This is the era of telemedicine

If I'm perfectly honest, most of the investments we make don't have a visible impact on peoples' lives.  Financial compliance software?  eSourcing services?  Online ad networks?  No doubt accountants, procurement directors and ad sales reps benefit from these innovations, but what about the man on the street?

This morning we announced an investment in a company that not only impacts your neighbours directly, but also benefits from some of the strongest industry growth drivers I've ever come across.  The company is Barcelona-based Telemedicine Clinic (TMC), a provider of teleradiology services to public hospitals and private healthcare providers across Europe. 

TMC is at the forefront of the changes technology is bringing to modern healthcare provision.  Today's medical imaging techniques -- including digital x-ray, MRI and CT/PET scans -- are increasingly powerful diagnostic tools.  In fact, the most complex 'modalities' like CT/PET are growing fastest.  The problem is that most Western healtcare systems (a) don't have enough scanners, and (b) aren't training enough radiologists to meet this demand. 

This has led to long waiting times for patients, and in some cases government intervention to reduce them.  In the UK, for example, it has been widely reported that NHS patients can wait more than half a year for an MRI. Now NHS is working toward an aggressive new diagnostic target of no more than 18 weeks (sic) from first GP visit to the beginning of treatment.

Quicker scans lead to earlier diagnosis which in turn improves the success (and reduces the cost) of treatment.  A no brainer.  But how to address the scanning bottlenecks?  In the UK, the NHS is contracting with private healthcare providers (ISTCs) like Alliance Medical and Inhealth to provide extra capacity in the form of mobile scanning units.  But the shortage of qualified radiologists persists and the private sector struggles to recruit them without stealing capacity from the NHS. 

Enter remote diagnostics, or teleradiology.  Most scanned images are now digital to begin with, and tend to be connected to the hospital IT system or PACS.  So it's easy to send them to a remote location for interpretation.  That is the technical infrastructure TMC exploits.  From a base in Barcelona and from reading centres in Europe and Australia, TMC's radiologists report on thousands of diagnostic images sent each month from UK and Scandinavian hospitals. 

Because TMC's radiologists are totally dedicated to reading, they are several times as efficient.  Since they can aggregate cases in higher volumes than any one hospital, they develop stronger sub-specialisations.  Because they are more productive, they can double-read images at lower cost than a hospital can.  With resources in other time zones such as Australia TMC can provide on-call (night-time) cover for hospitals. As a result TMC not only increases the capacity and responsiveness of its hospital clients, but it is also setting higher quality standards for radiological interpretation.

In the UK, the introduction of private healthcare provision to complement (some would say pressure) the NHS is controversial.  But the technology which enables teleradiology is here and is truly agnostic.  Public hospitals can as easily exploit this innovation to become more efficient as private health centres can.  But there are big differences within Europe in how free hospitals are to take advantage of outsourced services like this.  Scandinavia and the UK are at the forefront of experimentating with these types of public-private partnerships.  We are betting on their success triggering similar reform in other countries.

Teleradiology is only the beginning of how the Internet can revolutionise diagnostic medicine.  Telepathology allows doctors to send images of tissue samples to experts abroad.  Teleophtalmology can be used to screen patients for diabetic retinopathy, and teledermatologists can test patients for common skin ailments without having to be in the room.  Already countries like Australia and Sweden are using these concepts to provider specialist medical care to inaccessible parts of their countries.  In future, all patients could have access to the global pool of specialised medical knowledge this way.

There are huge research benefits of digitising and aggregating medical cases from multiple hospitals and regions.  In future, a lot of cutting-edge medical research is likely to take place where the most experience resides -- and that may well be in a virtual telemedicine clinic like TMC plans to become.

Comments

[nick bowles]

Max,

I just spoke with Daniel Hyde at Erevena and he mentioned your name and this investment.
I suggest you might like to talk to the team at Medstamp they have a complimentary technology that could make the telemedicine business even faster and efficient. They are currently working with Inheath and ELocum.
They are in Birmingham at UKRC this week and Barcelona at the end of the month for the industry show.