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"Telehealth Possibilities"

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Megan Walker: Hello and welcome to Market Savvy Conversations. My name is Megan Walker, the Director of Market Savvy. And today our very special guest is Dr Silvia Pfeiffer, who is the CEO of Coviu. Hi Silvia, how are you today?

Silvia Pfeiffer: Very well, thank you. Thanks for having me on your program.

Megan Walker: So good to have you because last time we spoke, about two years ago, not that long since you spun Coviu out of the CSIRO, and were setting it up, and doing a lot of education around what telehealth is. And then boom, fast forward a few years time. We've had COVID. And wow, how has telehealth changed since February 2020, for you Silvia? And what a ride you've been on.

Silvia Pfeiffer: Yeah. It's been quite a massive year for us. But actually, for the whole country, to be honest. All of Australia had to change in the way that we've been talking healthcare. And the interesting thing is, two years ago, hardly anyone knew what telehealth is, in the general population. Doctors had heard about it. Particularly, primary care practitioners didn't really think it was relevant to them. A few mental health practitioners had picked it up because of the better access Medicare items that were available, which, by the way, still are. But telehealth really took off obviously in the pandemic when the lockdowns came and the telehealth Medicare items were made available almost uniformly. Both phone and video telehealth items.

Megan Walker: It's well and truly here to stay, as we know now. Just explain for anyone who is still new to telehealth, are we talking about a consultation over a mobile phone? Are we talking about a screen view like this? Just paint that picture so we're clear about what we're talking about.

Silvia Pfeiffer: Telehealth is multiple things. From where I stand, the two most important ones are phone telehealth, when you hold a consultation via the mobile phone. And it has to be a proper phone consultation with a diagnosis and advice, et cetera, for it to be Medicare reimbursed for the GPs. And then the other one is video telehealth, which is sort of what we're doing right now in a video call, but is a healthcare consultation. Again, that needs to have a diagnosis and assessments and advice being given to the patient for it to be reimbursed. But all of those items were made available. There's generally other telehealth capabilities as well. You could have text chat to provide telehealth to patients. You could also send messages and have store and forward telehealth. That was not made available as reimbursable items during COVID. The government really only focused on phone and video telehealth.

Megan Walker: I see on your website, you're a preferred platform as recognised by the Australian Government. Well done. And I think it's probably important for us to mention that, with telehealth comes rigors around security and privacy, and that we're using Zoom to record this interview. But just tell us the benefits of using a platform like Coviu over and above, say, Skype or Teams or Zoom, if you could touch on that.

Silvia Pfeiffer: Sure. Skype was basically built for you to talk to your family more or less. Zoom and other conferencing applications for the boardroom were really built for enterprise to be able to hold video consultations or video meetings with a team. So, your custom built platform like Coviu is custom built for healthcare. It's a tele-health platform for a reason. We allow you to take payments with credit card payments. We allow you to take Medicare cards and get Medicare reimbursements. We have clinical tools, so clinical functionality that's been built into the live video call. You can have standardised assessments. We're about to release, for example, the K10 for mental health assessments. We've worked on artificial intelligence tools that can be used during the video consultation.

So it's really laser-focused on the medical use case, which has its own workflows, booking workflows, waiting area of workflows, where people need to sit and wait with music. It's really been adapted to the clinical workflows that we have in healthcare that don't really exist in a corporate environment. So it's a very different approach to video conferencing than your standard video conferencing applications.

Megan Walker: I'm so glad you mentioned all of that because we're not "casualising" healthcare by using an alternate technology. The rigors of security and privacy are just as critical, if not more so than ever. And so the practice owners who've embraced telehealth and video health over the last couple of years, what opportunities have emerged for them? And how have you seen practices embrace telehealth and grow using the platform?

Silvia Pfeiffer: So we've seen a whole bunch of practices embrace telehealth during the pandemic, and then realise that there are advantages for them to retain that going forwards. Now, the approaches are slightly different between Allied Health, GPs and Specialists. And I will just put out there that only about 3% of GPs picked up video telehealth during the pandemic, while the rest of the people that picked up tele-health just did phone consultations, which is fair enough. I totally understand that it is a big step to go from no technology to suddenly having to use a video call, and maybe a mobile phone or something like that to deliver care. So it's a big change.

What are some of the advantages? We've seen mental health practitioners, for example, make their dreams come true. We've got a customer that's moved to Hamilton Island, and is continuing to service their patients in the ACT with mental health consultations. They've gone full-time online, and are servicing patients just as well as before. And the patients are quite happy with the results. We've seen a psychiatrist, out of Melbourne, be able to deliver video consultations to people that live in cars, the homeless population, a population that would otherwise never receive care. That has just been opened up through video consultations.

We've seen practices, like speech pathology practices, expand their reach into rural and remote areas because they could suddenly hold the standardised assessments that are necessary in speech and language therapy to diagnose the children. They could do that via video as well. And they were able to expand their practice, have more patients come to them than before. We've heard from many practitioners that have picked up video telehealth that the number of no-shows has been reduced. So people turn up to their video calls. It's easier to turn up to a video call than to an in-person call, when you get stuck at work or something. You go in a quiet area, you hold your consultation and you come back. So there's lots of opportunities for practices to expand.

One model that we've seen work quite well for general practices is not so much to disrupt the practice that's actually already working and quite effective, but practices can add another practitioner to their service offering to their patients that just takes video calls. So that person would work from home and could be located anywhere. And they can provide the video consultations for patients, while the practice that is running with the local patients will continue running as is, with in-person services. So that allows these local patients to see their practice, and to get advice from the GPs, online as well as in person.

Megan Walker: How many amazing outcomes of connectivity and accessing health where you are. I love your example, from homelessness, regional, remote. I can imagine too, that people are now able to skip over long waiting lists or the distances we've got in Australia of travel to get to specialists. And so, in addition to those benefits for the patients and clients, then from the practice's side, I know we've talked a little bit about this, that notion of hyper-specialisation, so that you can choose the area that you are the absolute, go narrow, but go extremely deep in your area of expertise, and then access clients and patients where they are. Tell me about that notion of building a practice around a super niche focus in health.

Silvia Pfeiffer: Hmm. That's a very good example of a great use case of telehealth. When you, as a practitioner, let's say you're a GP, and you really want to focus deeply on women's health. I'm just picking an example here. I know practitioners have lots of different areas of their interests. But if you have one specific area that you really care deeply about, and you learn everything about it, and you become the specialist, then you would really want to just service patients that are looking for your expertise, not having to deal with all these other things that you might not be interested in. However, the biggest problem you have when you do that is that your local population, the population that comes to you is limited in size. And so, your specialisation is not really widely enough accessible. So the only way to get access to patients beyond your local border is actually through telehealth.

Except if you go and travel around and spend time in other regions just to get to the patients that need your help. But that's obviously not very practical. And it's obviously a lot of waste of your time. So telehealth is actually a really good way to offer those services. And because it's digital, you set up your website, you do the advertising around it. You put your tele-health service online with Coviu. You basically put a virtual front door link on your website and people can come through that virtual front door to see you. You can put a booking link on as well, if you prefer. So that actually allows you to go deeper in your specialisation, and to deal with the type of patients that you really care deeply about.

Megan Walker: I'm really excited about that, from the marketing perspective, as much from the patient's side. But for very low cost, you can find your patients and clients where they are. This is also coming to the time where we have such low cost advertising available through Facebook ads and Google Ads that don't have to be scammy or spammy, and find those people where they are, test out a use case for it. And then have either a hybrid brick and mortar with telehealth, or pure digital, and really expand the growth of the practice through telehealth. I think it's such an exciting time that we're in for practices, reaching people who need them.

Silvia, I wanted to touch on your comment about only 3% of general practices have taken on telehealth. And I'm imagining in that world, we're in the space of six minute, eight minute appointments, sometimes emergency presentations. General practice is a hard and fast world, typically. And so time, I'm imagining, is one of the barriers for people having adopted telehealth. But what other internal preparations would a clinic need to undertake to make the transition from traditional into telehealth, and to get started?

Silvia Pfeiffer: Yes. So with Coviu, we're trying to make those transitions as smooth as possible, and the uptake of technology as smooth as possible. So you want to obviously make sure that everyone in the practice is on board with it. Not every clinician will have to be on board with it. If clinicians want to just practice in person, that's fine. Or you can create a hybrid setup. Hybrid, in-person and remote. Maybe some of the practitioners decide that they're just going to offer video consultations every Friday afternoon, something like that, a pick a block. It can be quite disruptive if you're trying to do a complete hybrid setup where you have a person online, then you go see somebody in person. You come back to online. People don't switch easily between these different modalities. So actually blocking out times is a good way to do it.

What you will want to pay attention to is the booking of those sessions so that patients can book and know whether they see you in person, via telephone or via video. You'll want to make sure that patients find a link or find your virtual front door quite easily. You'll want to put that on your website. And you want to make sure that your staff, your front of house staff is available to manage all of this. I'm sure, as GP practices have picked up phone as a consultation mechanism, they also had to make sure that the front of house staff was actually able to deal with the phone consultations as well, that the receptionist really knew how to pick up patients in that way, or to make sure that the patients that were waiting for a phone call were actually slotted in at the right time with the practitioner. Those kinds of things translate for video consultations as well.

Megan Walker: And we really would love to get people embracing telehealth, wouldn't we? So tell us about the advantages of telehealth over using a phone for a consult?

Silvia Pfeiffer: Yeah. So there's huge advantages for the patients. I just want to tell a little story about a service that we've spoken with. And they've had a lot of phone consultations. Didn't pick up video at all. And the local emergency department was being driven crazy by their patients because their patients wouldn't get enough information out of the doctor from the phone calls. The doctor thought it was a great way of providing the service. The doctor would do the phone calls and thought the patient had understood. But because they couldn't see the face of the patient, they couldn't see the reactions of the patient, they didn't actually know whether the patient had absorbed all the information. So after three phone calls about the same thing, they just packed up their family and went to the emergency room and had to get emergency help.

And it's not a good way to provide service, not a good way to provide health care, if your patients do not understand what you're telling them. So, while the clinician might think that phone is just good enough, it actually isn't. Patients don't take away as much from a phone call as they do from a video call. They might not write things down. They might not hear you properly. They might be very confused, and you don't see it. And they might not feel like they can speak up, so they just let things go. You cannot actually see any changes in their posture, on their skin or anything like that. So we thought the visual component, it can also be quite difficult to diagnose.

So phone has a lot of drawbacks. Whereas video is a lot more like having an in-person consultation, so much closer to it. They will certainly be things that you still cannot do via video. So don't expect everything to be possible via video. But a lot more things are able to be done via video than they are by phone. So I really highly encourage GPs to try it out. We've had so many people that were skeptical, but once they've tried it, they're never going back. They're never doing phone calls again, because it is a much better interaction. And you've got the human connection via video call. You don't get that via the phone call.

Megan Walker: And as a lay person, parent, as soon as you've had the benefit of not having to get a sick child in a car, and sit outside a medical practice, and have masks on, and be called in for being able to stay at home and get that advice and support that you need. What a game changer.

Silvia Pfeiffer: Absolutely.

Megan Walker: Silvia, as we start to wrap up, I've got two more questions for you. One is, any other messages or information you'd like to get out to the Allied Health, GPs or Specialists who are listening to this? And then to wrap us up, how people can get started with Coviu and take the first step, and what they can expect from using your platform. So take us away.

Silvia Pfeiffer: Sure. I would like to point out that the government has just extended the Medicare items till the end of this year. And rumor has it, they will make them permanent. So the change is coming in the industry. And video is not going away. Video telehealth, phone telehealth, and the whole digital transformation isn't going away. It's just going to change over time. It's already happening everywhere overseas. We're also seeing mobile applications being turned into subscribable things. So it's almost like a mobile application is a replacement for medication. So, the digital world is changing. And telehealth is one way to get started with it. Video telehealth, specifically. The phone obviously is a 150 year old item, so that's not really any kind of digital transformation. But video calls are taking you in the right direction.

So I'd really highly encourage people to pick it up, even if you're struggling a little bit. All the changes you're making by picking up video telehealth, you put in some structure in your organisation, you might make your bookings more frequent, and you're offering a different kind of access for your patients that they can take more easily. I'd really highly encourage people to try it out.

About Coviu, if you wanted to get some help, we've got a chat bot on our Coviu website. There are real people behind it. So you will get actually a real person replying to you. So, if you're interested and you want some help, don't hesitate to reach out through that. You can also book a demo with us on our website, And our friendly customer success staff will help you, and will give you a demo and will talk through your specific use cases, and will also help you to determine what the best approach is for you. It's dependent on your practice, how ready you are for telehealth, how much training you might need, how much staff training you might need. Maybe you need to buy some hardware. It really depends. So I can't give a generic recommendation here. But do reach out. We're here to help. And that's what we do. We've done a lot with thousands of practitioners during the pandemic, and we're very happy to continue doing that.

Megan Walker: Wonderful. And the barrier to entry is not as high as, you know people, if they're worried about technology, that demo will, I'm just only imagining, will really show that it's quite simple and straightforward, and follow these steps and get started. So I love it from a marketing perspective. Of course, it's a wonderful service to add on that clients and patients are just lapping up and want it. And also love it for the reachability and the help that we can get to people with access issues. Silvia, thank you so much for the amazing work that you do. And I can only imagine how hard this last year has been for you. Send us off. What's your final thoughts as we wrap up?

Silvia Pfeiffer: Oh, it's been an amazing year. Of course, we've made 10 years of progress in digital technology in a couple of weeks, as Minister Hunt said. But we've also stepped back a little bit. People have gone to in-person health again. A lot of practitioners that have picked it up in a rush have dropped it again. It's not just for the pandemic. I want people to think about telehealth as something that's here to stay, and that people should take seriously, because it is definitely here to stay. It's definitely coming, even if it might take a generational change. This is technology that we will have to embrace.

Megan Walker: Wonderful. So we'll put a link to where people can get more information, where they're watching this video or listening to our interview. Silvia, thanks so much again. Really loved talking to you. And thanks again for all your great work at Coviu.

Silvia Pfeiffer: Thanks for having me. Have a great day.

Megan Walker: You too.


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