Hello everybody we're back for another episode of taking care of business my name is mike katz
i'm the executive vice president of t-mobile for business and today i am really thrilled to
be joined by jim tuggis who is the ceo of home md house call services now homemd house call services
is a small business they're based in howell michigan and they deliver in-house clinical
services to more than 1300 elderly patients who are either homebound or in assisted living
so jim thank you so much for being here i really appreciate it um you know first place i wanted to
go is obviously with what's going on with covid right now everybody knows how disproportionately
impacted elderly have been um how has how has your business changed uh post-covered
uh with the impacts that i'm sure your patient groups had with with this horrible disease
how hasn't it changed um it's uh i mean really everything everything we do you know
has really changed um you know we've we've gone a significant amount towards being telephonic now
now that we're able to do that medicare lifted restrictions on that um in light of the covent
crisis so um we've deployed tablets out to about i think we've got about about four or five hundred
of them out in the field right now and we've got another five or six hundred of them that
we're working on i'm currently surrounded by tablets all over my office right now
they're everywhere um so we're we're getting those out to our patients because um because the elderly
you know they they have a difficult time managing their iphone or their android phone or their
tablet if if they should have one and most of them don't so we need to be able to uh to kind of um
reduce the the complicated nature of these devices for them so we're able to kind of scrap almost
everything other than the software that we need we put those on the tablets and then we send them out
and then we don't have to worry about things like wi-fi connectivity and things along those lines
because we've got the t-mobile network backing the whole thing so um um it really it kind of
streamlines the whole the whole thing we know that when we send a device out to them we're going to
be connected it allows them to be able to reach us really you know it used to take us two three
four days sometimes to get into a patient's home if they were having a medical problem uh
you know to get them the medications they need or whatever it might be to resolve that problem and
and now we're able to get in there you know within literally within minutes um and and these elderly
folks you know they they're not they're not like you and i where where you know we have a problem
when we can sit on it and wait a couple days within a couple days they may be in the icu so um
so it's imperative that we get these things cracking and get it going very
quickly and we're able to do that um with all these tablets that we have out there so
that's been one way that it's that's been the primary way that things have really changed
um we're no longer because we do so many assisted livings um we're in about 80 or 90 assisted living
throughout the state of michigan most of these assisted living's locked down um a few months ago
to where they don't want any medical providers or anybody else in their buildings um you know
every time somebody walks in their building they're risking exposure and all it takes is
one of their residents or one of their workers to be exposed to to catch the the kobe 19 uh
uh thing and then we end up uh melting down in their entire building so we're able to kind of
get behind enemy lines with these tablets and um and that has helped quite significantly
so so pre covid you guys your interactions were physically in in front of each of the patients
absolutely yep um we would drive out to their home or drive out the assisted living facility
and uh and and and be right then right there with them you know face to face with them
and is it now 100 virtual no i'd say i'd say about 50 50 at this point um but but we're able to do
things that we could never do before um you know at eight o'clock at night if our patient's having
you know some kind of an issue um you know the assisted living facility coordinator or nurse or
the patient's daughter or the patient themselves if they're able to operate the tablet and in
most cases in the independent facilities and in the residential homes they're able to do that
um you know we're able to reach out to them at eight nine o'clock at night and really they kind
of have a virtual urgent care in their back pocket pretty much all day every day now which is pretty
awesome so yeah you know so this this transition from you know really kind of physical interactions
and your job being physically in front of your of your customers your patients uh to you know at
least a big portion of it being virtual you know there's a version of that that i think a lot of
businesses are going like at least contemplating right now or attempting to go through as you guys
have done it what it would have been some of the things that have made that transition successful
for you that you know that could be good advice to other businesses that are considering it
for us it's been it's been understanding our consumer understanding what their limitations are
and then meeting them halfway or all the way in you know when we need to you know um and and you
know getting the device to them um uh making it so that it's a it's a you know it it's very difficult
to not be able to operate it um you know those kinds of things those are
those are those are those those were our primary challenges um
trying to morph into a company that's doing inventory management things along those lines with
different devices and our remote monitoring blood pressure costs and our remote monitoring scales
and things along those lines it's been a little bit different and then our nurse practitioners who
who are used to being able to listen you know to somebody's lungs with a stethoscope um having to
having to tinker with our chart notes to support uh you know visual observations as opposed to
uh you know using our ears you know um so and really really becoming a company that's able
to coordinate care across all the other resources that are out there the home health care companies
um the medical equipment companies the medical the mobile diagnostic companies being able to
to really coordinate that care is really what we've
really become accustomed to doing um as opposed to delivering it ourselves in a lot of the cases
yeah so as you guys as you guys have gone through this change what what's the feedback from your
patients been and as well as from your employees because there's a big change for both of them
and and you know how they handled it and and you know what what would they say about it right now
uh yeah it's been a huge change and it was honestly it was pretty terrifying
because i didn't know it was it was the only way that we could get to these folks and
and take care of them and i i didn't know what what it would end up uh what what the outcome
would be if they would like it um if if my nurse practitioners if they would like it
but overall the uh the feedback has been not just good it has been incredibly good
the the elderly have done very very well with these devices they're able to use them the nurse
practitioners are are really able to get through their their visits and and diagnose and treat
uh more patients uh during a during the span of of a single day without nearly as much
in terms of distractions um you know uh traffic and things on those lines that they don't have
to deal with anymore they're able to they're able to hang out at home and take care of their kids
while they are providing medical care which is great for family balance um so so overall it's
really really made us much more powerful in our ability to deliver quality care um
and and because and i think and i think our consumers realize that i think they see that
your customers you know you mentioned this this is a group of people that you know may
not have in their personal lives adopted some of this technology like how have you how have
you helped them make that transition so that this you know to make this whole process so successful
yeah uh i mean some of our i'd say some of our patients were around during the last
pandemic in 1918 you know so um they they've been around for a while and a lot of them have never
ever interacted with you know a cell phone or anything like that um uh and they've got other
people who manage those things for them and some of the memory care units at living facilities so
um interacting with their families and and whatnot has
has made that a little bit easier having you know family support they're able to go in and
and and help mom with the tablet until she's able to kind of get an idea how do you use it um
uh really we haven't we haven't we haven't set it up so that they are contacting us
using any of these devices they're still contacting us to report their issue with with
a phone um and then we dial in and all they have to do is answer the thing so that way we can do
a video encounter because that's what we need to be able to do to be able to build our insurance so
has it has it changed at all the way that you go and find new patients like have you
have has it helped or hurt the way that you go and acquire new patients into your service
and it's changed this 100 everything it's everything like i said everything's different
now um uh i mean a day is like a month you know in terms of everything changing how fast how fast
everything's changing in medicine particularly surrounding this whole probit uh crisis the um
so yeah it's changed a lot in terms of how we market um you know we're marketing we're marketing
accessibility to care and availability to care now as opposed to um you know the the smiley face that
that somebody's gonna have the bubbly personality when they when when somebody pulls into your
driveway with a stethoscope on so um so now we're really marketing to the assisted living facilities
themselves and then to um home healthcare companies uh you know skill care nursing companies
they provide some of the you know the private duty companies you know we're marketing directly
to them to to show them how we can help their business by keeping folks out of the hospital
you know their clients out of the hospital and what that does for them and their businesses so um
so it's become our our customer has really become the the other businesses that are entrusted with
these folks lives while our consumer has become the patient um so it's it's it's made things a
little bit different um in a good way yeah has it has it caused you at all to think differently or
start acting differently in terms of um where you provide services because i imagine in your you
know pre-kovid model uh where you're physically going out and meeting with patients you know it
you're a little bit probably uh geographically bound by based on how far your providers could
go out like can you think differently now about where where you do business because of this
yeah like incredibly i mean we can do we're talking about uh taking on some patients out
in colorado um we're talking about texas um i'm no longer uh we no longer have to really
factor in so much the geography in terms of of which provider we assign to which patient
not not nearly as much anymore anyway um you know it used to be that we would need
i don't know maybe 10 providers to just kind of sprinkled in certain locations throughout michigan
rather than hiring the best provider maybe i would need to hire the best provider in a particular
area whereas now i can just hire the best of the best um and um and and and they can provide care
from anywhere to anywhere so um yeah that's been a huge difference it's really the the the secret
sauce in doing house calls really was you know how do you manage the logistics of of geography um and
no longer do we have to deal with that at all so yeah it's not it's also interesting to think about
if you're if you're physically putting tablets and connectivity into the hands of these patients
you know what what other services could you potentially provide to them
you know especially a group of people that sometimes can feel a little bit isolated
really i don't know if you thought about that at all but i'd be really interested to you know
hear about other services that you could provide i'll tell you we've got uh we have on every one
of our tablets we've got um connections to the michigan health exchange so these patients are
able to get and their family members are able to get access to their their health care records um
uh all over you know from anywhere um and uh and and they're able to do that with these tablets
um right it becomes a portal uh these patients are able to get we're figuring that at some point
in time we'll be hooking up with specialists so we'll be able to have a cardiologist on
staff a pulmonologist an endocrinologist and and have them available to consult
um you know and we would have the the daughter the patient our provider and whoever's consulting
all on the same phone call um we have uh apps that we're looking into right now for wound care where
somebody could take a picture of their wound and it would beam over to us and the wound care
supplies would be ordered like automatically through it which is pretty incredible um our
remote monitoring devices so our blood pressure cops our scales they are they're taking those
readings and then sending those readings to the device the device then beams them up to us through
the cloud um physical therapy we're uh looking into providing physical therapy telephonically
so it's it's pretty incredible what's out there um pill reminders i mean it's just
it's it's we haven't even scratched the surface yet on what we're able to do with these things
yeah i mean do you think that covet almost acted as a forcing function to push you and in this in
this industry like where it would have gone uh eventually just over a shorter period of time
you know even it was back in the end october 2019 there was a act that i think was the
connect with care act was sailing through congress it was i believe it was unanimously
voted out voted up in the house um and then uh ran into some congressional budget issue
in the senate um but but outside of that it would have gone through and that would have
enabled telehealth technology um it would have it would have opened the door to that just like
what we have right now um once uh once the covet prices hit it it gave them no excuse
no reason to not just let that out of the box and um and and you know so we've been
in telephonics we haven't been able to bill it out really until until now um but we've been dabbling
in it for about a year and a half really getting trying to kind of tinker with it get used to it
and that way when when at which point in time congress greenlighted it we'd be able to deploy it
and hopefully at that point be well ahead of competition and then this and then this all
hit and and i would say it probably fast forwarded um this kind of technology by at least at least a
couple of years um you know any lobbyists that were out there trying to slow it down you know
they were they were moved aside and and now it's full bore telephonics and medicine so
well i'm i can't i'm sure your patients are extraordinarily happy for that
um especially especially in this environment when when you think about that you know eventually uh
like hopefully cross your fingers we'll be out of this coved world um and we'll be back to some
some new normal and when you think when you think about what's what's happened over these last
weeks and months as your business has evolved and changed and you're serving your customers
and patients in a different way how does it change your business in the future like
is there do you guys go back to what you're doing before what's your new normal
um you know i think we're going to find out what our normal is when when new normal happens but
um you know we're kind of thinking about that a little bit um you know we don't want to be
a fully telephonic company but we don't but we want to be able to utilize the uh the you know
the tools that we now have available to us that we never had before so probably what we're thinking
about is is we'll end up having on-site visits um you know maybe every few months and then you
know augment those with typically we see patients monthly and then also whenever they have problems
in between those monthly visits so maybe every few months we'll we'll do the on-site thing and then
and then telephonic visits in between um you know uh which will be which would be great you
know our nps will be able to see more patients in less time and provide a higher level of care and
hopefully reduce hospitalizations across the board which i think is what we're going to find here
but i think that our new normal is going to be i think we're playing in our new normal right now
um and and i don't think this this genie in terms of medicine is never going back in the bottle
ever yeah well in this case it sounds like that's a good thing because um it sounds like
the level of care that you're able to provide uh is is far better than you know what anybody was
able to do before so um thank you jim thank you so much for sharing your story you know i think what
you what you and your company are doing are just are just so incredible and it's having such a big
impact i know to the you know 1300 patients that you're serving today future patients that you're
going to bring on and in these communities and to the families as well because i know all of us as
covet hit you know one of the first areas that we all think about are elderly relatives and are they
safe and are they being taken care of so thank you so much for what you're what you and your company
are doing with that um you know i think whether it's copen19 or not uh what the work that you're
doing is is really really important so thank you so much and for everybody out there listening
you know one one thing that i really would would love ever to encourage with everybody is find ways
to support your small businesses in your community uh they are the lifeblood of our economy they're
the backbone of our communities please find a way go out of your way to support them and thank you
very much and t-mobile for business uh you have our commitment that we'll continue to do the
same through great content and great support programs for it for our small businesses so
thank you jim i really really appreciate it uh keep doing great work thank you mike
i appreciate it and we appreciate all the support we've gotten from t-mobile it's been
the the customer service has been nothing but outstanding um in uh our our our marketing rap has
really empowered us and made us able to scale um i mean he's he's practically become a part of our
company um and uh i mean it's just been i couldn't we couldn't have done it without without fema
we'll really we wouldn't be able to do it yeah but thank you we we couldn't do it without incredible
customers like you and so thank you again for all the work that you're doing absolutely