Interview: Dr Robert Quigley, Medical Director at International SOS
ITIJ spoke to Dr Robert Quigley, Medical Director at International SOS, about game-changing technological advancements in assistance and extreme weather events
How has your role changed over time and how did you have to adapt to the pandemic?
Like most of my colleagues who oversee global medical assistance platforms, our role evolves with the appearance and disappearance of old/new infectious diseases, civil/regional stability, and the economy.
Prior to the Covid-19 pandemic, our role as an organisation, was in many respects reactive, where we provided assistance to business travellers crossing borders. With the unprecedented effects of this global public health crisis, business travel was practically shut down. Consequently, we had to change our value proposition. We transitioned from a reactive service provider to a proactive one where we, through our workforce resilience programme, assisted organisations, in every sector, with quarantine/isolation protocols, vaccination programmes, and return to work policies/procedures.
On the medical side of assistance, what technological advancements would you say have changed most since the pandemic, and do you think it accelerated change?
The first and most obvious technological advancement we have seen during the pandemic is the explosion of the telehealth. Healthcare professionals (HCPs), including those providing emotional support, could suddenly be accessed virtually. This protected the health of the provider as well as the patient.
The second and equally as impactful, technological advancement encountered was the evolution of the digital platform for communication between physicians. Zoom and Teams, to name but two, became the standard platform for communication between physicians even if the participants were in the same office.
Both of these advancements accelerated the principles of health and safety of the workforce to the forefront of operations.
And what new or forthcoming advancements do you think will prove game-changing over the next few years?
Care and attention must be given to the protection of protected health information (PHI) in this digital space. The game changer will be online platforms with impenetrable firewalls and cybersecurity processes/procedures that will become so secure that hacking will be an obsolete term.
With extreme events overseas becoming more common, how are you planning to adapt? What kind of challenges do they bring to you?
Managing extreme events overseas has always been part of our core practice. Success in the management, at least in our experience, is based on a decentralised service delivery model where every case(s) is managed by local subject matter experts (SMEs) who understand the culture, the infrastructure, the language, and most importantly the (medical/security) limitations. From a security perspective, with current global instability, cross-border travel will only become riskier. Part of the mitigation against such risks will be in the constant collection and sharing of intelligence between our stakeholders, who in turn act in a proactive/preventative fashion to support our clients around the world.
In the current climate, what are some of the main hurdles that an assistance company faces when organising a repatriation, and what are the best methods for overcoming these hurdles?
Historically, when we have been engaged to medevac an individual to upgrade their care, we would do so to the nearest centre of medical excellence. Since Covid-19, our strategy has changed in many cases due to governmental restrictions and healthcare capacity. For these reasons it is now commonplace to repatriate the sick and injured (assuming they are fit to fly). The health and safety of our transported patients as well as the aviation crew is of the utmost priority. Consequently, the planning of any repatriation now must include, over and above the usual protocols, Covid-19 mitigation best practices, understanding of local laws/regulations, and repeated testing. Setting expectations with the client and outlining how these aforementioned factors can contribute to delays is highly recommended. As is continued education of the transport team(s) about best practices in Covid-19 mitigation.
What do you do for training new people, how long do you train for, and how do you ensure ongoing professional development and learning for their coordinators?
Over the years we have recognised that certain profiles thrive in our business. So, to combat attrition we have educated our HR personnel to focus on those individuals that meet the successful profile. Once hired, the training programme(s) are under the supervision of dedicated trainers. There is a robust curriculum with plenty of ‘hands-on’ training in animated circumstances/scenarios. Since no one is allowed to ‘fly solo’ until the trainer and senior leadership has signed off, and all our criteria has been met, there is not set training period. Some individuals learn faster than others and some require more oversight/supervision. Once training is completed, every individual is always surrounded by an SME so there is never pressure to make an uncomfortable decision. Furthermore, it has always been our best practice to escalate any issue, at any time, where sharing of ALL data is paramount to successful outcome of our patients.
With telehealth solutions becoming more common, how do you think international healthcare will change in the future? Will people have easier and cheaper access to healthcare due to telehealth?
Telehealth has indeed been catapulted into the healthcare arena globally. There remain however, certain regulations that are not consistent around the world. For example, in some jurisdictions the telehealth provider must have had, at some time, a physical encounter with the patient, in other jurisdictions the provider must hold an active medical license in the area where the service is provided. As the technology evolves and as the pandemic limits access to HCPs telehealth will continue to grow as a new dimension in healthcare globally. It can serve several purposes. Firstly, it can keep people out of hospital where risk of exposure is greatest. Secondly, it can bypass historic queues to access a provider, and can be accessed almost from anywhere at any time.