Talking HealthTech: 311 – Improving Health Outcomes in Rural Australia with Virtual Neonatology. Darren Reynolds, Teladoc & Joe Cain, Philips

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Joining Pete for this episode are Darren Reynolds from Teladoc Health Australasia and Joe Cain from Philips. Darren is the managing director of Teladoc Australasia and the SVP for Global Emerging Markets. He’s been with Teladoc for twelve years, including a three-year secondment in their Boston. Darren also leads markets in Australia, New Zealand and Japan. Prior to Teladoc, he had leadership roles in insurance and publishing. 

Joe has over ten years of experience in remote patient monitoring and the virtual teleconsultation space, both in and out of the hospital setting. He brings a passion for optimising patient flow across facilities through comprehensive virtual care centres, implementing virtual care programs like eICU, Virtual eTriage Hospital in the home and a multitude of chronic disease remote monitoring programmes. 

The Partnership Progression Between Teladoc and Philips

Philips and Teladoc have been making strides since the partnership. Philips has gone into the market and is now in discussion with multiple Australian and New Zealand hospitals and health systems. They also have several strong business cases currently in development that will help to solve a number of the major issues in healthcare. 

For Teladoc, the company has been able to leverage the depth of Philips’ strong reach into the ANZ market. Needless to say that this has been advantageous for Teladoc. Additionally, the brand is looking forward to exploring Asian markets with Philips. 

Starting a partnership in Australia was pivotal since most multinationals tend to have partnerships born out of Europe, the US or the Netherlands. Seeing and learning new things about the Australian market as the Australian market evolves is significant for both companies, including the execution of these virtual care strategies that everyone has invested in over the last five years. 

Through this partnership, they have also learnt how the focus is shifting to urgent care centres, EDs and non-hospital facilities. These will play a considerable role in the collaboration between Philips and Teladoc going forward. 

A Virtual Neonatology Programme            

Access to specialist services in remote areas can be quite difficult. As such, Philips and Teladoc have helped with the design of a virtual neonatology programme, and it’s all about bringing neonatologists based in Brisbane to remote areas of Australia. Using their specialist virtual care devices and software, they can now connect those rural centres to that Brisbane’s expertise at the touch of a button. 

Why Specific Telehealth Technology?

Contrary to what a lot of people think, virtual care is not just putting a clinician in front of a camera. The process actually entails much more than that, and the programme being used must be built to ensure that it fits within the hospital’s environment, and it has to be purpose-built to make sure that it can literally be on demand. 

Due to the global nature of Teladoc Health, the company has already designed many virtual neonatology services with other world-leading hospitals, such as Mayo Clinic in the US. By leveraging this expertise, Teladoc was able to build an intuitive, easily-adoptable and scalable programme, using specific purpose-built devices. 

This particular device has a dual camera and sits over the crib, providing a direct image of the baby. The second camera points to other diagnostic materials in the room. Also, Teladoc made sure the system was designed to allow a really quick and efficient one-touch entry point to facilitate fast connection. 

Additionally, Teladoc created configurable software modules and tied the clinical workflows to be proven in a work emergent clinical situation. Another key difference between just using Zoom versus the virtual neonatology programme is the clear implementation of training and programme goals. For one, they had to ensure that the nuances of the super speciality of neonatology were taken into account. 

Philips has a long history of implementing in NICU and paediatric wards. To have this kind of direct impact on the triage of a very vulnerable population was something that Philips took quite seriously. Therefore, in the training, change management and outcomes measurement processes, the company ensured that it didn’t go in with any assumptions. Instead, they took learnings from Teladoc reference sites created for the Australian community. 

Key Lessons for Setting Up a Virtual Programme

An important thing to keep in mind is that not everyone actually understands what virtual care is. Also, not everyone wants to buy in. Some people are set in their ways, and they may not want that kind of change. So, a key goal is always to focus on the problem that you’re trying to solve. 

When approached by a client, by making sure that their issue is always at the centre of what you’re doing and then ensuring that you build the programme to be as easy and efficient as possible is a key way to make sure that the programme is going to be successful. Also, when working with rural teams, it is essential to ensure that solutions that require an internet connection will have a stable one, and this may be quite challenging to accomplish.  

Furthermore, you need to find the champions amongst the different teams. These are the persons in the clinical, networking, training team etc., who are excited about the project. You should use them to continue to build enthusiasm within the team. Another significant part of setting up a virtual programme is setting expectations and outcomes.

For some outcomes, timing is everything. Pay keen attention to the differences between caring for patients in the neonatal, paediatric and adult wards. Staff outcomes and staff satisfaction at the bedside with the service, along with family satisfaction, are also important. 

APGAR Scoring

APGAR stands for appearance, pulse, grimace, activity and respiration. This coring system is used to assess the acuity of a particular patient, such as neonates. Patients at less than seven out of ten at one minute will be assessed and scored. Their score will then determine their acuity and the need to tap into a remote and acute service potentially. 

Introducing  Similar Virtual Care Programmes Throughout Asia, Australia and New Zealand

There is the possibility of launching not only similar programmes across other hospitals but even expanding what Teladoc and Philips are doing in those spaces. For example, even though their current solution was set up for virtual neonatology, they’ve already begun looking at other use cases where they can use the camera and the software to make connections, such as maternity support and obstetrics. A natural extension of providing tele-neonatology to rural regions is also supporting paediatric retrieval services. Therefore, the virtual neonatology solution is a very good option to provide retrieval specialists with immediate audio and visual connectivity. 

The easiest way to think about it is the entire inpatient journey. Paediatric ED is a major priority for many of Philips and Teladoc’s customers. There are a lot of end-to-end programmes as a patient enters and leaves the hospital that can be driven with this kind of mothership programme.

Are virtual care solutions here to stay?

There is a lot of movement in the ED redesign space, as well as the ED triage space. The advent of increased investment in urgent care centres in New South Wales and Victoria, coupled with the tried and true in-reach and hit programme, scaling across virtual care monitoring should add to the expansion of sub-acute facilities and non-acute facilities.

In addition, two areas that virtual care can help solve are two of the biggest issues that healthcare is facing at the moment-workforce availability and health equity. COVID has created a huge issue, as many clinicians have left the system. Those still in the system are under immense pressure, facing burnout. 

Virtual care can absolutely provide a solution, either through facilitating one clinician to increase productivity by being able to care for multiple patients simultaneously through Teladoc and Philips’s virtual care technology. It can even allow clinicians to provide care from the comfort of their homes, which reduces stress and burnout potential. 

In terms of health equity, virtual care is already a proven methodology being used for a long time. We know it can help provide people in rural and remote populations with access to the same level of high-quality care city folks are afforded. Virtual care also lowers times to appointments and wait times. It saves travel times and lowers transfers etc. Also, let’s not forget that virtual care can lower costs because it increases capability, efficiency and productivity. 

Combining Philips and Teladoc

Back in episode 185, Joe and Darren mentioned the pros of their companies’ collaboration. Combining Philips’ over twenty years of expertise in remote patient monitoring with Teladoc’s award-winning teleconsultation platform and fleet of cameras really is an end-to-end solution for all care settings- hospital, the home and in between.

Interestingly, as this space evolves into different care models, their partnership is evolving with it. Their customers are bringing them new use cases, and they are working with their platforms together to fulfil those use cases with no parts left over, so to speak.

The Key Aspects of Launching a Successful Virtual Care Programme

For anything to be successful, you need to be capable, scalable and proven. You need to have the confidence and the know-how to produce results that can fit in any area. But in virtual care, the number one thing you need is to have a fearless attitude to commit, to change, to be able to push the boundaries and to challenge the status quo. 

Philips and Teladoc push boundaries globally, and there may not be two better companies ready to take on the challenge of helping health organisations in Australia and New Zealand get ready for the future of healthcare.

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