Hi Silvia, Thanks for taking the time to talk to DigitalHealthX. We’re excited to share your journey and of Coviu. Its great timing as you’ve also just released your new book “Beyond the Clinic“.
Tell us about your background, you’ve had a mix of research and commercialisation experiences over your career with Vquence and now with Coviu, always in video, and have also published several books on video standards. I studied Computer Science and Business Management in Mannheim, Germany and then did a PhD in Computer Science. Some of my publications in international journals found an interest by CSIRO so I was invited for a PostDoc. Australia’s charm and the complications of the DotCom bust made us decide to stay in Australia. My research was always in video and standards – I became involved in MPEG and then decided that video needs to be a native citizen of the Web, so created a video search engine, which we spun out of CSIRO in 2006 into a company called Vquence. I continued to be involved in standards, now at the W3C because we needed a native video capability on the Web. This made me work for Mozilla and Google and become a co-editor of the HTML5 specification. I even published two books on HTML5 video. My work contributed to the universal availability of video now – the likes of Netflix, YouTube and Brightcove would not be what they are doing now without our standards. Even today I still contribute to the Web captioning standard WebVTT and of course real-time video WebRTC.
What did you learn at Vquence (your first startup) that has helped you with Coviu? What’s your advice to entrepreneurs on their first startup? At Vquence, we made all the mistakes in the textbook. You have to understand: I was a research scientist with an interesting idea that was indeed ready for the market, but I had no idea about how to create a business, no idea about how to sell, create a product, the legal environment or even accounting. I had to learn it all. The environment in Australia also wasn’t ready for startups – the kind of help you get now as a founder didn’t exist. On top of this, we created a product that was ripe for the US, but Australian companies were still very hesitant. My advice to entrepreneurs is to start your company with a paying customer – if you can’t find one, keep tinkering in private.
What is Coviu? And why is it more than a TeleHealth platform? Coviu is a business tool for healthcare practices with a goal to making telehealth a new source of income. A traditional telehealth platform provides video calling functionality, mostly with a focus on hospitals. Coviu takes telehealth to the next level. We do this in three different ways:
Most importantly we offer rich digital tools for clinicians to make the online consult even better than the in-person consult. This is done through an add-on marketplace where Coviu and Coviu’s partners publish tools for medical specialisations. This may include standardised medical assessments, medical questionnaires, or increasingly artificial intelligence based tools that use computer vision and audio analysis to measure and monitor body functions.
Who was your first big customer? How did that happen? And what hurdles did your technology have to cross to meet their requirements? Our first corporate customer was Ramsay Healthcare. I simply reached out to them via LinkedIn after reading that they had an interested in digital transformation. I met with their IT manager and we discussed their challenges. They decided to explore the use of Coviu and telehealth on a couple of different projects. This was very early on in the development of Coviu and I credit them on their patience! Now, a number of teams are using Coviu in Ramsay Healthcare frequently, mostly for multi-disciplinary team meetings.
The hurdles we had to cross were both technical and regulatory. We had to fill in a lot of forms to confirm that we are conformant with their security and privacy requirements. We also did a number of custom developments, including a translation of the user interface into French, because of a collaboration they wanted to support into New Caledonia.
Tell us about your book “Beyond the clinic”, what inspired it, and how do you see it shaping the industry in future? My new book is about to be launched at the Wild Health Summit on the 20th November in Sydney. It’s called “Beyond the Clinic” and is now available on Amazon. It focuses on giving healthcare businesses a framework to follow when introducing video visits in their business and takes them through to making it a sustainable success. We’ve learnt from many of our customers and have also seen a couple of failures, so wanted to put the learnings and the recipe for success into the hands of more clinicians and healthcare businesses. My hope is that it will help the healthcare industry lose its fear of telehealth and start embracing video visits as just another successful means of delivering healthcare to patients.
Telehealth has been a technology that was ready for healthcare over a decade ago through SMS, phone calls and video. In economies without high-speed internet it has been a major force for improving access. In Australia, how has the regulatory landscape shifted recently? In economies without high-speed internet, SMS and phone calls do indeed work – video visits are very rare there because of the poor state of their Internet. Though with the introduction of 4G a 5G, that’s now changing and they may even leapfrog western countries stuck in their old way of thinking and old way of reimbursing for healthcare.
Video visits are Coviu’s focus, because they provide the best possible information for clinicians to triage, diagnose, and treat patients. Other systems focus on SMS, text chat and phone calls, but Coviu wants to make online consultations better than being there.
We easily forget the state of technology a decade ago – it really wasn’t viable to deploy video visits to patients directly back then.
Three things had to come together to make this work:
What other economies are really adopting Video for TeleHealth and do you see Coviu growing into other countries? Video visits are seeing a lot of adoption in the USA and China and increasingly in Europe. All countries are trying to figure out the reimbursement side of things, but China with its centrally focused decision making has been able to make the largest changes recently and adopt video visits as a core means of delivering services in their hospitals.
At HIMSS AsiaPac 2018 I was amazed to see the changes China has made in just the last couple of years. Their example hospitals – which are servicing millions of Chinese citizens every year – have worked towards the goal of “Making data travel instead of people”. Many hospitals have created a separate Internet Hospital entity that is using their existing clinicians to provide outpatient services via telehealth. All of this is built on integrated EMR systems, which are hooked up to all patient touch points, including WeChat, mobile apps, medical devices and even in-hospital kiosks. This has led to a massive reduction in patient wait time, an ability to track schedules down to the minute, and a huge increase in patient satisfaction. Telemedicine is accepted by 97% of patients. China’s challenge is now to reach the smaller rural hospitals with these changes.
What have been some of the toughest moments in building the company and spinning out from CSIRO? There are many tough moments in a startup, and particularly in a spinout project. You worry about whether CSIRO will continue to fund a project beyond its research stage and allow it to prove the commercial market, which is necessary when looking for investment. You worry about getting all the paperwork and approvals in place from CSIRO. You worry about getting the right team together. You worry about the progress of technology development – you can imagine new functionality faster than you can build it. You worry about giving customers the best possible support and the best possible solution. You worry about the business model and competitors and IP management and legal documents. You worry about getting the right partnerships.
I would say, raising capital has most certainly been the toughest part of creating a spinout from CSIRO. I pitched for many months to many people – finding the right partner who believes with us in the future of telehealth and the vision we have for the industry was hard. We’re so excited to have the right investors on board that are supportive and mentor us really well.
Do you think Australia is competitive in its global technology innovation rate, in terms of spin-out from research? What commercialisation models have worked overseas that can really enable spin-out formation in Australia in your opinion? There are a lot more excellent innovations in CSIRO and our Universities than are commercialised. The commercialisation models are no different for us than they are overseas: licensing, spinning out, open sourcing are really the three key approaches. We don’t have a problem in determining commercialisation models. What we have a problem with is supporting the process of commercialisation.
Focusing on spin outs alone: we need to encourage researchers and engineers to take technology and create a new business both by giving them fair shareholdings on their new businesses as well as giving them speedy processes and funding to get started. We need to match researchers and engineers to the right sales and business development managers that understand the business domain and how to sell and grow a business – or we need to train up the researchers/engineers to do this themselves. Some of this is starting now in Australia through accelerators, mentoring models, government grants and peer support networks. But we’re about 10-15 years behind the US on this, so it’s not surprising that it takes time to get this right.
Coviu has been winning some awards recently … Yes, we’ve won a couple of really interesting awards:
It’s been an amazing year!
What exciting areas for growth do you see at Coviu in the next year? Coviu’s focus for the next year is on integrations. We’d like to partner with more companies to bring more interesting tools into video visits. This includes both workflow tools – such as practice management software – as well as clinician tools – particularly as diagnostic and therapeutic tools similar to PhysioROM. Part of this will also be regulatory work that needs to be done – and we’ll be looking towards more investment to get this done. We’re enabling increasing numbers of healthcare businesses with video visits across Australia and will enter international markets.
Thanks so much for your time Silvia. We wish you great success!
Sign up to receive the latest from DigitalHealthX