Telemedicine – Clinical and Cyber Security Considerations with Suzanne Shugg, CEO Teleplus Healthcare

Hey Outcomes Rocket friends, thanks for tuning in to the podcast once again. As a leader in health care, you have big ideas great products, a story to tell, and are looking for ways to improve your reach and scale your business. However there’s one tiny problem. Health care is tough to navigate and the typical sales cycle is low. That’s why you should consider starting your own podcast as part of your sales and marketing strategy. At the Outcomes Rocket, I’ve been able to reach thousands of people every single month that I wouldn’t have otherwise been able to reach if I had not started my podcast. Having this organic reach enables me to get the feedback necessary to create a podcast that delivers value that you are looking for. And the same thing goes if you start a podcast for what you could learn from your customers. The best thing about podcasting in healthcare is that we are currently at the ground level, meaning that the number of people in healthcare listening to podcasts is small but growing rapidly. I put together a free checklist for you to check out the steps on what it takes to create your own podcast. You could find that at outcomesrocket.health/podcast. Check it out today and find a new way to leverage the sales, marketing and outcomes of your business. That’s outcomesrocket.health/podcast.

: Welcome back once again to the outcomes rocket podcast where we chat with today’s most successful and inspiring health leaders today. I’ve got an amazing guest for you today. Her name is Suzanne Shugh, she’s the CEO of Teleplus healthcare. Suzanne has over 20 years of experience in multiple health care sectors. She’s developed the new innovative insurance company. She’s implemented an expanded preventative cardiovascular clinics, assisted in the management of hospital systems and remains a hands on health care provider. Suzanne continues to teach all aspects of adult medicine at future tech in medicine at Rutgers University where a program has ranked number 7 in the U.S. as a pioneer in telemedicine she’s implemented telemedicine services and hospital systems, clinical settings and doctors offices. She was elected as a fellow of the National Lipid Association, one of the highest and most prestigious rankings in the organization. Suzanne was the director of preventative cardiovascular services at a large multi specialty medical group where under her direction the clinic grew to outproduce any other clinic in New Jersey she’s practiced various aspects of Cardiology in and out of hospital settings and established a preventative clinic. It’s a pleasure to welcome you to the podcast, Suzanne. Thank you for joining us.

: So thanks so much for having me. I’m excited to be here and sort of tell my story. So.

: We’re excited to hear it. So did they leave anything out of your intro that you want to share with the listeners?

: No. I mean so right now I’m working at a cardiology clinic NJ cardiology Associates which we are in various different offices in New Jersey all the way from West Orange Bill to Toms River. So we’re all over. And I’m one of the few legal specialists in New Jersey. And then I also teach it at Rutger’s in my spare time as well as also run a treatment of the company. So I’m very passionate about health care to say the least and that’s part of why I want to share my thoughts and feelings as to what’s going on in health care why we need to fix it and how I think we can fix some of it.

: Love that Suzanne and Sfar spare time. I don’t know how you have any of that.

: I think we’re all busy just giveaways and this is where my passion lies. So I’m fortunate to have supportive family members a husband and family members that believe in me.

: It’s awesome. Yes important. So important. So Suzanne take us back to the Genesis. Why did you decide to get into medicine.

: Well I think as a kid I was always helping people. So we just always knew that I was going to do something. I sort of veered off it and went into business degree first and then figured out well this is really boring is that behind a desk. Yeah. We went into medicine but I went in actually into nursing first you know and that was where I wanted to be as bedside nurse for a couple of years and went back and got my master’s and took him in for Tischer and then was like You know I need to do more. And then came back and got my doctor and then became a lipid specialist because there really isn’t many of them in the country never mind the world though focusing on prevention and trying to prevent disease or prevent recurrence which I think is really important. So I think that’s where telemedicine plays a big role and everybody thinks so telemedicine that this crazy thing that you do you’re talking to a provider over over the computer over your telephone. It’s pretty you know distant but the way we sort of focus on telemedicine is we want to connect our patients with their current providers. So our goal and why we’re so different from everybody else is that we want to make sure that our patients continue seeing their providers. And what my company does is give the doctors offices the software and the ability and the training to be able to care for the patients they’re already providing care to, to provide chronic care management which is as we all know a huge issue with our new what I call the silver tsunami, the baby boomers.

: Super interesting. Suzanne thank you for sharing sort of how you began very intriguing that you decided to go and get your doctorate and Lipid management and studying it. I’m intrigued so what would you say to the listeners. Right what’s one common misconception about lipids that maybe they need to know.

: So everybody thinks that their diet, everybody is doing something wrong. And most of limpets is actually genetic. Yeah you can do really bad things your diet like I told some of my patients like stop eating like a five year old, stop drinking three leaders a coke day and your will normalize but a lot of times if your family members have early heart disease you really need to be checked for that. And there’s certain risk factors that you can look at. And there are certain blood tests you can do to really see if you have that same genetic. So there’s different types of familial hypercholesterolemia that you have to I worry about and no matter what you do you can’t get your numbers down and unless you take medicines or do something else so that’s just important to know. So you know it’s scary. So that’s where my passion is for preventive medicine and then chronic care management with telemedicine.

: Now supercool. Now tell us in this space Suzanne what’s a hot topic that needs to be on every medical leaders agenda today and how are you guys addressing it?

: Hot topic I think is artificial intelligence, block Chain and telemedicine and I can tell you being in the healthcare arena and being also married to a physician, they’re all scratching their head and going oh my god don’t throw any more technology at us. That’s really I think all the providers are extremely overwhelmed today treating patients because of the EMR and the technology they have to deal with. So you get a lot of physician and provider burnout and then you get a lot of bad patient care because there’s just not enough time to take care of patients. So it’s a real problem. I don’t know if you have a primary care doctor or try to find a primary care doctor.

: I do.

: They’re really hard to find because there’s that many of them left and if they are their practices fall. So there’s a real dilemma that’s going on in medicine. You know not only the private or doctors and the other doctors are forced to see patients every 5, 10, 15 minutes. It’s crazy you can’t you can’t see patients effectively that way. And providers shouldn’t be forced to do that. That’s what’s going on in this country.

: And if half that time is being spent behind an EMR and you don’t get a fraction of that five minutes right.

: Absolutely. So it’s bad and the providers have to then check all these boxes and do all these other things that they’re responsible for. And it’s just the patient care amount of time is just going down and down and down and patients are really feeling it. So they’ve really really disconnected. So one of the things we’re trying to do with our telemedicine is actually connect the patients with their providers and their health care teams. So what we do is we go in and we actually train the office on how to how to treat patients so we’ve come up with certain logarithmic aspects to manage chronic care so I know you’ve talked about congestive heart failure in the past on some of your podcasts. I think it is just a topic because so many people get removed for congestive heart failure. The rate is something like 23 percent across the nation in the first 30 days after discharge. So almost a quarter.

: Insane.

: It’s expensive. It’s insane because they’re sick right. So we know that there are certain things that these patients experience that get them back into the hospital. So like they’ve shortness of breath and they lay down. they don’t feel well that day, they gain weight, their blood pressure to higher too low because they have too much medication or too little. So we basically taken a set of seven questions on a tablet that’s very easy for like an 80 year old to do. And based on those questions in the back it puts them into a red, yellow or green box. So their providers can effectively manage people with chronic diseases in a much more efficient way and get care to the people that really need it. So the sick people really get the care first and they’re effectively managed. And then we incorporated a hipaa compliant video conferencing built into the system so the provider can call the patient right on their tablet with all the other Seppelt. So we’ve essentially locked down the tablets that we’re using so they can’t get any viruses or surfing elsewhere. But that one is where people go surfing.

: That’s so key especially today with the issues in cyber security being such a big deal as it relates to that there’s no doubt you guys are approaching this telemedicine space differently and so with that you’ve locked down these these laptops anything else that people need to be thinking about as it relates to cyber security when they’re implementing telemedicine platforms.

: There’s a whole list of things. So if you are a new tech company and you’re becoming hipaa certified you need to go through a whole list and actually have someone do it. What we call penetration test and we do that every three months.

: Oh, really? Cool.

: Yeah. so they hit the security stuff is about if you start off it’s somewhere around 250 300 pages of documentation to begin with. So yes it’s a lot of work. It is getting harder because of the increasing threats. So that’s one of the things. The other thing is you have to make sure your line is secure. You have to make sure your computer’s secure. You have to make sure your laptops locked up. We actually have our tablets actually have a security device on it and then we actually sit Amazon with another security device another we call it cloud watch that Amazon sells on top of the cloud. And then we also have secure medications. So there’s a lot of there’s a lot of security that has to go into it. And then you have to keep up with it because we have.

: Always changing.

: All time. Yeah.

: This is a great topic and listeners as you’ve heard Suzanne her team keep on top of these things if you’re running telemedicine company you got to make sure you’ve got redundant practices in place to make sure you avoid these types of cyber attacks. And one of the things that I heard from a guest about a month ago Suzanne is if you’re compliant it doesn’t necessarily mean that you’re safe.

: Absolutely. So we will give you another example when we download information from we’re doing we’re monitoring sleep apnea with devices from different companies like ResMed and Philips where we take our data. A patient puts down honestly about Misener sicut machine. The data goes up the cloud. We take that if ResMed or Philips and I’m not saying they do they’re very secure but I’m just saying God forbid they ever had a leak a data leak directly to that to us. So it’s not just us it’s other people we communicate with. There’s a lot to think about.

: No there really is. There really is and so it sounds like you guys are definitely ahead of the game on this. When you’re seeking a telemedicine provider folks you make sure that you ask them the questions that Suzanne just walked us through. So few neater relisten to that just hit the rewind button on that podcast you’ll be able to hear it again. Suzanne, didn’t mean to go down a rabbit hole with that one but it’s definitely.

: It’s okay, no, no.

: If that topic of interest for a lot of people I think.

: Until they did it. So I actually did the whole hit to security hipaa training myself. Now we hired outside security team cyber security team but actually did it myself as I want to understand intimately I understand as a health care provider but it’s a whole different aspect to understand as I.T. provider and I was very afraid of it until I actually got to know it piece by piece. So it’s important to understand it.

: For sure. Yeah. Thank you for walking us through that. So let’s get back to the clinical application. So you were discussing some of these logarithmic just approaches that you’re taking. Can you give us an example of how you and your organization have created results and improved outcomes by doing things differently?

: I think number one is that the patients are comfortable with. So number one is they don’t get overwhelmed by the amount of data that we’re throwing at them. We keep these questions extremely simple. So they get the same questions they talk to the same nurse every day. So there’s consistency, there’s simplicity. There’s I.T. help sort of I.T. help actually calls the patient the nurses actually contact the patient. There’s a lot of continuity of care. So the patients have a level of comfort with it. The patients that are not sick don’t get contacted boy patient burnout a void provider for out which is very important as well because these people don’t realize that you’re contacting patients every day. You’re going to burn them out. They’re not going to want to do it every day. So these patients do it on their own. We do we tell them that there’s a set time in the morning hey can you answer these questions between the hours of 6 and 9 that we are our nurse can check their dashboard at 11 to 12 and then deal with all the patients that are are really sick at that time. That way they can manage a whole bunch of patients but get to the ones that are really sick first. So we create continuity of care like a caring environment where they actually know people’s first names and know who they’re talking to. We actually have good video quality and then we also have what we call peripherals. So we have blood pressure cuffs we have scales we have pulse boxes we have all those things. We actually have a Bluetooth nebulizer. So all those things can take in data that we can remotely picked up and are able to evaluate from the patient’s home.

: That’s pretty cool.

: Yeah. It’s actually very cool. So that lets us know with the patients or are running into trouble and just by knowing where patients usually sit meaning their own individual blood pressure we can customize it to each patient. Health sensitive the patient is we can tweak the algorithms.

: Yeah that’s pretty interesting Suzanne now. Now what if somebody doesn’t take the questionnaire that morning do they rise to the top as noncompliant and they follow up with them.

: So then we call them. So there’s a dashboard where basically we are if you look at our Web site and especially here we have a dashboard there it says you know a number of responses people who haven’t responded. And then how many people are in the red yellow and green box. And then also patients have questions they can text and questions through the secure portal so we can insure them as well so. Yes. So it’s all good. So he goes you know by priorities. So the red boxes are most important followed by the yellow boxes and then by the non, the people who don’t answer and then fall by the question. So we tell patients that so they have some knowledge of when they’re going to get a phone call or when we’re going to get to them. So if they requested they understand that that’s probably not the answer at least 3:30 – 4:00 o’clock in the afternoon.

: Gotcha. Very nice. So the expectations are set and everybody knows what to expect.

: Absolutely and I think that’s it’s just about communication with the patients. So the patients have a clear understanding of what’s going on.

: Now that’s really interesting. Now Suzanne you haven’t always had it figured out there was a time…

: Definitely not. Still figuring it out.

: It’s a journey and so can you tell us of a time when you had a setback and what you learned from that setback?

: Oh we’ve had tons of setbacks. I would think the biggest thing obviously is is funding. I think people think that startups funding is easy. Especially if you’re healthcare tech company. Funding is hard. I mean people really want an established company. They even know. You know I have a background in setting up telemedicine. We have a partnership with UPenn. We have one of the OPEC fellows on from John Hopkins. Keyport guarantees. And it’s it’s difficult there’s no guarantees when you’re dealing with a startup. So I think startup funding has gotten much more difficult. That’s been our biggest setback is it yes we’re getting funded here we’re getting from here we get this amount funding. Funding is never on time. So if you’re listening and you are startup funding is never on time. If anybody crosses their lives the way I think that’s the biggest setback because that limits are scalability. So once when funding is delayed, it definitely limits our scalability.

: So what have you done to circumvent that hurdle, Suzanne. What would you recommend for listeners to do?

: We made a lot of friends. So we’ve actually partnered with one of the largest telemedicine companies that does the EMRs in Asia right now. So we’re going into the Asian market for sleep apnea. So 80% percentage market share. And yet in Taiwan and 30 percent in China but so they have a interesting getting into the U.S. market. And they also been interesting to go to sleep apnea so that they had something that they were interested in that we have and we have something that they have that we’re interested in. So it’s just about finding that synergy and how you can work together. And I think the other things working with really good people and I think everybody gets burned out there. I think working with good quality people and I’m lucky to have finally found the team that we have. We have really hard working, good quality, well educated people.

: That’s awesome, Suzanne. Great message. Listeners, take these notes and take action. Because Suzanne just kind of shared some real gold nuggets with us. You know don’t always rely on those traditional routes for funding. You’ve got to be creative, make relationships. I mean this telemedicine company from China that they teamed up with is not a cookie cutter approach but it worked. And you all have to take no and do the same thing. Think outside the box and you’ll be surprised what you find as far as funding. What would you say one of your proudest medical leadership experiences has been Suzanne?

: I think starting starting the telemedicine company in the CGF program in engy cardiology associates we’re really working hard. I think that partnership with universal Pennsylvania Dr. Pack and and his team Liz Neilan are the really good people in America really hard. I think our educational piece we’ve come up with 20 plus online modules to educate providers on how to take care of patients with sleep apnea.

: Awesome.

: Amazing. Yeah.

: Now these educational modules you guys offer them for free. You offer them to your customers. How does that work?

: We have couple different models. But right now we’re partnering with hospitals and we partner with hospitals their staff get it for free.

: Nice.

: And then we also partner with other doctors offices and nurse practitioners and techs and when we do that they come with like a package deal so we can write and implement sleep apnea management systems. So we offer the education with that.

: Love it. So if the listeners sort of are intrigued right now and they want to learn more how do they get more information.

: So you can go to our website it’s www.teleplushc.com hc is for healthcare but we just want to make it that long .com and so we just have the context you can either give us a buzz or you can e-mail us and we are more than happy to reach out to you.

: Love that teleplushc.com listeners will provide that in the Schoenaerts as well. So don’t worry about remembering it but it’s easy to remember just in case. What would you say an exciting project right now within teleplus that you’re focused on is Suzanne?

: So I think the sleep apnoea in Asia is amazing.

: So are you guys going out there to work on that stuff or what?

: Well because sleep certainly nature’s almost in touch. Most of the sleep apnoea in Asia is and is untreated and it’s about 42 percent of Asians unfortunately because they’re the craniofacial muscles have sleep apnea and so they they really haven’t touched the market of sleep testing they really have an trick’s market on seep out a pop. You know all these different management styles that they need to do and they really don’t have a lot of sleep centers. So you have this whole population and China is huge. The whole population of untreated sleep apnea. So I think that’s one huge thing in the States. What we’re really focused on what I’m very very excited about is we’re working with a doc from John Hopkins who are we’re really working on doing model for obesity is going to be huge because we know unfortunately how heavy or whatever he want to use whatever nice word you want to use. For we know how heavy are the U.S. has gotten as well as around the world. So we’ve developed the model through telemedicine as well as text messaging as well as in person with health coaches nutritionists and exercise physiologists to sort of help these people.

: Well I think that’s really great. You’ve centered on some really core applications here. And I think that’s super important for the growth of any company site. I’m excited to see where you guys go with this Suzanne.

: Thanks. No, we are too. I mean I think the key messages we really do want to improve healthcare. And as a provider I really really care about patients and want to make things better because I don’t think we can continue down the same road we’re going.

: Totally agree. So on that note let’s pretend you and I are building a medical leadership course on what it takes to be successful in medicine today. It’s the 101 of Suzanne and we’re going to write a syllabus for the listeners. I’ve got four questions for you. Lightning round style followed by your favorite book. You ready?

: OK.

: All right. What’s the best way to improve health care outcomes?

: To actually listen to your patients needs.

: What’s the biggest mistake or pitfall to avoid?

: Not understanding the technology and how the technology works together.

: How do you stay relevant as an organization despite constant change?

: Lots of reading and upkeep with the latest technology and journals C you have to be up on it.

: Totally. And finally what’s the one area of focus that should drive every health organization?

: Improving patient care.

: Suzanne. What’s your all time favorite book that you like to recommend to the listeners?

: It’s funny. I’m trying to think of the Outliers.

: Malcolm Gladwell.

: Yes you have you read it.

: Great one. Love it.

: Yeah I just think it’s got a good amount of life lessons but the 10000 hours I think really rings true for a lot of things.

: That’s such a great call. Got to be in it for a while to really get good at it. Listeners, The Outliers. All the things that we discuss on the syllabus as well as a full transcript of Suzanne and I’s discussion you could find all of that at outcomesrocket.health/telemedicine. And Suzanne this has been a blast. I love if you could just leave us with a closing thought and then the best place where the listeners could get in touch with you.

: The closing thought is we really want to improve health care and we really do care about what happens to our patients and society going forward. I think that’s important. The best way to get in touch with me is my personal e-mail is sshugg@teleplushc.com or you can get in touch with me through our website www.teleplushc.com

: Outstanding Suzanne. It’s been a pleasure to chat about telemedicine and cyber security and comes with us. We covered a lot today. So really appreciate the time you took to highlight some of your experiences and help the listeners walk through better outcomes and business success for themselves. Big thanks to you.

: Thanks, Saul. I so appreciate you having me on the show and getting the time to actually talk about what I think is important in healthcare.

Hey Outcomes Rocket friends, thanks for tuning in to the podcast once again. As a leader in health care, you have big ideas great products, a story to tell, and are looking for ways to improve your reach and scale your business. However there’s one tiny problem. Health care is tough to navigate and the typical sales cycle is low. That’s why you should consider starting your own podcast as part of your sales and marketing strategy. At the Outcomes Rocket, I’ve been able to reach thousands of people every single month that I wouldn’t have otherwise been able to reach if I had not started my podcast. Having this organic reach enables me to get the feedback necessary to create a podcast that delivers value that you are looking for. And the same thing goes if you start a podcast for what you could learn from your customers. The best thing about podcasting in healthcare is that we are currently at the ground level, meaning that the number of people in healthcare listening to podcasts is small but growing rapidly. I put together a free checklist for you to check out the steps on what it takes to create your own podcast. You could find that at outcomesrocket.health/podcast. Check it out today and find a new way to leverage the sales, marketing and outcomes of your business. That’s outcomesrocket.health/podcast.

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