In This Episode
There are many different approaches to telemedicine – after-hours calling for triage and emergencies, video calling and texting clinic staff for consultation and advice – and as with all emerging markets, the best model, if there is one, isn’t known yet. Tony Cairo, the CEO and Co-Founder of Anipanion, wants to create a service that serves as the primary way to contact your veterinarian, and he discusses the challenges of incorporating telemedicine into a clinic’s workflow – including integrating into their existing practice management software – with Shawn and Ivan.
Mr. Cairo recommends Good to Great by Jim Collins.
- Integrating Telemedicine Into Clinic Workflows
- Segmented Telemedicine
- The Difficulty of Software Integrations
Shawn: You’re listening to the veterinary Innovation podcast. You’re listening to the veterinary Innovation podcast. My name is Shawn Wilkie and along with my awesome co-host. We interview innovators in the space every week before we get started. I want to put a showed out to the London Vet show happening the 14th and 15th of November in London England. It’s a great show. I was there last year and without further Ado Ivan. Why don’t you go ahead and introduce today’s guests.
Meet our guest – Tony Cairo of Anipanion
Ivan: Hey, I’m Ivan zag and I’m happy to introduce Tony Cairo a CEO and co-founder of any penguin founder of animal. Is who was ranked as best in under Premiership business strategic management and marketing at Babson College on a personal side of things at Babson. He was a part of the indoor soccer club ping pong Club Consulting club and under / neural Club. That’s a lot of clubs. Why did you have an indoor soccer club as I know you live in San Diego? You guys don’t play outside what happened?
Tony: This is true, and I have to say I’ve been in Trump. Thank you so much for having me. Me today really excited to be here with you. Both Babson is actually out in Wellesley, Massachusetts. And as you know, Massachusetts can be a pretty cold place and that said even though a San diego and love playing outside in the sun. Indoor soccer was pretty much what we had to do when we were in those parts, but want to give a special shout-out to my alma mater Babson go beavers and again, very excited to be here gentleman.
Ivan: Tell his’n stead very hot topic and we’ve had three so far. So it’s CEOs and founders of different flavor of telemedicine. They were they were sort of telephone service and they were a true telemedicine. I am as a veterinarian struggling. How am I going to use telemedicine my day-to-day practice. So, can you tell us how do you think the engineers will use it because it’s new sector. I would say our new division of veterinary medicine.
Tony: Yeah, absolutely. That’s a terrific question. So I just want to backtrack a little bit and just give you a brief update on where we are with an opinion and what we’re ultimately trying to do and then I could get right into that question. So any penny in is a leading virtual? Are platform and we probably help practices enable access to Care by way of virtual consoles. We have a b to B to C model. And so we essentially provide our telemedicine software veterinary hospitals and they in turn can use it to communicate and engage with their pet her and clientele or effectively. We like to think of it as the bridge that is really, you know, connecting the communication gaps for the veterinary practice than their clients and most of our use cases to date really stem from post-operative retracts dental and dermal rechecks preliminary triage scenario. And behavioral inquiry scenarios. And so the idea here is we firmly believe that based on the practice size. We can leverage this kind of solution as a lead generation tool to get the clients into the door and then of course for instance enhancing the overall user, excuse me patient experience, I should say so the idea there is if a client for instance happens to bring their pet in for surgery, we can start using our platform to help communicate and walk them through you know where their pet is in the surgical procedure process. Yes, maybe taking a picture before they’re about to go into surgery and then following suit when they’re getting you know ready to be picked up. For instance. We could send another text to let them know that they’re going to be okay, but really our bread and butter is for the post-operative recheck or the follow-up if you will so a few days later, what we’ve come to find is for the larger size practices that use any pan Ian most of them prior to using any pinion. We’re having the client come into the practice. And of course, there’s a lot of how shall I say this redundancy and inefficiency? He’s when that happens. It takes about 35 minutes to have that client be check in and out of the practice and the practitioner is just letting them know. Hey, everything looks okay. So if we can find a way to obviously have these video call consult switch have chat built into them. So the clients can share those images like the incision site letting them know how the healing process is going and ultimately communicate more effectively through those means that’s going to be a significant value add internally for the practice. So we’re essentially helping them do more with less.
Integrating Telemedicine Into Clinic Workflows
Ivan: That’s fantastic. So Shawn, we have your new project out. I think you need to learn from Tony how to fit in the pitch for your product anywhere you can that was that was amazing. So it’s not I think it will be wildly adopted and I think that you’re in the right sector as for any Innovation, I think that’s where the telemedicine is at right now there needs to be sort of the penetration Point into the Markets mind and how do you use it in the day-to-day practice? And I think that recheck is the excellent example of how you use that but all of those use cases that you have. Those are very interesting do Training vintage narrations into using them and those different environments. Do you see any resistance and how do you go about convincing them that some workflows should change?
Absolutely. No, that’s that’s another fabulous question. It sounds like I’m talking to an expert here Ivan. I might have to bring you on board team and opinion but joking aside, you know, I think ultimately at the end of the day change is difficult, right? It’s very hard to embrace change in general. I mean we try to get Sean to show up on time for certain appointments like this podcast today and sometimes we’re just not used to fulfilling their Very nice. No pun intended there Sean or anything along those lines shots fired, but that no in all seriousness. It is difficult. It’s not an easy task. We were burning the midnight oil a team an opinion to ensure that we can you know have our system integrates seamlessly into that practice care flow and I think the idea right now is because we’re setting the foundation for how telemedicine will be used for many many years to come we have to do a lot of hand-holding in that process. And so again, there’s specific strategies that we Implement in place to ensure that we can in turn. Roll this out seamlessly and the first part is is getting everyone to be bought into the process. And so one of the beautiful beautiful benefits of an opinion is we’re integrated with some of the leading practice Management systems. And so before when we were a standalone system if we wanted to schedule, let’s say a follow-up video chat consultation the csrs of the practice would have to literally schedule that in the Annie panting calendar and then quickly login. Meanwhile, they might be getting a call to for someone that scheduling that appointment slot, but they have to quickly log into their hymns and Then of course schedule it in that calendar as well. And so, you know, that was a friction point to be very candid with you. The other thing is after a consult is completed. How are we making sure that all that pertinent Medical Data the video chat the chat dialogue for instance any images that are shared on that consult. How do we make sure that we can export that and put that into the patient medical record. I mean initially, you know, we had certain functionalities where they would have to do that manually, but at the same time now we’ve been able to work closely. Strategic partners and ultimately ensure that we can push that back into the patient medical record automatically. So I think when we limit these friction points in the overall workflow that really makes the experience a lot easier to use for the practitioner side and then of course ultimately that’s going to manifest into them being able to use it more frequently and of course giving them a guideline to how to do it with certain use cases like retracts preliminary triage scenarios and behavioral inquiries and overtime will see that Ization go up significantly. So we’re all about maximizing the user experience. And I think it’s critical to adapting to changes within our day-to-day.
Shawn: That’s awesome. Tony. Thanks for that. I do have a question for you. I think back to episode 7 when we interviewed Jamie movie from vets direct it seems as if telemedicine has the potential to be split up into different segments. So Jamie’s company if I can recall properly. It’s kind of like a 5-1 1 in Canada for preliminary. Health questions for humans, they do the initial triage and they really focus in on that specific segment of telemedicine. Do you think the telemedicine will be like other areas of veterinary medicine and be broken up into pieces with certain companies specializing in those pieces or well, it’d be one Integrated Health System where you know, it’s one company that does all of the electrical interactions like a banyan for vets direct that kind of Supplements those electronic elements of the healthcare experience for an organization. What’s your view on that? Where does your future?
Tony: Yeah, that’s a great question Sean. So I think you know I did listen to that podcast fabulous podcast, by the way, and I do have to commend Jamie for what he’s doing. I think, you know, we need to assist veterinarians as much as possible to help make their day-to-day significantly easier and I think telemedicine ultimately empowers them to do that. Not only that but it serves as a great enabler for access to care for their It’s but specifically my opinion on this is that any panty and will be helping more for the day-to-day business operations and then for after-hours triage, that’s where that kind of helpline or hotline of you know resources that can kind of Route those specific clients the hospital to an emergency bed or two additional care is really going to be critical to making this whole Continuum of Care process significantly seamless for the profession as a whole. So I do think that every telemedicine company can specialize in different Pause and practice managers and owners, you know, these are their clients. This is their book of business. They built that line of business up for quite some time. And so to pass that along to another copy to assist with triage related scenarios is something that will definitely have to you know, I think take a little bit of time to manifest and to percolate internally, but I definitely think there’s a fit for multiple companies and what we’re looking to achieve here, which is really all about enabling access to care.
Ivan: I love that demarcation that you put into different Services one is third of your day-to-day. And then another one hotline after hours for future of telemedicine, but the challenge that that comes with it and it will be a challenging question to you. I love those here. They toothbrush test. Like how do we make sure that people keep the app and then they do know that that is the source of connection back to your veterinarian because ultimately if now we have to telemedicine as ones for Urgent Care and one for day-to-day things and then I don’t even know if they want to have that app all together because by statistics we see in our pets for 17 minutes. It’s once a year. So is it worth having a nap in my pocket and learn how to use it to address a certain problem or should I just click the button, you know through Google Calendar find their phone number call and say hey this is what’s going on. So, how are you combating that in your solutions for people to understand that that’s the abdication uses a connection to their Veterinary.
Tony: Yeah. No great. That’s that’s a that’s a great question. And I appreciate you bringing up more challenges here. I feel like I’m climbing up Mount Everest. So thank you. I know but joking aside. I hate men who just getting started. Hey, I exactly right are We Done Yet. No joking aside, you know, I do think that we will be that one vertically integrated app, but it’s going to take a lot of time for us to get there first and foremost. It’s not like we can just throw these two different companies into you know, a specific practice and try to make it work but to your point Ivan, I think there are so many options that’s profession that the client has to download and there isn’t that one vertically an integrated app that can really provide all these different kinds. Oceans hopefully some genius out there is thinking about it. But that said I truthfully think that it’s all about pimps integration and making sure that we can at least get those necessary to points and then aggregate them and put them together with in-car offering for us specifically right now as a start-up, you know, how it works both of you. If you have to be hyper focused at solving one problem. And then from there you could certainly Branch out. So while I did mention in the previous question that there are going to be a couple Solutions and providers out there more than a few that might be Eating a specific subset of Veterinary telemedicine as a whole I do think there is room for improvement for that one solution to maybe expand their offering out outside of just having day-to-day hour and maybe put together, you know, a group of Veterinary Consultants or folks that you know might be working from home. And for instance. There’s a group on Facebook. That’s the moms for veterinary medicine Facebook group and a lot of these moms are pretty much taking time off work because they have to manage and raise the kids. Maybe they just gave birth to certain children as well. And so I think one of the opportunities that we’re looking to exploring is, you know, helping them get access to work and obviously their home, but if we can be the plug or the bridge if you will that connects those Veterinary Consultants with clients that need that access to care for specific Hospital sites will now we can essentially have that after-hours kind of hotline built into any panting as well. So as we kind of take this back to the original question, you know, the big thing that we were We want to focus on is enabling the practice with virtual care software for day-to-day hours. But that said one of our initiatives by you know, mid-next year is to certainly explore the opportunities around building our own network of Veterinary Consultants that could in turn off or those kinds of services after hours as well. So again to your point Ivan everything streamlined, it’s all one app. And again, I think you know having those types of integration capabilities with the Pimm’s is critical to making this successful because again when Have that type of integration. There’s a lot of different applications that can be leveraged moving forward. Shawn: Now we’re going for the next rung on the ladder. This is where we asked specific questions at the same time try to confuse the shit out of you and see how you make out. You’re ready to go. Let’s do it. All right. So interesting backgrounds Tony Oracle TripAdvisor, and then this departure to the veterinary space, which is very interesting and you see here how that Journey happened the next question. Let’s talk about integration. She said it’s one of your secret sauces. It sounds like a nightmare. So go ahead and spill your guts. Go ahead.
Tony: Yeah, absolutely. So I think you know, I am going to give a little bit of an anecdote here guys. I definitely want you to understand the true Tony Cairo story and the story for my partner’s so, you know, feel free to cut me off if it’s a little long winded here, but that’s he’s trying to slow us down Laughter and get them back. I’m just I’m just trying to bite as much time as possible gentleman. No, but that said yes, I did start at Oracle. But prior to that. I was working at TripAdvisor. I started as a business development consultant their climbed up the corporate ladder very quickly after graduating from my alma mater. Again Babson College go beavers and of course by second year at trip. I was able to be tasked with Crossfit departmental responsibilities, and I got to work closely with Elite Executives and marketing product and Engineering teams at trip and really our initiative was to Bring about one of their most Innovative products to date which is called in Booking. I had the privilege and honor of working with the team that put together the go-to-market plan with and also helped develop the overall robust sales protocols that they used today for their Global sales teams in the organization. So, you know crushed in a trip. It was a fantastic experience early on and then following that I worked with Oracle for a couple of years on on the side. I work closely with a startup called toast currently the leading hospitality and restaurant management POS system at the time. Working with some really robust Engineers that work for a company called and deca and sure enough. They said Tony we can’t afford to pay you right now. But that said we’d love to get you a job at TripAdvisor. So that kind of segwayed into trip, but had I stuck around guys. I’d be a very happy camper right now toast that startup that I was working with is now worth over three billion dollars. They are unicorn status and I would have been employee number one hindsight 20/20. All of these tremendous experiences have really helped mold me into who I am today. Day, and I’m an avid believer that you have to go through the valleys before you can climb up the mountain tops and see the breathtaking views. So how does that segue into veterinary medicine? Well, I basically had my career in Boston and wanted to come back to San Diego where I was born and raised and sure enough. I call it drew mate Bobby Ready who’s my current business partner at an opinion happened to be working in San Diego. So when he graduated he moved to San Diego and of course, I stayed in Boston working for those companies as mentioned. Working for Qualcomm. And when I basically road-tripped it back to San Diego. We always wanted to start a business together. We always had these ideas in mind and college God should we start this and we start that Babson is an entrepreneurship school. They Foster that type of mindset. We’re really proud of it. And so long story short. We started looking at potential opportunities around us and specifically I remember Bobby had a professor that said, you know Animal Health Care veterinary medicine is still decades behind human health care. And so there’s always going to be opportunities. Unity’s there so that kind of started, you know triggering us into thinking well, maybe we should have utilize certain human Healthcare Technologies and apply them to the veterinary medicine space. And of course Bobby’s father happens to be a dedicated shareholder in an opinion and he has a pretty big it firm overseas that’s focused on building robust secure connected care Technologies on the human health care side. My mom is a pretty big executive here with a massive southern California hospital group and the more we started thinking about what was around us the more we Realizing gosh, it makes sense. Ultimately if we can start leveraging existing Technologies and human health care. We can apply them in veterinary medicine because there’s a huge huge opportunity Gap there and the rest is kind of History to complement that it kind of hit home personally because my aunt was dealing with several health issues when I moved back to San Diego, she’s doing much better now thankfully, but she had a 5 Chihuahuas that would never go see the veterinarian and they were during pretty critical times as well that I got to witness. First hand, of course. I helped out with those efforts, but there was kind of a light bulb in my mind that said gosh putting these dogs in the car is not the easiest thing to do wouldn’t it be awesome if I could just connect with a pet doctor through telemedicine or be able to text them accordingly. And so I think most parents don’t really want to deal with friction points of taking their pet to see the vet because they deem it too expensive or quite inconvenient and sure enough in today’s day and age where we live in an instant gratification kind of society. Why wouldn’t I want to be able to connect with our fellow Veterinary practitioners from home.
Shawn: You guys are in market. Now, you’ve got customers. What are the most interesting kind of use cases for this software? Like what are the most interesting things that people are really getting and driving value from using your platform?
Tony: Yeah, Sean. I think it’s really just you know, it’s funny. We call it telemedicine and virtual care but really it’s just a communicate. It’s a new communication method and the fact that sin can be archived and seamless stored in the patient medical record and the doctors can actually monetize their time from this outside of you know, being able to just text. And get texts and emails from their clients is you know is a huge game changer from that standpoint. But what I will say is some of the use cases today that just come to mind gosh, you know the other day we had a practice that connected with their client and I guess the client needed a wrapping a bandage around their pets paw. And so there’s you know, just a lot of quirky kind of things where clients just genuinely need Cream of questioning is with you know, there’s their practitioner because they’ve built a relationship with that practitioner. They have a lot of trust with that practitioner. And so at the end of the day, you know, we’ve we’ve just we’ve had a lot of different use cases. I think the other one was pretty interesting to me is there was oh yes, so there was one case whereby the pet parent just wanted to pretty much Gage why her pet kept sleeping under the bed and she couldn’t wrap her head around that so she had to get In touch with her Veterinary practitioner and chat with her for about 15 minutes. Obviously. She was a bit of a Chatty Cathy like myself today and sure enough ended up, you know engaging specifically with the veterinarian and just asking questions again, most of our use cases to date stem around I would say rechecks Dental dermal post-op. But then again there are certain behavioral increase that come up that are just very strange very unique. One of the cool ones that we had recently to is, you know, it turns out the pet was just had really bad. Society and so at the end of the day having that virtual consult from home really helped them out significantly, they weren’t freaking out at the practice. They were very relaxed calm and composed because they’re in their own environment. And so again, we can’t underestimate how much stress there is for the pets alone when they are coming into the practice. And so I think there’s a lot of value from all angles. There’s so many different applications Sean, whether it’s someone complaining about you know, why their pets sleeping under the bed whether it’s an anxiety thing. Whether it’s just getting some assistance wrapping a bandage around, you know, their pet spa broken nail inquiries as well happen pretty frequently on any panty. And so there’s just a lot going on, but we’re proud to kind of be that bridge for the client and the practitioner like you remember the second question the integration question, I would probably like computers for
Shawn: Yes, of course, absolutely. So that said the integration question.
The Difficulty of Software Integrations
Tony: It’s not it’s pretty easy. I mean, haven’t you guys not had any issues trying to integrate? I completely forgot about it because it’s just you know, it’s something that we don’t so it’s a walk in the park Sean start up with limited resources.
Shawn: How do you choose you choose? The biggest ones first you choose easiest ones first, you know, there’s so many of these practice management software is they are the epicenter for every Veterinary Hospital. What’s your strategy? How you doing it? How’s it going?
Tony: Absolutely. So we are blessed because we have an amazing technology team overseas and we have access to about 15 developers that are working on our team full-time the adage that we always say in the profession is because they’re about 12 and a half hours ahead of California time Pacific Standard time. That is you know, when we’re going to sleep they’re waking up when they’re going to sleep or waking up. So we’re truly a 24/7 by 365 company, but but that said, we have a significant amount of Technology resources that really helped us punch above our weight. And so coming down to the strategy of how we selected certain practice Management Systems first well, We looked at how big the market is and the you know, there’s roughly around 29,000 practices in the market today and of those 29,000. There’s a fair amount. I would say well over 9,000 of them are using Cornerstone, you know, there’s a little bit of a split there with Ava Mark some of the numbers are a little bit questionable as well. But that said they’re pretty much you know, right around the same frame I would say in the sense that you know, 9000 is ballpark. What we have been told is kind of how much of the market share that they each own. And so 18,000 practices are using a Mark or Cornerstone. Now when you think about it, that’s a huge chunk of the market right there. And so ultimately that’s where we focused our efforts initially. Has it been insanely easy God no and I hope you know the talk that I was saying earlier didn’t come across office integration is easy. It’s been incredibly difficult. You have to build these incredible relationships with Executives at these prospective companies, like idexx and covet wrists but one of the things that helps us punch above our weight is our technology. Horses and so at the end of the day we’ve been able to pretty much solidify the integration process well within about six to nine months it took a little bit of time early on because we were you know working with IDEX and of course, you know, it was our first rodeo to say the least so that one took a little bit longer than expected. But you know, as we Master these Integrations we’re going to be getting a lot more effective with being able to roll out those Integrations into the marketplace and for that matter, you know integrators Institution.
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 podcast.com. Thanks so much for listening.