Rubicon
Carlos Reines is the CEO and co-founder of RubiconMD.
As well as revolutionizing healthcare in the US, the founder raised more than $40 million since the start-up's inception in 2013.
Reines has been interested in healthcare since he was a child, but instead of going into medicine, he opted for telecommunications engineering - Reines says this was because he thought tech would be a better way to make a difference in improving people's access to healthcare.
He studied at the Polytechnic University of Madrid, Spain, and obtained a specialization in Biomedical Engineering at the Technical University of Delft in the Netherlands.
He started his career in digital health at Siemens Medical in Pennsylvania and prior to RubiconMD, he managed a division at Telefónica.
Reines told Insider he was named a Young Global Leader by the World Economic Forum and has an MBA from Harvard, which was the starting point for Rubicon.
Reines got involved in all the events with startups during the master's degree and at one such event, he met the man who would become his partner in founding RubiconMD.
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Gil Addo is also passionate about trying to improve access to healthcare in the United States.
"We hit on the idea of collaborating together and so we got started in one weekend," said Reines. They both won a competition for best pitch, which encouraged them to pursue the idea and they ended up registering the company.
While all his fellow master's students were looking for a place in a big company that summer, Reines decided to bet everything on RubiconMD and turn it into his own project.
"I went to New York and we set up the company that summer and made a small pilot," he explained.
Rubicon MD is a platform that connects primary care doctors with specialists so that they can consult with patients to avoid unnecessary referrals and make more accurate diagnoses.
The pilot, in which Reines had to work almost manually on a consultation-by-consultation basis, yielded information from more than 200 consultations.
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"It allowed us to understand the system from the inside, what things needed to be optimized," explains Reines.
The feedback was decisive: the primary care doctor who took part in the pilot confirmed that in the last two months using the platform he had had more interaction with other doctors than in the last 10 years.
Rubicon improved the quality of care that primary care physicians can provide to patients who might not otherwise be able to access a specialist or would end up making an emergency room visit.
From there, the founders sought funding and Reines combined the second year of his master's degree - turning down an offer to help him with the project on the condition that he leave the master's.
What little savings the engineer did have had gone into his MBA. He even slept on his partner's sofa.
"It was a tough time, but at the same time super nice because we took a leap of faith and it was all working out," he said.
In the first year, the startup raised $1.5 million, mostly through angel investors and some funds and medical groups.
"The healthcare system in the US is a very complex system," Reines said. "It's the most expensive system in the world and they don't do any better than countries that spend half as much."
"The main problem is that it is a very unequal system," he says. "Half the country may not have access to a specialist."
"What we do in the US works very well because we connect primary care with the specialist so that they do a remote consultation. The specialist reviews your question and shares some impressions and recommendations about how they normally treat these types of cases and with that input the family doctor makes a more informed decision about diagnosis and treatment for their patients," he said.
Reines says that 80% of the time, this results in a very significant improvement in the patient's care plan and almost half of the time avoids what would have been an unnecessary referral to a specialist, "thereby offloading the system and reducing unnecessary costs."
Rubicon is now present in nearly 40 states across the country and has hired employees in each of them.
Thousands of doctors already use the platform and the number of patients under the care of these doctors has "already exceeded 10 million," the entrepreneur said.
Who are RubiconMD's customers? "Well, mainly the most innovative medical groups," says Reines.
The country is experiencing a boom in companies that are transforming primary care, and Reines says that "most of them are already customers".
"We have found a niche in clinics that have an incentive to improve quality and reduce total cost, rather than a pay-for-service," he said.
RubiconMD also works with companies that have an in-office clinic, including "some of the largest technology companies on the West Coast,"as well as assembly-line factories and factories in rural areas.
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On the other hand, RubiconMD is also used by a number of clinics known in the US as safety-net clinics, where people with the most basic insurance (which doesn't cover specialist costs or even papers) can be seen.
For Reines, this is the best illustration of the startup's philosophy and mission.
"Maybe the patient in a practice is an executive in a technology company, who might have access to the specialist in another way. But, at the same time, you are also seeing the patient who has no insurance, or no papers, who works part-time and can't make time to go to the doctor. They would never be able to go to see the kind of top-notch specialist that we are bringing in".
"Our mission as a company is to democratize access to healthcare," he said.
For now, however, Rubicon MD has its hands full with the USUnited States, although one of its short-term priorities is to continue hiring Spanish talent to expand the subsidiary in Spain.
"In terms of service, what we have done is to go deeper into certain specialties and some types of conditions. For example, mental health," said Reines.
"Primary care can help a lot to solve patients' mental health problems, which are also closely linked to their physical health," he added.
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"We created a service that basically allows primary care doctors to manage patients with mental health issues much better, with remote support from a psychiatrist," said Reines. "The platform has a database of each patient, which allows them to follow their progress and a question and answer session can be organized."
Reines said that they plan to do the same with chronic diseases.
As for going international, though RubiconMD is focused on the US market, the startup carries out impact and non-profit projects in areas where there's a greater need.
"For example, on the US-Mexico border there are refugee camps for people who have fled violence in their country and are waiting to cross into the United States," Reines said. When a child gets sick, they can be treated in the US, but it's naturally a difficult decision for the parents as they don't know when they'll see them again.
Rubicon works with a number of NGOs that send doctors to treat families on the ground, to avoid separating them at all costs.
They do similar work at a children's malnutrition clinic in Haiti, another for underprivileged patients in the Dominican Republic, and a series of clinics in Nigeria.
