Perfect partnerships

ITIJ 207, April 2018
There has never been a more exciting time within this industry and there are many businesses emerging
Dominic Howard
Director of European Sales & Accounts
Best Doctors

ITIJ caught up with Dominic Howard, Director of European Sales & Accounts at Best Doctors, to find out more about the growth of second medical opinion services


How did you first get started in the international health insurance industry, and how did you come to be in your current role? 

My first job was for broker Jardine Lloyd Thompson, where I gravitated towards the Accident and Health division, focusing mainly on international risk. Over the years, I have worked in a number of strategic business development roles for some of the leading insurance businesses including Lloyd’s and Aon.

When headhunted for this role, I was aware of second medical opinion services and Best Doctors – it felt like the perfect opportunity, not only to be involved with a leading provider in the sector but also to be involved in a market that had such potential for growth and still has.

In addition, having had a family member with a serious medical condition, I could see the value proposition and I liked the idea of helping to make a difference for other families in similar situations.

In a world where pressure on public health services is mounting, the value of a second medical opinion has never been more important. Employers, health insurers and the medical fraternity are beginning to wake up to the benefits of early intervention for patients, the costs associated with misdiagnosis and the financial benefits saved when partnering with a second medical opinion provider.


When providing a service such as Best Doctors, establishing an extensive and trusted network of medical professionals is essential. Can you tell us a little about how Best Doctors developed its network, and how it is maintained?

The evidence is clear regarding the value of a second opinion – recent research from the prestigious Mayo Clinic suggests that in just over a fifth of cases (21 per cent), the diagnosis was completely changed; and in over half (66 per cent) of cases patients received a refined or redefined diagnosis.

But a second opinion is only as good as the experts providing it, which is why we assure that our network of over 50,000 doctors are leading global healthcare professionals at the top of their specialties. The key is that these experts have been chosen by their peers as the ones they would want to be treated by. The result is a database of the best doctors in hundreds of specialty and sub-speciality areas globally.


More and more companies in the insurance sphere are recognising the potential of data analytics to improve their service offering. How do you see this methodology developing over the next few years?

With 30 years’ experience, Best Doctors is ideally positioned to take advantage of better analytic technology. But what if we go one better and use technology to predict those patients at greatest risk of misdiagnosis or inappropriate treatment, and offer them a second opinion at precisely the time they are most likely to need it? That's what our proprietary algorithms help us to do, using data markers such as the medical condition in question, the treatments currently received and claims patterns to spot individuals and groups most likely to be misdiagnosed. I think this is an approach that will become increasingly widespread across the healthcare sector generally.


How do you/will you utilise AI to deliver your SMO services?

AI, particularly when combined with the expertise of our top ranked physicians, is powerful and can provide an incredible complement to evidence-based medicine. Best Doctors already has a unique partnership with IBM Watson Health to help enhance the reports we deliver to cancer patients. Oncology Insight with Watson can read 200 million documents in three seconds. Best Doctors will gather additional data from patients who have contacted us seeking a second opinion, covering aspects of their medical records, family history and test results. The Best Doctors oncologists are then provided with confidence-ranked treatment options and supporting evidence that help inform optimal expert second opinion reports. In one recent case involving a 50-year-old woman with breast cancer, Watson helped confirm our specialist's opinion that debilitating chemotherapy, with all its unpleasant side effects, was not required.

It would take a physician 29 days to stay up to speed with this type of literature – we’re putting at doctor’s fingertips invaluable data and providing a highly personalised expert report that is changing the paradigm of clinical quality and providing the best in human and machine learning – a powerful combination.


Best Doctors was acquired by Teladoc last year. What was the impetus behind this deal, and how has it changed the way in which Best Doctors operates and services its clients?

Teladoc, the leading virtual health provider in the US, focuses on high-frequency, low-severity, episodic conditions, whereas Best Doctors focuses on high-severity, low-frequency conditions. By combining the two approaches we will be able to provide patients with answers for a full spectrum of healthcare needs with the highest levels of clinical quality. The joining of the two leaders in the industry provides one solution for help with care needs ranging from episodic conditions like flu and upper respiratory conditions, to mental health and chronic complicated conditions like cancer, offering better convenience, outcomes and value. It's a natural partnership and a very exciting development for all of us.


Best Doctors and Teladoc recently launched their integrated mobile app. What was the thinking behind the app? Do you think that insurers are generally exploiting the full potential of apps or is there more room for exploration and creativity?

Ninety per cent of adults under the age of 65 now have a smartphone and use apps to manage everything from email to shopping and even banking. Apps to manage healthcare are the next logical step – in fact, research in the US suggests that two-thirds of Americans are either already using a health-based app or are open to the idea of using one.

Users of our new integrated app, launched last October in the US, will not only be able to access the leading telehealth service provided by Teladoc, they will also be able to request a second opinion.  


Best Doctors is ISO 9001 accredited. What does this mean for your partners in the insurance world, and how arduous a process was it to get the accreditation?

Being ISO 9001 accredited is a very important quality marker for the service that Best Doctors provides. In combination with our long track record of getting results – 17 per cent of the cases handled by our EMEAA team resulted in modified diagnosis; 34 per cent in an alternative treatment recommendation – this means that our insurance partners can have great confidence in us. Private medical insurers sometimes worry that second opinions may raise their costs – in fact, the complete opposite is more often the case.

If you could change the way medical services are delivered to globally mobile employees, what would that change be?

PwC data reveals that expatriate levels have increased by 25 per cent over the last decade and predict a further 50 per cent growth in secondments by 2020. This is a very important sector for Best Doctors and for our clients, and we have already partnered with some high-profile international private medical insurers, with expatriates (and their families) being key beneficiaries. For employees working in emerging markets and often remote locations, having access to services such as Best Doctors can be an invaluable benefit, giving them peace of mind should anything go wrong. It also provides employers with a key differentiator in terms of their health services while ensuring that their employees get the right diagnosis and treatment in their given destination.

Our goal with Teladoc and the Best Doctors services is to make getting care a better experience - no matter where you are, being able to access quality care, on your terms, where and when you need it.


Do you think mental health support services are well utilised by insurers and their corporate partners?

We are starting to see the subject of mental health move onto the boardroom agenda but there is much more to be done. Some of the biggest challenges facing insurers and their clients include engaging their employees effectively and, in a wider sense, helping employees who could benefit from valuable mental health services to overcome the stigma. Best Doctors and Teladoc have already begun to pilot breakthrough behavioural health programmes that help patients overcome barriers to receive necessary care and support from the comfort of home. Using virtual health to support mental health needs is a logical next step.


What are your proudest achievements, both professionally and personally?

Professionally, my proudest achievement was when Best Doctors won ‘Best Added Value Service’ at a recent industry awards ceremony in London – we were the first winner of a brand-new category for 2017. That award was the culmination of many years of hard graft from the whole team.

On a personal level, I have a couple of teenage daughters who sometimes drive me to distraction. However, they are polite and charming (mainly with people outside the family), which makes me immensely proud.


If you could do any other job in the world, what would it be and why?

I am lucky to be at the cutting edge of healthcare for a business that really does make a difference to people’s lives. If I were to do any other job, I would enjoy being a non-executive director for a portfolio of a few different companies, most likely within the healthcare arena.  There has never been a more exciting time within this industry and there are many businesses emerging. I very much enjoy helping senior teams align around a clear strategic business growth plan – something many start-up businesses need to adapt to early.

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