Solei Systems Inc. (fka SOLI)

[Fishing at Surfside]

This is a long post but some pretty good weekend reading. CareClix is mentioned in a very positive light. If you make it to the end of the article the author seems to say that companies like CareClix are the future because they bring the technology that makes it happen. On the downside, he is also using data from one of those pages that estimates revenues by the number of employees. He must have caught one while it was at 400x.

This is translated from Russian, some words may not make sense. CareClix has a Russian interface on it's website.

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Free medicine of the USSR was a unique phenomenon, the value of which everyone realized only after years. Adapting in the capitalist world, we realized that health is a very expensive commodity, often simply unaffordable for the majority of the population. Will telemedicine be able to bring back the times of the "bright past"?
Telemedicine and everything connected with it, more recently would be a certain essence of the boo-going, something certainly useful, but at the same time complex and incomprehensible. Treating people through the Internet using modern concepts of information and communication technologies is an extremely tempting idea that, despite its long existence, still raises many questions and doubts.

Despite the fact that universal coverage of telemedicine services is presented to us somewhere in the distant future, already in 2015 the international non-profit organization Cochrane2 published an interesting document. This report assessed the effectiveness, acceptability and cost of interactive telemedicine "provided in addition to conventional medical care or as an alternative to conventional care, compared to conventional medical care ». The paper states that in a sample of 93 studies, the use of telemedicine resulted in either the same results as personal visits to a doctor (e.g. in the treatment of heart failure) or better care (e.g. in monitoring blood glucose levels in people with diabetes.

One of the main problems of telemedicine for a long time remained a lack of understanding of what this thing should look like at all. There are at least five parties interested in remote treatment of patients: patients, doctors, insurance companies, information and communication service integrators and the government. It is only natural that each participant has their own, well-founded views on what telemedicine should be. It is logical that these views are absolutely not the same, because their carriers think in completely different planes. And now we are talking not so much about Russia as about the rest of the world.

Taking a step aside, we ask an abstract question: how to invent something new? The easiest way is to adapt something already clear and well-known to the novelty. For example, the process of putting an internal combustion engine on the horse-powered vehicles went exactly the way of direct replacement of the horse with a motor. As it turned out, it is not as easy as we wanted. It was necessary to invent not only a new design with a steering wheel, gimbal and transmission, but also to create unprecedented infrastructure, with special roads, road services, traffic lights, etc.

The introduction of telemedicine in the first stages also took place on the principle of "get out the horse, and in its place we will insert a kerosene unit!" Initially, it was assumed that the doctor, as before, will receive patients in the same clinic where he has been working for many years, with the only difference that it will happen by teleconference and patients simply will not come to the appointment in person. However, as the experience of the last few years has shown, minimal changes in the work of doctors and installation in their workplace, say, Skype as a working tool can not do.
First of all, telemedicine has created a number of completely new problems that doctors have not had to face before. The most important of these can be called psychological. Patients want to see a doctor and talk to him live, as before. Will the doctor be attentive to the visitor's ailment if it is a virtual visit?

Americans would not be themselves if they did not investigate the difference between "-tv and just medicine and would not write a scientific article on this subject. The essence of the experiment was that from 2016 to 2017, a group of 5,500 patients was selected, which was randomly divided into two parts. Patients who were in the first cohort received telemedicine services, and the participants of the second - were treated only through personal visits to the doctor. Diagnoses, patient welfare, regions of the country and many other factors were taken into account and appropriately correlated. The conclusions are interesting.
Within two weeks, patients in the telemedicine group were treated by emergency physicians by 1.3% and the usual 6.6%. In the group of personal visits of emergency cases it was 1.1%, and the usual 5.1%. That is, the frequency of appeals was about the same. Doctors who examined patients remotely prescribed fewer antibiotics (36.1% of visits) than those who saw patients in the office (40.1%). The cost of doctors' working hours cost an average of $38 for each patient versus $114 per face-to-face rate. That is, in terms of the quality of services there is almost no difference, but the economic benefits of the "teledoctor" are obvious.

Telemedicine and globalization

Let's think about some more things that may seem fantastic now. Today, to get an appointment with certain medical specialists, you have to wait. Sometimes it's a long time. However, what if the desired specialist is taking right now, say, in Sydney or Madrid? Suppose a foreign language is not a problem either: the advent of public voice translators in real time is a matter for the next few years. Now we are all on some grounds fixed for a certain medical institution and insurance company. But assuming that there is no more centralization? What happens when anyone can make an appointment with a doctor anywhere? Competition among doctors increases by an order of magnitude, plus it will become global. A young endocrinologist from the Volga region will compete with a professor from Moscow or Dusseldorf. How high will the chances of a novice specialist stay in the profession?
At this level of globalization, the issue of paying for health services, insurance and insurance companies will be very acute. It will be much more difficult to understand in person which clinic will agree to accept your health insurance specifically. Probably, there will have to be some financial and insurance metastructure, the main task of which will be to account for and agree on insurance payments.

It looks like the usual health care structure today is unlikely to harmoniously fit into the new reality of the near future. What will come in return? Apparently, it will be aggregators like CareClix.

According to Healthline.com and Investo-pedia, CareClix is the best telemedicine company in the United States in 2018. The range of what they do is really amazing! The company has managed to gather many doctors across the U.S., bring them in with patients, and even connect Medicare, Medicaid and some others. It's not a little, but they've gone much further! From the available doctors in the system, you can create a virtual clinic under your own brand and start your own telemedicine business. You can buy a piece of equipment or a ready-made "medical cabinet" from CareClix from fourteen FDA-approved medical devices and install it at school, for example, so that children can receive medical care immediately at the time of treatment. Conducting consultations, training staff and integrating with existing medical software is, frankly, difficult to imagine the magnitude of the task they have been able to solve.

Unlike many other aggregators CareClix are ready to provide assistance even to our compatriots. For the sake of interest, I registered on their website. If you want to experiment, you'll need a Clinic ID, and you should specify CC1216. I have no idea what this means, but without these "magic" numbers you can't start an account.
Another unusual area in which CareClix is also trying to succeed is investment. Thanks to the transparency of the processes provided by the software platform, this company is a convenient tool where you can invest money and make a profit. The company's annual turnover, by U.S. standards, is small, only $8 million. However, in terms of "the share of turnover per employee. Revenue per Employee, RPE) they occupy a confident first place with a figure of $400,000. per person versus $200,000. most competitors.

If we try to look into the near future, the use of telemedicine aggregators can give another advantage. Experimental modern medical artificial intelligence systems used for diagnostics are now tied to certain locations. Somewhere AI is doing pulmonology, elsewhere in psychiatry. An aggregated network of medical services will make it easy to connect and use AI systems, along with human doctors. This is likely to further reduce the cost of using and owning such a structure and is likely to improve diagnostic accuracy.

Telemedicine Information Security

Behind the scenes was only one question - information security. At the time, Dr. E.V. Kryvtsova noted that the success of telemedicine solutions will depend on whether it is possible to create a simple and universal method that will allow to uniquely identify the remote user. And the conversation is not about traditional logins, passwords and even two-tier authentication systems using OTP. One Time Password).

If we are talking about the application of these tools to telemedicine solutions, all of them do not allow for a guaranteed 100% authentication of the patient, as a pair of login password and OTP can be used without being tied to a particular person.
On the other hand, traditional biometric characteristics, such as fingerprints or retinal drawing, require special equipment and cannot be qualitatively obtained and processed without its help.

Why is the question of absolutely reliable authentication so important? For many reasons. First of all, it will avoid a medical error in the prescribing of treatment. We are all unique. Even twins can react very differently to the same drug. The doctor should be sure that prescribes the medicine to the person to whom this treatment is intended. The second important point is financial. Insurance companies are unlikely to be happy with the prospect of paying for a doctor's appointment, albeit a virtual one, to a person without insurance who just happened to be close to the patient and got access to his identification data.

An interesting solution called "Unified Biometric System" (EBS) was recently presented by Rostelecom. Unlike Apple Face ID, which only recognizes the face image and Siri, which so far is only used to distinguish between different users, ebs is a ready-made solution for unique user authentication and provides error level 10-7, that is one wrong decision for ten million. Connection to the EBS system is via the portal of State Services.

Despite the fact that now this decision allows only to open an account in some banks and is positioned as an authentication platform for financial structures, it obviously has huge prospects! Two-factor authentication of the EBS provides a high probability of correct user identification, and integration with state services in the future can be a big advantage in working with telemedicine projects.

Obviously, the future of telemedicine is for aggregators of medical and ICT services, which will bring together doctors and patients, insurance companies and banking structures, training centers, hospitals and intensive care centers. New technologies have enormous potential and will provide access to health services so broadly that the term "world health" will take on a very different meaning.

http://bit.samag.ru/archive/article/2113