You have been with Charles Taylor since 2015 and Chief Medical Officer since 2017. How has your role changed over time and how did you have to adapt to the pandemic?
As Charles Taylor Assistance has grown and taken on new challenges over the years, my role has also grown and diversified, and this has made it more fascinating and stimulating than ever. We’ve expanded our client base in most areas, not least in the global energy, retail and leisure sectors and, today, we provide medical assistance and repatriation all over the world, including war zones and remote destinations.
As with other assistance providers, the pandemic has brought significant changes to our working lives. I am proud that, as a company, in the initial lockdown we were able to adjust to a remote working model for all our staff in a very short period and have continued to maintain our usual high level of service.
We have also had to manage frequent alterations of global government, health and travel policies, and adapt our own policies accordingly. The world of repatriation has been significantly impacted by the pandemic in all respects, from the inability to cross borders - affecting commercial repatriations – to air ambulances and their crews not being permitted to remain overnight in some destinations. All of these seemingly daily curveballs have required lateral thinking, decisive but speedy decision-making and proactive policy-making. Fortunately, despite the challenges, we’ve had many success stories.
On the medical side of assistance, what technological advancements would you say have most changed since the pandemic and do you think it accelerated change?
The pandemic has created new opportunities for the medical assistance sector, and digital development is just one of them. As mentioned above, our own digital advancements have enabled us to adapt quickly to remote working as the UK goes in and out of lockdowns, and to keep our workforce current and operational.
Whilst a lot has been said about the acceleration of access to digital healthcare during the pandemic, and to automated claims options, less has been reported about the development of medical risk mitigation tools, and these are an important innovation in the assistance sector.
As with other assistance providers, the pandemic has brought significant changes to our working lives
Our own digital health risk assessment tool, Venture, was developed in response to an increasing need to understand the travel and health requirements of employees that corporates need to manage. Employees using it complete an online questionnaire, from which health risk assessments are created to assess their suitability for travel and provide key information to employers. This doesn’t just enable their employers to put appropriate risk mitigation plans in place, it also allows risks to be correlated with local healthcare overseas and it can give insurers access to AI to help determine underwriting decisions.
The pandemic has highlighted the value of developing agile technology like this to proactively meet clients’ changing needs, and it’s important for the medical assistance sector to keep up the momentum.
And what new or forthcoming advancements do you think will prove game-changing over the next few years?
Continuing digitisation is likely to be the biggest game-changer over the next few years. The prevalence of mobile technology has already driven services such as digital claims, single-source medical and security assistance, risk management alerts and automated medical screening. The globally mobile increasingly want rapid access to information, advice and emergency assistance.
This will likely drive the increased use of tools that make it easier to reach out for help, such as digital doctor (an amalgamation of video doctor and advanced diagnostic services) and wearables, especially in more remote areas of the world. It’s likely too that AI will be increasingly valuable in mitigating travel risk, providing customers with enhanced information and support and helping underwriters to make the right decisions.
But the assistance sector will always need niche human expertise from doctors and nurses, multilingual travel specialists, case managers and more. The value of human intervention can never be underestimated: whether it’s in carrying out complex negotiations with overseas authorities about an air ambulance mission, in organising a multi-faceted repatriation for a life-or-death situation, in reassuring the worried partner of a Covid patient or even in organising a birthday cake for an isolated individual far from friends and family.
With extreme events overseas becoming more common, how are you planning to adapt? What kind of challenges do they bring to you?
We’ve supported our customers in the wake of extreme natural or man-made events for decades; not least after the Boxing Day tsunami in the Indian Ocean, avalanches the world over and, of course, Covid-19.
As medical assistance providers, we’re trained to expect the unexpected and to manage anything from multiple-casualty scenarios to claims surges. We also draw on the skills of our specialist risk management teams to support clients with contingency plans covering evacuation, risk mitigation, medical care and more. These are valuable in the wake of events that may, for instance, reduce access to airports, hospitals and transport, or that may destabilise political situations.
Our global network of medical, security and transport providers also plays a vital part in these scenarios, giving us access to real-time intelligence and resources on the ground to help us assist customers.
As an organisation, we constantly work together to plan for and pre-empt extreme events and our clients expect us to be proactive.
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?
As I mentioned earlier, Covid-19 has made a huge impact on repatriation medicine. What used to be a relatively simple medically-escorted commercial repatriation now calls for a military-style approach. Today, we need to be aware that countries’ compliance requirements may change with little notice, international borders can be closed, local medical facilities over-stretched and virus testing rules made more stringent.
France was a good case in point when it closed its borders just before Christmas, necessitating the rearrangement of transport and accommodation for many individuals stranded in ski resorts, some with Covid-19.
The majority of our staff also work in the NHS, ensuring that their knowledge is up-to-date
The limited availability of commercial flights has also added a layer of complexity to repatriations, as have isolation requirements for medical escorts. Current isolation regulations in some countries, for example, make it hard to deploy local medical escorts and have necessitated the use of air ambulances whose crews are often exempt from quarantine requirements.
This means that it’s more important than ever for us to create bespoke solutions for our customers, often in short time frames, whilst containing costs for clients. It’s also critical to establish patient and client expectations at the start and to communicate about the different processes involved in a repatriation. As important is using our partners across the world to stay abreast of changing situations, ease access to transport and accommodation and communicate with local authorities.
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?
All our new medical staff participate in bespoke training and orientation programmes, and our office-based doctors and nurses undergo training and mentoring for at least three months before they ‘go solo’.
Our flight practitioners, comprised of doctors, nurses and paramedics, also undergo a stringent training programme on a section of an aircraft used for training aircrew - and they are required to pass both written tests and simulation exercises. These revalidations are repeated annually to ensure they remain current.
The majority of our staff also work in the NHS, ensuring that their knowledge is up-to-date. In addition, we arrange regular study days with external lecturers and have clinical group meetings at a number of different levels.
Another important part of our training agenda is the immersion of our new medical staff in the business as a whole. Each will spend time during their training period in a different business department, ranging from procurement to travel management, so they can gain a real understanding of our whole operation.
Meanwhile, our medical teams also train our front-line claims and assistance specialists to enhance their understanding of customers’ problems and optimise service. This training will cover everything from basic anatomy and general medical terms, to more specific issues such as rabies and animal bites.
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?
The global community, especially in the western world, has increasing access to telehealth services and a significant number of corporates now provide this as an option for globally mobile staff.
There are aspects of medicine where telehealth is the most cost and time-effective solution, particularly in remote areas. It can also ease the pressure on potentially overstretched healthcare providers - and the changes to medical practice in the pandemic have shown this.
But we must acknowledge that, whilst telehealth can provide an efficient, user-friendly way for policyholders to access medical triage services - and that its prevalence will grow - it is not always the most appropriate clinical option. There are times when a doctor does need to see a patient face-to-face to make an accurate diagnosis and provide appropriate support.
Going forward, assistance providers offering telehealth services will need to ensure that stringent quality control measures are in place to ensure that third-party providers provide both value for money and safe, high quality healthcare provision.