Heroes of Healthcare
Heroes of Healthcare

Episode · 7 months ago

Tales of Telehealth: Remote Care for Women Around the World

ABOUT THIS EPISODE

Thanks to COVID, most people are familiar with telemedicine, but some healthcare heroes were using it to change lives long before the pandemic.

In this episode, two pioneers — Tanya Mack, President, and Dr. Anne Patterson, CEO, from Women's Telehealth — share their insights about the past, present, and future of telehealth.

We discuss:

  • How Women’s Telehealth started and provides care for high-risk patients in remote areas
  • How COVID-19 changed telemedicine
  • What telemedicine will look like after the pandemic is over
  • The importance of vaccination for pregnant women

Heroes of Healthcare is hosted by Ted Weyn.

To hear this interview and more like it, subscribe to Heroes of Healthcare on Apple Podcasts, Spotify, or wherever you listen to podcasts.

Listening on a desktop & can’t see the links? Just search for Heroes of Healthcare in your favorite podcast player.

You were listening to heroes of healthcare, the podcast that highlights bold selfless professionals in the healthcare industry focused on transforming lives in their communities. Let's getinto the show, welcome to the heroes of health carepodcast, I'm your host Ted Wayne Today, I'm joined by two pioneers in women'sTell Health Tanya Mac and Dr Ann Patterson had been trail blazingwomen's tell health in maternal fetal medicine before people knew that therewas such a thing as tella medicine. Tanya MAC is a license or end and ispresident of women's teller health. For more than ten years, women's healthservices delivered by Tela Medicine in severn South Eastern United States thatspecialize in high risk upseting, maternal fetal medicine and the groupis completed over ten thousand sub specialty women. Health encounters thecompanies provided their services as far as when he's Guatemala, India,Congo and WHO's Bekes. Tan. Also joining me as Dr Anne Patterson, aboard certified physician and her team had been providing maternal fetalmedicine expertise for years. Dor Patterson received her medical trainingand completed her obgect and M F M fellowship at Emery University. She wasbased in private practice at Norsine Hospital for over twenty years and as anational leader, an obstetrical care dor pattison also has her master'sdegree in engineering from Georgia Institute of Technology and has been anearly adopter and cutting edge, ultrasound M R and Tela MedicineTechnologies. Doctor Patterson is also a true rocket scientist and prior tomedical school door. Patterson was using her engineering skills fromGeorgia. Tech working at NASA, Dr Patterson, has been featured on n PR.The Wall Street Journal Prevention magazine most recently, both Tania andDr Patterson author to timely article for Connections magazine exploring theOvid nineteen vaccine with pregnancies. It's my pleasure to welcome to thehears of health care, podcast Tanya and Dr Patterson welcome. Thank you we'reglad to be here. We're excited to have you guys here and we're talking aboutthe great work you're doing, and I know that there's going to be lots ofinterest in this episode, because there's a lot of uncertainty in thisarea so before we dive in, I would love it. If you two could just give ourlisteners a little bit of your background, where you come from how yougot into this crazy world of health care that we're in and a little bitabout your group and your organization, I'll start because mine's, quick, I'mTanya Mac and I'm president of women's Tella Health and I was trained as anurse and after two years in Pedi African Cology, I kind of went into thebusiness of health care and never really looked back. So Dr Patterson andI have worked together now for well. We won't ave ourselves here in exactly onabout your, but our specialty that we want to talk about today is women'sTelle health and in particular, a subset of that which is high riskpregnancy care and in two thousand and eight we sold a business where we had abrick and mortar medical practice that focused on obstetrics Donacola Gy in aparticular high risk. Ob Care and Dr Patterson will share her background ina minute. But after we sold that business, we were looking for a way towork together again and we blossomed into telep and I'll. Let her tell thestory because she was more closer to it, but the two areas we'd like to focus ontoday is to talk about how we got into Tela Health, the growth of Tela Hell,which has really sped up in the adoption over this year of the pandemicwith ovid nineteen. Most people saw it before them as a nice to have, or onealternative way. If you didn't really have access and we've all learned inthe past year- that it's become a necessity to decrease our risk rightand then a second thing. We'd like to talk about that Ted. I appreciate youhaving us on today, for that is pretty timely. Is We want to talk about howCovin is affecting pregnancy and expectant parents, and as a subset ofthat, we want to talk about the ovid...

...vaccination and how that's impactingpregnancy and what our real life experience has been with that. So letme turn it over to Dr Patterson to introduce herself and also tell alittle bit about how we got started in the business. So I never planned to bein medicine, and I was an aerospace engineer. I went to Georgia, tech and Iwent to work for NASA and while I was there, I got involved with a boutmedical project and I actually worked for the man that Dr William Living, whoinvented the first laser ever used in medicine, and he strongly encouraged meto go back to school and go medicine which I resisted for some time. But Iended up coming back to Atlanta, going to tack getting my masters and mypremed simultaneously and ended up at Emery, Madam School and withoutquestion just fell in love with him tetric and stayed in obstetrics. I havea fellowship and VI physiology and Maternal del Medicine, and so obviouslyboth engineering and medicine. As Tommy said, we had a break and order practicepretty traditional and after we ended that practice. I was looking foranother way to be able to provide eternal, feel care in smaller ruralareas, where patients obviously would either have to travel if they could ornot get the kind of care that we could provide and bound tell a medicine.Eleven years ago, long before it was, you know, really well known, or evenpeople thought it was a viable option, and so we started a business back inthe in early twenty ten and never look back, and all we really do is tell themedicine, and we really do provide this in multiple places and multiple statesto people who would otherwise not be able to have this kind of Cape Yeah. Iwanted to interject here just a little bit Ted to give you the scope of whatwe're talking about maternal fatal medicine requires a three yearfellowship beyond an OB gyn residency wow. So since we operate in multiplestates, for example in Georgia, we probably have somewhere between onlyforty and fifty doctors, for the entire state that are qualified to care forPiros pregnancy care, and that would be when the Obin does not know what to do.They punt to the next level specialist, which is what Dr Patterson does andother states that we've been in on New Mexico. When the widespread in theSouth East they're similar, we have higher specialists, mostly in academiccenters and in large metropolitan areas, but are stimulus for creating telahealth. Maternal fetal care was, if you're pregnant, with twins in themountains or in an auroral area where there isn't a metropolitan, where aNiku or anything like this. We saw tela medicine ten years ago at the veryfirst beginning of for our specialty, the use of telle medicine as a way tokind of pipe it into areas that did not have access, because how it was beforethen is. If you were pregnant with twins of jocolate, you would be Hellovaor ambulance into Atlanta, and we hope you made it. So this allows us to usetelal technologies to communicate with the O B G Wyns in the community. Ourbusiness is referral. We don't have hires women call us up and want to behigh risks, certainly they're afraid of these diagnoses and concerns. But weare a resource for local obgd, the country, and it is a way for us to keepthe patients in their home communities and yet their higher situationsresolved. And how would you say, and maybe eight eighty to ninety percent ofthe time they do not need to be transported and we can manage them byscanning their babies. Doing audio visual calls and tell a howl andkeeping them in their home. Communities for the duration of the frequency maybe even higher than that, depending on the resources locally, sometimes asmuch as ninety five percent can be...

...managed. Like yeah, we were kind oftrail blazers. Here we actually acted over almost fifty thousand high risk. Ob visits, one hundredpercent by Tallahala wow, that's amazing yeah, I would say. Maybe weshould change this episode to the Pioneers of Health Care, a nabors ofhealth care, it's hard to be a trail blazer sometime back, then nobody paidfor it today. Reimbursement is very well, but when we started only eightstates in the United States paid for what we were doing and Georgia was oneof Georgia was one wow yeah. So love to talk a little bit more about that, DrPatterson and time to tell us a little bit more about so technology is sorapid and eleven years ago. What did tell a health look like you know. Nowwe live in the world of zoom and teams, and every laptop has a camera on it andall those sorts of things. I'm sure. That's not quite how it looked abouteleven years ago, and the other thing too is rural communities today evenhave conative y issues, so I had to work with that eleven years ago. Yes,it's a complication, so Georgia actually had done something reallyprogressive about this under Zel Miller and Oxendine. When he was acommissioner of Insurance, they started what was then called the Georgiapartnership, Potel held now known as the Global Partnership for Tella Hell,and they actually at that point in time, actually had t one lines laidthroughout the state and people had really good connectivity throughoutGeorgia for tell help so in tale health they're kind of several things, butfirst I want to say to Real, tell a health isn't much much more than a zoomcall for sure. So you have to have a network that is vote, hip, Ocola andsecure. You have to have equipment and equipment back in those days. Look likea kind of large older, sound machine was a cart and it caused somewherebetween, depending on who, you bought it from thirty five and forty fivethousand dollars. So it was expensie yeah and you had to be. You know,obviously pain to be on whatever network you are on, so it could bequite constantly and the equipment costs have come down significantlysince we started, which is really nice, because it makes it much more fordablefor practices, clinics, hospitals wherever we are right. So you havethose two things and then you have the provider, and so the global partnershipor tell a health, has multiple specialties that use their network andmultiple providers throughout Georgia, but they're not exclusively in Georgiathere in other areas as well, but they are one of the platforms that we use.Just to give you an example Ted when we first started. You know Dr Pattersonmentioned just the cart alone, which they were made for each specialty, andso a cardol would have an kjaere. We look at babies, we have ultra sound,they were all custom made. They had to have a T, one connection point to pointto get them all working and those both up front and maintenance costs,probably worth fifty fifty to sixty thousand dollars to start a programfast forward to today's environment. We can stand up one of these centers, weby past the cart and we can connect through laptops, APPs peripheraldevices for probably six to ten thousand dollars. So in ten years, westripped away about three fourths of the cost of standing these up so reallyany doctor's office. We operate in doctors, offices out patient clinics,like departments of community health and also hospitals that don't havehieroscopes physicians, but it's gotten to the point that a big plus astechnologies roll reimbursements come in is we're now about a fourth of thecost that we were when we started ten years ago. But keeping up withtechnology is definitely one of our strengths and one that we have to keepup with. The other thing is there are amazing, peripheral that people don'trealize, especially when we're talking about business more than a in call.Obviously, we can see in what we do...

...real time. Older, sound wherever thepatient is and that we've scanned patients as far away as bang with dish,and we can look at the baby and see what's going on. We can see the heartand all that, just like we were standing right there in the room usingthe other thing. That's amazing is that they have blue two stethoscopes that Ican put in my ears and direct on a screen here. They can see it there andthey put it on the patient, and I can hear the most maternal hard or thematernal lungs. Just like I was standing in bed stile. I do think onedirection were headed that we've alluded to Ted, that everybody's gottenused to at least the idea of tellaheens, whether it's a medication refill orsure a follow up visitor whatever. But those visits are mostly audio, visualbased on any kind of platform and during covin wavers. They really don'teven need to be today hip a compliant kind of bypast that during thispandemic period, but the next evolution we think will be connected tellah. So,for example, right now we have a project in New Mexico, where we have alittle kit that were sending to pregnant ladies homes up in themountains that have a pulsometer, a Thedosei, a dolar. So we can hear thebaby's heart beat a blood pressure cough a scale all with blue toothtechnology in their homes for less than two hundred and fifty dollars amazing.So we're going to move beyond just zoom. One of the challenges is, if you're, DrPatterson, you want real data, real clinical data, not just what thepatient's self reporting so right now we're all zooming with our doctors. Butif I put you know a bean in my ear and tell you, I have an ear infection, youcan't look at home and say, but soon with those kids, you will be able to sowe're zooming tell a health today, as the majority of patients haveexperience, but the next version of what we're already doing for all theseyears is what I call connected Telal, where we have real clinical data toback it up. That's I mean it is unbelievable how fast it goes, and itjust keeps getting faster so with the blue toot. So with the patient you're,sending all the different meters, the pull sox and the different meters. Iwon't try to say the others, I'm not clinical, and I won't try to be andthose work through their computers, blue tooth reception or there would iteven work with their ephone or whatever, depending on what is sound and whatplatform and they are own with the institution that is providing this forthem and there are different different platforms that work a littledifferently. Sekor instance, if you have a cold sox on your finger and notonly tells you how well your oxygenating, but it tells you yourheart right, so you know that's a very easy device that can data can betransmet and some work there, rooting in the direction of smart, cotten Ology,where you have a glue comiter that plugs into your smart phone and e. Thenthose results are just transmitted up to your provider. In some cases, yoursmart phone acts as the platform or an APP on your smart phone acts as theplatform, rather than installing a totally different tela medicine by forYeah. So we're moving in the right direction of making care mobile, whereI am with my sparpot we're heading in that direction. But your men, yourguy's services, though, is it still requires the mother to go to a facility,a you're not quite yet probably doing home, but that's probably not farbehind. So I think it depends on what you are do: Okay, for instance,wherever the patients are seen initially plegar. They have a telehealth presenter there and that's wise because most of these women that come,I have some complication or are the baby, has a complication that we o beseeing them. I mean they are certainly occasions when we say everything lookswonderful, you don't need to come back, but they do come to a center where theyhave for they are scanned and we have...

...trained, alter Sonogram RS, who do howrisk stede alter sound. So that's how I can see the baby real time I like tothink of it. Ted As there is direct a consumer Tela health which, on the backof our insurance cards, rather than go to the Er at you know ten at nightright. We can call and get a low acuity kind of audio visual zoom experience,but for us we're not direct a consumer were more business to business, so theyhave to be in a clinical setting until women learn to scan their own babies,which probably isn't going to be soon to get us. Those hiris pictures we'restill dependent upon the TELHAM presenter in the clinical setting toget us the clinical data. We need to be able to diagnose and treat the patientat this high risk level. Perfect. Make sense thanks for clarification. Do youthink it will get there? Will it be? You know I can call M, live to yourpoint or tell a dock tell them. I got a cold or I've sore throat or whatever itmight be, and they can do something and prescribe to it. Do you think it willget there? I think for certain types of clinical problems lot, like I say, lowacuity. You know I one time had the opportunity to talk to Blue Cross BlueShield nationally for their director consumer calls centers that handle allthese. You know zoom calls, and they were telling me that eighty six percentof the time is a low acuity thing. I have the flu, I have a respiratoryinfection, but for us in particular, and may be like, for example, of Cardio.You know I'm not going to diagnose your heart problem remotely over a zoom call,probably, but the APPS are getting surprisingly innovative and precise andthey're improving all the time. So for some circumstances I think yes, it willget there faster, but for ones that are complex anyway, they sub specialties. Ithink we're still going to have to have clinicians as the eyes ears and handsfor the patients in a remote setting. What do you think yeah? Okay, great sowe've seen how ovid and the pandemic have loosened, as your guys said, a lotof the abilities to build a lot of the abilities to do a lot of the work viatella and hopefully we're in the beginning of the end of this pandemic,and things will go back. What do you guys see in the Tele World? Do youthink we're going to go back to a lot of those regulations and those what Iwould call it tempt I'll answer that one? It's a good question right now inthe industry, with the pandemic and we're in a period of section eleven,thirty five wavers, which means we can use any device. We can cross statelines to provide tela health where we had to be licensed where the patientsits before we can not be on a hip a compliant device, and President Bidenhas extended these wavers already through December of this year. Some ofthem. We think it will the answer to your questions. I think it will be ahybrid. I think that some things like pick up hippocooen's will be reinstated.You know, and we like our privacy. We don't want our health records out foreveryone to see. I think getting back on a hip. A complaint platform will bean example that will be rolled back. Some of the reimbursements may berolled back. You know what we're able to do on a virtual exam with realclinical evidence versus a phone call will be reimbursed at different rates,not the same. On the other hand, the access and availability and some of thepayment structures, I think, will continue so my opinion is, it will bemixed will have some regulations rolled back already. We have one newregulation, that's been made permanent and that is the geographical location,so it used to be only if you're in a rural area like for Medicare, forexample, are you allowed to be paid for Telham that has permanently gone away?o? You know, we've learned that in Ovid,...

...even you know where people are on topof each other are more important to decrease. The risk of you know out inthe middle of a you know, farm somewhere. What do you think? I? Ithink it will be a mix, I think definitely more hypoclinea will be reinstituted because I think that's you know. I think we don't want our healthrecords just running around the world, and you know people being able to youknow, have access to whatever you're saying or doing immediately that youdon't even know who they are. So I think that will roll back. I do thinkthat you will always have more tello health than you ever did in the past,and it will be more accepted and it will be more accepted, not just I don'tthink patients have ever had a problem. I've had very very I've had like maybeone ever and had a problem with hello, health and eleven years, but I thinkthat there were institutions who really were had great reservations about usingit that this will always now be a part of their platform Yeh. One other thingI wanted to add to D was a good by product of this Ovid antella healthintersection has been what you brought up earlier, and that is that we assumein the United States that we all have great broad band coverage. Tell ahealth can occur by satellite, Zila or broad band in the US. It's mostly broadband and we've made great strides in now, realizing that there are largemedical deserts that need to be wired for Telham and that process has startedwith coved funding and stimulus money, and so where Dr Patterson said before,Georgia was one of the leaders in wiring a network for telher early onten years ago. We now are going to have a better network after ovid or tell OlYeah so to well. I guess two things. One is so, while some things make slideback, you know the hip of compliance things and terms of the platforms andall it sounds like, though, you feel that one of the benefits of a pandemicwill be that we have accelerated telle medicine. The Tele Work that you guysare doing. It has enabled us to move this faster than if we were going underthe old pre pandemic days. Oh Yeah, there were definitely states that didnot allow tell a health reverse at all or license your restrictions. You knowin licensor and payment in clinical processes we probably have acceleratedteleothen by several years in the past year of the pandemic M. Well, that'sgood, it's good to find some of the silver linings. Yes, such a tough orour business. Yes, yes, for such a tough year that we've gone through, youknow. I heard you mention, and I think it might be fun to hear some of thestories, though, that you mentioned about Bangladesh and some of the thingstell some of the listeners about some of the far reaching places that you'vebeen able to do and where you've been able to bring care where care normallywouldn't have been available. So there have been a lot of odd places, a riverbedding, Wadena and Baglieh w. But to me the most important has been inreally small rural communities and the rural south. Were these patients. Wereally have some sick, ladies, and they really just couldn't get help andyou're there, and you realize the baby had a major heart defect and you areable to arrange for the patient to be delivered in a Metropolitan Center sothat the baby has immediate access to heart. Surgery is needed, you know tome, those things are really great. The Bang of their story is kind ofinteresting, a good one. You should tell he ask me if I would do ademonstration to the Minister of Hell about what we could do and I agreedwith the caveat that the patient that we were standing live so that theycould see that you know they had an interactive audio visuals situation.They had the patient there, but they could see what I was seeing and sheobviously gets a predominantly Muslim...

...country. And so she was screened andshielded from from the audience, and I would say to you that if they were notall of the positions that were there, I think were making. And so my one thingthat I said was that this lady had to agree and that whoever picked herplease pick a normal haver scan before, and we know that this is a normal baby,because this was an exercise and a demonstration of how equipment worksright and how? What kind of care you could ger. This was not a demonstrationand finding a feel after malite. So when I came on the screen ahead of timeto talk to the patient and packs everything was fine, she looked like adeer in headlight shes petrified, and I thought, Oh, my goodness, they havetwisted this woman's arm, and so of course you know I kind of be veryunderstanding of patients and their situations and what they go throughanyway, and I felt really felt sorry for this lady and I tried to be asgentle as I could, and then we started the scan and fortunately- and I Iobviously had to keep a straight face and a steady voice realized that thischild had hydroceles hm, so the baby had in large ventricles on both sidesof the head, and I guess before we ever had appropriate medical terms for this.We in all the child water hid- and you know there was a time- and I doremember when we didn't didn't know to shut, and today you can put a shot inchildren, can go up and know a position who had hydroceles on has a shut inplace and operates every day. Some. You can certainly be perfectly normal. It'sa something that can demetia ly managed easily today, but it does the medicalattention and without it there can be some significant consequences. Anyway.This child had large ventricles on both sides of the head and would definitelyneed to be delivered in a center where the baby was, you know, would getimmediate attention need a shot and obviously I did not feel like. It wasmy position in what I was doing to do this. So I insisted in the end of thedemonstration that an obstetrician and the audience to come with top with meindividual, and so I was able- and I thank the lady is asked- you know forher graciousness and allowing us to show this to the Minister of Health andthe compadres he had had come there. So I talked to the obstetrician, and Isaid. Obviously this was not the intent here, but the baby has hateras bilaterally and obviously she needs to have attention. And can you see thatshe is scanned and the Haristoi a trition see her and he promised me hewould so I mean that was the best I could do. That was not what wasattended or yeah, but it chose the power and the significance of what youguys do and work, and you know, hopefully she got the care that shemight not have normally had had. You know you not done that. So, while shewas probably, as you said, scared- and you know frightened by the situation,it certainly was a blessing in disguise. I was going to interject us one morequick story. We have a relationship with a group called the Adis Group whoworks by Tela Health and over thirty eight countries, and primarily in subSaar in Africa, and these are Bush clinics where they may not have anobstaret, let alone a high risk obstetrician, and we are one of thevery few in the country groups where they send us. Patients like, forexample, I can think of One lady at about twenty weeks came in. Theysuspected she had a stroke. She wasn't moving on one side, they didn't reallyknow what to do in the Bush clinic, but they get us all the clinical data andthen the doctors kind of log in and direct the care. Not directly with thepatient but kind of the idea of directing the clinicians in the clinicwith what to do so, even though we're oceans away, we still have the abilityto provide access in a Bush clinic in Africa, amazing to help pretty close toreal time. Amazing, that's great such such awesome work. You guys are doingappreciate it. So, let's start talking about. If you don't mind, let's talkabout Ovid lets it's a hot topic: Yeah...

Er, it's hot topic where you thinkwe're tired of it, but it's funny. We all want to continue to talk about itand there's so much more to still learn. I think everybody thinks we're kind ofwe're at the end of it, but I think it's really just the beginning of somuch that we've learned coming out of this, especially as it relates to youryour world, but so let's talk about it in terms of what did you guys see ayear ago, it's hard to believe it was a year ago that this was. We were now infull full gear of attacking this pandemic and what have you seen overthe last year and then we can Segui into a little bit of the vaccine andand what are your guys? I know that our listeners are going to really want toknow about it, especially as it relates to pregnancy. But let's, let's talkabout what you be learned over the last twelve months. Well, we've learned thatI think that vaccines are important and both the American college and theSociety of maternal people, medicine encourage pregnant women to bevaccinated, because it's far far better to have a vaccine and prevent this, andyou know we get ovid. It is an RNA vaccine. It is not a live vaccine, soyou're not going to get it from, is you're not going to have a problem withthe NA, because it's Marna vaccine, and so we really encourage people to get isI can pause you there? Can you can you and you- and I know, you're, not aepidemiologist and your. You know an infectious disease. But can you explainthat a little bit to the audience- and I reason why I say that is because Isat on a round table about a week or so ago, and it's funny that one of the bigmisconceptions of that RNA technology is people believe that the vaccine isaltering their DNA. We hear that too. Yes, no, it doesn't as though it is nota DNA. It has nothing to do with DNA and so with the vaccine. What it doesis it that makes if you like, the RNA of the virus and that way when we havethat in our body our body builds up an immunity we see. If we are thenunfortunate enough to be exposed, we have an immunity that prevents it andit has nothing to do with our DNA. R. Dana isn't altered at all, but it doesreact against the RNA in the vaccine. So, in Lehman's terms, my terms, itgives the body a picture of what the virus kind of looks like and says. Ifyou see this again go get it. This isn't good right. I mean again in itssimplest terms, but we're not altering anything genetically in US at all,we're just because giving our bodies a picture of this is what this is the badstuff and if it comes in here and you see it go attack it and my Leman'sterms is that correct, I think that's a great summation N. besides the DNA ted,another thing that we hear is a concern of patience is, if I get the vaccine,will it affect my future fertility, not only my own personal DNA, but if I getthe vaccine, will I be able to get pregnant again and not have a problem?You want to dress that rig and in the answer is it doesn't affect this at all.It doesn't affect him fertility if that's a effect, your ability toconceive so early on when the vaccine was first being assessed. There werepeople who got the vaccine who didn't realize theywere pregnant and there were no untoward events in the ALF sprayingthat were delivered, and subsequently there have been far more people who'vebeen vaccinated, who are pregnant with no problems at all. So in fact, weencourage people to have it, because if you have commorit and get copet infection in your pregnant, itcan be far worse. So we've seen that by the way- and so it's the cost benefitof the vaccine versus if you're pregnant and you get sick. How willthat fair for both you and the baby right? So you want to tell a little bitabout what we've actually seen in clinical practice with elations thatare infected some patients who get it and who do not have any significantproblems otherwise tend to whether it...

...pretty well. On the other hand, ifthere are patients- and obviously in my world, there are plenty of patients whohave coobiddies that hypertension they have diabetes, they have very large vmeor a really oves. All of these things can really make the situation far worse,and these women can be quite sick with it, as you know, the general populationand be as well and unfortunately, we've seen a themis or two, and so you knowif you're healthy- and you know no problems, you know you can, we will besick and people. I've heard people say to me: I've never felt as terrible inmy life. It can really get your attention, it's sure is significant,but it's not to the level of where you're in and as it you and your ownaviator. On the other hand, if you have come or busies you certainly can be,and so it's far better to take something that prevents you from havingthis kind of a scenario when you know- and I hope the whole world gets themessage- This is not going to change your DNA. It's not going to change yourtea of your children to come, you're really going to be fine, so thevaccination is important. So let me let me just push a little bit because Ithink the question that also is typically comes at. This point is: Howdo you know right? Because the feeling is this is so new we haven't had enoughtime. You know how do we know that there may not be down the road infertility issues or how do we know that there may not be some other areas, andmaybe we don't so I don't mean to be putting you on the spot, but I thinkthat that's typically one of some of the other things is the fear of thevaccine comes from it's so new. We don't know- and I think there's somemyths around that as well. So just as an overarching thought, we are allstill learning globally about Covin in the long term, effects of Covin, andespecially coved and pregnancy, because pregnant patients were eliminated fromthe vaccine trials. Initially, it there's some trials going on right nowthat include pregnant women, but we pretty much are in a period globally ofsharing data and research as it is occurring, and we now have what a yearunder our belt, with tens of thousands of pregnant women with ovid that werelearning from each other. Some studies have been as many as seventy thousandpatients that have been infected. What are the results of them and what aresome of the things that are happening? You want to address a little bit aboutthe research, so some of the studies that have come out so the collectivelythey started, trying to put together all the pregnant women and whatresearch was available from just patients getting this and theiroutcomes. One study included something like sixty four thousand pregnant womenwho had to Estepona Farvie and in those store, seventy four bits, so you knowwell I I occur. It was not pan and obviously, to like the vaccine reducethe rist for this. In addition of the studies that have also been carried out,looking at multiple hospital over of mule periods of time, all of thepatients were SA symptomatic that had model symptoms. Some had moderatesymptoms, but only have eight percent had severe symptoms and four percentwere put some. These are some of the things that look at en look at what'shappening with code and passion. So that's kind of in the history thatwe've seen so far and while moderate covin infections kind effected, is thesever ones that we hope to prevent and holes Pirot as well. I e Max CutPatterson. Can you talk a minute about transmission? Another question we getTed is, if I'm covin positive, will it transmit to the baby at deliberate yeah,and that was that's great and I'd love to hear that because we are alsocurious about. has there been anything in terms of the vaccine transmittingthrough the plesent to the baby, but...

...yeah like immunity? Continue theimmunity yeah? Well, we know that some some babies have been have testedpositive for coved after delivery, although it's been a small number andto less than one percent yeah. So while it can occur, it's all O, not its mostof Y, not say so. It doesn't seem just to make sure understand, so it doesn'tseem. So if I'm pregnant mother I get coved, it does not seems in very rarecases that the fetus is getting coved as well less than one per cent. So farfrom our studies. So far more right- and I would say to the the secondquestion about children that are born being positivefor coid after the vaccine. I don't think they have actually ever looked atthat per se, but I would think that is pretty unlikely, because you know Idon't. I just don't see that as a situation that hurt you think it'sunlikely that I'm maybe I'm confused, do you think? Is it if I'm a mother andI've been vaccinated? Do you think there is a likelihood that the vaccinehas now transmitted to the Child? No okay? I don't think so. I mean it'sjust same as if you were say, vaccinated against habitate. Okay, itdoesn't translate that you would automatically the child would bechildhood automatically. Have the benefits of your vaccine. I think oneof the other things that's a big question. Mark Tete is, although westarted studying in the past year, what is happening with pregnant women andOvid or vaccine cost versus benefit, we still know, least of all about how longwill immunity last with our vaccines? How long will natural immunity lasts?And how long will you know the the vaccine immunity last, so we just don'tknow that yet. So I think most of the pregnancy and Covin studies that werelooking at right now have to do with complications of pregnancy,transmission of pregnancy. We haven't mentioned it yet. You know transmissionthrough breast milk and those kind of transmission and cost versus benefitstudies, as opposed to how long will this last or will in community, betransmitted across the posent we're just not there yet right, you know, andjust just staying with the immunization topic, while we're talking about this,you know prior to Ovid, I know in the past probably ten years, there's been alot around immunizations and are they good? Are They not good for the childand things of that nature? What is your guy's opinion in terms of immunizationssafety around the whole process, not just with the ovid vaccine, but justvaccines in general? I think we should use vaccines. I understand that thereare people who feel like vaccines have caused an occasional problem, but youknow I do long remember when polio was a real problem and it's almost beeneradicated, because we have been very judicious about giving vaccine for thisand that's very important. And while I really didn't say the vaccination isimportant. I think it's important to vaccinate your children. I think it'simportant to take a blue shot every year and if somebody has reallyexperienced how bad the blue can be prior to on set and coved, not in, Ithink it was in two thousand and eighteen we actually had lost sixtyseven thousand people to the flu because they chose not to be vacatedwhich, to be honest, when you is the beauty of this country, we have thebrine to choose or not choose to do something sure, and I cherish thatfreedom, even though I prefer to it, be vaccinated. Someone chooses not tothat's their choice, but diseases can kill you and the flu can fill you andprior to Ovid, coming along to lose. Sixty seven thousand people, when youcould have had a vaccine is a pretty high number sure well, and I think isthis of my knowledge. There's never been pain. White spread documentednegative from any vaccination like we, you know we never said Jeez. We nevershould have vaccinated everybody for this disase because look at all the badit did right. So I think the data is in...

...the favor of pro vaccine. Smallpox andpolio have almost been completely eradicated because of their youth. Well,we're on vaccines. I did just want to bring up. Not only are we talking aboutgetting the Covin vaccine and recommending it as the you know,professional societies and the C DC and the World Health Organization are allrecommending pregnant women. You know, have the Covin vaccine what if you'vedelivered, but your breast feeding you know, should you now have the vaccineand they're all doing to say they're all recommending the same. You knowthat it's Samin yeah, it's not it's not unsafe for the baby and is not alteringthe baby in any way. It's not passing down to the baby, and so vaccinationfor lack tating women is also you know on the table here great. This has beenfun and so informative and really important for us to get this out. Whatdo you guys? Let's talk a little bit about future? What do you see? What doyou think is coming down the road? I know we talked a little bit about thetechnology and we got blue tooth coming on board and you know all it's reallyadvancing on the technical side. You know I mean I wouldn't be. You know therural communities, I think going back to the we were talking earlier aboutbroad band and things like that. I'm hearing a lot about this star tack thatEel on Musk is behind, and these satellites that are now going aroundthe earth and that they're going to be bringing the access to high speedInternet to a lot of rural communities. So I do think that all of thattechnology is going to continue to be better and continue to accelerate thething. But what are the things? Are you guys seeing an tell a that? You tellthe health and tell a medicine that you have you most excited about you've seena lot of change in eleven years. What's coming, you know, I think the fact thatyou can use it in your on your computer. The fact that the low earth orbitingsatellites for communication are not new. We were were doing it many manyyears ago, and we've actually used them before with us in the early days forreally remote places, but I think the fact that it will be more baby, morecost effect et, will make it east. I was just going to say: Yes, as you said,the equipment went from being. You know forty fifty sandolas now to four to sixthousand dollars, and so I'm the communications is all getting.Everything gets faster and cheaper over time right. I think. For me, one of thethings that is most exciting for me is that we are moving to mobile, APPs andbetter wearables. When you have wearable technology, where we cantransmit things and as we move from Zoom Tella Health to connect itTalaheeti to the end user being to access at where they are, you know whenwe, because everyone doesn't have access to a laptop. I think, if youlook at our our child Barry Ages, if we can't get them on a smart phone, we'renot even going to get him, so I think we're moving in the right direction togo smaller, faster, more affordable and to impact more people that don't haveaccess to services where they live, and I would assume you're seeing more inTelamonian as well right where yea help patient home remote monitoring that wetalked about before for pregnant women was unhurt up two or three years ago.Now, like we mentioned our study in New Mexico and Utah, has done a good jobout there with protocols for women, I mean, I think, one of the things that'sgoing to happen with tellin medicine is instead of coming thirteen times to seeyour atrice and waiting in the waiting room. You'll have some of your nontesting visits right from your home and they'll be totally appropriate and itwill be way faster, more convenient and easier for the provider and the patient.So the more we move to remote the more we move to care at home and asks uswhere we are instead of getting up and going somewhere. I think the better.The impact will be that's great, so as we kind of wrap up here, if some of thelisteners want to get in touch with you folks or learn more about what you dowhat's the best place for them to find out more about you and we'll put thaton the website as well, but would love for you to share a yeah appreciate that,so you can visit our website at w w w dot women's Tellah. Our phone number isfour o four, four, seven, eight three,...

...oh one and seven you can find a lot. Wehave samples, if you want to see like what's one like, can go to a section onour website and see what we do and I'll see some videos of how we do it, andyou know what it kind of looks like it's kind of sometimes hard to wrapyour head around, but so appreciate that opportunity to have people learnmore great. Well, thanks for sharing that and we'll be sure to put that onthe website as well. So if people didn't grab it, they can check out theheroes of health care, podcast and we'll have that when the episode getsput up there. I so appreciate the work you, ladies, are doing. I know formyself personally and my life, it's been a real passion of my wife, shevolunteers at a nick, Yu, pre, coid and love that and we've actually gone on tomission trips to China and worked in orphanage where they were just infants,with challenges of all shapes and Hydrocephalus and that we talked aboutearlier and some of the other things so love having you guys on the shows andlove the work that you're doing it's. So critical, you certainly are some ofthe heroes of health care for sure. Typically, as we close each one ofthese episodes. I always love to ask my my question, which is who's your hero.So if you guys don't mind sharing that with us, we'd love to hear you knowcurrently growing up, there's no right answer who's your hero for you, guysyeah. So we appreciate that chance to give someone to shout out. One of ourheroes is a nonprofit organization. I'm led and started by some parents calledFetal Health Foundation at work is that you can reach them, and you knowparents expect things to be normal and when things go not normal during apregnancy, it can be scary and a big surprise. This organization supports,provides research and provides hope for parents that will get a fetal diagnosisalong the way and it's a group of several high risco be centers acrossthe country that patients can tap into so fetal health foundation. Dot Org isone of our heroes and thanks for letting US high light them for a secondgreat. Well, thanks so much again for joining us. We love having you on theshow, as I say to all of our guests, we're going to stay in touch. We wantto continue to hear. I think it's going to be important down the road that weupdate people as new information becomes available. So we consider youpart of the podcast family and look forward to having you on again in thefuture sounds great. Thank you. So much ted thanks again for being here, you'vebeen listening to heroes of health care for more subscribe to the show in yourfavorite podcast player, or visit us at heroes of health care, podcast com.

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