Heroes of Healthcare
Heroes of Healthcare

Episode · 8 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're listening to heroes of healthcare,the podcast that highlights bold, selfless professionals in the healthcare industry focused on transforminglives in their communities. Let's get into the show. Welcome to the heroesof healthcare podcast. I'm your host, Ted Wayne. Today I'm joined bytwo pioneers in women's tell a health. Tanya Mac and Dr Ann Patterson havebeen trailblazing women's tell a health in maternal fetal medicine before people knew that therewas such a thing as tell a medicine. Tanya MAC is a license our endand as president of women's tell a health for more than ten years,women's health services delivered by tell a medicine in seven southeastern United States that specializein high risk upsettrics, maternal fetal medicine and the group is completed over Tenzerosubspecialty women health encounters. The companies provided their services as far as ways Guatemala, India, Congo and Uzbekistan. Also joining me is Dr Ann Patterson,a board certified physician and her team have been providing maternal fetal medicine expertise foryears. Dr Pattison received her medical training and completed her obgyn residency and MFMfellowship at Emery University. She was based in private practice at Norside Hospital forover twenty years and as a national leader in obstetrical care. Dr Pattison alsohas her master's degree in engineering from Georgia Institute of Technology and has been anearly adopter and cutting edge ultrasound, Emr and tele medicine technologies. Dr Pattersonis also a true rocket scientist and prior to medical school, Dr Patterson wasusing her engineering skills from Georgia tech working at NASA. Dr Patterson has beenfeatured on NPR, The Wall Street Journal Prevention magazine. Most recently, bothTanya and Dr Patterson authored a timely article for connections magazine exploring the covid nineteenvaccine with pregnancies. It's my pleasure to welcome to the heroes of healthcare podcastTanya and Dr Patterson. Welcome. Thank you. We're glad to be here. We're excited to have you guys here and we're talking about the great workyou're doing and I know that there's going to be lots of interest in thisepisode because there's a lot of uncertainty in this area. So before we divein, I would love it if you two could just give our listeners alittle bit of your background, where you come from, how you got intothis crazy world of healthcare that we're in, and a little bit about your groupand your organization. I'll start because mine's quick. I'm Tanya Mac andI'm president of Women's tell a health and I was trained as a nurse andafter two years in pdafric oncology, I kind of went into the business ofhealthcare and never really looked back. So Dr Patterson and I have worked togethernow for what? We won't out ourselves here in exactly one about here,but our specialty that we want to talk about today is women's tell a healthand in particular a subset of that, which is high risk pregnancy care.And in two thousand and eight we sold a business where we had a brickand mortar medical practice that focused on obstetrics, gone ecology and, in particular,high risk OBE care, and Dr Patterson will share her background in aminute. But after we sold that business we were looking for a way towork together again and we blossomed into tell a health, and I'll let hertell the story because she was more closer to it. But the two areaswe'd like to focus on today is to talk about how we got into tella health, the growth of tell a health, which has really sped upin the adoption over this year of the pandemic with covid nineteen. Most peoplesaw it before than as a nice to have or one alternative way if youdidn't really have access, and we've all learned in the past year that it'sbecome a necessity to decrease our risk right. And then the second thing we'd liketo talk about, that Ted, I appreciate you having us on today, for that is pretty timely, is we want to talk about how covidis affecting pregnancy and expectant parents and,...

...as a subset of that, wewant to talk about the covid vaccination and how that's impacting pregnancy and what ourreal life experience has been with that. So let me turn it over toDr Patterson to introduce herself and also tell a little bit about how we gotstarted in the business. So I never planned to be in medicine. Howwas an airspace engineer. I went to Georgia tech and I went to workfor Nassa and while I was there I got involved with a bio medical projectand I actually worked for the man, Dr William Livin, who invented thefirst laser ever used in medicine, and he strongly encouraged me to go backto school and go to medicine, which I resisted for some time, butI ended up coming back to Atlanta going to take getting my masters and mypremed simultaneously and ended up at emery medical school and without question, just fellin love with obstetrics and state in obstetrics. I have a fellowship in field physiologyand maternal field medicine and so obviously both engineering and medicine. As Timyou said, we had a brick and water practice, pretty traditional, andafter we ended that practice I was looking for another way to be able toprovide maternal fietal care in smaller rural areas where patients obviously would either have totravel that they could or not get the kind of care that we could provide. And found telling medicine eleven years ago, long before it was, you know, really well known or even people thought it was a viable option,and so we started a business back in the in early two thousand and tenand never look back. And all we really do is tell the medicine andwe really do provide this in multiple places in multiple states to people who wouldotherwise not be able to have this kind of care. Yeah, I wantedto interject here just a little bit Ted to give you the scope of whatwe're talking about. But anal fetal medicine requires a three year fellowship beyond anobgyn residency. Wow. So, since we operate in multiple states, forexample, in Georgia we probably have somewhere between only forty and fifty doctors forthe entire state that are qualified to care for high risk pregnancy care, andthat would be when the OB gyn does not know what to do, theypunt to the next level specialist, which is what Dr Patterson does. Andother states that we've been in, on New Mexico and widespread in the southeast, they're similar. We have higher specialists, mostly in academic centers and in largemetropolitan areas, but are stimulus for creating telehealth. MATERNAL FETAL CARE wasif you're pregnant with twins in the mountains or in an aurural area where thereisn't metropolitan or a nick, you or anything like this. We saw telemedicine ten years ago, at the very first beginning for our specialty, theuse of Tele Medicine as a way to kind of pipe it into areas thatdid not have access, because how it was before then is if you werepregnant with twins of Jacoa Georgia, you would be hell of act or ambulancedinto Atlanta. And we hope you made it so. This allows us touse telehealth technologies to communicate with the Obgyns in the community. Our business isreferral. We don't have high risk women call us up and want to behigh risk. Certainly they're afraid of these diagnosis and concerns, but we area resource for local obgi ends around the country and it is a way forus to keep the patients in their home communities and get their high risk situationsresolved. And how would you say? And maybe eighty, eighty to ninetypercent of the time they do not need to be transported and we can managethem by scanning their babies, doing audio visual calls and tell a health andkeeping them in their home communities for the duration of the pregnancy. Maybe evenhigher than that, depending on the resources locally. Sometimes as much as ninetyfive percent can be managed like yeah,...

...we were kind of trailblazers here.We actually acted over almost fifty tho high risk OBI visits, one hundred percentby tell a health. Wow, that's amazing. Yeah, I would saymaybe we should change this episode to the pioneers of Healthcare, and so maybeits of healthcare. It's hard to be a trailblazer. Sometime back then nobodypaid for it. Today reimbursement is very well, but when we started,only eight states in the United States paid for what we were doing and Georgiawas one up. Georgia was one wow. Yeah, so love to talk alittle bit more about that, Dr Patterson, and time to tell usa little bit more about so technology is so rapid and eleven years ago,what did tell a health look like? You know, now we live inthe 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 connectivity issues. So I had to work with that. Eleven years ago, ys a it's a complication. So Georgia actually had done something really progressiveabout this under Zell Miller and Oxendine when he was a commissioner of Insurance.They started what was then called the Georgia Partnership for tell a health, nowknown as the Global Partnership for tell a health, and they actually at thatpoint in time, actually had t one lines laid throughout the state and peoplehad really good connectivity throughout Georgia for tell a health. So in tell ahealth they're kind of several things. But first I want to say to realtell a health isn't much, much more than a zoom called for sure.So you have to have a network that is both hip a compliant and secure. You have to have equipment, and equipment back in those days looked likea kind of large older sound machine, was a cart and it caused somewherebetween, depending on who you bought it from, thirty five, forty FIVEZEROdollars. So it was expensive. Yeah, and you had to be, youknow, obviously paid to beyond whatever network you are own. So itcould be quite costly. And the equipment costs have come down significantly since westarted, which is really nice because it makes it much more fordable for practices, clinics, hospitals wherever we are right. So you have those two things andthen you have the provider, and so the Global Partnership for tell ahealth has multiple specialties that use their network and multiple providers throughout Georgia. Butthey're not exclusively in Georgia. There in other areas as well, but theyare one of the platforms that we use. Just to give you an example,Ted when we first started, you know, Dr Patterson mentioned just thecart alone, which they were made for each specialty, and so a cardiologistwould have an ekg machine. We look at babies, we have ultrasound.They were all custom made. They had to have a te one connection pointto point to get them all working and those, both upfront and maintenance costs, probably worth fifty fifty to sixty thousand dollars to start a program fast forwardto today's environment. We can stand up one of these centers. We bypassedthe cart and we can connect through laptops, APPs peripheral devices for probably six totenzero. So in ten years we've stripped away about three fours of thecost of standing these up. So really any doctor's office. We operate indoctors offices, outpatient clinics like departments of community health, and also hospitals thatdon't have high Risko B physicians. But it's gotten to the point that abig plus as technlogies rolled reimbursements come in, is we're now about a fourth ofthe cost that we were when we started ten years ago. But keepingup with technology is definitely one of our strengths and one that we have tokeep up with. The other thing is there are amazing peripherals that people don'trealize, especially when we're talking about this is more than a zoom called.Obviously we can see in what we do...

...real time ultrasound wherever the patient isand that we've scanned patients as far away as Bangladesh, and we can lookat the baby and see what's going on. We can see the heart and allthat just like we were standing right there in the room easing. Theother thing that's amazing is that they have Bluetoo stethoscopes that I can put inmy ears and direct on a screen here. They can see it there and theyput it on the patient and I can hear the maternal heart or thematernal lungs, just like I was standing at bits. I do think onedirection we're headed that we've alluded to Ted that everybody's gotten used to at leastthe idea of telehealth over covid. Right. Some I had, whether it's amedication refill or sure, a follow up visit or whatever, but thosevisits are mostly audio visual, based on any kind of platform, and duringcovid waivers they really don't even need to be. Today, hip a compliantkind of bypass that during this pandemic period. But the next evolution, we think, will be connected tell a health. So, for example, right nowwe have a project in New Mexico where we have a little kit thatwe're sending to pregnant ladies homes up in the mountains that have a Pul sockSimitar of fetoscopes, a doppler so we can hear the baby's heartbeat, ofblood pressure, cough, a scale, all with Bluetooth technology in their homesfor less than two hundred and fifty dollars. Amazing. So we're going to movebeyond just zoom. One of the challenges is, if you're Dr Patterson, you want real data, real clinical data, not just what the patient'sself reporting. So right now we're all zooming with our doctors. But ifI put, you know, a being in my ear and tell you Ihave an ear infection, you can't look at home and see. But soon, with those kits, you will be able to. So we're zooming telehealthtoday, as the majority of patients have experience. But the next version ofwhat we're already doing for all these years as what I call connected tell help, where we have real clinical data to back it up. That's I mean, it's it is unbelievable how fast it goes and it just keeps getting faster. So with the Bluetooth, so with the patient, you're sending all thedifferent meters, the Pul socks and different meters. I won't try to saythe others I'm I'm not clinical and I won't try to be. And thosework through their computers, Bluetooth reception or there. Would it even work withtheir iphone or whatever, depending on what is sand and what platform that theyare own with the institution that is providing this for them. And they aredifferent, different platforms that work a little different. Like say, for instance, if you have a pull sox on your finger and not only tells youhow well you're oxygenating, but it tells you your heart right. HMM.So you know, that's a very easy device that can data can be transmitted. In some work they're moving in the direction of smartphone technology where you havea glucometer that plugs into your smartphone and then those results are just transmitted upto your provider. In some cases your smartphone acts as the platform or anAPP on your smartphone acts as the platform, rather than installing a totally different telemedicineplatform. Yeah, so we're moving in the right direction of making caremobile. where I am with my smartphone. We're heading in that direction. Butyour men, your guy services, though, is it still requires themother to go to a facility? Yes, you're not quite yet, probably doinghome, but that's probably not far behind. So I think it dependson what you are doing. Okay, for instance, wherever the patients areseen initially legally, they have a telehealth presenter there, and that's wise becausemost of these women that come I have some complication or the baby has acomplication, or that we would be seeing them. I mean, there arecertainly occasions when we say everything looks wonderful, you don't need to come back,but they do come to a center...

...where they have where they are ourscand and we have trained altar synographers who do how risk stetric ultrasound. Sothat's how I can see the baby real time. I like to think ofit Ted as there is direct to consumer. Tell a health hm which on theback of our insurance cards. Rather than go to the Er at,you know, ten at night right, we can call and get a lowacuity kind of audio visual zoom experience. But for us we're not direct toconsumer. Were more business to business. So they have to be in aclinical setting. Until women learn to scan their own babies, which probably isn'tgoing to be soon, to get us those high risk pictures, we're stilldependent upon the telehealth presenter in the clinical setting to get us the clinical datawe need to be able to diagnose and treat the patient at this high risklevel. Perfect makes sense. Thanks for clarification. Do you think it willget there? Will it be you know, I can call md live to yourpoint or tell a doc, tell them I got a cold or I'msort throat or whatever it might be, and they can do something and prescribeto it. Do you think it will get there? I think for certaintypes of clinical problems low, like I say, low acuity. You know, I one time had the opportunity to talk to Blue Cross Blue Shield nationallyfor their direct to consumer calls centers that handle all these, you know,zoom calls, and they were telling me that eighty six percent of the timeit's a low acuity thing. I have the flu, I have a restwhich infection. But for us in particular, and maybe like, for example,a cardiologist, you know I'm not going to diagnose your heart problem remotelyover a zoom call. Probably, but the APPS are getting surprisingly innovative andprecise and they're improving all the time. So for some circumstances I think yes, it will get their faster, but for ones that are complex anyway,they subspecialties, I think we're still going to have to have clinicians as theeyes, ears and hands for the patients in a remote setting. What doyou think? Yeah, okay, great show. We've seen how covid andthe pandemic have loosened, as your guys said, a lot of the abilitiesto build, a lot of the abilities to do a lot of the workvia tella and hopefully we're in the beginning of the end of this pandemic andthings will go back. What do you guys see in the tell of world? You think we're going to go back to a lot of those regulations andthose what I would call it tempts? I'll answer that one. It's agood question right now in the industry with the pandemic and we're in a periodof section thirty five waivers, which means we can use any device, wecan cross state lines to provide tell Ahalth, where we had to be licensed wherethe patient sits before. We cannot be on a HIPOC compliant device andPresident Biden has extended the waivers already through December of this year. Some ofthem, we think it will be. Answer to your questions, I thinkit will be a hybrid. I think that some things like pickup hippocompliants willbe reinstated. You know, and we like our privacy. We don't wantour health records out for everyone to see. I think getting back on a HIPPOCcompliant platform will be an example that will be rolled back. Some ofthe reimbursements may be rolled back. You know what we're able to do ona virtual exam with real clinical evidence versus a phone call will be reimburse atdifferent rates, not the same. On the other hand, the access andavailability and some of the payment structures, I think, will continue. Somy opinion is it will be mixed. Will have some regulations rolled back.Already we have one new regulation that's been made permanent and that is the geographicallocation. So it used to be only if you're in a rural area,like for Medicare, for example, are you allowed to be paid for telehealth. That has permanently gone away. You know, we've learned that in Covideven you know, where people are on...

...top of each other are more importantto decrease the risk them the you know, out in the middle of a,you know, farm somewhere. What do you think? Am I thinkit will be a mix. I think definitely more HIPOC compliants 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, you know, have access to whatever you're saying or doing immediately thatyou don't even know who they are. So I think that will roll back. I do think that you will always have more telehealth than you ever didin the past and it will be more accepted and it will be more accepted, not just I don't think patients have ever had a problem. I've hadvery, very I've had like maybe one ever that had a problem with tella health and eleven years. But I think that there were institutions who reallywere had great reservations about using it, that this will always now be apart of their platform. They one other thing I want to add Ted wasa good byproduct of this covid and tell a health intersection has been what youbrought up earlier, and that is that we assume in the United States thatwe all have great broadband coverage. Tell a health can occur by satellite,cellular or broadband. In the US it's mostly broadband and we've made great stridesin now realizing that there are large medical deserts that need to be wired fortell a health, and that process I started with covid funding and stimulus money, and so, where Dr Patterson said before, Georgia was one of theleaders and wiring and network for tell a health early on ten years ago,we now are going to have a better network after covid or tell a health? Yeah, so too. Well, I guess two things. One isshow while some things may slide back, you know, the hippo compliance thingsand terms of the platforms and all. It sounds like, though, youfeel that one of the benefits of a pandemic will be that we have acceleratedtell a medicine, the Tele of work that you guys are doing. Ithas enabled us to move this faster than if we were going under the oldpre pandemic days. Oh Yeah, there were definitely states that did not allowtell a health reimbursement at all, MMM, or licensure restrictions, you know,in licensure, in payment, in clinical processes. We probably have acceleratedtelehealth adoption by several years in the past year of the pandemic. HMM.Well, that's good. It's good to find some of the silver linings atus. It's such a tough for our business, yes, yes, forsuch a tough year that we've gone through. You know, I heard you mention, and I think it might be fun to hear some of the stories, though, that you mentioned about Bangladesh and some of the things tell someof the listeners about some of the far reaching places that you've been able todo and where you've been able to bring care where care normally wouldn't have beenavailable. So there have been a lot of odd places, a riverbedding,Guatemala and Bangladesh, wow. But to me the most important has been inreally small world communities and the rural south where these patients, we really havesome sick lights and they really just couldn't get help. And you're there andyou realize the baby has a major heart defect and you were able to arrangefor the patient to be delivered in a Metropolitan Center so that the baby hasimmediate access to heart surgery is needed. You know, to me those thingsare really great. The Bangladesh story is kind of interesting. The good oneyou should tell. Hey ask me if I would do a demonstration to theMinister of Health about what we could do and I agreed with the caveat thatthe patient that we were scanning live so that they could see that. Youknow, they had an interactive audio visual situation. They had the patient there, but they could see what I was seeing and she obviously it's a predominantlyMuslim country and so she was screened and...

...shielded from from the audience and Iwould say to you that if they were not all of the positions that werethere, I think we're made fan. So my one thing that I saidwas that this lady had to agree and that whoever picked her, please picka normal have her scanned before, and we know that this is a normalbaby, because this was an exercise and a demonstration of how equipment works rightand how what kind of care you could give. This was not a demonstrationand finding a fetal aftermality. So when I came on the screen ahead oftime to talk to the patient and make sure if everything was fine, shelooked like a deer and head light. She's ptrified and I thought, ohmy goodness, they have twisted this woman's arm. And so, of course, you know, I tried to be very under standing of patients and theirsituations and what they go through anyway, and I felt, really felt sorryfor this lady and I tried to be as gentle as I could. Andthen we started the scan and fortunately, and I obviously had to keep astraight face and a steady voice, realize that this child had hydrocephles. HMM, so the baby had in a large ventricles on both sides of the headand I guess before we ever had appropriate medical terms for this, they callthe child waterhead and you know, there was a time, and I doremember, when we didn't didn't notice shunt. And today you can put a shuntin. Children can go up and I know a position who had hydrocephalusand as a shut in place and operates every day. So you can certainlybe perfectly normal. It's a something that can be medically managed easily today,but it does the medical attension and without it there can be some significant consequences. Anyway, this child had large ventricles on both sides of the head andwould definitely need to be delivered in a center where the baby was, youknow, would get immediate attention. Need a shunt and obviously I did notfeel like it was my position in what I was doing to do this.So I insisted at the end of the demonstration that an obstetriction in the audienceto come to talk with me individual and so I was able, and Ithank the lady and asked, you know, for her graciousness and allowing us toshow this to the Minister of Health and the compadres. He had hadcome there. So I talk to the obstetrician and I said, obviously thiswas not the intent here, but baby has hackercephalis bilaterally and obviously she needsto have attention and can you see that she is scanned and risk obstetrician seeher, and he promised me he would. So I mean that it was thebest I could do, but it was not what was intended for.Yeah, but it shows the power in the significance of what you guys doand work and, you know, hopefully she got the care that she mightnot have normally had had, you know, you not done that. So whileshe was probably, as you said, scared and, you know, frightenedby the situation, it certainly was a blessing in disguise. I wasgoing to interject us one more quick story. We have a relationship with the groupcalled the addus group, who works by tell a health and over thirtyeight countries and primarily in sub Saharan Africa, and these are Bush clinics where theymay not have an obstetrician, let alone a high risk obstetrician, andwe are one of the very few in the country groups where they send USpatients like for example, I can think of One lady at about twenty weekscame in. They suspected she had a stroke. She wasn't moving on oneside. They didn't really know what to do in a Bush clinic, butthey get us all the clinical data and then the doctor's kind of log inand direct the care, not directly with the patient, but kind of theidea of directing the clinicians in the clinic with what to do. So eventhough we're oceans away, we still have the ability to provide access in aBush clinic in Africa. Amazing, to help pretty close to real time.Amazing. That's great. Such awesome work you guys are doing. Appreciate it. So let's start talking about if you don't mind, let's talk about covidlet's it's a hot topic. Yeah,...

...where it's a hot topic. Whereare you think? We're tired of it, but it's funny. We don't wantto continue to talk about it and there's so much more to still learn. I think everybody thinks we're kind of we're at the end of it,but I think it's really just the beginning of so much that we've learned comingout of this, especially as it relates to your your world. But solet's talk about it in terms of what did you guys see year ago?It's hard to believe it was a year ago that this was we were nowin full, full gear of attacking this pandemic. And what have you seenover the last year? And then we can segue into a little bit ofthe vaccine and and what are your guys? I know there are listeners are goingto really want to know about it, especially as it relates to pregnancy.But let's let's talk about what you be learned over the last twelve months. Well, we've learned that I think the vaccines are important and both theAmerican college and the society maternal people medicine encourage pregnant women to be vaccinated,because it's far, far better to have a vaccine and prevent this then,you know, get covid it is an RNA vaccine. It is not alive vaccine, so you're not going to get it from it. You're notgoing to have a problem with DNA because it's an RNA vaccine, and sowe really encourage people to get this. I can pause you there. Canyou expect? Can you and your and I know you're not a epidemiologist andyour you know infectious disease, but can you explain that a little bit tothe audience? And I reason why I say that is because I sat ona round table about a week or so ago and it's funny. The oneof the big misconceptions of that RNA technology is people believe that the vaccine isaltering their DNA. We hear that too. Yes, no, it doesn't.It has no, it is not a DNA. It has nothing todo with DNA. And so with the vaccine, what it does is itthat makes it, if you like, the RNA of the virus and thatway, when we have that in our body, our body builds up animmunity. We see if we are then unfortunate enough to be exposed, wehave an immunity that prevents it and it has nothing to do with our DNA. Or DNA isn't altered at all, but it does react against the RNAin the vaccine. So in Layman's terms, my terms, it gives the bodya picture of what the virus kind of looks like and says, ifyou see this again, go get it. This isn't good. Right, Imean again and and it's simplest terms, but we're not altering anything genetically inus at all. We're just beinally giving our bodies a picture of thisis what this is the bad stuff, and if it comes in here andyou see it, go attack it and and my layman's terms, is thatcorrect? I think that's a right. So My shock, besides, theDNA said another thing that we hear as a concern of patients as if Iget the vaccine, will it affect my future fertility? Not only my ownpersonal DNA, but if I get the vaccine, will I be able toget pregnant again and not have a problem? You want to address that room andin the answer is, it doesn't affect this at all. It doesn'taffected fertility, it doesn't affect your ability to conceive. So early on,when the vaccine was first being assessed, there were people who got the vaccinewho didn't realize they were pregnant and there were no untoward events in the outsprayingthat we're delivered, and subsequently there have been far more people who've been vaccinatedwho are pregnant with no problems at all. So in fact we encourage people tohave it because if you have comorbidities and get covid infection and your pregnant, it can be far worse. So what we've seen that, by theway, and so it's the cost benefit of the vaccine versus if you're pregnantand you get sick, how will that fare for both you and the baby? Right? So you want to tell a little bit about what we've actuallyseen in clinical practice with Oh allations that are infected. Some patients who getit and who do not have any significant problems otherwise tend to whether it prettywell. On the other hand, if...

...there are patients, and obviously inmy world are plenty of patients who have corbidities, that hypertension, they havediabetes, they have very large Dmi or really obeys, all these things canreally make the situation far worse and these women can be quite sick with it. As you know, the general population and be as well, and unfortunatelywe've seen the eyes or two. And so you know, if you're healthyand you know no problems, you know you you could, we will besick and people. I've heard people say to me I've never felt this terriblein my life. It can really get your attention it's sure it's significant,but it's not to the level of where you're in an I see you andyour own avaient layer. On the other hand, if you have come orabilities, you certainly can be and so it's far better to take something thatprevents you from having this kind of scenario when you know, and I hopethe whole world gets the message, this is not going to change your DNA. It's not going to change your DNA of your children become you're really goingto be fine. So vaccination is important. So let me let me just pusha little bit, because I think the question that also is typically comesat this point is how do you know right, because the feeling is thisis so new, we haven't had enough time. You know. How dowe know that there may not be down the road, infertility issues, orhow do we know that there may not be some other areas? And maybewe don't. So I don't mean to be putting on the spot, butI think that that's typically one of some of the other things is the fearof the vaccine comes from. It's so new, we don't know, andI think there's some myths around that as well. So just as an overarchingthought. We are all still learning globally about covid in the long term,effects of covid and especially covid and pregnancy, because pregnant patients were eliminated from thevaccine trials initially. There's some trials going on right now that include pregnantwomen, but we pretty much are in a period globally of sharing data andresearch as it is occurring and we now have what a year under our beltwith tens of thousands of pregnant women with covid that we're learning from each other. Some studies have been as many as seventyzero patients that have been infected.What are the results of them and what are some of the things that arehappening? Do you want to address a little bit about the research? Sosome of the studies that have come out so the collectively they started trying toput together all the pregnant women and what research was available from just patients gettingthis and their outcomes. One study included something like sixty four thousand pregnant womenwho had tested positively for further and in those that were seventy four this.So while it would occur, it was not calm and obviously we can lockthe vaccine that reduce the realsk for this. In addition, of the studies thathave also been carried out, looking at multiple hospitals over a muwful periodof time, all from the patients were, say, symptomatic, that had mildsymptoms, some had moderate symptoms, but only eight percent had severe symptomsand four percent were political. So these are some of the things that welook at when we look at what's happening with coded and the patients. Sothat's kind of been the history that we've seen so far. And while moderatecodd infections and affects the severe ones that we hope to prevent and hope toprevent the spread as well. I'm seen the vaccine. Dr Patterson, canyou talk a minute about transmission? Another question we get Ted is if I'mcovid positive, will it transmit to the baby at delivery? Yeah, andthat was it. That's great and I'd love to hear that because we're alsocurious about as there been anything in terms of the vaccine transmitting through the placentthat to the baby. But yet like...

...immunity, continued immunity? Yeah,well, we do that. Some some babies have been have tested positive forcovid after delivery, although it's been a small number and so less than onepercent. Yeah, so while it can occur, it's often not. It'smost aty not see. So it doesn't seem just to make sure I understand. So it doesn't seem. So if I'm I'm pregnant mother, I getCovid, it does not seems in very rare cases that the fetus is gettingcovid as well. Less than one percent so far from our studies. Sofar. Sure, all right. And I would say to the second questionabout children that are born being positive for covid after the vaccine, I don'tthink they have actually ever looked at that per se. Okay, I wouldthink that is pretty unlikely because, you know, I don't. I justdon't see that as a situation. And her you think it's unlikely that I'mmaybe I'm confused. You do you think is it if I'm a mother andI've been vaccinated, do you think there is a likelihood that the vaccine hasnow transmitted to the Child? Know, okay, I don't think so.I mean it's the same as if you were, say, vaccinated against hepatitis. Okay, it doesn't translate that you would automatically the child would be childautomatically have the benefits of your vaccine. I think one of the other thingsthat's a big question Mark Ted is, although we've started studying in the pastyear what is happening with pregnant women and Covid or vaccine cost versus benefit,we still know, least of all about how long will immunity last with ourvaccines? How long will natural immunity last and how long will you know thethe vaccine immunity last? So we just don't know that yet. So Ithink most of the pregnancy and covid studies that were looking at right now haveto do with complications of pregnancy, transmission of pregnancy. We haven't mentioned ityet, you know, transmission through breast milk and those kind of transmission andcost versus benefit studies, as opposed to how long will this last or willimmunity be transmitted across the Placenta? We're just not there yet right you know. And just just staying with the immunization topic while we're talking about this,you know, prior to Covid, I know in the past probably ten yearshas been a lot around immunizations and are they good? Are They not goodfor the child, and things of that nature. What is your guy's opinionin terms of immunizations, safety around the whole process, not just with thecovid vaccine, but just vaccines in general? I think we should use vaccines.I understand that there are people who feel like vaccines have caused an occasionalproblem, but you know, I do long remember when polio was a realproblem and it's almost been eradicated because we have been very judicious about giving vaccinefor this and that's very important. And while I really don't think that vaccinationis important, I think it's important to vaccinate your children. I think it'simportant to take a flu shot every year and if somebody is really experienced howbad the blue can be prior to ownset of covid not in I think itwas in two thousand and eighteen, we actually had lost sixty seven thousand peopleto the flu because they chose not to be back thing which, to behonest with you, is the beauty of this country. We have the rightto choose or not choose to do something, sure, and I cherish that freedom, even though I prefer to be vaccinated. Someone choose. It's notto that's their choice, but diseases can kill you and the flu can killyou and prior to covid coming along, to lose sixty seven thousand people whenyou could have had a vaccine is a pretty high number. Sure. Well, and I think is best of my knowledge, there's never been a widespreaddocumented negative from any vaccination like we, you know, we've never said,Geez, we never should have vaccinated everybody for this disease because look at allthe bad it did. Right. So...

I think the data is in thefavor of pro vaccine. Smallpox and poleio have almost been completely eradicated because oftheir use. While we're on vaccines, I did just want to bring upnot only are we talking about getting the COVID vaccine or recommending it as theyou know, professional societies and the CDC and the World Health Organization are allrecommending pregnant women, you know, have the covid vaccine. What if you'vedelivered but your breastteating, you know, should you now have the vaccine?And they're all doing the same. They're all recommending the same. You knowthat it's safe. Yeah, it's not. It's not unsaved for the baby andis not altering the baby in any way, if that passing down throughthe baby. And so vaccination for lactating women is also, you know,on the table here. Great, this has been fun and so formative andreally important for us to get this out. What do you guys? Let's talka little bit about future. What do you see? What do youthink is coming down the road? I know we talked a little bit aboutthe technology and we got Bluetooth coming on board and you know, all it'sreally advancing on the technical side. You know. I mean, I wouldn'tbe. You know, the rural communities. I think, going back to thewe were talking earlier about broadband and things like that and hearing a lotabout this startak that Elon musk is behind and these satellites that are now goingaround the the earth and that they're going to be bringing the access to highspeed Internet to a lot of rural communities. So I do think that all ofthat technology is going to continue to be better and continue to accelerate thething. But what are the things are you guys seeing? And Tella thatyou tell a health and tell a medicine that you have you most excited about. You've seen a lot change in eleven years. What's coming, you know, I think the fact that you can use it your own your computer,the fact that low earth orbiting satellites for communication are not new. We werewe were doing it many, many years ago and we've actually used them beforewith us in the early days for really remote places. But I think thefact that it will be more baby, more cost effective will make it these. I was just going to say, yeah, as you said, theequipment went from being, you know, forty fifty thousand dollars now to fourto six thousand dollars, and so I'm the communications is all getting everything getsfaster and cheaper over time. Right. I think for me, one ofthe things that is most exciting for me is that we are moving to mobileacts and better wearables. We now have wearable technology where we can transmit thingsand as we move from zoom tell a health to connect to tell a health, will move to the end user being to access it where they are.You know, when we because everyone doesn't have access to a laptop. Ithink if you look at our our childbearing age, if we can't get themon a smartphone, we're not even going to get them. So I thinkwe're moving in the right direction to go smaller, faster, more affordable andto impact more people that don't have access to services where they live. AndI would assume you're seeing more intell a monitoring as well. Right where now? How patient home promote monitoring that we talked about before for pregnant women wasunheard up two or three years ago now. Like we mentioned our study in NewMexico and Utah has done a good job out there with protocols for women. I mean, I think one of the things that's going to happen withtell the medicine is instead of coming thirteen times to see your odetrition and waitingin the waiting room, you'll have some of your non testing visits right fromyour home and they'll be totally appro Britain. It will be way faster, moreconvenient and easier for the provider and the patient. So the more wemove to remote the more we move to care at home and access where weare instead of getting up and going somewhere, I think the better the impact willbe. That's great show. As we kind of wrap up here,if some of the listeners want to get in touch with you folks or learnmore about what you do. What's the best place for them to find outmore about you? And we'll put that on the website as well, butwe'd love for you to share that. Yeah, appreciate that. So youcan visit our website at www dot women's tell a healthcom. Our phone numberis four hundred and four seven eight,...

...three hundred and one seven. Youcan find a lot. We have samples. If you want to see, likewhat's one like? Can Go to a sectional on our website and seewhat we do and see some videos of how we do it and you knowwhat it kind of looks like. It's kind of sometimes hard to wrap yourhead around, but so appreciate that opportunity to have people learn work. Great. Well, thanks for sharing that. Will be sure to put that onthe website as well. So if people didn't grab it, they can checkout the heroes of healthcare podcastcom and we'll have that when the episode gets putup there. I so appreciate the work you ladies are doing. I knowfor myself personally in my life it's been a real passion of my wife.She volunteers at a nick. You, Pre Covid, and love that andwe've actually gone onto mission trips to China and worked in orphanage where they werejust infants with challenges of all shapes and hide your cephalitis and that we talkedabout earlier and some of the other things. So loved having you guys on theshow and love the work that you're doing. It's so critical. Youcertainly are some of the heroes of healthcare, for sure. Typically, as weclose each one of these episodes, I always love to ask my myquestion, which is who is your hero? So so if you guys will mindsharing that with us, we'd love to hear you know, currently growingup. There's no right answer. Who is your hero for you guys?Yeah, so we appreciate that chance to give someone a shout out. Oneof our heroes is a nonprofit organization I'm led and started by some parents,called Fetal Health Foundation Dot Org. Is that you can reach them and youknow, parents expect things to be normal and when things go not normal duringa pregnancy it can be scary and a big surprise. This organization supports providesresearch and provides hope for parents that will get a fetal diagnosis along the wayand it's a group of several high risko be centers across the country that patientscan tap into. So Fetal Health Foundation Dot Org is one of our heroes, and thanks for letting US highlight them for a second. Great well,thanks so much again for joining us. We loved having you on the show. As I say to all of our guests, we're going to stay intouch. We want to continue to hear I think it's going to be importantdown the road that we update people as new information becomes available. So weconsider you part of the podcast family and look forward to having you on againin the future. Sounds Great. Thank you so much, Ted. Thanksagain for being here. You've been listening to heroes of healthcare for more subscribeto the show in your favorite podcast player or visit us at heroes of healthcarepodcastcom.

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