Mobile Telehealth

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Shawn: You’re listening to the veterinary Innovation podcast. My name is Shawn Wilkie. And before we jump into today’s guest I wanted to put a show to our friends at the New York Veterinary show which is happening next week in New York at the Javits Center the 7th and 8th of November. It promises to be a great show and my new company talkatoo to will be exhibiting at the show as well. So hopefully we’ll see some of you at the show feel free to stop up to our booth and say hello and with that. I’ll turn it over to you. Ivan why don’t you go ahead and introduce today’s guests.

Meet our guest – Thom Jenkins of PetsApp

Ivan: Hi, I’m Zak and I’m happy to introduce. Dr. Tom Jenkins personal friend of mine and quite an entrepreneur in the industry. So I’m super excited to introduce him. He’s currently on top of everything you’ve done in the past is the co founder and the CEO of Gula (now PetsApp) which is a mobile Telehealth platform. He’s a non-executive director of recruit for vets. He’s a co-founder of tea. I’m Reno and conservation awareness group. He carries the degree of Bachelor bitter medicine from the University of Cambridge Cambridge in the UK not in Ontario. I guess there’s no vet school in Cambridge Ontario. So the personal side of things he contributed to a television show filmed in South Africa where he carried for Reno’s giraffes lions and zebras oryx and buffaloes. He is a fan of lizzo having seen her in Minnesota earlier this year. So let’s jump in super happy to see you here. I would probably walk a little bit more through. So this is you know, this is kind of a stamp that we got off the internet and we have but I love your story you went to vet school. Then after that you were building a consolidation group in Asia tells just like background Splash in addition to what we’ve outlined already.

Thom: Yeah, I guess I always wanted to be a vet quite early on. Swapped paper around for web development. I got some sort of commercial exposure project management. So that’s where that interesting from and we’re lucky to be in such a sort of diverse X and profession that it was obvious that would be possible to merge those two interests and towards the end of that school. I read a book by a guy called Jim O’Neill called the gross map where he outlined the brick concept. So that’s Brazil Russia India China as the growth economies, and I decided Well, Ain’t it be great to sort of kick off my career in one of these Emerging Markets where there is this emerging pattern of population and there’s this real opportunity to have quite a broad impact on sort of raising standards of care and increasing the accessibility of care. So that’s sort of what led to me sort of leaving vet school to go straight up to China and operate clinics out there and we ended up having a group of banks in six cities across. Mainland China Hong Kong and Singapore. So that was really the Starting platform for the rest of my career today.

Ivan: It’s incredible. So with these so we had sort of a Telehealth I think guess here, but they were more in this sort of triage business. Why don’t you tell us a little bit of where you sit with that? And where do you think the opportunity is right now? I think I expressed my opinion about Telehealth. I think it’s early to be honest in the veterinary industry. And I think we we aligned on that and one of the conference’s but if it is early, you’re probably one of the first ones to tap into this Market, And can you tell us why I think it’s important and why did you choose this area?

The Need for Pet Advocacy

Thom: I guess feeds into might distort the Arc of my career being about increasing the accessibility of any expertise. I think the let me team are the best people to advocate for x and I suppose going out to China opening thinks there was a way to increase the accessibility of pet care to this emerging population of pet owners and then doula Of this chapter of my career now is about lowering the barriers to accessing very expertise in the first place. It’s about providing an effortless getting on point to engage with that we care that can compete with Googling or actually more than Googling pet owners. Just hoping for the best which is actually the biggest competitor for Veterinary Care veterinary clinics in terms of it being early on not super interesting. Hey because it’s certainly true that not many people. Turner’s accessing that leak are remotely in terms of using an app or video consultation. But in terms of uptake of telemedicine every clinic in the world, does it in some form So it might not do it in a constrained away or the most optimized Like to provide for them, but they certainly do it via the phone calls or emails or even WhatsApp messages Facebook groups that sort of thing. So adoption is probably further along than we think it’s not formalized optimized

Ivan: Interesting and when you see the owners are just hoping for the best do you mean those owners that come with a five days vomiting blood animal and say is this still? Okay?

Thom: Yeah, and I think that’s the bias for vets is Even that example is an example that you do see in the clinic. Sometimes you don’t see that yet because it was too late or when I’m having these conversations about telemedicine and I quote there that the Innovation Council stat that 92% of all pet issues. Go on a dress by that Nixon sees the Vets assume those are kind of trivial things, but we’ve seen in Gula already one of the cases we had was a grumbling UTI that been going on in this Labrador 14 month old Labrador for Some months and the pet owner had to take that pet outside to toilet like 8 to 10 times a day. And this was an experience that’s on that they had two other dogs. They just assume this Behavior was normal that dog and their heuristic that they use for accessing Veterinary Care to tell them when they needed to pick up the phone to that. What is my dog in pain and they didn’t perceive that dog to be in pain so they did not reach out for that expertise. They did not initiate the high effort process of accessing that the expertise But when they saw that they had the ability to just do a video call or text chat with a vet. Even that vet. Just telling them hey, you need to go through that process. You need to come into the clinic because this is something we can solve. This is something that we can resolve was value relative to their experience and men that that issue was then addressed by their own expertise when it otherwise wouldn’t have been so I think there is this bias of is actually enshrined in the regulation in the UK and elsewhere where we talk about the animal under our care and that’s the focus of the Its ability of the vet but there’s so many animals that we just never see or don’t see as much as we should. I think we do have a responsibility to advocate for them as well. And I think telemedicine is about broadening the top of the funnel.

Ivan: Yeah, absolutely and I think that well it technology as well as any business. I think succeeds when you start removing the barriers or really the friction of accessing the care and and I think that that’s what you’re doing a lot of the conversations that That we had with you. I think that you mentioned this Statistics that there’s technically two to three reasons a month for a pet owner on a reasonably healthy animal to reach out to veterinarian with a question, but they just don’t there’s a cost barrier. There’s a fear barrier. There’s a travel barrier. There’s all of these things that telemedicine seems to solve.

Thom: Yeah, and we surveyed as soon as where they talk about the beautiful relationship with it. So it’s not it’s not anything that we’re doing wrong. Inherently. I mean who talks about their beautiful? It with their accounts and all their lawyer. We may get complaints off my accountant and lawyer now, but we’re in a really privileged position as a profession that we’re very highly regarded. So it’s not that that’s making people from accessing expertise and it is things like having to load the kids into the car seat. And I think we do a really good job as a sector of if someone needs something doing to their pet they will come to us but we do a less good job of is capturing people at the point of curiosity. So we Capture them at the point of need but we don’t catch that point the Curiosity and we don’t value the things that we can offer that pet owners really do value. So for example are Googling skill we can provide it’s really well curated set a resources. So just by pushing out an article on vomiting in dogs that you have found on Google and you have found to be credible and providing that to a pet owner that is value added to that pet owner, but very few vets see And so this idea of a curated digital pet care experience is incredibly compelling to pet owners, but that’s don’t always realize that just by giving that advice you are creating value. You don’t have to have done something.

Shawn: Yeah, it’s really interesting Tom. I want to jump in there one of the posts that I saw on social media from you. I think the last year was kind of the rise of digitalization and pet care and it’s interesting because there’s definitely more players in the space. You know, it’s definitely something that’s getting very Thing but it seems like there’s a reluctance of the pet owners to jump on board and I liken this to kind of the adoption of Technology, you know in general consumers typically, you know will adopt technology first and it seems like it’s kind of like almost a reverse, you know, there’s these Enterprises driving these digital platforms, but it doesn’t seem like Can you talk to us a little bit about that and kind of how you see that playing out over the next 12 to 18 months?

Thom: It’s really about how you pursue digitization and where digitization has been pursued has that been a positive thing for the sector in which it happened. And so the way I think about digitization in Veterinary is Pets or fundamentally physical things. You can’t upload them to the cloud. And so you need this network of physical locations Clinic. I swear they can be taken to receive the very highest possible standards of care. So trying to devise a way that that part of the aspects of pet ownership I think is incorrect, but you can digitally augment these services. So I think for pet owners to really engage with these devices ation opportunities, they have to see it being led by their trusted veterinarian and we know it’s going back to that pattern of the sky. Their relationship with their very beautiful the vet has this very trusted Pace whether if the vet says this is a means by which you can interact with me. You can receive the best advice you can know with full confidence whether or not you need to come in and see me that is much more credible than that’s a direct consumer play with vet sitting in a call center somewhere and they’re not the ones that are going to ultimately deliver that joined up Healthcare experience. So, I think it’s really about how you do it. We haven’t reached that Tipping Point. We’re not better. New clinics and engage with this opportunity. I think we’re getting there and we’ve seen a lot of enthusiasm but we’re not there yet. So it is a bit chicken and egg, but that’s that’s true of any sort of marketplace or platform that supply and demand Dynamics really come into play in a big way.

Integrating Telemedicine into a Workflow

Ivan: Yeah with what Sean asked there. I think that it’s also it is region dependent but it’s also by saying that the pet owners don’t want to reach thousands digitally. I don’t think that that’s the case. Well, at least it’s not in Europe maybe in Canada where Sean is that but I’m in Ukraine right now when we were, you know, let’s talk about that. Let’s talk about the so there’s a barber shop here that I was working on that. I need the bed when my new haircut but technically through the app. You can book an appointment at a barbershop. It’s really kind of high-end. You can come in have put shot of whiskey there sit down have a chat like it’s a super fancy place, but it’s like It’s All Digital. Why would that be personal one that who recommended? At a barbershop to you like it was weird to pay in Ukraine. Don’t tell anybody again a bold joke, you don’t get anything else. So anyway, but that person you know, who uses that a poor who recommended me that app. They would want the same experience from their Visionary and then it’s all over the place. So I think it’s really not about the pedal and I think it’s the vets that are really behind and then they don’t know how to pitch those. Services, so I think to me the whole struggle with telemedicine all of these apps. It’s to make it engaging to have it in the owner bucket because you know, if I have some sort of app that beeps in my pocket to remind me about the vaccination one, you know one time of year, I wouldn’t keep it. But if this is something I can accident tear through this is my you know, my emergency button that I call my veterinarian that makes sense. But the question that I have to you tell him on that is then well, how do you make veterinarians available? Because this is my struggle. How would telemedicine which canarians would accommodate to their day to really be available? One thing is to say hey, this is the channel to reach out and how do you make yourself available? Maybe your technology sold that I think I real differentiator. All of our products is its role based? So we engage the whole vet new team in communicating with pet owners. So receptionist’s nurses and vets can all be on there. It’s also Veterinary team led the operational complexity of that new clinics is Staggering when you think that any number of types of pet could come in with any number of issues requiring any combination of thousands of products and services. There’s incredible operational complexity and different connects operate try and overcome this operation complexity in different ways with different operational models. So I think one thing that goes wrong with software or any solutions really implementing veterinary clinics is they add to that complexity rather than reducing that complexity and so our product is very much there. To fit around the model of any Vector effect, so it could be a one vet clinic or it could be a large hospital or a group of large hospitals because it’s very much what is offered to the pet owner and how those expectations are set. I’m very much led by that that we team and really we think that telemedicine should not be exceptional eyes. It shouldn’t be this thing that you offer to one side Should be completely integrated in the business of a of ETSU you book a video consult just like you book any other console a receptionist response to a text chat message coming in just like they would respond to a phone call. So it’s about how do you integrate it into into that workflow? I think there’s actually a huge capacity utilization opportunity here. We’re having telemedicine in your business can improve your capacity utilization now also when largely private healthcare environment where If as we believe telemedicine will be it is Market expansive increases the total addressable market for that my expertise. Well, we can open more connects we can train more vets. Although that may be a bottom that currently and hire more than to do more patient. Advocacy. Which from my perspective is the right way to go about this. This should be Market expansive and there are some direct consumer place which film or Market erosive wear as I think the people aren’t accessing that my expertise as Austin as they should or would want to if they could it’s not a case of the market being over-served or anywhere near over serve currently that’s brilliant with the extension of the operational model in the veterinary hospital. Where do you see if you had a dream hospital or group of hospitals. If you were to partner up with a new consolidator that would say look we want to incorporate telemedicine to the core of our processes. We wanted from our strategic plan. We wanted as a part of it. Did you have that experience? Or did you conceptualize of what that would look like? We’re in their process is it like sequestered time of the veterinarians or group of veterinarians? They take turns of taking those appointments. Is it just a regular book of appointment where one is on line one is not what it would look like in their facility because you know some of that said 10 people in a row in a little room with the engines and everybody yelling. So what would that look like an ideal world? Yeah, I think integrating it as far as possible into existing workflows makes much more sense than having a dedicated resource for telling us. We have had an X and connect groups that want to do it different ways and we can definitely Flex to that and the product can be used basically. However, you want to use it. However, you want to set it up. But I think again for this to be sustainable long term for it to deliver the advantages. We think it can deliver. It shouldn’t be exceptional eyes. It shouldn’t be put in a box. It shouldn’t be a separate strategic business unit. It should be just as natural for a vet to do a video consultation as it is for them to do an in-person consultation. And that’s Anna. Is it should become very comfortable switching between the two depending on what’s appropriate for that patient? And for that pet owner? There’s actually quite a useful shortcut to work out whether a telemedicine is the most appropriate medium for that consultation. I tell people if the consultation seems to be more for the pet owner than the pet than 10 minutes and there’s a fantastic route to go down if the consultation is if the Constitution is more for the pet than the owner get them in and get Hands-On on the animal. Line, yeah, I love it. Every vet can understand what that means. We all do lots of constellations which are more for the pets on that and that’s perfectly reasonable. That’s as it should be but there’s no reason you can’t do that right

Ivan: now with that if I could triage which ones for their owner and which ones for the pet.

Thom: I would actually choose to be in the hospital doing only those for the pet.

Shawn: I’ve got a couple of questions for you. Tom one is why having some of the larger or have I guess it’s super question why or have any of the larger consolidators work this into the workflow and to me it seems like it’s going to take something like a VCA or Mars or blue pearl or one of the larger consolidators in the UK to start driving this idea of digital Health before? You’ll have mass adoption because if it’s down to the veterinarian that has a relationship with the client to promote these services and help get the adoption started. It seems like that’s going to be the way to actually make waves in this area. Would you agree or disagree and have or haven’t they agree a hundred percent that vet saw pivotal to this.

Thom: I see when I started gorilla. It was a key question for me is we have a really great value proposition for pet owners around convenience and Improving their life of their pet and we have a great proposition for clinics around monetization of a previously on monetizable touchpoint improve us utilization lead generation client acquisition cetera, but why there’s a vet or another member of the vector team want to engage with this and we betta tested our first our MVP across 40 different clinics That’s where incredibly engaged with it and they found let’s all get on board with in general anything that advances their patient advocacy efforts and leads to better patient outcomes and improves their ability to deliver clinical excellence. And this definitely seems to be a tool that does that and I again another analogy I use is imagine I’m selling you an option down and telling you it can diagnose everything and sure everything you you wouldn’t believe me so much get out of town. If I told you. This is a tool that can improve your patient advocacy efforts. Santa’s going to be better in your hands and less could in this other person’s hands depending on your skill in using it and you’ll probably get better over time. And that’s much more analogous to what telemedicine is like and so I think that’s are getting on board with they are seeing that it’s becoming less scary the assumption that somehow telemedicine means you’re going to be sitting in some foreign country prescribing opioids to dying dog somewhere distant. I think that’s that’s sort of scare stories dissipating. And yes, actually larger ethnic groups are doing it. I think VCA bundles text chat with their pet health plans and IVC evidence here in the UK and Europe have built a platform and this creates a really interesting window of opportunity for us because it’s you know, look people at clinics are doing it and that means you need to do it as well. So other clinics are doing it. So the rest of the fence should have an offering to pet owners because it’s And I become an expectation that this is something that you offer. There’s also an insurer back to providers that are direct consumer which provides another sort of incentive for clinics to say. Hey, we should be offering this ultimately. If you are taking from a competitive point of view is that threat that the larger Bentley groups are doing it. I think it provides that incentive for other things to do it and we can we can help them do that and ultimately without wanting to disparage anyone else. They’re not technology companies. This is what we do. This is all we do. This is what we About day in day out we live this and we will be relentlessly iterating on this because if there’s one thing that is hundred percent for short no one has got telemedicine right yet, you know, we think we have a great product with great features that does a subset of things incredibly well, but the extent of this opportunity and the new technologies that are the opportunities that’s going to open up you need to be running fast just a standstill. It’s that whole Red Queen thing and there’s a question mark that over whose best place to do that. I think our This focus on this space is what gives us an edge there.

Shawn: It makes sense, you know, and there’s this whole the idea or the concept Telehealth to me sounds data major call it fax machine health. Yeah, because there’s all these different iterations in it, you know, there’s people texting there’s people calling on the telephone but it true digital experience where you can interact and even you know, draw on the screen, there’s almost a graduated Telehealth or telemedicine that exists out there. There that maybe you know you it sounds like you guys are driving very much towards it but having the people that we have had on the show, you know, we’ve had Brendan the technology and Innovation lead for detail on the show. Everybody’s touching these things but nobody’s doing Mass adoption, and I don’t know for sure, but I’m pretty positive that VCA hasn’t sent an internal memo owed to all of their veterinarian said say telemedicine is now part of our offering please promote it at every consult and I think it’s going to be That type of Engagement with those larger organizations, like either created bringing it into the workflow before it actually before we see Mass adoption. And then the other thing I would say and interested to get you explain the experience. I think it’s going to have to be an app that’s so easy to use that Grandma can use it, you know, and I think of Uber or Lyft or these ride-hailing apps that are so easy to interact with whether you’re on the driver side or the customer side. That’s what I think Telehealth is going to need to be in order for it to get the type of adoption that is available for it. So a couple things you know, we have a lot of veterinarians right into the show every week and I’d like you to explain it to the veterinary and it doesn’t understand the experience. So if they’re interested to learn more info they know what it is that you guys do and how that interaction looks.

Thom: So we’re all about setting up connects to deliver telemedicine and really you’re right elements in is the wrong word. You should be Talking about client engagement and it should be a sort of no-brainer, you know, do you want to engage more often and more deeply with your pet owning population? If you could would that improve the life of pets would improve your business? I think there’s this very obvious win-win-win where it’s good for better and is good for pets and good for vets and Clinics and that’s why I think just sort of linking back to earlier in our conversation. I love it. You don’t want this to be a sort of dedicated resource where we offer telemedicine on the side. You do want to integrate it into your existing workflows and your existing team to engage with this. I think a really interesting way to talk about it with Lex and the vet new team more broadly is right. Now there’s this incredible pressure to just just extract every ounce of advocacy opportunities from that vaccination consultation or the annual health check because you’re not sure you’re going to see that a toner again. So if they come in with one thing you need to talk to them about these ten other things because that’s your chance that year to Advocate that patient. That’s an incredible amount of pressure and I think it feeds into why there’s this sort of idea that vets are uniquely bad sales people, you know, they’re very bad advocating for what the needs was because we don’t set them up to succeed and say vets won’t recommend something if they don’t think it’s in the interest of the pet. So that’s a fantastic starting point. You don’t have to worry in the main about Anyone any Bad actors there? So if they’re recommending it means they really want the tenants have it. So imagine if we could just reduce that pressure a little bit and saying rather than this one visit this one time you’ve been able to convince the pattern it to overcome the high effort experience of coming into the clinic instead. We’re going to take those advocacy opportunities and we’re going to set them up and we’re going to spread them over the year and they’re going to look different. Sometimes they’ll be in the clinic. Sometimes it’ll just be a text chat exchange some Times it’ll be a video console. Sometimes it will be a push notification that they open up on the phone and they get a video of how to actually get the tablets you prescribe into the cap. For example, imagine that I think every vet just feels when we have these conversations. They just you can feel the weight lifting off them as I think that is a world. I want to be a part of if I can have this ongoing conversation with a China’s about a digitally curated optimize pet care experience for their pet and the exact context of that. I think that feels good and that’s something we can all get on board with. I think it’s just incredible the things that we can do today. You could get every seven year old or older Labrador and send a push notification to them and say has Daisy been having trouble getting up on the sofa and all of a sudden you’ve got that pattern engaged in a conversation about osteoarthritis or send me a picture of your pet smile. Did you keep scent or more pet suffer from dental disease all of a sudden you’re on the path? Pathway to getting that Peta Dental at yeah, I think these are incredible opportunities for that person. I think vets are as they discover this again pretty excited about the opportunity that

Alleviating Burnout Through Telemedicine

Ivan: Absolutely you know, I was thinking that when you were saying about that one appointment, I remember where I seen this stats, but on average, I believe it’s this 17 minutes that veterinarian engages with any given pet per year 17 minutes. That’s all we have to pitch everything. We want to sell them or recommend to them a year. That’s difficult and terrible. So stretching it over a period of time and having access to them to make those recommendations and not sound like salespeople. That’s just that’s just incredible the the 17 minutes. Remember we say that the pattern is most likely to come into the clinic a point of neat. So they’re in a nice state. They’re worried about something and you’re trying to feed them other messages that are super important to the pet. But not what they’re worried about in that need State. It’s just not Going to be the most effective are doing things. Yeah, it’s going to bounce right off them. You’re not even here. They came in with it with the engine light on and you’re trying to sell them the shocks and their windshield wipers and everything. That’s that’s that’s that’s what we’re doing. So we always talk about a couple of things that are related to the whole kind of industry problem. One of them is the burnout and the whole suicide issue and I don’t know if this is a issue in the UK as well. But differently if America First sudden is it is to okay, so that’s yeah, it’s the same. Not in Canada, everybody’s happy and then another one that is coming up is the lack of vets. Hopefully it’s not because of those issues. It’s not that bad. But just that there’s not enough fiction Aryans out there and especially with the consolidation. They’re leaving the hospitals because of the change of culture and you know and everything that comes with the consolidation. So do you see telemedicine and the access to different types of services allowing veterinarians for more balanced lifestyle? And potentially augmenting their income through doing something like telemedicine and supplementing their regular day-to-day work and making it a little bit more flexible and maybe even available to do a little bit more traveling and working at the same time.

Thom: The answer is hunson. Yes, definitely some of the work we’ve been doing at recruit for that is related to this and Did elective in business and I validated the net promoter score as a measure of customer satisfaction in the very context and in that work we found that a good Benchmark MPS client net promoter score and that’s How likely you will be to recommend a certain that you think to a friend colleague or family member as a client a good Benchmark level is 60% Okay, the scale is from minus 110 to positive 100% And the veteran event tonight is about 60% it changes depending on how you collect it. But 6% is incredibly good score clients. In general enjoy the veteran experience at that point of need we service what they want done to the animal pretty well recruit hurt surveyed a load of X and nurses and the on the employer NPS. So How likely would they be to recommend the employer and this e NPS has been found to be a leading indicator of Staff turnover staff churn and it was negative 30 something percent. Well, that’s and nurses and this is very unusual to find. This discrepancy. Let’s take a credit card company. Usually they have a very low client NPS and quite low employee NPS but it’s quite a stressful place to work because clients are not very happy in general if they’ve pulled you up at the call center. They’re complaining about something. So this idea that we’ve got this quite disengaged quite burnout as you said compassion fatigue population of team members going above and beyond to do an incredible job for clients at some point. Something’s got to give and And one of the answers, there is flexible working patterns and Veterinary has just been inherently an inflexible job. You have to be in the clinic to do it and I was actually presenting Gula the tournaments and platform to a group of clinics. And one of the Vets came up to me afterwards and said that I really hope we go through this because I’ve just had to say that I’m leaving because it’s no longer. My work is no longer compatible with my home life. I love this Clinic. I love these people. Just can’t keep up and if telemedicine allowed that clinic to keep that passionate employee and get them working for them working with them. I think that’s an incredible opportunity and imagine if there was a vet any job advertised that said you can work at home for one day a week. I don’t think that’s particularly want to work less. I think in general we’re here, you know, incredibly hard-working very cheap with German team orange parented people, but we do have lives that We need to fit into our into our passion into our vocation and I think this does provide an opportunity to actually restore some balance. There’s lots of assets or less that you can tell. I find it really exciting. I want to geek out over but that’s one that I’m very passionate about. I think I think it is a part of the answer. It’s not all of the answers.

Shawn: Thanks so much for listening to the veterinary Innovation podcast. We’re pretty social people. So you’ll find us on every social media channel. Also, you can check out our website at the veterinary innovation.Cast.com thanks so much for listening.