between 2004 and 2015, there was a decrease in the population who did not seek medical consultations due to a lack of money, dropping from 24.7% to 6.9% (17).
One of Peru's objectives for 2023 is to reduce maternal mortality to 60 per 100,000 live births and the neonatal mortality rate to 8 per 1,000 live births.
According to the National Plan for 2030, Peru aims to: - HIV: Reduce the HIV incidence rate from 1.3 per 1,000 inhabitants in 2019 to 0.6 per 1,000 inhabitants in 2030. - Malaria: Reduce the malaria incidence rate from 4.4 per 1,000 inhabitants in 2019 to 0.5 per 1,000 inhabitants in 2030.
One of Peru's objectives for 2030 is to strengthen human resources in healthcare.
Peru aims to reduce the incidence rate of tuberculosis from 93 per 100,000 inhabitants in 2019 to 36 per 100,000 inhabitants by 2030.
Information not available as August 2023
9.5.1 Research and development expenditure as a proportion of GDP
Perú has various regulations that promote investment in Research, Development, and Innovation (I+D+i), including tax benefits for those who invest in this sector.
One of Peru's objectives for the year 2030 is to strengthen the healthcare system through the incorporation of innovation.
Secondary SDGs addressed
Directly impacted stakeholders
People
Gender inequality and/or marginalization
Public sector
Indirectly impacted stakeholders
People
Planet
Outcome Risks
Technology or internet connection failures can lead to interruptions in medical care or errors in data interpretation.
The lack of a complete physical examination due to technological limitations can result in a misdiagnosis or the omission of important symptoms.
Patient data privacy and security can be compromised due to the online transmission of medical information.
Lack of training and experience among medical staff in using telemedicine technology can lead to inadequate care or misdiagnosis.
Gender inequality and/or marginalization risk: Difficulties in communication between the patient and the doctor due to cultural and language barriers can lead to poor understanding or a lack of empathy.
Impact Risks
Exclusion of vulnerable or marginalized populations who do not have access to the necessary technology for using telemedicine.
Job loss for healthcare workers who become obsolete due to the adoption of telemedicine.
The risk of overloading telemedicine services, which can lead to lower quality of medical care and an increased likelihood of errors.
Changes in the doctor-patient relationship, which can have implications for medical care and the population's perception of health.
Gender inequality and/or marginalization risk: Generation of inequalities in access to medical care due to the economic capacity of patients to acquire technology and internet connectivity.
Impact Classification
What
A positive and significant outcome due to increased efficiency and the adoption of technology, in line with what the state promotes
Risk
Increasing distrust in the Peruvian healthcare system due to poor care or connectivity failures.
Impact Thesis
Having a healthcare system that is universally accessible and innovative, adaptable to social changes
Enabling Environment
Policy Environment
The National Multisectoral Health Policy by 2030, with the objective of "Comprehensive Care throughout the Lifespan," is based on health equity criteria and prioritizes primary health care (PHC).
The National Telemedicine Plan 2020-2025 is a program that promotes the use of digital means for medical care, with a focus on rural areas.
The National Digital Health Plan 2021-2025 aims to strengthen the digital health ecosystem, promote digital health records, and telehealth.
Financial Environment
Financial incentives: In 2022, the Executive Branch approved the granting of subsidies of up to 1,563,649 soles to co-finance projects related to innovation, internationalization, and other purposes (under the loan agreement "Improvement of Productive Innovation Levels at the National Level" and the Mipyme Entrepreneur Fund).
Fiscal incentives: Tax exemptions for the importation of medical technology: In Peru, the importation of medical technology is exempt from the General Sales Tax (IGV) and customs duties, which could reduce investment costs in telemedicine.
Other incentives:The Peruvian government, as part of the National Plan for 2050, prioritizes digital transformation, with a specific focus on the healthcare sector through telemedicine and the digitalization of medical records.
Regulatory Environment
Ministerial Resolution No. 1010-2020-MINSA - National Telehealth Plan of Peru 2020-2023, with the objective of establishing the guidelines, actions, strategies, and technical guidance to implement and develop telehealth primarily in rural areas.
Ministerial Resolution No. 297-2012-MINSA, which approves the Technical Document Establishing the Conceptual Framework for Strengthening Information Systems and Information and Communication Technologies in the Ministry of Health.
Law No. 30421 - Telehealth Framework Law, to establish the general guidelines for the implementation and development of telehealth as a strategy for healthcare service delivery, in order to improve its efficiency and quality and increase its coverage through the use of ICT.
Supreme Decree No. 003-2019-SA, Regulation of the Telehealth Framework Law, which regulates the process and actors of the telehealth ecosystem.
Ministerial Resolution No. 117-2020-MINSA, which approves the Directive for the implementation and development of synchronous and asynchronous telemedicine servers.
Marketplace Participants
Multilaterals
The Inter-American Development Bank (BID) has financed health projects in Peru, including a primary care strengthening program in Ayacucho and hospital management improvement in Lambayeque. The Pan American Health Organization (OPS) has worked on improving primary healthcare and strengthening health information systems.
Non-Profit
Telesalud Peru: It is an organization that promotes the implementation of telehealth in Peru through the training of human resources, the implementation of pilot projects, and the dissemination of information about the technology.
Non-Profit
Partners In Health works on disease prevention and treatment in Peru, especially among vulnerable populations. They have used telehealth to improve access to medical care in remote areas of the country through teleconsultation and teletraining.
Non-Profit
The Amazonia Project operates in the Peruvian Amazon on issues related to health, education, and sustainable development. They have utilized telehealth to enhance medical care in remote areas, especially for tropical diseases such as leishmaniasis and Chagas disease.
Non-Profit
Doctors Without Borders provides emergency medical care worldwide. In Peru, they have used telehealth to enhance medical care in areas affected by natural disasters, such as the earthquake in the Loreto region in 2019.
Target Locations
Macroregion Norte
Macroregion Selva
Macroregion Centro
References
- (1) CEPLAN (2022), Plan Nacional 2050.
- (2) CENTRUM e IMD (2022), Resultados del Ranking de Competitividad Mundial 2022"
- (3) Instituto Nacional de Estadística e Informática (2022) - Encuesta Nacional de Hogares.
- (4) MINSA (2022), Diagnóstico de Brechas de infraestructura y equipamiento en el sector salud
- (5) Organización Panamericana de la Salud (2021), Perfil de Perú.
- (6) INEI (2022), Brechas de Género en el Perú.
- (7) MINSA (2023), Ministra Kelly Portalatino sustentó el proyecto de presupuesto del sector Salud para el Año Fiscal 2023.
- (8) Dirección de Inversiones Descentralizadas - ProInversión (2022), RANKING DE DEPARTAMENTOS POR MONTO DE INVERSION EN OBRAS POR IMPUESTOS 2009 - 2022.
- (9) PROINVERSIÓN (2023), Cartera de proyectos de inversión modalidad Asociación Público Privada.
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- (29) Lazo-Porras et al (2021 Impacto financiero de la telemedicina en pacientes con enfermedad renal crónica en el Perú.
- (30) Saga Journals (2022), Analysis of medical appointments for patients with overweight and obesity in a public hospital of Lima, Peru: a cross-sectional study of audio-recorded consultations
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