What does your current role entail; do you have an ‘average’ day you could walk us through?
I have been with Aetna International for four years now, and lead all medical affairs across the business, in anything from insurance claims to managing the assistance teams that provide emergency evacuations, through to managing our telemedicine service, vHealth.
I oversee, and provide professional leadership to, around 100 clinicians, including doctors and nurses, across the entire organisation. I’m also involved in clinical policy and claims decisions in addition to advising the organisation and clients on how to deal with the impact of Covid-19. There is no typical day, every day varies.
How has your clinical experience influenced your career in insurance?
I’ve had a fairly convoluted journey to reach my current role. I’ve been a doctor for over 20 years and had a number of medical leadership roles for the NHS, government, healthcare providers, consulting and start-ups, which led me to the medical insurance industry.
In clinical practices, you’re looking after an individual, so trying to get the best health outcome for that one person. But in insurance you’re looking after a population of people, which provides the opportunity to get the best health outcome for hundreds of thousands of people. In my role, I’m applying my clinical knowledge in a different way, but the aim is still the same: to make the most significant impact on those that you are supporting. My perspective is much the same in both roles, and my clinical teams are here to act in the best interest of our members and fund medically appropriate care decisions, not to deny claims.
Covid has changed the healthcare landscape for many people, but you were recently part of a panel discussion on how Long Covid is impacting employers and employees. What insights can you share on this topic?
Post-acute Covid syndrome, what’s commonly known as Long Covid, is defined by the Centers for Disease Control and Prevention in the US as ‘individuals with ongoing symptoms of Covid-19 that persist beyond four weeks from initial infection’. Post-acute Covid is described as a syndrome because the ongoing symptoms can vary and affect any system of the body, from neurological issues like ‘brain fog’, memory issues, fatigue or respiratory with breathlessness, cardiological, liver, kidneys, bowel, blood system and more. It is very difficult to determine which ones are more likely to affect whom.
The UK Office of National Statistics (ONS) found that the five-week prevalence of any symptom for that testing positive between April and December last year was 22 per cent and the 12-week prevalence was just under 10 per cent. That’s one in 10 of those being diagnosed with Covid-19. The most common symptom that people suffer from is fatigue which ONS reported affects about one in eight at five weeks. Some studies have shown nine out of 10 people suffer from fatigue several weeks after the acute phase. Other common symptoms are breathlessness and mental health issues such as anxiety and depression. All of this clearly has an impact on those people returning to the workplace after Covid-19 and their ability to undertake their jobs.
It’s clear that employers need to show compassion and empathy for their employees who are suffering from, or have suffered from, Covid-19 or Long Covid. Listening and understanding are very important too. I recommend employers think carefully when choosing their health benefits provider as this responsibility and decision is now more important than ever. This is no longer about picking a provider that can manage employee claims, it is about managing their health.
Telemedicine has been a key part of healthcare delivery during the pandemic. Are you seeing engagement in telemedicine wane now that people are going to see their primary care physicians in person again, and what do you think insurers can do to keep the engagement with telemedicine going?
Telemedicine has removed barriers for people to visit healthcare facilities. It has filled a much-required gap during the pandemic, providing care for people who need it, especially when they are anxious about physically attending their usual health facility or if access is limited due to the pandemic. In our experience, people who have used our telemedicine service, vHealth, have had a good experience and many of them return for further care. The first time is usually the biggest step as it is a change in their normal behaviour when seeking medical advice. The peak of usage seems to have passed in many of our services as it coincided with the height of the pandemic, but the usage has settled at a much higher base rate than pre-pandemic. It’s obviously important for people to get physical care, but people are seeing real value in telemedicine, and it will only grow over time. It’s definitely here to stay and is now a genuine choice for people to consume high-quality healthcare, particularly in places where people don’t have good access to care.
The feedback we’ve received from members shows that vHealth has reduced absenteeism by 86 per cent. Our member satisfaction score with a vHealth doctor is 4.8/5 and the Net Promotor Score for vHealth is +73. Without vHealth, 77 per cent of our members have told us that they would have seen a doctor or medic in person instead.
Do your members express concerns over data privacy when it comes to personal health data use?
People do worry about the privacy of their healthcare data, and this is universal around the world. We take data privacy very seriously and we do a lot of work to make our members know what their data will and will not be used for. We explain data confidentiality, data security and restrictions. We try to stay ahead of the game and communicate to our members to relieve their concerns as much as possible.
In a recent global survey, we found that 80 per cent of employees would be happy for their employer to use their anonymised health data/profile if it was used to improve health and wellness benefits offered across the business, while 74 per cent would be happy if it was used to help personalise the health and well-being services offered. In another global survey, 74 per cent of employees told us that they were not worried about HR/management finding out details about their mental health. This figure was 81 per cent for their physical health.
Mental wellbeing has been an ongoing problem while Covid has continued, with isolation being a real issue for many people. What specific tools has Aetna introduced that are designed to help members access the care they need?
Mental illness has been hidden over the years, but the impact of the pandemic has rightly brought this issue to the forefront. Anxiety, depression, loneliness and other related conditions are just some of the consequences of the pandemic, which have all grown significantly around the world in the past 18 months or so. Supporting those with mental health issues is an important aspect of our offering to our members. We have designed our tools and services to provide help wherever people are in the journey and whichever way they wish to gain their assistance.
This includes Aetna Mind to support emotional and mental health and our new mental health resource selector tool, our Wellbeing Calendar to engage members via monthly health education content, access to third-party digital apps like Wysa (an award-winning AI-driven emotional well-being chatbot app that allows people to connect, anonymously, via text and access professionally trained therapists) and Pzizz (to help improve quality of sleep). In addition, we provide our members with access to vHealth, our telemedicine service where members have access to doctors to get professional medical advice, diagnoses, and treatments, should they require this.
Has Aetna International seen any impact on its clients due to Brexit? Are hospitals in Europe just as easy to work with as they were before the UK left the European Union?
From a medical perspective, Brexit has had minimal impact on our ability to support our members in the UK or European Union. We continue to maintain excellent relationships with our hospital networks throughout the world.
The working relationship between insurers and the hospitals treating their clients can be a difficult one. What are the keys to successful relationships of this nature, in your opinion?
The relationship between medical insurers and hospitals is a tight and important one, but it doesn’t need to be a difficult one. We share a common aim, which is to support our members to receive the best possible healthcare for their needs. Good quality hospitals and doctors have the same aim and, therefore, difficulties only rarely arise where the aim shifts away from this. On the rare occasion this happens, we act as an advocate for our member so that the best possible health outcome can be reached. This clinically driven approach usually stands us in good stead with our hospitals and leads to an overwhelmingly successful relationship with them.