Activ Doctors Online Executive Vice President Bernard Lee featured in Medical Travel Today


Medical Travel Today (MTT) : Can you give our readers some background and an overview of Activ Doctors Online?

Bernard Lee (BL): At our core, we are a global health partner offering a complete suite of telemedicine solutions designed to empower consumers and providers. Activ Doctors Online (ADO) brings three very important aspects of healthcare delivery together under one umbrella for any patient or entity interested in medical travel, whether it is domestic or international. By providing access to personal health records (PHR), expert second medical opinions (SMOs) in as fast as 48 hours and eConsults, ADO solutions patients save money, time and, in extreme cases, lives.

I think for any patient or entity interested in medical travel, the PHR is the most important place to start. A patient can have an immediate impact on the process by enrolling and uploading their entire medical history on to ADOs PHR platform and the possibilities are endless from there. Now that theyre in control of their medical information, they can grant access to providers regardless of location, which is an incredible time and cost savings when it comes to traditional medical tourism. Once a medical procedure is done, the PHR can be easily updated to add the new healthcare information before the patient is discharged.

The SMO feature adds further benefits for the patient before a medical procedure or surgery, in that they can get a SMO online from a highly regarded specialist to provide a better idea of specific healthcare pathology as it relates to the treatment in as fast as 48 hours.

eConsults also play a critical role in this situation when a patient returns home after the procedure. With the easy-to-set-up platform, the patient can be followed by the physician performing the medical procedure or surgery regarding any complications or labs, which lead to greater patient satisfaction and confidence.

For self-insured employers, TPAs and insurance companies interested in medical travel for their employees or patients, Activ Doctors Online products ensure patient satisfaction, privacy, efficiency and cost containment – all in one seamless process from a secure and encrypted platform.

By way of background, the company was established by Florent Monssoh, the most successful French African entrepreneur in history.

Mr. Monssoh has what can only be described as an impressive IT background. In addition to founding the publicly-traded technology firm Aubay, he developed an automated scheduling software that has been used by Frances Department of Revenue/Tax, Australia Telecom, as well as the Pentagon.

While he was busy doing that, the French government was re-crafting its medical system, including reducing the number of days and hours physicians could work. As it turns out, his brother is a physician so they had many discussions about the system and challenges. He engaged in discussions with the French Ministry of Health for nearly a year and then in 2004 launched Medic Services, the first medical interim company in French history to employ doctors. Basically, Medic Services employed and placed physicians throughout the country. Very quickly the service created a vast network of physicians and specialists, and placed them in hospitals where they were needed.

That experience actually provided the impetus for developing the online SMO. The Medic Services network was connecting some of the best minds in medicine and allowing them to support each other through the sharing of opinions. Mr. Monssoh wanted to make that type of interaction available to the regular citizen.

In 2008, Mr. Monssoh founded Activ Sant and took not just SMO online, but also PHR a first for France.

That same year, President Obama began putting a major focus on healthcare here in the US. Mr. Monssoh thought the timing was right to bring the services of Activ Sant here. In 2009 Activ Doctors Online was launched. Since then the business model has evolved to include PHR, SMO and eConsultation.

We then took the model to Shanghai in 2011 and are now in discussions with hospitals in India, and weve set a target of being operational in Brazil by the end of 2013. I should mention we also have offices in Paris and Madrid, and anticipate having a presence in Portugal and the UK shortly.

MTT: If I understand correctly, the aim of the organization is to assist the patient first, correct?

BL: The goal is to be an advocate for patients and be their ally. However, a more informed patient is essential to increasing the standard of care, which is a win-win scenario for patient, employer and provider. Having a PHR gives the patient a knowledge base of their health, improves their relationship with their physician, and, studies show that if you have a PHR you actually take better care of yourself versus those without a PHR.

However, consumers arent our only market. At this point in time we are engaging providers, and actually have hospital groups approaching us because of our platform its secure, encrypted and puts everything in one place.

In fact, India came to us because of the work we did in France. Specifically, we became the first telemedicine company to provide e-consultation through AP-HP (Assistance Publique Hopitaux de Paris). We are the only provider that offers e-consults to a group of 30 hospitals. Initially the consults were focused on kidney transplant patients.

Transplant aftercare costs France 250 million Euros annually. Through eConsults, patients and physicians pretty much have an open and ongoing line of communication, and recovery is improved. That access translates into huge cost savings.

MTT: I see how that savings works for a country with socialized medicine like France. Whats the potential gain for US hospitals?

BL: That really depends upon their structure.

Take a hospital center. It they dont have a telemedicine capability but are looking for cost savings, access and speed of care, we can establish an eConsult program.
This allows physicians to deepen the relationships they have with their patients and enhance the continuity of care. Ideally, this leads to fewer readmissions and saves money.

MTT: If we can, Id like to jump to your Second Medical Opinion service. Im curious about two things. First, whats the criteria for being able to offer an opinion and, second, how do you handle licensing issues across state and international boundaries?

BL: Ill start with the criteria.

First we have a US medical director as well as individual state medical directors. The state medical directors actually recruit the specialists who then provide the opinions.
In order to be considered you have to be board certified, currently practicing, currently licensed in your state, and you can have never lost a malpractice suit.

As for the licensing, the specialist offering the second medical opinion must follow state licensing requirements. On the international side, we abide by the laws of the country of origin of the patient. And as you might guess, that varies by country, but it is what dictates how we operate.

MTT: So how does a patient gain access to a SMO?

BL: Its pretty straight-forward. First, a member and it could be a direct member or one who comes to us through an employer has to have all their information in the platform. Then they simply go online and request a second med opinion. To be clear, opinions are only offered on serious conditions. Think cancer, not ankle sprains. They go online, fill out the form and make the request. That request goes to the US medical director who does a brief consultation with the member on the reason for the request. Once thats done, the US medical director contacts the appropriate state medical director, who in turn contacts two specialists to review the case. They then confer on an opinion and create a report. The report is provided to a US medical director, who reviews it and then sends it to the member via the platform. Thats followed by another communication from the US medical director to the patient to make sure they received the report and understand it.

MTT: If I may ask, whats in it for the specialist to participate?

BL: Its two-fold. First, they are paid for each opinion offered, but second, and often more appealing to the specialist, they get to engage with other highly-credentialed thought leaders. Typically the cases they’re reviewing are challenging. They really want to be involved in discussions.

I do want to point out that its not a glory job. We dont promote the individual physicians in any way. Their names appear on the report but thats it. That is to say, prestige isnt a motivator.

MTT: Is Second Medical Opinion intended to or is there the potential for it to actually direct patients to different types of treatment, caregivers or even institutions for care?

BL: That hasnt happened yet. The SMO request is made by the patient, and its really up to them to decide how to use that information. Its really intended to simply offer more guidance. Its up to them whether they stay with the physician who provided the diagnosis or seek an alternative.

MTT: Your products and services are clearly aimed at ensuring that consumers have access to their medical records at any time, controlling costs for employers, as well as ensuring that they are getting the proper treatment. These are all big areas of concern in the field of medical travel.
How do you think Activ Doctors Online might be best applied to or integrated into the industry?

BL: I think theres the potential for an excellent fit, particularly as it applies to the eConsult part of our service.

Say a patient decides they want to see a particular orthopedist in Florida. Whether he or she is in Iowa or Indonesia, they can get a jumpstart on their relationship with the doctor by doing a consult online. All their records, imaging and relevant information is accessible, and you can speak one-toone with the physician.

It has the potential to strengthen the patient-physician relationship and lead to a better experience all around.

MTT: If youre willing, can you share whats the fastest growing area of your business?

BL: Definitely the employer side. Thats true in both the US and Europe. In Europe theres a lot of interest from large companies in SMO.

Unnecessary treatments and procedures are a huge area of concern for employers. In 2008 alone, $700 billion was spent on unnecessary treatments and procedures. PHRs, SMO and eConsults offer a way to bring some control to those costs.

About Bernard Lee

Bernard Lee is the executive vice president of Activ Doctors Online in Coral Gables, Fla., and directs the firms Global Sales and Business Development teams. He is also responsible for directing strategic partnerships in the healthcare provider and insurance segments.

Bernard works with clients to develop web-based health and wellness strategies to include Personal Health Records, Online Second Medical Opinions and eConsultations in alignment with clients organizational goals to engage, empower and educate its workforce while assisting in lowering their overall health-related expenses.

Bernard joined Activ Doctors Online in 2011 after experiencing a major health issue, making him acutely aware of the importance and vital role that telemedicine plays in creating more intelligent healthcare consumers, while providing increased access and greater control of an individuals health information resulting in a higher standard of care.

He is the former managing director of Laurus Wealth Management, a Coral Gables-based asset management firm that provided a wide range of investment services to a diversified and substantial client base worldwide.

He also served as senior vice president of Intercap Wealth Management/Gunn Allen Financial, where he specialized and participated in over 40 Initial Public Offerings and Special Purpose Acquisitions ranging from $15 million to $250 million. In 2006 he was awarded the Gunn Allen Financial Investment Banking Player of the Year. In 2008, he was honored by Success South Florida Magazine as one of South Floridas 50 Most Powerful Black Professionals.

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