Medical services are jumping in remote areas

Clients include travel insurance companies and governments – the Japanese government uses Medical Rescue to help evacuate injured or sick diplomats.

Within Australia, Medical Rescue partners with Toll to provide helicopter rescue services. On the ground, the company has its own resources.

“We have a fleet of about 50 response vehicles,” says McKay. “We have also developed deployable health units – large trucks, effectively mobile hospitals, which can meet the needs of ICU patients for 24 hours.”

Glenn McKay, MD, Medical Rescue

Managing Director Glenn McKay says the medical rescue is growing rapidly.

Over the past two years, the company has provided ground medical services, including ambulances, paramedics, doctors and nurses, to the Australian Defense Force in support of defense training across Australia.

McKay says there has been increasing demand for the services Medical Rescue can provide as public health services consider how best to supply hospitals and clinical outreach programs used by remote communities. The COVID pandemic has strained health services, he adds, and hospital staff are tired.

This increased demand prompted the company to expand rapidly.

“Before the pandemic, it was like sitting in a tube, floating on a river in Thailand, drinking a cocktail, and watching the business grow exponentially,” Mackay says. “For the past two years, she’s been swimming against the tide. We’re growing fast, but there were no cocktails or tubes in sight.”

Telehealth services are required

The pandemic has also increased demand for Australian telehealth company Coviu, which ended an expanded platform just months before the disease hit the world.

At the start of the COVID crash, CEO Sylvia Pfeiffer says, the Coviu platform ran about 400 medical consultations a day. Within two to three weeks, after Medicare introduced telehealth discounts, the numbers had risen to about 25,000 consultations a day.

“It was a huge, massive increase; it was crazy,” she said. “We’ve had eight million medical consultations since the start of the pandemic.”

Coviu grew out of a plan in 2012 to improve access to specific aspects of healthcare in rural and remote areas of Australia. He was inspired by news of a group of speech pathologists having difficulty providing services to rural and remote parts of far western New South Wales, particularly schools.

Coviu calling and conference calling interface

Coviu employs about 55 people, and the organization is expanding from digital health to telehealth over the phone.

Speech pathologists were using different products, such as Adobe Connect and Teams, and were dissatisfied with the quality of the video and audio – so important for communicating with children.

CSIRO scientists hope to pave the way. “That was the impetus for building Coviu originally,” says Pfeiffer.

She adds that computer technicians got to work and came up with a product that had good video and audio quality, especially lip-syncing.

“The doctors said that introducing speech pathology through Coviu was almost as good as being there.”

In 2018, Pfeiffer and her colleagues spun Coviu out of CSIRO and, as an independent entity, began providing a platform to other types of health professionals, including nutritionists and mental health practitioners — psychologists and psychiatrists.

In 2019, Coviu entered into a massive digital health collaboration with HealthDirect, a company jointly owned by several Australian government health departments and the Federal Department of Health.

Coviu experts have begun building a larger platform to support hospital outpatients and six months into the pandemic.

“So, in March 2020, we were there at exactly the right time in the right place with our platform, providing all of those clinicians across hospitals, specialists, GPs, allied health providers and anyone in healthcare, with the ability to successfully deliver virtual care,” Pfeiffer says.

Silvia Pfeiffer, CEO, Coviu

Coviu CEO Sylvia Pfeiffer says it has the potential to change the industry.

While some diseases and conditions, such as appendicitis or a broken elbow, cannot be examined or treated via video links, many diseases can be assessed.

“A lot of things are possible — a lot more than people thought before the pandemic,” Pfeiffer says, noting that Coviu is building clinical tools into the platform to provide health professionals with expanded assessment options.

“A lot of virtual emergency departments now use Coviu for a virtual triage point; people can call that virtual emergency department to see if they should go to the emergency department,” she says.

“75 per cent of people who call this hotline don’t have to go to hospital, they are redirected to a GP or somewhere else. It offers peace of mind: ‘This can wait.’”

Demand has fallen since the peak of the pandemic, but Pfeiffer says the platform continues to manage 13,999-14,000 consultations each day, and the numbers are slowly increasing.

Coviu employs about 55 people, and the organization is expanding from digital health to telehealth over the phone, helping doctors build SMS conversations with their patients. In addition to expanding in the United States, Coviu is also focusing on Canada and New Zealand.

“We want to transform the industry,” says Pfeiffer. “We want to give clinicians a chance to embrace technology, to truly embrace the future of healthcare, which will certainly include virtual care.

“So, that’s why we’re building Coviu the way we’re building it. Healthcare practitioners in general understand that it’s the future and they can’t resist it for much longer.”

Hypnosis as a therapeutic tool

And the booming demand for telemedicine in the COVID era has also bolstered Mindset Health, a fast-growing company that markets a suite of digital hypnosis-based therapies to patients around the world.

Mindset Health was founded by brothers Alex and Chris Naomidis from Melbourne, aged 27-25, and currently offers three digital therapy apps – to treat irritable bowel syndrome and menopausal hot flashes and to help users quit smoking.

Mindset Health co-founders Alex Naomidis (right) and his brother Chris Naomidis

Mindset Health co-founders Alex Naomidis (right) and his brother Chris Naomidis.

“In 2017, my brother and I were at Monash University, both business finance students, and taught ourselves to code,” says Alex Naomidis. Their first endeavor was a peer-to-peer apparel rental startup, but they ended up flirting, leaving fashion to focus on psychology, mental health, and behavioral sciences.

The potential of hypnotherapy caught their attention. “Our father classified it and used it in the past,” says Naomidis. “We thought it was a little strange, but we decided to look at the science and found that there is an overwhelming amount of clinical evidence supporting hypnosis as a therapeutic tool.”

Focused attention and absorption lead to improved therapy, he adds, and hypnotherapy even works through a recording heard on a machine.

“When hypnotherapy is performed, particularly in randomized research settings, the hypnotherapist is only reading from a text,” he says. “It is transferable – through application. The results and effectiveness of hypnotherapy conducted by means of an audio recording are very similar to the results of personal hypnotherapy.”

Mindset’s core product is an app called Nerva, designed to help people with irritable bowel syndrome manage their condition without using drugs or sticking to a strict diet.

Simon Peters, PhD scientist in gut-guided hypnotherapy and psychophysiology from Monash University, conducted a randomized controlled trial to compare the effectiveness of gut-guided hypnotherapy with the often recommended low-FODMAP diet (which limits certain types of carbohydrates – FODMAP stands for Class of Carbohydrates and the expansion of the acronym is Oligosaccharides, Disaccharides, Monosaccharides, and Polyols).

I found hypnotherapy and diet to be equally effective. Her hypnotherapy protocol is now central to the Nerva app, which generates 95 percent of Mindset’s revenue. Over 300 million people worldwide suffer from Irritable Bowel Syndrome and speak English, so there is a large potential customer base. Mindset has been “global since day one,” Naomidis says, and most of Nerva’s 27,000 paid members are in the United States.

“We get a lot of referrals and recommendations from doctors, dietitians, and gastroenterologists who recommend Nerva to their patients,” he says, adding that rather than a cure, the company’s apps have been self-help tools.

Mindset Health now employs 28 people and expansion is on the agenda. Under study are applications for anxiety, depression, insomnia, chronic pain, and weight management. With the goal of ultimately providing a wide range of digital therapeutic applications. “Our mission is to help empower a billion people to improve their health with their minds,” says Naomidis.

Digital health monitoring

Another fast-growing company has capitalized on the growing need to monitor and manage digital health. Developed to connect healthcare teams with patients to improve chronic disease management and prevent unnecessary hospitalizations, CareMonitor is the face of healthcare in the future, says founder and CEO Deepak Biswal.

“You can do a lot of things at home to manage and monitor vital signs,” he says, noting that this type of health monitoring can cover extended periods of time at home. “This is where the patient spends most of the time during the year, not in the hospital.”

20 percent of patients account for nearly 80 percent of health care costs, and these people usually have complex, chronic conditions, often suffering from a number of diseases simultaneously, which require treatment from a group of health professionals, from general practitioners To specialists to pharmacists to allied health professionals.

“The challenge for clinicians is how to collaborate with other healthcare providers to manage a patient’s condition,” says Biswal.

The CareMonitor platform can keep patient records to allow seamless communication between health professionals, he explains, and it also offers a patient app and patient portal, so patients can be reminded of medication schedules and what tests they need to take at certain intervals.

For example, a diabetic patient is reminded every few months of the importance of taking an HPA1C test to determine average blood sugar levels, and is reminded daily to measure blood sugar levels.

The platform can be linked to other electronic medical records in health systems, and educational materials can be sent to patients.

Many of CareMonitor’s customers are from public health services, such as the Northern Adelaide Health Network, who use the platform to run ‘hospital at home’ programmes.

“For some patients with the sub-acute condition, instead of coming to hospitals, they are being catered for,” says Biswal.

“The hospital can monitor them effectively. If you know the patient is doing well, there is no need to send them back to the hospital, so you can allocate resources to someone who has actually fallen off a cliff.”

Platform settings can be customized to suit needs. In January, the CareMonitor platform was used by Medibank and a large Catholic hospital to manage 100,000 COVID patients in five states: collecting data from them, managing their progression to recovery, escalating care when necessary, and discharging them when appropriate.

With a background in digital healthcare strategy in the Asia Pacific region, Biswal saw the opportunity to develop a comprehensive digital healthcare ecosystem. It took his team some time to build the platform and CareMonitor finally started trading about three years ago.

The system is still transforming and evolving, he says, adding that the company now employs 23 people and to date has managed nearly 200,000 patients across the platform, which is built to deliver more efficient care in a range of settings.

“This whole space is evolving,” he says. “The increase in the prevalence of coronavirus has led to an understanding of the possibility of remote care.”

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