Podcast interview with Dr. Deborah Jeffries of Polycom (transcript)

This is the transcript of my podcast interview with Dr. Deborah Jeffries of Polycom.Williams: This is David Williams, co-Founder of MedPharma Partners and author of the Health Business Blog speaking to you from the exhibit hall of the Connected Health Symposium in Boston.  I'm speaking today with Dr. Deborah Jeffries, director of health care markets for Polycom.  Thanks for speaking with me today.Jeffries: You're welcome.  It's good to be here.Williams: I'm looking at a pretty impressive Polycom set up here with the video and PC and a bunch of pieces of equipment.  Tell me what you've got set up.Jeffries: David, right now we're at a unique time in history.  We see the rollout of broadband, the  $7.2 billion that's going out so that connectivity is really going to be achieved in rural areas. Polycom is a leader in voice, video and collaborative data and we have products that will enable anyone from anywhere to hop on and have a high quality video encounter. In particular, you're standing in front of the Polycom practitioner cart. This cart is wireless, it enables you to have the patient presented in front of this cart and bring in a physician at a distance to consult. Whether it's a neurologist, a cardiologist, or rheumatologist, they're going to see a high definition, excellent image, hear excellent sound and be able to help that patient.Williams: What do you find in terms of the ability of a physician who hasn't grown up in the telehealth era to be able to look at an image for the first time and to be able to use it?  Is there a learning curve or are there pieces that are missing for them?Jeffries: When I went through medical school, I went through the traditional method of looking in an ear and someone else looking in an ear and deciding whether we both saw the same thing.  When you look at using telemedicine, all of a sudden you have cameras that are able to show you the tympanic membrane, full size on a big beautiful monitor. You can point to the stapes and you can look at whether there is fluid.  It just makes it bigger, more beautiful and better than if you were in person.  So there are many instances with these cameras that can be attached to the Polycom practitioner cart.  You can see things better than you could if you were in your office.  If you use an examination camera for example to look at the back of your throat, the uvula is the size of your hand and you can see what's going on with the patient.  So yes, there are some differences that the physician will learn in terms of working from a telemedicine point of view, but what they find is, because of the convenience of Polycom equipment, to work from anywhere you can use Polycom CMA desktop to hook up with your patient; and with the quality of the images --because of the lighting and the magnification-- you can see these beautiful images that help them work with their patients.Williams: What's impression is gained by the patient or their family?  Are they comfortable not seeing the doctor or physically being with the doctor?Jeffries: Yes, well this is very interesting. The patient actually is very excited about this because they don't have to drive into a major hospital system, try to figure out the complex parking situation, and locate their doctor.  It's very inconvenient many times for patients to be able to get in front of their doctor.  With the quality of the image on the high def beautiful monitors, you can see the person very well.  It means that they're seeing the physician in an excellent fashion, but also that it's convenient for them.  They can stay in their community health center or they can be at their rural hospital and still connect with an expert that might be many miles away at a stroke center of excellence for example.Williams: The Wall Street Journal did an article on this the other day and they mentioned a couple of high impact opportunities.  One was stroke, to determine whether the patient can get tPA within the window for that and another one was about whether a neonate should be transferred to a neonatal intensive care unit.  Are you actually seeing those applications and are there others that are like that?Jeffries: Absolutely, and in fact tele-stroke is one of Polycom's primary initiatives.  It's so important because it benefits everyone.  First of all, let's talk a little bit about stroke: you're going to have either a stroke that's due to a clot or you're going to have a stroke that's due to a bleed.  If you're a person that's having a stroke due to a clot, you're going to have four hours to get a drug called Tissue Plasminogen Activator that can break that clot up.  If you get that drug within a three to four hour period, you can walk away from a stroke without the debilitating effects of the stroke.  So from the patient point of view, it makes the difference whether they leave the hospital happily in a week or so versus dealing with rehab for the rest of their life.In terms of the physicians, the neurologists, we don't have enough of them.  It's critically important for them to make the evaluation between a clot or a hemorrhagic stroke.  If you have a hemorrhagic stroke and you give this drug, it can be devastating if not fatal.  So the neurologist needs to be able to hop on a product like Polycom's CMA desktop from anywhere, hook up and see the patient live, do an NIAH stroke scale evaluation, because they visually can see the patient, as well as from their desktop unit.  They can bring in the CT image and determine if it's a clot or it's a hemorrhage.  So the neurologist is better able to do their job and has a better quality of life and they can help their patients.  Not only that, there are many instances where patients currently without telemedicine are being sent to the stroke centers of excellence that really can't do anything for them.  So from the perspective of the hospital center of excellence, they have their beds perhaps occupied by people they can help.  They can bring the neurologist in over the Polycom equipment and have a live encounter to triage and decide if perhaps the patient is better served by staying in the remote, rural hospital than by being transferred.  So it basically benefits everyone all the way around, primarily and most importantly the patient, but also the neurologist, the remote hospital and the center of excellence.  Now from the remote hospital's perspective, they want to be able to have the patient in the community so that their family can visit so that they can really make it a better quality and better experience for that patient.Williams: A lot of technology in health care tends to drive costs up, which is different than in other industries.  Do you think the impact of telemedicine will be to drive costs up, down, or will it be a neutral impact?Jeffries: It's a very interesting question.  I think now that we see the rollout of broadband the communication quality is taken care of. I think what we're going to find is that the power of the information is going to be able to be pushed from medical centers of excellence and universities out all the way to the community health centers and to perhaps the patient at their home.  What you're going to find is a transfer of that information out to that area.  Now incorporated in this are the benefits of collaborative video.  Not only are you able to save the trips  --perhaps a psychiatrist is having to drive 15 hours in their car around the vicinity to see their patients-- now can do that from their desktop.  Not only do you save that, but if you look at the health care organizations and the amount of money that is spent on sending physicians to be trained where they're paying for hotels and transport and even board members being moved from the different organizations, all the cost savings in a truly collaborative video world that Polycom offers can contribute to the bottom line a very significant way.Williams: One of the things that you typically see is on this subject is a diagram that shows a state and then the state capitol or large city and then some rural areas in places like New Mexico or South Dakota; it shows the nodes coming into the center.  If you take it a step farther, is there any reason conceptually that the center couldn't be in Singapore or India or someplace that's low cost and high quality? Could you cut the regional center of excellence out of the loop completely and have more competition among the physicians or more choice for the patients to select specialists from around the world as opposed to just around their state or region?Jeffries: Well certainly that's a very interesting question.  Here at Polycom, as you mentioned, I am the Director of Health Care Markets for the Americas, but we also have the Global Director of Health Care Markets, Ron Emerson who is a registered nurse and a respiratory therapist. He has served on the American Telemedicine Association’s board and also supported a telemedicine organization in Maine. Ron has just finished a global trip and we are seeing a tremendous growth in telehealth and collaborative video throughout the world.  I frequently am on with Australia, India, and China, so things are opening up and avenues are going to be presented that allow the patient ultimately to receive the best care.Williams: I've been speaking today with Dr. Deborah Jeffries from Polycom at the Connected Health Conference in Boston.  Dr. Jeffries, thank you very much.Jeffries: You're welcome.