Season 1, Episode 6: Transcript

Introduction

Angela: Welcome everyone. Thank you for joining us. You’re listening to Atlanta Business Impact Radio with Veanne Smith. And I’m your co-host, Angela Greenwell. Atlanta Business Impact Radio is a podcast that showcases some of Atlanta’s most innovative and forward thinking business and technology professionals. In our first season we take a deeper look into the world of healthcare IT.

In today’s podcast we talk about Telehealth. How technology is improving this age-old approach to medicine and the possible innovations that are around the corner. Both Veanne and I are very excited to welcome as our guests Adrian Davis and Sean Middleton.

[Music intermission – 00:00:41]

Veanne: Welcome everyone. Thanks for joining us; this is Veanne Smith with Atlanta Business Impact Radio. In this episode of our podcast we will learn about the history of Telehealth, and discuss some of the innovations, benefits and challenges in this approach to providing care. I’m excited to welcome Adrian Davis and Sean Middleton, from My Ideal Doctor as our guests today to talk

On this topic. Adrian is the founder and CEO of My Ideal Doctor, which is a leading provider of cloud-based telemedicine and in health services. A fun fact is that Adrian and I actually share something in common. We both worked for Baxter Healthcare in the past, it was just more than 10 years apart.

Sean works alongside Adrian and serves a their CTO. He has nearly twenty years of experience leading software development initiatives, with the last 11 year focused on healthcare IT solutions. Hello Adrian and Sean and welcome to Atlanta Business Impact Radio.

Adrian: Hey Veanne, how are you doing today?

Veanne: I’m fantastic.

Sean: Thanks for having us Veanne.

What does Telehealth and mHealth Mean?

Veanne: Good to have you Sean. All right guys, we’re gonna cover a lot of topics today I love this space in healthcare. So lets get started. Adrian if you wouldn’t mind, could you first help us understand some terms, you know, maybe could you tell us, what is Telehealth and what is mHealth. And are they different?

Adrian: Yeah they’re different in a sense, but they definitely intertwine as well. So Telehealth is essentially the delivery of care through telecommunications whether that’s store forward or through video, as well. And then mHealth is essentially the practice of medicine and public health support supported by med, mobile devices.

Veanne: M, for mobile?

Adrian: M, for mobile. Exactly right.

Veanne: Well mHealth is a newer terminology for me so I wanted to make sure I understood it. And maybe for those that are out there listening may not know as well.

Sean: Yeah I think you’ll start seeing them being used interchangeably a lot more. Here in the near future.

How did Telehealth emerge and how is it being leveraged today?

Veanne: Excellent. Excellent. Thanks for that. Okay so, lets now just talk about how, Telehealth emerged and how is it being leveraged today? Maybe Adrian if you want to start out?

Adrian: So Telehealth has really been around for hundred years. I mean you know as, a, as soon as we had the phone, physicians have been contacting their patients through audio and in really performing Telehealth services. So it’s been around a really long time. And you started seeing Telehealth really in the marketplace as far as Teleradiology. And then the VA, was definitely, a doctor of Telehealth series whether it’s for episodic care or chronic care, or behavioral health as well. You definitely see it on our battlefield. And trying to help our soldiers who are in need for Telehealth.

So Telehealth has really been around a long, long time. You know over the past I’d say five years, you seen a big uptick in the industry and, as more and more people are coming on to insurance roles and cost have always skyrocketed and we’ve had access issues with the number of physicians that we do have in the marketplace. Telehealth is kind of filling that void, in a lot of different areas. Whether it’s episodic care whether it’s chronic care, tele stroke, Telecardiology, obviously tele radiology and behavioral health is a big one as well. So you’re looking and the employers are really looking to reduce cost.

And provide more access and convenience for their members. And, and obviously, we’ve got a lot of non merging ER cases that do good to our ER’s that, you know we can kind of redirect to, a more appropriate modes of care such as Telehealth.

Veanne: So you talk about non-emergent cases, so what are the primary uses of Telehealth today, episodic. So we’re talking things like?

Adrian: Our top three I would kind of say in the industry top three is a cold and flu. Sinus infection and urinary tract infection. So you know mainly it’s pink eye, a lot of times it’s hey doc I got this rash what type of cream do I need to get or, hey you know I cut my finger do I need to go in and get stitches. So you’re really focused on episodic care. I think you’re gonna see more chronic care happening the future.

Especially with the prevalence of video and the prevalence of medical devices as well. And so that’s gonna be a big part. And then behavioral health. When you look across the spectrum there are a lot of behavioral health needs out in the world today. And a lot of those needs go unmet. Most of the time behavioral health members you know speak of or complain of a physical symptom. About 69 percent of the time, versus a mental health issue.

So a lot of times, for a long period of the time those symptoms go undiagnosed so we spend a lot of money diagnosing symptoms that are not there. We don’t get down to the core problem. So I think you’re gonna see a big uptick in that arena as well in the near future.

Veanne: So this whole progression. So today there’s so much with the devices we have and with computers, I guess the video, the photography, so is the care better now because of that video and all, you know attached to the audio.

Sean: I would think so, it definitely is especially as you know, just remember the one megapixel camera now, the iPhone takes more pictures in the world, so. The, the quality is there, the video is there not only in still pictures but moving video. The audio is that much better, everything is you know digital, now as opposed to over analog. So we’re trying to keep up with that technology and now that people are seeing and businesses are seeing the benefits of Telehealth and the cost-savings and the convenience. you know it’s really poised to take off.

Veanne: So there are cost benefits I assume keeping folks out of those situations where they can contract another illness or whatever so that’s part of the benefit as well. So it’s money it’s keeping better health in general.

Adrian: It’s productivity. Um you know really the, it takes four hours on average to leave your office, a go see a physician and, and get your prescription and come back. You know you’ve got a lot of busy families these days, I mean everyone is kind of running here and running there. So it provides a convince but also access in a timely manner, and and it, it you know alleviates that I don’t want to go. And it at least gets a consult. Again not everything’s, you know lot of consults are informational.

Not everything requires a prescription. So it’s being able to see a physical and get the information you need, when you need it and the, the care that you need at the time.

What are the challenges that are being faced in delivering Telehealth?

Veanne: That’s great. So a lot of obvious benefits to Telehealth, lets talk about some challenges so Adrian, from a business perspective what are some of those challenges that are being faced today in delivering Telehealth. And then Sean maybe you can pipe in on the technology challenges that are involved in delivering from a telemedicine perspective.

Adrian: Yeah so I’d say there is a, there is a few and I’d say one of them’s customer awareness. Knowing that they have the benefit through their employer or just using it for the first time. Maybe some nervousness as far as speaking to a physician by the phone or through video. And so customer awareness is big. I think you’re gonna see that kind of, kind of infiltrate a little bit more in 2016 and ’17 as you see more health plans and more employers providing the benefit. You’re gonna see more health systems and retail partners also providing Telehealth.

And so I think you’re gonna see that ease within the, the consumer segment. And then also regulatory. There’s definitely regulatory hurdles throughout the US. And you know whether it’s on just the medical board side or the CMS side and reimbursement side. And so the good news is they’re getting better and better even from a licenser standpoint. So you know they got some test cases with some licensure contacts where essentially a physician who is in good standing and eligible physician and once they can give an expedited license in another state that’s part of the compact.

So it alleviates a lot of barriers in that sense. And then from the CMS standpoint, you know they’re moving along very well, typically you see CMS, being the first to go at something. And they inter market. But with Telehealth commercial pairs really have been first to go. And CMS has kind of lagged behind, but you’re starting to see that change a bit.

Matter of fact there as an article last week that CMS said that Telehealth visits for video could as face to face visits for home health services, so essentially you need to see a physician face to face before home health services approved and so they said that face to face video visits with Telehealth could be used in that scenario. So that’s huge. Absolutely huge.

Veanne: Fantastic. Cause a lot of those people wanted to get home health care services can’t get out that easily right so it alleviates that whole, they might never get it cause they can’t get out in the first place to go get that first visit out the way, right.

Adrian: No doubt. No doubt. So and then even actually today. So there’s a, there’s a bill, called connect for health act. Bipartisan bill that’s really just trying to expand the, expand the use of Telehealth through the Medicare population so you’re starting to see things really come around and everyone and all the stake holders in the industry realize this is an opportunity to blend technology with medicine and, and you know create a lot of efficiencies within the program.

Veanne: One of the reasons you started out talking about just getting awareness. One of the reasons that I wanted to get you guys in here is because I think that there are a lot of people that aren’t aware of this service so one of the reasons I thought it would be beneficial to have you all in, so.

Sean: Yeah like Adrian mentioned that’s one of our challenges is awareness. Not only for employers of companies that buy the service but you know we, you can come off the street and come into our portal and get services as well. So, it’s just that awareness and I think it’s you know on the on the uptick like Adrian mentioned that, you know it’ll become more mainstream here very soon. So.

Veanne: Are there any specific technology challenges, is the head of technology for the organization, Sean, what are some of those things keeping you up at night and working long hours?

Sean: There’s definitely, challenges or, not necessarily challenges but things that you need to be aware of you know coming from a traditional EHR, background you know securing the data is one thing. You know which, which we obviously do. But when you’re talking to your physician in an office setting. you know I don’t have to secure you and I talking back and forth. You know now that we’re going over cellular networks or going over the Internet with a video, all that has to be secure. So now it’s not only the transmission and the storage but then you know making sure that, that is a, is a all compliant with the regulations and standards like HEPA and those things so, it’s, it’s a challenge to make sure that every little piece of that data information that whether you’re recording it or transmitting it or storing it is secure and safe and making sure that our patients and doctors information are all secure.

So that’s probably the main, main piece and then now you know from a technology standpoint in supporting you know, everyone’s got a different version of their iPhone. Everyone’s got a different browser. Everyone’s got a different type of computer, you know so trying to make sure that your platform runs on all of them.

Veanne: Control the environment. It’s the population what they have?

Sean: And are they secure, right? You know so it’s, there’s a lot of challenges there. having your, your physicians walk around in office with a tablet or a PC or a hardwire desktop station, in those exam rooms, is totally different than you on your Android tablet talking to a doctor on his Mac you know when he, is wherever he is right? and wherever you are. And making sure that those connections are across all those wires are secure. So it’s a definitely a big challenge and a big difference from your traditional EHR type of setting.

Learning about MYidealDoctor

Veanne: Yep, I can imagine. Very good guys. Let’s move into talking about My Ideal Doctor specifically. So since your organization actually serves the general population I thought it would be nice for our listeners to understand a little bit more specifically about your business model and what you do. So if you could maybe address, who do you serve? What do you offer, and who pays for it?

Adrian: Yeah absolutely and so, so My Ideal Doctor started about 3 years ago. And we’re a Telehealth company that provides 24/7 on demand access to physicians, by phone or video, who can consult, diagnose and prescribe medications if need be. Most of the time it’s a low dose antibiotic or antihistamine and again a lot of informational consults as well. We do not prescribe any DEA controlled drugs, lifestyle drugs or psychotics, so we have a very narrow scope in what we do, do and what we don’t do. And so really when we started we wanted to focus on a segment and that was employer groups. Mainly self funded groups who are paying their own claims. And looking for ways to reduce cost and again increase productivity, increase access for their employees.

And so today we got about 580 employer groups on the platform and then really in 2015, started looking at different verticals within the market such as health plans and medicated plans and the retail segment as well. And some of that is coming to fruition now, we think the Medicaid population is a population that could definitely use Telehealth and they got transportation issues, they have issues where physicians don’t self medicate patients sometimes. And so they are definitely going into ER’s more so. And for common and acute ailments that we can treat over Telehealth. And you’re starting to see Telehealth being more prevalent in the retail setting.

I mean retailers are really looking at, being healthcare destinations and, and so you know before too long you’re gonna be able to walk into stand alone pharmacy like a CVS or Walgreens, or, you know a grocery chain like a, like a Safeway or Albertsons and essentially be able to walk into a kiosk or room that they already have built and zoom a physician up on the video screen and at the same time have scopes there that we can look at, you know dermatology issues or monoscope to looking in your ear, oral scopes as well.

I think you’re gonna see it in more and more places and, and really providing more and more access points for the consumers.

Veanne: So explain this, who pays for it, how. Yeah so you’re offering it mostly, I know understand you’re moving into different populations but, in the employer situation. So, an employer such as Sol Tech decides to offer it to their employees. Who pays for it and what do you pay for? Can you explain that?

Adrian: Yeah so, a couple different payers are in the system so if you’re a self-funded group you’re already paying your clients, even though your insurance car may say SIGMA, you’re company is paying the claims and SIGMA’s really acting like the TPO, uh TPA behind the scenes.

And so, so at the end of the day, the employers paying for it. The employee may have to call share some of that, especially if they have a deductible health plan and it’s first dollar out, they may have to share some of that expenses until they hit their deductible. And then payers are paying for it, payers are embedding it into their plans, um again trying to reduce some of their costs in claims as well. And so you’ve got a mix of whose actually paying for it. And then consumers on their own are paying for it.

So it’s a, it’s a mix right now of, a lot of different entities, paying for the service that you can get.

Veanne: So there are various options it sounds like, but at the end of the day what I’m hearing is, if I the patient decide to use a Telehealth provider instead of going to an ER it’s going to be less expensive?

Adrian: No question, no question I mean you’re looking at a typical ROI for an employer group you’re looking at 3 to 1 and then you know running the numbers every ER cost is different really, but you’re looking at essentially a 750 dollar cost to an ER versus where anywhere from 38 to 49 dollars depending on the setup. And the same thing goes for urgent care and even your primary care physician.

Veanne: Well it’s just a win-win, right? it’s convenient, it keeps workers at work. It saves money for the employer, for the patient, it’s just a win-win all around for some of those regular run of the mill, I don’t have to go to the doctor to realize I have an ear infection for my child. Right?

Sean: So Veanne can be our new sales, saleswoman right?

Veanne: Sign me up. Sign me up.

Sean: Exactly. That was part of you know, I came on last year with Adrian that’s was definitely part of what enticed me coming on is that there’s so many avenues of not only application but the convinces and benefits of the service and, and the opportunity in the market. And right now it’s, it’s a land grab you know there’s so much opportunity out there from, you know partnering with hospitals that one to reduce their readmissions so they don’t get find. You know rural settings in retail where the shortness.

Not only have met a couple riders, but behavioral are their, you know we can get them on the platform.

Veanne: Yeah cause I think of red, I mean there’s a shortage of physicians now and anticipated in the future. It’s another problem that you’re solving right?

Sean: Absolutely. Then it’s, then it yeah and it, and it’s ease of access you know? How many times have you had a kid throw up at 3 in the morning and not want to go down to children’s healthcare. You can get online, talk to a doctor, go to your 24-hour pharmacy and before the sun comes up you can have some medicine in your child. There’s just a lot of benefits it’s a win-win like you said and there’s a ton of opportunity both technically and financially and everything in the new feature.

Veanne: It’s very exciting so I think I heard this, I’m just gonna ask one more question on this. Did I hear you elude to the fact that eventually this could become an offering that doesn’t have to go through an employer group or might it be something you can market directly to consumers eventually or is that something that you think is gonna happen in the future?

Adrian: Yeah if you’re a consumer you can actual go to My Ideal Doctor dot com right and sign up. So yeah, so you do not have to have the benefit through an employer. Again once it hits retail and you’re starting to see it more and more in the retail setting you can just pay cash and be done with it. So yeah you can sign up as a consumer, and we’d love for you to sign up today, and it’s a.

Veanne: I might just do that.

Adrian: Yeah please do. And you can definitely use the service without having to you know have the service through your health plan or employer.

What other new technology innovations are you seeing?

Veanne: All right so one thing is certain today, technology is critical to providing care and the pace of change is rapid so I would love to just hear from both of you on this, what new hardware, software, device innovations are you seeing and where do you think things are headed I mean we’ve talked a little bit about anything else you can, like to share about the crystal ball.

Adrian: Yeah I mean from a device setting I would say you now today, we connect about a 150 different devices whether it’s glucometer’s or your fit bits or your jaw bones you can simply connect up to our mobile app or your health portal and we can track that information for you, it helps as well with some of our physicians being able to see that information. It is self-purported so we don’t use it to make a diagnosis but it’s nice to have and have available. And I think you know really cool product that you’re probably gonna see come in summertime or early fall this year it’s called Med Wand.

They just won Health 2 dot 0 and it’s an incredible product really small product, light product and essentially it’s you know takes’ your vitals, clinical data, heart rate, pulse, listens to your lungs, you can actually has a scope in it so you can look at your mouth and your eyes and examine your skin and take your temperate. But the cool thing about the med wand is it’s really physician direct and so to turn on all of those capabilities you have to have a Telehealth visit going on. And so essentially, you know a consumer like yourself will have the Med Wand, you start up a consult with a Midol doctor physical and then our physical is actually running the Med Wand itself, but really cool because it really enhances the experience. And it’s like having a lot of different scopes and, and devices at the home. That you get away really from the self reported data, because again the physician is running the Med Wand through the technology.

So cool device, I think in the retail setting like I mentioned before you’re starting to. You’ll start to see really neat consult rooms and video opportunities with Telehealth with different scopes and so forth. So really neat to be in the industry and a lot of changing times within the technology.

Veanne: I always say it’s great to be in technology but it’s even better to be in healthcare technology.

Sean: All the devices and peripherals are, are, are also they’re gonna give a lot of benefit to virtual visits and, Telehealth moving forward but at the same time they give me headaches and nightmares at night, cause we go to keep up with it all, right. So you know it we want to make sure we’re competitive and we’re offering the best functionality to our platforms so. That definitely goes back to one of your earlier questions with the challenges, how do we keep current not only the security and privacy but with the technology in general. You know so.

Veanne: Well I can imagine you all gotta a pretty bright team at your firm but this is a great time, right? So Adrian’s out there forging ahead with ideas and tackling down business problems and opportunities and you’re making it happen Sean.

Adrian: We’re doing our best.

Veanne: Great, great. Well thanks guys so much for sharing your experience and perspective on this valuable service which is rapidly becoming more and more available to the individuals via their benefits plans at work and now as I know directly if they go to your portal. So for anybody out there that wants to learn more, you can visit their website at My Ideal Doctor dot com and then Adrian and Sean if anyone wants to reach out directly to you, what’s the best method to do that?

Sean: Yeah so you can reach us on Twitter our handle is @MyIdealDoctor, or you can simply email at Info@MYIDEALDOCTOR.com.

Veanne: All right knowing how much you have going on with all the growth you’re experiencing and all the new offerings and technology things you’re doing Sean it means so much that you both took time to come out here today so thanks very much.

Adrian: Thank you.

Sean: Thank you.

Angela: You have been listening to Atlanta Business Impact Radio with Veanne Smith and I am your co-host Angela Greenwell. This program has been brought to you by SOLTECH. For more information about the podcast including other episodes you can visit our website at soltech.net or find us on iTunes. Thank you for listening and we look forward to having you listen again.

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