Interview: Dr Juliane Kause of Everbridge
Dr Juliane Kause, Chief Medical Officer at Everbridge talks about duty of care, business travel assistance and patchy public health information
What are the primary responsibilities in your current role, and what do you enjoy most?
As Chief Medical Officer, I oversee all aspects of medical care that we provide, as well as our fabulous and diverse team. This includes governance, service delivery, and responding to new and emerging medical situations, be they a viral pandemic, earthquake, tsunami or man-made crisis, such as international food shortages. I most enjoy the huge variety every working day brings because no human being, and therefore no patient, is the same. Everybody comes with different issues, whether that’s related to clients, patients, my colleagues, the wider internal team, and the various challenges that come with practising medicine internationally – including regulatory bodies and laws that differ country by country. And that’s what also makes it enjoyable: problem-solving stays fresh and I have a great team to work with.
Has Covid-19 changed how travellers view travel health risks?
I’d go a step further and say that Covid-19 has changed the way risk is perceived and managed. As we are emerging from the pandemic, there’s a better understanding that risk can’t be assessed in isolation. Initially, there was a focus on the prevention of transmission of viral diseases; now, it’s become apparent that a singular focus on Covid-19 may have exacerbated other issues that were bubbling under the surface. For example, the increase in mental health emergencies or the delay in treatment for complex conditions like diabetes or cancers.
The pandemic has also accelerated the development of health technologies. We can see how, in the future, medical assistance services will be changed using artificial intelligence with human overlay, providing people with the best possible service, because machines are very good at identifying deviation from standard patterns. For example they're excellent at detecting an irregularity in somebody’s heart rate, blood pressure or respiratory rate, helping our highly skilled humans to detect and respond to issues ahead of time.
One of the problems that the pandemic highlighted is the fragmented nature of global health information provision; how is Everbridge trying to ensure consistent messaging to clients?
Everbridge produces a weekly, bespoke global health risk and threat report for clients, triangulating available data sources. While the data quality will vary from country to country, from continent to continent, our excellent health risk analysts use combined sources to give the best possible information – not just on diseases prevalent at this moment, but also looking ahead and predicting epidemiologically what is relevant to our client’s decision-making process.
Like anything in medicine, or any other industry, tools have their place. Telemedicine is a tool
We’ve had fantastic feedback from clients. Whether they are in manufacturing or the entertainment industry, and however the information is used, we’ve seen it lead to improved productivity and avoidance of loss. For example, avoiding planned work in an area where there might have been a combined outbreak of influenza, Covid-19, and respiratory syncytial virus (RSV), which has been quite common in parts of the US this winter. It’s helpful for corporations to be able to predict the peaks of these waves and plan accordingly.
Crisis management, particularly for high-profile events garnering worldwide attention, is of particular importance to companies from a public relations perspective, as well as ensuring they are upholding duty of care responsibilities. How does Everbridge help from this perspective?
ISO 31030 highlights the duty-of-care element. However, we go well above those standards by providing wraparound medical care. Whether it is preventative, such as our pre-travel occupation health screening, or support during an event and analysis following, we look to learn anything that we can. We also want to ensure that those impacted by a critical event have appropriate support when they return from their business trip. We don’t just look at the aspect of travelling for business; we want to ensure that our clients’ employees can be their best possible selves and represent their businesses while travelling.
Telehealth seems to ebb and flow in terms of usage statistics, whether by region or demographic. How can medical assistance companies encourage its ongoing adoption by employers and employees?
Like anything in medicine, or any other industry, tools have their place. Telemedicine is a tool – a fantastic option to get a face-to-face, virtual consultation almost anywhere, at any time, with an appropriate expert. Travel patterns change throughout the years and geographies; therefore, it’s not surprising that our telehealth patterns change. People who travel to countries with First World medical provision are usually much happier obtaining face-to-face traditional medical opinions; whereas people in more remote or hostile locations often feel comforted and reassured by the fact that they can have a telehealth appointment when they fall acutely unwell. In addition, when we set up services for remote locations, we can provide telehealth clinics for routine medical care. This is slightly different to the medical assistance telehealth services, but it’s hugely useful and reassuring that staff know they have access to care in a sort of quasi-clinic setting.
Both those factors – alienation from the home culture and use of alcohol in hospitality – encourage more risk taking
The bottom line is that the use of telehealth will continue to evolve and change. I think it’ll be more linked to the use of integrated physiological data in the future, meaning rather than just sitting and having a video chat, as everybody’s got used to, it’s becoming increasingly likely that those tools will include the opportunity to measure basic physiological data. For example, heart rate, respiratory rate, blood pressure – possibly even a reliable heart tracing and electrocardiogram will be hallmarks of future telehealth appointments, which will probably look a lot more like face-to-face medical appointments.
Business travellers are known to present increased risks for alcohol and/or drug abuse compared to employees that don’t travel. How do you encourage transparency around these issues and manage the risks effectively?
Traditionally, travel health insurance and business travel insurance exclude conditions related to drugs and alcohol. Therefore, culturally, people are reluctant to disclose this use while travelling. In practice, I think most of us know that people are known to take more risks while business travelling because they’re out of their usual environment. There’s also a business culture that encourages hospitality through alcohol. Both those factors – alienation from the home culture and use of alcohol in hospitality – encourage more risk taking.
Therefore, there is an association between the health trends we see in the use of alcohol and drugs. Alcohol is linked to road traffic accidents and other incidents, but interestingly and often overlooked, also the deterioration of chronic medical conditions such as high blood pressure and diabetes. The way we can encourage openness and transparency is to have a conversation between employers, employee assistance programmes, insurers and medical assistance providers. The issue needs to be looked at afresh by the industry because it remains a fact that people will drink, take risks, and/or take drugs when travelling internationally.
How is Everbridge’s technology helping to educate and inform travellers while cutting through the information overload?
When planning, travellers are traditionally overwhelmed with sources of information, such as from their employer with policies, regulations, and expectations from travel providers, and from the people in the industry they’re visiting. In addition, they will need to take into consideration environmental conditions, civil disruptions, and possibly language and culture they’re not familiar with.
Our new travel app puts everything in one place, so that when the traveller needs the information, they have it in-hand rather than being overloaded at inconvenient times. There is a lot of evidence in medical literature that the provision of information is largely ignored because it comes in floods. Most hospitals and doctors’ offices we visit contain a huge number of leaflets, or possibly electronic displays or links to apps, where we can read about all conditions under the sun. Despite best efforts by public health professionals, this hasn’t changed the health behaviours of people globally. Otherwise, nobody would be a smoker any more; nobody would drink alcohol other than in moderation; there would be no unplanned pregnancy or sexually transmitted disease. However, if you provide information at a time when it’s relevant to your health needs, it’s more effective. Additionally, there are tools related to diversity, such as LGBTQ, along with specific disease prevention and psychological first aid tools for stressful situations.