The 10 Best Performing Telehealth Solution Providers in November2020

10 BEST PERFORMING

VOLUME 1 1 ISSUE 02

WWW.INSIGHTSCARE.COM

TELEHEALTH SOLUTION PROVIDERS IN 2020

RAOUF KHALIL

CEO & FOUNDER

TruDoc 24x7 Doing The Right Thing

T

THE YEAR OF TELEHEALTH SERVICES

his year has been exceptional when it comes to telehealth services. Due to the pandemic, physical consultation with doctors became restricted. But health emergencies seldom wait. More importantly, certain health conditions need regular monitoring, check-up and consultation with the medical practitioners. The pandemic made such patients suffer the most.

However, with telehealth services already in practice, the situation was saved from going berserk. Ever since the lockdown was imposed in most of the countries, medical practitioners made sure that they moved to telehealth portals if they were not already using it. They guided their

EDITORS COLUMN

patients on how to make the switch to virtual consultations instead of physical and made sure that they were always around for their patients.

The industry too rose to the occasion.

Flooded with sudden requests they had to scale themselves really quick. They had to make sure that they had enough trained people on-board to handle the surge. They also relied on feedbacks in real-time and with real users to improve on and add to the services they provide. More importantly, they had to make sure that the services reached the patients in even the remotest areas so that the services could be availed.

The patients too took to the means being offered in such critical situations. While most were averse to technology initially, the ease of

operations that the telehealth services provided and the necessity that the pandemic created pushed them to learn and utilize the technology to stay healthy and safe.

Altogether it was a collaborative effort from everyone involved that saw the rise of telehealth services. In this issue of Insights Care, we applaud the efforts of “10 Best performing Telehealth Solutions Providers in 2020� that pitched in their everything to make sure that no health-related request went unattended.

Sneha Sinha

sneha@insightssuccess.com

C O N T E N T s

10

COVER STORY

TruDoc Healthcare LLC Taking Telehealth Services to the Next Level

18 ARTICLE

34 Remote Health Telemedicine During Covid-19

COMPANY OF THE MONTH

Apollo TeleHealth Transforming Indian Telemedicine Space Dynamically

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Coviu

A Virtual Clinic ConďŹ gured to your Needs

Interview with Insights Care

Walk With Path

36

Patient-oriented Quality Healthcare Programs

Creating Simple Solutions for Positive Impact

CXO

26

QARE

30

Patients in need of Diagnostics Tests are Avoiding Pathology Labs Due to Covid Fears DOCTORS

Editor-in-Chief Sumita Sarkar Managing Editor Sneha Sinha Quality Assurance Team Abhishaj Sajeev Contributing Editor Darshan Parmar Art & Design Head Asha Bange Art & Picture Editor Mayur Koli Co-designer Priyanka Rajage Operations Head Megha Mishra Business Development Manager Nandan Deshpande Asst. Manager Swapnali Vasaikar Business Development Lead Pawan Jadhav Business Development Executive Ashwini Thakare Technical Head Amar Sawant Technical Specialist Pratiksha patil Digital Marketing Manager Amol Wadekar SME-SMO Executive Atul Dhoran Circulation Manager Tanaji

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10 BEST

PERFORMING

TELEHEALTH

SOLUTION PROVIDERS IN 2020

Company Name

Management

Brief

Andiamo

Naveed Parvez CEO andiamo.io

Andiamo delivers a medically effective orthosis within two weeks of a person’s need globally.

Apollo Telehealth Services

Vikram Thaploo CEO apollotelehealth.com

Apollo Hospitals has created the largest and oldest multi-specialty telemedicine network in South Asia.

Coviu

Dr Silvia Pfeiffer Founder and CEO coviu.com

Breaking down the barrier of distance and enabling fair and equitable access to healthcare for everyone.

KIMS Global

Sheriff M. Sahadulla MD kimsglobal.com

KIMSHEALTH is a quaternary care hospital network offering end-to-end healthcare services

Medoc

Udi Gafni Founder medoc-web.com

A leading developer and manufacturer of neuro-diagnostic medical systems used to assess and monitor acute and chronic pain.

Medtronic PLC

Geoffrey S Martha CEO medtronic.com

One among the largest medical device companies in the world.

Qare.fr

Olivier Thierry President and CEO qare.fr

Telehealth Consultation made easy.

Quio

Jared Schwartzentruber Founder quio.com

On a mission to improve lives through Better Health + Care.

TruDoc 24x7

Raouf Khalil Founder and CEO trudoc24x7.com

Combines next-generation telemedicine, telemonitoring and home health to provide immediate access to doctors and wellness experts.

Walk With Path

Lise Pape Founder and MD walkwithpath.com

Creating inclusive innovations to make a positive impact

TruDoc Healthcare LLC Taking Telehealth Services to the Next Level

COVER STORY 10 Best Performing Telehealth Solution Providers in 2020

‘

Our goal is to ensure an appropriate balance between quality and cost, starting from the moment you access our physician helpline to the point of recovery.

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T

he evolution of modern technology and advances in scientific medicine has now made it possible for individuals to be seen by a healthcare professional from the comfort of their home, office or anywhere in the world. This, aligned with their lifestyle preferences has transformed access to healthcare in line with the new post-COVID-19 era.

The arrival of COVID-19 meant health systems around the world had to rapidly adapt to the critical need for social distancing among physicians and patients. The result has been an unprecedented demand for telehealth services, involving the use of different technologies and networks to enable communication between the patient and provider. Telehealth services are increasingly becoming a major force in the effort to reduce healthcare-related COVID-19 transmissions, and ultimately protect both the patient and the health professionals. Therefore, providing patients with access to 24x7 available healthcare professionals is needed now more than ever.

The increased awareness of telehealth and the quality services now made available during the pandemic has increased confidence in the use of such services. It is anticipated post-COVID-19 that many people will adopt the telehealth solution as the norm. The opportunity for telehealth services to become a standard of care is growing and will continue to grow post-COVID-19 as it has proven to be effective during the outbreak.

Considered as the first Care Level Management Delivery System Provider in the world, TruDoc 24x7 with its multiple 24x7 Entry Points, has been very successful in safely managing its patients with innovative healthcare delivery.

An Integrated Delivery System The biggest challenge for healthcare consumers and payers is a fragmented healthcare system. To align patients, providers and payers TruDoc24x7 is staffed with full-time Doctors, Psychologists, Wellness Experts,

Pharmacists, Case Managers and comprehensive IT specialists. TruDoc has succeeded in integrating multiple entry points to ensure consumers are provided with the proper level of care 24x7, based on Evidence Based Medicine. Having an integrated team approach has led to early interventions in care, with better clinical outcomes being a key element of TruDoc’s success in aligning patients and payers.

TruDoc 24x7 was set up in 2011 in Dubai, UAE, with a mission to change consumer behavior through TruDoc’s 24x7 Entry Points to align patients and payers based on Evidence-Based Medicine.

The company provides a one-stop-shop for healthy, acute and chronic patients through TruDoc’s 24x7 Entry Points all connected to its 24x7 Medical and Wellness Call Center. When travelling, the patients can get connected via TruDoc 24x7’s inte- grated mobile application; when at the office, through TruDoc 24x7’s Virtual Clinic or On-site Clinics; when at the hospital, through TruDoc 24x7’s Hospitalists Program and when at home, through TruDoc 24x7’s Hospital @ Home Program including telemonitoring, all as one integrated delivery system.

Ensuring the Truth through Evidence-Based Medicine TruDoc’s doctors are full-time employees who have no incentives for overutilization, this ensures that patients are told the truth about what they need and not what they can afford, all based on Evidence-Based Medicine.

This not only provides a better clinical outcome for the patients but also a better financial outcome for their healthcare payer.

TruDoc 24x7 Entry Points include: Integrated Mobile Application: Members can speak to TruDoc 24x7’s doctors through the mobile application via voice/video call and live chat or book an appointment with its wellness team or psychologist. The mobile application also has an AI-based Symptom Checker for both general check-ups as well as COVID-19 specific symptoms. Other features and services include medication delivery, lab specimen services from the comfort of the office or home, 24x7

vital signs tracking for chronic as well as wellness support, doctor appointment reminders and health/wellness articles.

thus discharging them into TruDoc’s Hospital at Home Program where they are managed effectively at home for better clinical and financial outcomes.

Health & Wellness Virtual Clinic: TruDoc 24x7’s Virtual Clinic provides members with 24x7 access to video consultations with available doctors.

Members can also measure their vital signs by using integrated, smart telemonitoring devices that are connected via Bluetooth to TruDoc’s Call Center. The readings will sync to the Call Center where TruDoc’s doctors are available 24x7, monitoring patients’ readings. Virtual Clinics can be placed in different locations including corporate offices, staff accommodation, pharmacies, schools, malls, nursing homes, hotels, etc.

Hospital at Home Program: TruDoc’s Hospital at Home Program provides hospital-level care for patients in the comfort of their homes. Patients are provided with necessary medical equipment and onboarded onto the program. Their readings are automatically synced to its Control Center where its doctors are ready to intervene 24x7 and provide the appropriate level of care. When necessary, its doctors and nurses make home visits. The Hospital at Home Program aims to reduce unnecessary hospital admissions, reduce hospital average length of stay and provide peace of mind for patients and their families.

Hospitalist Program: TruDoc’s Hospitalist Program focuses on early discharge of patients from hospitals to reduce unnecessary average hospital bed-days. Its Doctors making rounds in hospitals can determine whether a patient requires inpatient treatment or not based on Evidence Based Medicine

Although TruDoc 24x7 caters for patients with Healthy, Acute and Chronic conditions, TruDoc recognize the FACT that it’s 20% of the population that consumes 82% of medical cost and that Telemedicine

‘

We provide immediate access to highly trained and licensed doctors, Psychologists and wellness experts via video/voice calls and live chat, anytime, from anywhere in the world.

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alone does not work for these high-risk chronic patients. What sets TruDoc 24x7 apart from other competitors in the region is the focus on this 20% of the population by providing connected Entry Points: Hospital at Home Program with 24x7 Telemonitoring, Hospitalist Program, On Site Virtual Clinic and mobile application all controlled by TruDoc 24x7 Control Center.

A Profound Leader Bringing Significant Difference The inceptive mind behind TruDoc 24x7 is its Founder and CEO, Raouf Khalil. Mr. Khalil has 33 years of experience in outpatient care services.

Before founding TruDoc 24x7 LLC, he founded and served as Chairman and CEO of multiple healthcare providers including Professional Home Health Services (PHHS), a California company providing Home Infusion, Home Health, Hospitalists, Hospice and Durable Medical Equipment.

PHHS was sold to Option Care Inc. a USA national home infusion company.

Mr. Khalil was instrumental in developing an early intervention clinical model which connects inpatient and outpatient care for chronically ill patients. The model incorporated Hospitalist Programs and 24-7 access to Doctors home visits by providing over 40,000 Doctors home visits per month in USA. He also developed a unique healthcare financial reimbursement model based on better patient satisfaction and net savings for payers.

Under the leadership of Mr. Khalil, TruDoc 24x7 successfully transited from just a Tele-medicine provider to a one of its kind 24x7 Care Level Management serving healthy, acute and chronic conditions. He believes the only truly sustainable healthcare solution is the one that aligns, patients, payers and providers through Evidence Based Medicine. TruDoc has developed a practical solution for the 20% of the population that consumes 82% of medical cost by connecting the entry points and utilizing telemonitoring technology for early

intervention and 24x7 triaging to the appropriate level of care which avoids unnecessary medical expenditure, unless there is an imminent clinical and/or financial risk. Thereby ensuring high patient satisfaction and net savings for payers.

Leveraging AI to build Topnotch Solutions One of the most prominent trends in digital health technology is the use of Artificial Intelligence (AI), which TruDoc has implemented in the form of a Symptom Checker for both general symptoms as well as COVID-19 specific symptoms.

TruDoc’s one-of-a-kind Care Level Management Delivery System is supported by its own IT-solution which was developed in-house 6 years ago.

Through its innovative technology, TruDoc is able to provide 24x7 access to doctors, wellness experts, therapists, pharmacists and case managers via voice/video calls and live chat.

One of the most important elements of TruDoc’s IT system is its ability to stratify chronic high-risk patients and monitor their readings through its 24x7 Call Centre where its doctors are ready to intervene and provide the appropriate level of care; thus, addressing clinical and or financial risks appropriately. This ensures TruDoc’s ability to generate net ROI to its payers while significantly enhancing patient satisfaction.

Enlightening Emerging Healthcare Leaders Mr. Khalil opines that the healthcare sector is witnessing a lot of changes and reforms in recent years. As it grows, there will always be many challenges facing it. This is by itself an incentive for all entrepreneurs to start exploring new and innovative ideas which will eventually create a thriving market for health-related businesses to benefit consumers and payers.

The coronavirus outbreak has impacted many businesses worldwide bringing the healthcare sector at the epicenter of this global pandemic challenge and thus there are a lot of potentially great and sustainable healthcare business ideas that can be developed in this industry. To all the emerging entrepreneurs aspiring to enter into the healthcare industry, Mr. Khalil advises, “The next opportunity is there waiting for you, believe in your vision and start achieving. This is an exciting period of evolution to make a change.”

Spreading Wings TruDoc 24x7 reaches its consumers by partnering with healthcare payers, who offer TruDoc’s services as an additional benefit to their members. TruDoc 24x7 now has over 4.4 million paid subscribers in multiple countries and over 6,700 multinational corporate clients including insurance carriers, governments, brokerage firms and TPAs, telecom providers, pharmacies, etc.

TruDoc 24x7 currently operates in UAE, Nigeria and Egypt and is planning to expand its services in 6 new countries in the next 12 months and enroll 30 million new members on the program through organic growth and strategic partnerships.

Currently, its team consists of General Practitioners, Family Medicine Doctors, Psychologists, Wellness Experts, Pharmacists and Case Managers. It is planning to add more specialties in the future.

Case Study – Ensuring Financial Savings and Customer Satisfaction TruDoc 24x7’s Hospital at Home Program (licensed by Johns Hopkins University) This program was implemented in July 2017.

Patients were discharged from hospitals into the Hospital at Home Program to be managed by its doctors, nurses and supporting team who would go on to provide hospital-level care for these patients in the comfort of their own homes. Both patients and their families were extremely satisfied with the program and significant savings were made for payers. All savings analysis was done by a third-party actuarial firm” Lux Actuaries & Consultants”. The impact TruDoc made on Chronic Care can be seen below: Reduction in Overall Claims Cost

~40%

Reduction in OP GP Consultation

~30%

Reduction in ER Visits

~35%

Reduction in Ambulance Utilizations

~30%

Reduction in Hospital Bed Days

~30%

Reduction in Specialist Consultations

~30%

Reduction in Readmissions

~15%

Patient Satisfaction

~90+%

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TRANSFORMING INDIAN TELEMEDICINE SPACE DYNAMICALLY

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elentless innovation is the key to create value across every industry and the healthcare industry is certainly no exception. The healthcare industry in India has been a late adopter of technology which is why the implementation of several initiatives that relied on the use of technology faced some major obstacles.

The adoption of different forms of technology is crucial for increased efficiency, expanded access and improved outcomes. While telemedicine is one area where we are now seeing increased use of telecommunications and medical technology, there is a dire need to adopt the same attitude across every segment of the healthcare industry to ensure better healthcare, quality and deliverability.

Working with the intention of enhancing the healthcare deliverables, Apollo TeleHealth is one of the industry leaders in the telemedicine sector.

Under the leadership of Vikram Thaploo, CEO of the company, Apollo TeleHealth is taking giant strides towards achieving its mission and goals. How is it doing that? Let’s

18 | INSIGHTS CARE

Tele-ICU, Tele-Radiology, Tele-Condition Management, Tele-Cardiology, and many more.

We are constantly adding innovations to our digital health vertical paving the way to easy and affordable healthcare accessibility to the remotest corners of the country.

read in the below exclusive Interview with Insights Care:

Apollo TeleHealth is like a close-knit family guided by the values of Compassionate Care, Trustworthy Spirit, Excellence, Proactive Involvement and Pioneering Attitude.

Our values unite us and hold us for a common cause which is to provide quality services to a globalised populace by facilitating the interactions through innovative use of technology.

Our mission and vision are to provide healthcare accessibility to a wide population base, even in the remotest corners by using state-of-the-art technologies to ensure a healthier tomorrow.

IC Team: Please brief our audience about your company, its values, vision, and mission.

IC Team: What are the prominent solutions and products that make your company stand out from the competition?

Vikram: Apollo TeleHealth is the oldest and largest multispecialty telemedicine network in South Asia.

Being a pioneer in telemedicine, we serve both rural and urban communities ensuring that quality health services are available to all. We offer telehealth services like Teleconsultations, Tele-Emergency,

Vikram: Apollo Telehealth empowers its patients with integrated healthcare delivery to offer services like Teleconsultations, Tele-Emergency, Tele-ICU, Tele-Radiology, Tele-Condition Management, Tele-Cardiology, and others. By blending in advanced medical devices, IT and quality clinical services, Apollo VOLUME - 11, ISSUE - 02, 2020

VIKRAM THAPLOO CEO

Vikram Thaploo CEO

Remote Healthcare is empowering its patients to get effective treatment without the need to step out of their homes.

Our approach to evidence-based quality healthcare supported by high end connected and state-of-the-art devices and clinical protocols have given us an edge in medical expertise with a massive presence across India.

Since the telehealth service is an offshoot of Apollo’s integrated healthcare delivery system, we certainly have the edge of being the leaders offering critical services like Tele-Emergency and Tele-ICU as well as regular services such as Tele-Consultancy, Tele-Condition Management, Tele-Radiology, 2020, ISSUE - 02, VOLUME - 11

COMPANY OF THE MONTH Tele-Cardiology, etc. This is what helps us to strengthen our position in the market and remain the leaders.

IC Team: Brief us about the featured person(s) and their journey in the healthcare industry.

Apollo TeleHealth Team: A veteran with extensive experience in setting up sustainable business models and strategizing innovative projects, Mr. Vikram Thaploo is a successful business leader who is presently in charge of Apollo’s Remote Healthcare Vertical. He has more than twenty years of experience working for some of the most prestigious organisations

that span across diverse industries like retail, healthcare, and hospitality.

As the CEO of Apollo TeleHealth, he is hailed for his efforts to put in place a sustainable business model that delivers quality healthcare services to all, be it for people from the rural parts of the country or the urban areas. With his knack for excellence and implementation of successful business operations, his objective is to provide affordable healthcare services by bringing together Medtech ecosystems, telecom, and technology. ASSOCHAM awarded ‘Leadership Award of the Year’ to Mr. Vikram Thaploo and he won the accolade for ‘CEO of the Year’

INSIGHTS CARE | 19

which was presented by Healthcare Achievers and Leadership Award, among many such awards.

IC Team: Taking into consideration, the current pandemic, and its impact on global economies, how are you driving your organization to sustain operations and ensuring safety of your employees at the same time?

Vikram: The COVID-19 pandemic has affected businesses and economies across the world. It is now more important than ever to refocus on business operations to maintain seamless business continuity. We are adopting a collaborative, pragmatic approach to adapt ourselves to new ways of running a business and ensure that things are happening in an 20 | INSIGHTS CARE

empathetic, timely manner. We are also following an active communications strategy to employees, suppliers, clients, and partners so that business operations remain free from hurdles.

Our primary focus is the safety and health of our employees, their family, and our Apollo community as-a-whole.

We have been adhering to safe work practices and a safe work environment ever since we became a part of Apollo.

Keeping in mind the present situation, we have implemented different measures to prevent the risk of spread and provide a safe, healthy environment for our employees. No delay in salaries, adequate insurances and flexibility in their areas has been a motivation for employees.

IC Team: What do you think could be the future of Telehealth technologies and solutions market post the COVID-19 pandemic?

Vikram: The widespread adoption and popularity of telehealth services is a clear indication of the fact that it is here to stay. Instead of just being viewed as another technological fad, telehealth should be an enabler that would support the overall healthcare delivery system. With advancements in technology happening at a fast pace, I believe that telehealth will turn out to be one of the most useful clinical tools for increased operational efficiencies and better patient care.

As healthcare providers look for ways to cut-down healthcare costs while VOLUME - 11, ISSUE - 02, 2020

maintaining their quality of service, they will need to adjust to changes like telehealth to better meet the needs of their patients. With several countries and states set to adopt meaningful telehealth legislation over the coming months, the future of telehealth certainly looks promising. Telehealth is the only means to provide continuum of care.

IC Team: What would be your advice to the emerging entrepreneurs aspiring to enter the healthcare industry?

Vikram: Clear vision and passion are two of the most essential qualities to be successful in any business. Another important factor is how much time you are investing to learn the subject in-depth. Being an entrepreneur, one must understand that there are no rule books or guides to move from one step to another. There will be moments of uncertainty and doubt, but the idea is to move ahead even if there are failures.

My advice would be to keep your goal in sight and fuel it with perseverance.

Telehealth is a promising sector where people from the medical field as well as IT can make their presence felt.

There is a vast pool of opportunity waiting to be explored, so just believe your instincts, and turn your dream into reality.

recognized as a feasible solution to quality healthcare accessibility, we are partnering with different state governments to address the healthcare needs of the population.

We will continue to focus on the digitalization of healthcare with IoT, AI-enabled platforms, CDSS, IoMT and machine learning (ML) to expand the reach of telemedicine to every corner of the country. Presently we have our presence across 350,000 touchpoints in India along with 50 prominent cities and 48 countries having touched over 12 million lives. We want to take this further by touching more than one billion lives and expand the reach of telehealth services.

• Touched over 12 million lives (11 million in the last four years) • Delivers more than 20,000 clinical transactions daily including Consultations, Counselling, C-SAT, Lab Investigations, Eye Screening, Quality Audits and Training Sessions.

• World’s first V-SAT enabled Tele-Emergency and TeleSpecialty services in remote locations of Himalayas at a height of 14,500 ft above sea level. More than 1300 emergency cases handled and 20,000+ tele-specialty consultations provided till date.

• Largest Public Private Partnership with Governments.

Over 700 centres across India having delivered more than 10 million teleconsultations.

• Widespread 110 teleclinics in 17 countries, more than one million teleconsultations provided across 95 specialties.

• More than 1.5 million NCD screening done in 15 cities of India and 10,000+ CME’s and Social Health Education were delivered.

IC Team: Where do you envision your organization to be in the long run and what are your future goals?

Vikram: What we started as an initiative to provide healthcare services at reasonable prices to people in villages across India has now turned into a comprehensive development that spans across rural and urban geographies, globally. With telemedicine being gradually 2020, ISSUE - 02, VOLUME - 11

INSIGHTS CARE | 21

F

or businesses to stay relevant in these times of change, adapting technology innovation is the only way. This is true for healthcare as it is for education as well as other service-based industries. The young generation - the digital natives - have grown up finding everything online, buying online, keeping friendships online, and working online. Imagine such a digital native looking after their children’s health by having to fill in paper-based forms, making appointments via phone calls and having to drive to doctors and pharmacies just to get a panadol. It’s completely alien to them.

The future of healthcare is digital. The current pandemic has further shown that the future of healthcare is hybrid.

Telehealth services will help us do what we can online, and this includes seeing clinicians online via video calls.

Face-to-face consultations will remain important, but only for procedures that cannot be done remotely and require actual touch. Businesses that embrace telehealth are thriving through the crisis, while those that continue working as before are struggling.

Foreseeing the change, Coviu, Australia’s leading video telehealth platform, was created to transform the healthcare industry. The entire team is passionate about breaking down the barrier of distance and enabling fair

22 | INSIGHTS CARE

and equitable access to healthcare for everyone.

Digital Solutions Coviu is built specifically for healthcare, and its digital workflows are tailored to replicate existing ‘brick and mortar’ processes of healthcare businesses. One can schedule appointments, take ‘walk-ins’ with the customizable waiting area, take patient payments, and manage multiple virtual clinics under one account with administrative capabilities. The platform is HIPAA compliant and complete with end-to-end and peer-to-peer encryption, keeping sensitive patient data safe.

Coviu is more than just a video call.

The platform is equipped with in-built clinical tools, tailored to the practitioners’ speciality. The platform allows one to level up their telehealth game, by sharing resources, performing clinical assessments, using artificial intelligence diagnostic tools and more.

An Erudite Leader Dr. Silvia Pfeiffer is the CEO & Co-founder of Coviu Global. Silvia is a repeat entrepreneur, previously having founded a Web video analytics company and now Coviu, a telehealth turnkey solution for private practice.

Silvia has more than 20 years of experience with Web video businesses

having worked in technology innovation for Google, Mozilla, NICTA, and CSIRO. She co-edited the standards that made video a prime citizen of the Web and underpin not just the likes of Netflix and YouTube, but also her startup Coviu. Silvia has a PhD in computer science, a masters in business management, has published two books on HTML5 video and recently one for healthcare businesses to help them set up video consultations sustainably.

Coviu was first created within the Australian research organisation CSIRO as part of research into telehealth delivery platforms. Working closely with clinicians, Coviu found that existing consumer video calling software and corporate video conferencing applications were not sufficient for healthcare services. Not only do they not satisfy the stringent security and privacy requirements of healthcare businesses, but they miss important business functions such as collecting payments, making appointment bookings, gathering patient consent, and speciality specific add-ons. Silvia and her co-founder and CTO Nathan Oehlman, set about co-creating Coviu with the input of clinicians and healthcare businesses and spun the company out of Data61/CSIRO with the support of venture capital investment in May 2018.

VOLUME - 11, ISSUE - 02, 2020

I wanted healthcare to be ready for the 21st century, but to maintain a human connection in an age when everything’s going digital.

Dr. Silvia Pfeiffer CEO & Co-founder

Clients Affirm Marion Adeney-Steel, Clinical Lead Physiotherapist at Remedy Healthcare “The global pandemic has given us the leverage we needed to get a fully functioning and effective telehealth service offering in place. Now that we’ve seen first-hand the ease and successful outcomes that telehealth - specifically video consultations - can bring not only to our patients but also to our staff, I can’t imagine a world without it. Our healthcare system is forever changed - we will never go back entirely to faceto-face consultations.”

2020, ISSUE - 02, VOLUME - 11

Kathy Matheson, Psychologist and Founder of Karepsych “We left Canberra in February 2020, moving our entire client base and administration team into a virtual health space. While we were initially met with some trepidation, the feedback we have since received has been extremely positive. Our clients find the entire experience easy, engaging, and trouble-free. No more parking fees or travel time! Coviu has helped us achieve our goal, allowing the Karepsych to practice the opportunity to become location independent and distributed workforce. They have consistently provided a reliable, fit for purpose video consultation and telehealth service.”

INSIGHTS CARE | 23

The Pandemic Rush When Medicare reimbursements for telehealth were announced on the 13th March in Australia, Coviu scaled from doing 400 video visits a day to 25,000 a day within 3 weeks. This meant that the company had to scale in three dimensions: ● Infrastructure: Coviu had to scale on technology. Being in AWS, Coviu was prepared for this and could make use of the horizontal and vertical scalability functionality of AWS. ● Team: With so many clinicians asking Coviu how they could change their business and adopt telehealth, it had to answer up to a thousand enquiries a day. So, scaling the team came next with quick hiring and even quicker training. “We hired a dozen people within two weeks and we brought up the number of staff from 7 pre-pandemic to 30 during the crisis. I’m still impressed by the quality of staff that we hired in such a short time - most are still with us and focus on other work now,” says Silvia. ● Business: Coviu also had to consider how it would scale as a business to survive through this crisis. The firm was fortunate that its business model was already in place, so it was taking payments from clinicians in a fully automated way. Everything was set up for scaling already and it didn’t run out of money.

Telehealth is Here to Stay and Thrive Telehealth is only at the beginning of its integration into healthcare across the world. “People are still focused on seeing their clinicians in person. For some types of consultations that is 24 | INSIGHTS CARE

necessary. However, things are changing. More devices and different tools are being developed that will make it easier for these consultations to move online. I foresee that every person will have several small clinical devices at home to enable telehealth,” asserts Silvia.

She continues, “I foresee the creation of small home clinics. I believe that this is what COVID-19 has set us up for. Increasingly more consultations via video are held from home and they are starting to create a change in the way we provide care.”

An Expert’s Advice for the Novice The healthcare industry is not a simple industry to build a business in. In healthcare, there is a separation between the people that receive the care and those that pay for it. Most often, the payers are insurers or the government. So, the entrepreneur has to convince both that what he/she is providing is valuable.

Another challenge in healthcare is the regulatory aspects. These are much more rigorous in healthcare than in any other industry - and rightly so: after all, it’s about human lives. Regulatory systems in healthcare are typically limited to country borders. So, even if one finds a scalable business for one country in healthcare, it might not easily apply to another country. So, one needs to have a good understanding of the healthcare system and the potential business models in the different countries targeted. All of this in addition to being persistent because people are highly averse to change in healthcare.

The advantage of working in healthcare, however, is that you are making a direct impact on peoples’

lives. It is a highly rewarding area and very motivational for everyone involved.

Silvia’s final piece of advice is a bit more general: “don’t be too scared of making mistakes. Some of the best business models have come off the back of failure. When you know what doesn't work, you’re one step closer to finding something that does, as long as you treat it as an opportunity to learn and grow.”

What Next for Coviu Telehealth is only at the beginning of its integration into healthcare in Australia and across the world. Coviu has big plans to further humanise technology through telehealth. Key technology developments need to be servicing, not replacing humans.

Artificial intelligence tools are important to relieve medical specialists of tedious triage work to allow them to focus on the most challenging cases that require human lateral thinking.

New models of care will lead to more diversification of clinical jobs to allow nations to deal with the onslaught of chronic illnesses coming through aging populations. All of this can be integrated into virtual care and telehealth. This is where Coviu plans to make a difference.

In 10 years, Silvia expects Coviu to be the communication centre for healthcare businesses. Whether a clinician needs to talk to a patient, provide group therapy, needs to meet with a peer, or needs to join a company meeting – it will all be taking place in the same virtual clinic location that is provided through Coviu. “We will be a hub for enabling digitally transformed healthcare businesses,” concludes Silvia.

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QARE

Patient-oriented Quality Healthcare Programs

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ver the past few years and specially in the past few months, telemedicine and telehealth solutions have found themselves in favor from both patients and medical practitioners. If trends are to be believed, telehealth solutions are poised for more growth and a stronger presence.

France-based Qare is among the prominent providers of care and telehealth solutions. Qare’s mission is to give patients better access to quality healthcare, through a comprehensive digital healthcare platform that answers patients’ needs.

The company leverages technology to enhance the quality of care. Serving patients, physicians and organisations in France, it offers the best integrated care possible. Qare addresses this through teleconsultations 7/7, of course, but also by working on prevention and follow-up. It also provides, through enterprises, healthcare programs that address specific needs.

More about Qare from Oliver Thierry, President & CEO through the following interview.

What are the prominent solutions and products, that make your company stand out from the competition?

Qare is the truly « medical approach » telemedicine service.

For patients, leveraging telemedicine, Qare provides better healthcare services to patients who need it through: Ÿ

A large pool of quality, diverse health professionals assembled, continuously trained and coached.

A superior teleconsultation product through great user experience and feature-depth. Ÿ A good understanding and management of the patient, through unified patients’ medical record, data collection and mining. Ÿ

Our healthcare practitioners are a key part of our service, they are our cornerstone provider. We enlist quality healthcare professionals that we train, support and follow, in order for them to deliver the best possible quality medical service through our solution. We cater to physicians that are ready to commit sizable time and effort to patients using Qare. Qare attracts liberal and non-liberal healthcare professionals alike.

Qare will complement it’s telemedicine strategy by a territorial presence strategy, through its own Healthcare Centers, in order to enable genuine online-to-offline offer.

Virtual first, but with the possibility of an in-person followup when necessary, thus contributing to its better healthcare value proposition.

This goes together with the deployment of Qare’s telemedicine offering in local points of care – such as pharmacies, that will enable assisted teleconsultations and enhance remote medicine for a better care all over the country.

Taking into consideration, the current pandemic, and its impact on global economies, how are you driving your organization to sustain operations and ensuring safety of your employees at the same time?

From an operational standpoint, we have everybody in our teams working from home for some time. Our offices in Paris remain opened for those who prefer to go to work (but this is not mandatory). Wearing a mask is required at all times in our offices, and there can be no more than 30 % of employees at the same time.

While this is expected to be less optimal for collaboration, we estimate that our business will not be materially adversely affected, since ours is a service, technology and knowledge business.

We work closely with all the managers to maintain and

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Interview with Insights Care

ABOUT THE LEADER Olivier Thierry, President & CEO, Qare, has had more than 20 years of experience in high-tech, high-growth companies. He grew up with doctors in his family and it was important to him to work in a company that helps people improve their way of life. Health is the main driver of people’s quality of life and happiness. There is no more important goal.

Olivier Thierry President & CEO

Before Qare, Olivier was COO and B2B Director of TheFork & TripAdvisor Restaurants, and prior that, Global VP in tele-sales at SAP. He started his career at McKinsey, working on four continents, more speciďŹ cally in Media, Telecom, and Corporate Finance/ M&A & Private Equity.

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INSIGHTS CARE | 27

From patients : “This app has changed my life! I can access a doctor easily when I need it, without having to go there, and receive quality healthcare” From physicians : “I can serve additional patients whenever and wherever I want it, without hassle and with tools that allow me to deliver an ever better healthcare” From Enterprises : “I can keep my employees present, productive and engaged, through maintaining a good physical and mental health”

We observe a strong increase of teleconsultations across all specialties, which shows that people are not just going to teleconsultation for matters related to the Covid-19 but mainly for other matters, adopting the teleconsultation practice as a whole. We also observed that older patients (50+ years old) turn to telehealth.

What would be your advice to the emerging entrepreneurs aspiring to enter into the healthcare industry?

There is probably no better mission. Be advised, though, that things take time, in this space, that conservatism and regulatory barriers are many, and that you need to be patient for things to happen. The time frames are longer than in other industries. And no matter how creative or bold you are, you will need to remain cautious and thorough.

Because of its potentially high-impact on people’s life, you cannot cut corners and play it like an amateur.

Where do you envision your organization to be in the long run and what are your future goals?

We will further build on already existing assets that differentiate us from other players:

grow social relationships amongst all the teams, even remotely, since we had to scale-up very fast since the beginning of the pandemic.

Ÿ

What do you think could be the future of Telehealth technologies and solutions market post the COVID-19 pandemic?

Ÿ Ÿ Ÿ Ÿ

What we’re seeing is that a lot of people and companies, who previously were hesitant about adopting this new healthcare practice and possibly were not viewing it as an urgent need, are now jumping in without hesitation.

Telehealth has gained a lot of media attention too, meaning now every patient and physician knows what is it, what are the benefits of it and what are the key providers in France (amongst whom Qare).

Ÿ

Ÿ

Ÿ

From a business standpoint, this has increased the volume of our activity a lot, stretching our teams. We were already in a strong, double-digit, month-over-month growth, but the pandemic has increased our growth by an additional 25 percentage points roughly.

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Ÿ

A strong brand which relies on superior and qualitative user experience for patients and physicians, through an emphasis on…

Product development Support services (both for patients and physicians) Training & coaching (of physicians) A close monitoring of operations, quality and satisfaction along the whole user experience chain.

A definitive “medical” positioning and capabilities, through the involvement of doctors in the design of our roadmap of services and in all major or ongoing decisions made by the company, as has been the case since the beginning.

Partnering with other players in the medical and healthtech world, in order to enhance our value proposition and to extend our reach.

Emphasizing certain specialties, such as mental health, and developing health packages and programs for specific life moments or conditions.

Decision-making support tools, information and transparency for patients and doctors, helping them to make the right choices by and for themselves. A strong emphasis on data mining and insights.

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Abhinav is the Managing Director of Accurex Biomedical Pvt. Ltd and the Secretary of the Association of Diagnostic Manufacturers of India. He is a speaker at various healthcare & business events.

ABHINAV MANAGING DIRECTOR

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PATIENTS IN NEED OF DIAGNOSTICS TESTS ARE AVOIDING PATHOLOGY LABS DUE TO COVID FEARS DOCTORS

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any pathology labs have reported drop up to 70% of routine tests during the COVID 19 pandemic.

With a fear of the second wave of COVID 19 being around the corner, patients are still delaying their diagnostics tests.

The reason behind the delays boils down to fear: According to a survey, 70% of consumers say they are very or

somewhat concerned about contracting the coronavirus if they go to healthcare facilities to receive care for issues not related to COVID-19. This fear is translating to lower rates of infectious, chronic disease diagnostic testing and preventive health check-ups.

To reverse this troubling trend, pathology laboratories must take immediate action to inform patients that deferring essential diagnostic tests can pose greater health risks than the risk associated with contracting the virus itself. To help, we have summarized both the potential precautions that your laboratory should consider to help assure your patients, as well as the communication message for communicating your laboratories safety protocols to patients. Here is how to help your patients overcome these fears.

TOP five things you can do to help patients overcome their fear of getting pathology tests done during COVID: 1. Separate your COVID-related testing services from your non-COVID testing.

Patients do not want to walk

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into the lab to give COVID sample or neither encourage this because it has a huge negative impact on non-COVID patients. Non-COVID patients seeing lab personnel in PPE kits collecting COVID samples adds fuel to their fears. In fact, non-COVID patients will often ask, I hope that your lab is not collecting COVID samples. So, assure them that your lab is not collecting COVID samples and you only do it from home collection or inform them of some other strategies that you may follow to mitigate the infection risk as follows: • Location: If possible separate the rooms for COVID and non-COVID sample collection.

This may not be possible if there is a space constraint. If there is a space constraint, there look at an option to establish special hours for high-risk patients. This strategy could be used for scheduled preventive or follow-up visits for senior citizens, expectant mothers, and the immunocompromised.

• Staff: Finally, patients may be reassured to know that you are separating COVID testing and nonCOVID testing staff so that those who test COVID positive INSIGHTS CARE | 31

patients are not also testing non-COVID patients.

2. Focus on home collection service Home delivery services have increased across all industries due to COVID. In Pathology also both COVID and non-COVID patients are more comfortable with home collections of samples, laboratories must focus on building capacity for home collections. The laboratory may have to hire and train more phlebotomist. The phlebotomist is the face of your laboratory, so it is important the phlebotomist visiting the patient’s home is well trained in blood collection and customer service. The phlebotomist must be presentable and be given a smart home collections kit. The patient will not be visiting the lab in case of home collection hence the phlebotomist is the face of your laboratory. It is especially important that Phlebotomists are caring and understanding while drawing samples to make the patient feel as comfortable and at ease as possible. Also, the speed of home collections will play a key role in customer satisfaction i.e. how fast can your phlebotomist reach the home of the customer after the test is requested.

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3. Strong IT systems Since home visits will be higher during the pandemic strong IT systems need to be built to offer strong customer service outside the laboratory. There needs to be an app for the customer to books their tests, view their appointments, make their payments, and review the services. The phlebotomist must have an app to capture the sample details so the pre-analytical errors are reduced.

Finally, there should be a system to email the reports to the patient since the patient will not prefer visiting the laboratory to pick up the reports.

4. Continuously sanitize public spaces (in plain sight to patients).

Pathology laboratories know the value of a clean work environment. To ease patients' minds, take this one step further and ensure you are cleaning public spaces—and that you are doing so in plain sight of patients. For instance, you can: • Establish hand sanitizer stations; • Remove magazines, brochures, and other frequently touched objects from common areas; • Disinfect waiting area chairs, door handles, etc. continuously

throughout the day; and • Emphasize that you are sanitizing rooms and equipment between patients.

5. Feature images or posters of the safety precautions your laboratory has put into place in the waiting area and sample collection area.

This strategy has been also utilized by non-healthcare organizations such as restaurants and shopping malls to build confidence in the customer's mind that all safety precautions are being followed.

In its campaign #AapKiSevaMein Big Bazaar show the precautions put in place to keep customers safe and minimize the risk of contracting Covid-19.

Patients are putting their lives as a risk due to the fear of getting infected by COVID at medical facilities and the above steps may help calm them and save their lives by taking important diagnostic tests. By following the five steps enlisted above you can make your patients feel safe to get lifesaving tests done.

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TELEMEDICINE

DURING COVID-19

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moke and drum-beats were a way to warn people from afar of things fatal like enemy attacks and hordes of wild animals. For things that needed closer examination as is the case with medical assistance, what worked till a while was the age-old system of meeting in person, explaining the ailment and getting the right course of treatment.

Being in close proximity gave the medical practitioner(MP) a first-hand understanding of the situation for the right course of action. These were to an extent negated with the arrival of the telephone which gave MPs leeway in understanding the situation and recommending likely cures. This though, was more prevalent in the case of known persons and their ailments.

With telecom going digital and live videos entering the scene, the stage is now set to move medical assistance online to a very large extent. Add to this the advances in digitization and bandwidth which have brought center-stage wearables from head to toe giving humanity the

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chance to move the field of healthcare to the cyberworld.

If these weren’t reason enough to move things online, along came a pandemic whose spread could only be controlled by an act which perfectly complemented the spread of telemedicine(TM). Social Distancing.

With in-patient meetings being a big no-no and most healthcare systems stretched to their limits, the only option available to most patients, be it of Covid-19 infection or other diseases is telemedicine. We give you a few scenarios and why the latter is the best option not just in these times but for all times!

It helps take away the physical load from the primary healthcare system Pandemic or no pandemic, most health-facilities anywhere in the world (and more so in underdeveloped parts), especially those mandated by law and supported by public money stand stretched to their limits be it for beds, specialists, medication, caregivers or even cleanliness. Taking away a significant proportion of hospital

visitors thru the online route can help reduce the burden on a stretched-tothe-limits facility, and reduce its chances of avoidable fatalities. In the case of Covid-19, a significant number visiting brick-and-mortar health facilities do so on being confirmed.

With a high percentage of these needing rest, isolation and prescribed medication and being outside the immediate fatalities zone, they can be handled perfectly well while they stay at remote locations instead of crowding designated health facilities. Doing so would help the healthcare system concentrate on fatal cases.

For those with associated morbidities, TM provides for the essential safe distance and reduces their chances of being infected had they visited a medical facility Experience shows that most Covid-19 casualties had co-morbidities which include among others diabetes, various infections, low immunity, heart conditions etc. These, as a rule, are said to reduce one’s natural immunity to fight infections. Bringing them to an established Health-care facility like a

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Remote Health

hospital that’s choc-a-bloc with all manner of viruses and pathogens may prove fatal, more so for those with compromised immunity. In such cases, it could make sense to resort to telemedicine and keep such patients in safe places while administering treatments online, with limited on-site in-person treatment.

55 billion by 2023 coming on the back of a 19% CAGR.

With remote locations and wearables, TM can get all details online for quick relief Wearables to combat Covid-19 have become rampant with data from them being the resource to predict the onset of the virus. A report of the Rockefeller Neuroscience Institute on the Oura ring, a wearable sleep and activity tracker in combination with a dedicated app says that it can measure vital signs in advance (up to 3 days) of whether a user could develop Covid-19 symptoms including cough, fever, and shortness of breath before they manifested.

Helps connect with medical specialists worldwide Without the need to visit a medical facility, telemedicine offers patients the option of consulting any number of specialists and medical practitioners worldwide without the need to visit them in person. This could prove a boon where one wants to double-check on any aspect of the treatment. Being an online approach, it can be expected to be much cheaper than trying to visit the same set of specialists in person. It could also save enormously on time and patience.

DETECT, short for Digital Engagement & Tracking for Early Control & Treatment, a study by the Scripps Research Translational Institute using devices such as Fitbit, Apple Watch, and Garmin among others for tracking heart-rate, activity, and sleep data and matching it with Covid-19 symptoms have shown that a fitness band can predict Covid-19 in 78% of patients studied.

There are concerns though with the accuracy of wearables as also the high cost associated with them which deters most from acquiring them. Despite these figures, they continue to be one of the fastest-growing sectors in the global tech space likely to reach USD 2020, ISSUE - 02, VOLUME - 11

Coupled with the right technology in telemedicine, details from these devices could help Medical practitioners treat patients remotely without the need to visit a medical facility.

Medical Practitioner even while remaining away from the scene (as also being infected), can be part of the action On the other side of the table, telemedicine can help medical practitioners and those associated with the field operate from remote locations.

With personnel in the field of medication being in high-risk category, those in the field can treat patients from afar as well, and do so simultaneously for more than one!

Even those practitioners diagnosed with Covid-19 – provided they are in a state to do so, can examine cases from afar thus boosting the number of front-line fighters who are braving the storm and treating those in need.

Patients can be treated in different parts of the same facility and reduce exposure to life-threatening diseases Telemedicine can help reduce the load within a medical facility. Patients with Covid-19, depending upon their circumstances, co-morbidities and medical condition, can be shifted to different parts of a facility or nearby with the facility of being in constant touch with a team of medical practitioners and care-givers through varied devices including wearables.

Where then is the hitch?

They say that if something is too good to be true, it could only be a dream with reality being far removed. That thankfully isn’t the case with Telemedicine which never-the-less has its own set of hitches and glitches including some mentioned below.

- Patients may still need to come for testing where they may contract the disease.

- For patients in severe cases, there could be no option but an in-person medical care - Technology- especially bandwidth for advanced telemedicine does not exist in most places. In fact, in some cases, bandwidth doesn’t allow for even normal remote patient care - Procedures to admit patients, queuing them for consultation, billing etc are still not up to the mark - Quality of hardware for correct remote diagnosis is still an issue.

- Presence of special facilities including noise-free environment, lighting etc for better consultation may not always be available.

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INTERVIEW WITH INSIGHTS CARE

Lise Pape started exploring issues of daily life with Parkinson’s and multiple sclerosis in 2014, whilst studying Innovation Design Engineering in London, at Imperial College and the Royal College of Art. She was driven by personal experience as her father has Parkinson’s disease and she wanted to create simple solutions that make a difference, whilst having no side-effects. Having a close family member with a movement disorder is incredibly frustrating, and seeing the difference her work can have on people’s lives is what drives her and the team to innovate.

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ABOUT THE

FOUNDER VOLUME - 11, ISSUE - 02, 2020

Walk With Path Creating Simple Solutions for Positive Impact

“

We believe in supporting the ownership of our own healthcare and enabling independence for as long as possible.

“

Helping Clients Walk with Confidence Walk with Path users feel empowered and less exposed in their daily lives “This is the furthest I have walked in a day for years! I use Path Finder to train my walking.” Matt Eagles, Manchester UK “I find it useful when I get stuck. It helps me get around. Everything flows better.” - Melanie Powles, London, UK “Freezing makes me feel vulnerable. Having the line helps me build up the momentum.” -David Parrish, London, UK

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alking steadily is crucial for mobility independence. However, due to old-age, neurological diseases or some other incidents, human mobility can be greatly affected. Helping such people regain mobility and walk with confidence is Walk With Path, a multi-award-winning company focused on injury prevention, improved mobility and user-centered design.

Based out of the UK, Walk with Path Founder and Managing Director, Lise Pape, shares the details, inspiration and the future of the company.

Please brief our audience about your company, its values, vision, and mission.

Walk With Path was founded out of personal experience as my father has Parkinson’s disease and I wanted to create simple solutions that make a difference whilst helping people stay active and mobile. This has driven our vision as we believe in enhancing human life and shaping the future world. Our mission is to create inclusive innovations to make a positive impact.

What are the prominent solutions and products, that make your company stand out from the competition?

Path Finder is a wearable tech device. It creates visual cues on the ground using laser projections, in an automated and hands-free way. Path Finder has improved older people’s in- and out-of-home mobility globally for over 1000 direct end users and many others indirectly.

We are currently developing our second device, Path Feel.

Path Feel is an insole that provides vibrational feedback to the soles of people at risk of falls, such as those with peripheral neuropathy, who are unable to feel the ground properly due to a sensory deficit, or those with general balance issues. By amplifying the sense of touch of the feet to the ground, users are able to identify accurately when their feet touch the ground, thereby reducing the sense of imbalance as well as incidence of falls.

Being an experienced leader, what is your opinion on the adaptation of newer technological developments to sustain business competency?

I think it is critical for all businesses to keep abreast of technological advancements so that products can be improved in line with innovation. It is also important to stay in close touch with end users, so that there is a constant reinforcement that the product meets an actual need.

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Taking into consideration, the current pandemic, and its impact on global economies, how are you driving your organization to sustain operations and ensuring safety of your employees at the same time?

Our product development is at a crucial point and it can be challenging to work remotely and have the same level of collaboration as a team and resolve issues effectively.

However, the health and safety of our team is the top priority so we make sure to follow all the government guidance and have frank and open discussions about it, and how we feel as a team as the situation changes.

What do you think could be the future of Telehealth technologies and solutions market post the COVID-19 pandemic?

I think Telehealth will continue growing. Covid has allowed healthcare systems the opportunity to realise that Telehealth can work and it has truly spiralled its adoption. This is an exciting change, and I think that it will also fuel innovation in the area.

What would be your advice to the emerging entrepreneurs aspiring to enter into the healthcare industry?

Healthcare is a challenging area. it requires the alignment of several elements to become successful, including engineering, regulatory and reimbursement. The timeframes are long and I would say that healthcare requires a lot of patience. It is also a market driven by economics as a priority over patient benefit, which can be disheartening.

Entrepreneurs looking to enter healthcare need to be aware of the timeframes and hurdles in the market, and the necessity of funding to support these steps. However, saying that I realise that perhaps I would have hesitated to enter the market if I had known it all upfront. Sometimes it’s better to discover obstructions as you move along, as they will seem more possible to overcome.

Where do you envision your organization to be in the long run and what are your future goals?

We aim to become the mobility company of choice. We are at a crossroads, where we are also seeking to develop products outside the medical area to support and impact a wider population. Our future goal is to become the go-to expert on mobility within the medical field and of course the other area that we are developing, which I cannot discuss as of yet.

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