Heroes of Healthcare
Heroes of Healthcare

Episode · 1 year 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 transforming lives in their communities. Let's get into the show. Welcome to the heroes of healthcare podcast. I'm your host, Ted Wayne. Today I'm joined by two pioneers in women's tell a health. Tanya Mac and Dr Ann Patterson have been trailblazing women's tell a health in maternal fetal medicine before people knew that there was such a thing as tell a medicine. Tanya MAC is a license our end and 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 specialize in high risk upsettrics, maternal fetal medicine and the group is completed over Tenzero subspecialty 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 for years. Dr Pattison received her medical training and completed her obgyn residency and MFM fellowship at Emery University. She was based in private practice at Norside Hospital for over twenty years and as a national leader in obstetrical care. Dr Pattison also has her master's degree in engineering from Georgia Institute of Technology and has been an early adopter and cutting edge ultrasound, Emr and tele medicine technologies. Dr Patterson is also a true rocket scientist and prior to medical school, Dr Patterson was using her engineering skills from Georgia tech working at NASA. Dr Patterson has been featured on NPR, The Wall Street Journal Prevention magazine. Most recently, both Tanya and Dr Patterson authored a timely article for connections magazine exploring the covid nineteen vaccine with pregnancies. It's my pleasure to welcome to the heroes of healthcare podcast Tanya 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 work you're doing and I know that there's going to be lots of interest in this episode because there's a lot of uncertainty in this area. So before we dive in, I would love it if you two could just give our listeners a little bit of your background, where you come from, how you got into this crazy world of healthcare that we're in, and a little bit about your group and your organization. I'll start because mine's quick. I'm Tanya Mac and I'm president of Women's tell a health and I was trained as a nurse and after two years in pdafric oncology, I kind of went into the business of healthcare and never really looked back. So Dr Patterson and I have worked together now 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 health and 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 brick and mortar medical practice that focused on obstetrics, gone ecology and, in particular, high risk OBE care, and Dr Patterson will share her background in a minute. But after we sold that business we were looking for a way to work together again and we blossomed into tell a health, and I'll let her tell the story because she was more closer to it. But the two areas we'd like to focus on today is to talk about how we got into tell a health, the growth of tell a health, which has really sped up in the adoption over this year of the pandemic with covid nineteen. Most people saw it before than as a nice to have or one alternative way if you didn't really have access, and we've all learned in the past year that it's become a necessity to decrease our risk right. And then the second thing we'd like to talk about, that Ted, I appreciate you having us on today, for that is pretty timely, is we want to talk about how covid is affecting pregnancy and expectant parents and,...

...as a subset of that, we want to talk about the covid vaccination and how that's impacting pregnancy and what our real life experience has been with that. So let me turn it over to Dr Patterson to introduce herself and also tell a little bit about how we got started in the business. So I never planned to be in medicine. How was an airspace engineer. I went to Georgia tech and I went to work for Nassa and while I was there I got involved with a bio medical project and I actually worked for the man, Dr William Livin, who invented the first laser ever used in medicine, and he strongly encouraged me to go back to school and go to medicine, which I resisted for some time, but I ended up coming back to Atlanta going to take getting my masters and my premed simultaneously and ended up at emery medical school and without question, just fell in love with obstetrics and state in obstetrics. I have a fellowship in field physiology and maternal field medicine and so obviously both engineering and medicine. As Tim you said, we had a brick and water practice, pretty traditional, and after we ended that practice I was looking for another way to be able to provide maternal fietal care in smaller rural areas where patients obviously would either have to travel 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 ten and never look back. And all we really do is tell the medicine and we really do provide this in multiple places in multiple states to people who would otherwise not be able to have this kind of care. Yeah, I wanted to interject here just a little bit Ted to give you the scope of what we're talking about. But anal fetal medicine requires a three year fellowship beyond an obgyn residency. Wow. So, since we operate in multiple states, for example, in Georgia we probably have somewhere between only forty and fifty doctors for the entire state that are qualified to care for high risk pregnancy care, and that would be when the OB gyn does not know what to do, they punt to the next level specialist, which is what Dr Patterson does. And other 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 large metropolitan areas, but are stimulus for creating telehealth. MATERNAL FETAL CARE was if you're pregnant with twins in the mountains or in an aurural area where there isn't metropolitan or a nick, you or anything like this. We saw tele medicine ten years ago, at the very first beginning for our specialty, the use of Tele Medicine as a way to kind of pipe it into areas that did not have access, because how it was before then is if you were pregnant with twins of Jacoa Georgia, you would be hell of act or ambulanced into Atlanta. And we hope you made it so. This allows us to use telehealth technologies to communicate with the Obgyns in the community. Our business is referral. We don't have high risk women call us up and want to be high risk. Certainly they're afraid of these diagnosis and concerns, but we are a resource for local obgi ends around the country and it is a way for us to keep the patients in their home communities and get their high risk situations resolved. And how would you say? And maybe eighty, eighty to ninety percent of the time they do not need to be transported and we can manage them by scanning their babies, doing audio visual calls and tell a health and keeping them in their home communities for the duration of the pregnancy. Maybe even higher than that, depending on the resources locally. Sometimes as much as ninety five 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 percent by tell a health. Wow, that's amazing. Yeah, I would say maybe we should change this episode to the pioneers of Healthcare, and so maybe its of healthcare. It's hard to be a trailblazer. Sometime back then nobody paid 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 Georgia was one up. Georgia was one wow. Yeah, so love to talk a little bit more about that, Dr Patterson, and time to tell us a 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 in the world of zoom and teams and every laptop has a camera on it and all those sorts of things. I'm sure that's not quite how it looked about eleven years ago. And the other thing too, is rural communities today even have 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 progressive about 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, now known as the Global Partnership for tell a health, and they actually at that point in time, actually had t one lines laid throughout the state and people had really good connectivity throughout Georgia for tell a health. So in tell a health they're kind of several things. But first I want to say to real tell 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 like a kind of large older sound machine, was a cart and it caused somewhere between, depending on who you bought it from, thirty five, forty FIVEZERO dollars. So it was expensive. Yeah, and you had to be, you know, obviously paid to beyond whatever network you are own. So it could be quite costly. And the equipment costs have come down significantly since we started, 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 and then you have the provider, and so the Global Partnership for tell a health has multiple specialties that use their network and multiple providers throughout Georgia. But they're not exclusively in Georgia. There 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 Patterson mentioned just the cart alone, which they were made for each specialty, and so a cardiologist would have an ekg machine. We look at babies, we have ultrasound. They were all custom made. They had to have a te one connection point to 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 forward to today's environment. We can stand up one of these centers. We bypassed the cart and we can connect through laptops, APPs peripheral devices for probably six to tenzero. So in ten years we've stripped away about three fours of the cost of standing these up. So really any doctor's office. We operate in doctors offices, outpatient clinics like departments of community health, and also hospitals that don't have high Risko B physicians. But it's gotten to the point that a big plus as technlogies rolled reimbursements come in, is we're now about a fourth of the cost that we were when we started ten years ago. But keeping up with technology is definitely one of our strengths and one that we have to keep up with. The other thing is there are amazing peripherals that people don't realize, 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 is and that we've scanned patients as far away as Bangladesh, and we can look at the baby and see what's going on. We can see the heart and all that just like we were standing right there in the room easing. The other thing that's amazing is that they have Bluetoo stethoscopes that I can put in my ears and direct on a screen here. They can see it there and they put it on the patient and I can hear the maternal heart or the maternal lungs, just like I was standing at bits. I do think one direction we're headed that we've alluded to Ted that everybody's gotten used to at least the idea of telehealth over covid. Right. Some I had, whether it's a medication refill or sure, a follow up visit or whatever, but those visits are mostly audio visual, based on any kind of platform, and during covid waivers they really don't even need to be. Today, hip a compliant kind of bypass that during this pandemic period. But the next evolution, we think, will be connected tell a health. So, for example, right now we have a project in New Mexico where we have a little kit that we're sending to pregnant ladies homes up in the mountains that have a Pul sock Simitar of fetoscopes, a doppler so we can hear the baby's heartbeat, of blood pressure, cough, a scale, all with Bluetooth technology 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 Dr Patterson, you want real data, real clinical data, not just what the patient's self reporting. So right now we're all zooming with our doctors. But if I put, you know, a being in my ear and tell you I have 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 telehealth today, as the majority of patients have experience. But the next version of what 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 the different meters, the Pul socks and different meters. I won't try to say the others I'm I'm not clinical and I won't try to be. And those work through their computers, Bluetooth reception or there. Would it even work with their iphone or whatever, depending on what is sand and what platform that they are own with the institution that is providing this for them. And they are different, different platforms that work a little different. Like say, for instance, if you have a pull sox on your finger and not only tells you how 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 have a glucometer that plugs into your smartphone and then those results are just transmitted up to your provider. In some cases your smartphone acts as the platform or an APP on your smartphone acts as the platform, rather than installing a totally different telemedicine platform. Yeah, so we're moving in the right direction of making care mobile. where I am with my smartphone. We're heading in that direction. But your men, your guy services, though, is it still requires the mother to go to a facility? Yes, you're not quite yet, probably doing home, but that's probably not far behind. So I think it depends on what you are doing. Okay, for instance, wherever the patients are seen initially legally, they have a telehealth presenter there, and that's wise because most of these women that come I have some complication or the baby has a complication, or that we would be seeing them. I mean, there are certainly 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 our scand and we have trained altar synographers who do how risk stetric ultrasound. So that's how I can see the baby real time. I like to think of it Ted as there is direct to consumer. Tell a health hm which on the back of our insurance cards. Rather than go to the Er at, you know, ten at night right, we can call and get a low acuity kind of audio visual zoom experience. But for us we're not direct to consumer. Were more business to business. So they have 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 high risk pictures, we're still dependent upon the telehealth presenter in the clinical setting to get us the clinical data we need to be able to diagnose and treat the patient at this high risk level. Perfect makes sense. Thanks for clarification. Do you think it will get there? Will it be you know, I can call md live to your point or tell a doc, tell them I got a cold or I'm sort throat or whatever it might be, and they can do something and prescribe to it. Do you think it will get there? I think for certain types of clinical problems low, like I say, low acuity. You know, I one time had the opportunity to talk to Blue Cross Blue Shield nationally for 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 time it's a low acuity thing. I have the flu, I have a rest which infection. But for us in particular, and maybe like, for example, a cardiologist, 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 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 the eyes, ears and hands for the patients in a remote setting. What do you think? Yeah, okay, great show. We've seen how covid and the pandemic have loosened, as your guys said, a lot of the abilities to build, a lot of the abilities to do a lot of the work via tella 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 tell of world? You think we're going to go back to a lot of those regulations and those what I would call it tempts? I'll answer that one. It's a good question right now in the industry with the pandemic and we're in a period of section thirty five waivers, which means we can use any device, we can cross state lines to provide tell Ahalth, where we had to be licensed where the patient sits before. We cannot be on a HIPOC compliant device and President Biden has extended the waivers already through December of this year. Some of them, we think it will be. Answer to your questions, I think it will be a hybrid. I think that some things like pickup hippocompliants will be reinstated. You know, and we like our privacy. We don't want our health records out for everyone to see. I think getting back on a HIPPOC compliant platform will be an example that will be rolled back. Some of the reimbursements may be rolled back. You know what we're able to do on a virtual exam with real clinical evidence versus a phone call will be reimburse at different rates, not the same. On the other hand, the access and availability and some of the payment structures, I think, will continue. So my 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 geographical location. 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 Covid even you know, where people are on...

...top of each other are more important to decrease the risk them the you know, out in the middle of a, you know, farm somewhere. What do you think? Am I think it 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 health records just running around the world and, you know, people being able to, you know, have access to whatever you're saying or doing immediately that you 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 did in 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 had very, very I've had like maybe one ever that had a problem with tell a health and eleven years. But I think that there were institutions who really were had great reservations about using it, that this will always now be a part of their platform. They one other thing I want to add Ted was a good byproduct of this covid and tell a health intersection has been what you brought up earlier, and that is that we assume in the United States that we 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 strides in now realizing that there are large medical deserts that need to be wired for tell a health, and that process I started with covid funding and stimulus money, and so, where Dr Patterson said before, Georgia was one of the leaders 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 is show while some things may slide back, you know, the hippo compliance things and terms of the platforms and all. It sounds like, though, you feel that one of the benefits of a pandemic will be that we have accelerated tell a medicine, the Tele of work that you guys are doing. It has enabled us to move this faster than if we were going under the old pre pandemic days. Oh Yeah, there were definitely states that did not allow tell a health reimbursement at all, MMM, or licensure restrictions, you know, in licensure, in payment, in clinical processes. We probably have accelerated telehealth 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 at us. It's such a tough for our business, yes, yes, for such 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 some of the listeners about some of the far reaching places that you've been able to do and where you've been able to bring care where care normally wouldn't have been available. So there have been a lot of odd places, a riverbedding, Guatemala and Bangladesh, wow. But to me the most important has been in really small world communities and the rural south where these patients, we really have some sick lights and they really just couldn't get help. And you're there and you realize the baby has a major heart defect and you were able to arrange for the patient to be delivered in a Metropolitan Center so that the baby has immediate access to heart surgery is needed. You know, to me those things are really great. The Bangladesh story is kind of interesting. The good one you should tell. Hey ask me if I would do a demonstration to the Minister of Health about what we could do and I agreed with the caveat that the patient that we were scanning live so that they could see that. You know, 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 predominantly Muslim country and so she was screened and...

...shielded from from the audience and I would say to you that if they were not all of the positions that were there, I think we're made fan. So my one thing that I said was that this lady had to agree and that whoever picked her, please pick a normal have her scanned before, and we know that this is a normal baby, because this was an exercise and a demonstration of how equipment works right and how what kind of care you could give. This was not a demonstration and finding a fetal aftermality. So when I came on the screen ahead of time to talk to the patient and make sure if everything was fine, she looked like a deer and head light. She's ptrified and I thought, oh my goodness, they have twisted this woman's arm. And so, of course, you know, I tried to be very under standing of patients and their situations and what they go through anyway, and I felt, really felt sorry for this lady and I tried to be as gentle as I could. And then we started the scan and fortunately, and I obviously had to keep a straight 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 head and I guess before we ever had appropriate medical terms for this, they call the child waterhead and you know, there was a time, and I do remember, when we didn't didn't notice shunt. And today you can put a shunt in. Children can go up and I know a position who had hydrocephalus and as a shut in place and operates every day. So you can certainly be 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 and would definitely need to be delivered in a center where the baby was, you know, would get immediate attention. Need a shunt and obviously I did not feel 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 audience to come to talk with me individual and so I was able, and I thank the lady and asked, you know, for her graciousness and allowing us to show this to the Minister of Health and the compadres. He had had come there. So I talk to the obstetrician and I said, obviously this was not the intent here, but baby has hackercephalis bilaterally and obviously she needs to have attention and can you see that she is scanned and risk obstetrician see her, and he promised me he would. So I mean that it was the best I could do, but it was not what was intended for. Yeah, but it shows the power in the significance of what you guys do and work and, you know, hopefully she got the care that she might not have normally had had, you know, you not done that. So while she was 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 more quick story. We have a relationship with the group called the addus group, who works by tell a health and over thirty eight countries and primarily in sub Saharan Africa, and these are Bush clinics where they may not have an obstetrician, let alone a high risk obstetrician, and we are one of the very few in the country groups where they send US patients like for example, I can think of One lady at about twenty weeks came in. They suspected she had a stroke. She wasn't moving on one side. They didn't really know what to do in a Bush clinic, but they get us all the clinical data and then the doctor's kind of log in and direct the care, not directly with the patient, but kind of the idea of directing the clinicians in the clinic with what to do. So even though we're oceans away, we still have the ability to provide access in a Bush 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 covid let's it's a hot topic. Yeah,...

...where it's a hot topic. Where are you think? We're tired of it, but it's funny. We don't want to 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 coming out of this, especially as it relates to your your world. But so let'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 now in full, full gear of attacking this pandemic. And what have you seen over the last year? And then we can segue into a little bit of the vaccine and and what are your guys? I know there are listeners are going to 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 the American 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 a live vaccine, so you're not going to get it from it. You're not going to have a problem with DNA because it's an RNA vaccine, and so we really encourage people to get this. I can pause you there. Can you expect? Can you and your and I know you're not a epidemiologist and your you know infectious disease, but can you explain that a little bit to the audience? And I reason why I say that is because I sat on a round table about a week or so ago and it's funny. The one of the big misconceptions of that RNA technology is people believe that the vaccine is altering their DNA. We hear that too. Yes, no, it doesn't. It has no, it is not a DNA. It has nothing to do with DNA. And so with the vaccine, what it does is it that makes it, if you like, the RNA of the virus and that way, when we have that in our body, our body builds up an immunity. We see if we are then unfortunate enough to be exposed, we have 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 RNA in the vaccine. So in Layman's terms, my terms, it gives the body a picture of what the virus kind of looks like and says, if you see this again, go get it. This isn't good. Right, I mean again and and it's simplest terms, but we're not altering anything genetically in us at all. We're just beinally giving our bodies a picture of this is what this is the bad stuff, and if it comes in here and you see it, go attack it and and my layman's terms, is that correct? I think that's a right. So My shock, besides, the DNA said another thing that we hear as a concern of patients as if I get the vaccine, will it affect my future fertility? Not only my own personal DNA, but if I get the vaccine, will I be able to get pregnant again and not have a problem? You want to address that room and in the answer is, it doesn't affect this at all. It doesn't affected 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 vaccine who didn't realize they were pregnant and there were no untoward events in the outspraying that we're delivered, and subsequently there have been far more people who've been vaccinated who are pregnant with no problems at all. So in fact we encourage people to have 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 the way, and so it's the cost benefit of the vaccine versus if you're pregnant and 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 actually seen in clinical practice with Oh allations that are infected. Some patients who get it and who do not have any significant problems otherwise tend to whether it pretty well. On the other hand, if...

...there are patients, and obviously in my world are plenty of patients who have corbidities, that hypertension, they have diabetes, they have very large Dmi or really obeys, all these things can really 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 unfortunately we've seen the eyes or two. And so you know, if you're healthy and you know no problems, you know you you could, we will be sick and people. I've heard people say to me I've never felt this terrible in 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 and your own avaient layer. On the other hand, if you have come or abilities, you certainly can be and so it's far better to take something that prevents you from having this kind of scenario when you know, and I hope the 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 going to be fine. So vaccination is important. So let me let me just push a little bit, because I think the question that also is typically comes at this point is how do you know right, because the feeling is this is so new, we haven't had enough time. 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? And maybe we don't. So I don't mean to be putting on the spot, but I think that that's typically one of some of the other things is the fear of the vaccine comes from. It's so new, we don't know, and I think there's some myths around that as well. So just as an overarching thought. 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 the vaccine trials initially. There's some trials going on right now that include pregnant women, but we pretty much are in a period globally of sharing data and research as it is occurring and we now have what a year under our belt with 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 are happening? Do you want to address a little bit about the research? So some of the studies that have come out so the collectively they started trying to put together all the pregnant women and what research was available from just patients getting this and their outcomes. One study included something like sixty four thousand pregnant women who 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 lock the vaccine that reduce the realsk for this. In addition, of the studies that have also been carried out, looking at multiple hospitals over a muwful period of time, all from the patients were, say, symptomatic, that had mild symptoms, some had moderate symptoms, but only eight percent had severe symptoms and four percent were political. So these are some of the things that we look at when we look at what's happening with coded and the patients. So that's kind of been the history that we've seen so far. And while moderate codd infections and affects the severe ones that we hope to prevent and hope to prevent the spread as well. I'm seen the vaccine. Dr Patterson, can you talk a minute about transmission? Another question we get Ted is if I'm covid positive, will it transmit to the baby at delivery? Yeah, and that was it. That's great and I'd love to hear that because we're also curious about as there been anything in terms of the vaccine transmitting through the placent that to the baby. But yet like...

...immunity, continued immunity? Yeah, well, we do that. Some some babies have been have tested positive for covid after delivery, although it's been a small number and so less than one percent. Yeah, so while it can occur, it's often not. It's most 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 get Covid, it does not seems in very rare cases that the fetus is getting covid as well. Less than one percent so far from our studies. So far. Sure, all right. And I would say to the second question about children that are born being positive for covid after the vaccine, I don't think they have actually ever looked at that per se. Okay, I would think that is pretty unlikely because, you know, I don't. I just don't see that as a situation. And her you think it's unlikely that I'm maybe I'm confused. You do you think is it if I'm a mother and I've been vaccinated, do you think there is a likelihood that the vaccine has now 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 child automatically have the benefits of your vaccine. I think one of the other things that's a big question Mark Ted is, although we've started studying in the past year 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 our vaccines? How long will natural immunity last and how long will you know the the vaccine immunity last? So we just don't know that yet. So I think most of the pregnancy and covid studies that were looking at right now have to do with complications of pregnancy, transmission of pregnancy. We haven't mentioned it yet, you know, transmission through breast milk and those kind of transmission and cost versus benefit studies, as opposed to how long will this last or will immunity 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 years has been a lot around immunizations and are they good? Are They not good for the child, and things of that nature. What is your guy's opinion in terms of immunizations, safety around the whole process, not just with the covid 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 occasional problem, but you know, I do long remember when polio was a real problem and it's almost been eradicated because we have been very judicious about giving vaccine for this and that's very important. And while I really don't think that vaccination is important, I think it's important to vaccinate your children. I think it's important to take a flu shot every year and if somebody is really experienced how bad the blue can be prior to ownset of covid not in I think it was in two thousand and eighteen, we actually had lost sixty seven thousand people to the flu because they chose not to be back thing which, to be honest with you, is the beauty of this country. We have the right to choose or not choose to do something, sure, and I cherish that freedom, even though I prefer to be vaccinated. Someone choose. It's not to that's their choice, but diseases can kill you and the flu can kill you and prior to covid coming along, to lose sixty seven thousand people when you 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 widespread documented 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 all the bad it did. Right. So...

I think the data is in the favor of pro vaccine. Smallpox and poleio have almost been completely eradicated because of their use. While we're on vaccines, I did just want to bring up not only are we talking about getting the COVID vaccine or recommending it as the you know, professional societies and the CDC and the World Health Organization are all recommending pregnant women, you know, have the covid vaccine. What if you've delivered 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 know that it's safe. Yeah, it's not. It's not unsaved for the baby and is not altering the baby in any way, if that passing down through the baby. And so vaccination for lactating women is also, you know, on the table here. Great, this has been fun and so formative and really important for us to get this out. What do you guys? Let's talk a little bit about future. What do you see? What do you think is coming down the road? I know we talked a little bit about the technology and we got Bluetooth coming on board and you know, all it's really advancing on the technical side. You know. I mean, I wouldn't be. You know, the rural communities. I think, going back to the we were talking earlier about broadband and things like that and hearing a lot about this startak that Elon musk is behind and these satellites that are now going around the the earth and that they're going to be bringing the access to high speed Internet to a lot of rural communities. So I do think that all of that technology is going to continue to be better and continue to accelerate the thing. But what are the things are you guys seeing? And Tella that you 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 were we were doing it many, many years ago and we've actually used them before with us in the early days for really remote places. But I think the fact that it will be more baby, more cost effective will make it these. I was just going to say, yeah, as you said, the equipment went from being, you know, forty fifty thousand dollars now to four to six thousand dollars, and so I'm the communications is all getting everything gets faster and cheaper over time. Right. I think for me, one of the things that is most exciting for me is that we are moving to mobile acts and better wearables. We now have wearable technology where we can transmit things and 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. I think if you look at our our childbearing age, if we can't get them on a smartphone, we're not even going to get them. So I think we're moving in the right direction to go smaller, faster, more affordable and to impact more people that don't have access to services where they live. And I 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 was unheard up two or three years ago now. Like we mentioned our study in New Mexico 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 with tell the medicine is instead of coming thirteen times to see your odetrition and waiting in the waiting room, you'll have some of your non testing visits right from your home and they'll be totally appro Britain. It will 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 access where we are instead of getting up and going somewhere, I think the better the impact will be. 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 learn more about what you do. What's the best place for them to find out more about you? And we'll put that on the website as well, but we'd love for you to share that. Yeah, appreciate that. So you can visit our website at www dot women's tell a healthcom. Our phone number is four hundred and four seven eight,...

...three hundred and one seven. You can find a lot. We have samples. If you want to see, like what's one like? Can Go to a sectional on our website and see what we do and see some videos of how we do it and you know what it kind of looks like. It's kind of sometimes hard to wrap your head around, but so appreciate that opportunity to have people learn work. Great. Well, thanks for sharing that. Will be sure to put that on the website as well. So if people didn't grab it, they can check out the heroes of healthcare podcastcom and we'll have that when the episode gets put up there. I so appreciate the work you ladies are doing. I know for 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 and we've actually gone onto mission trips to China and worked in orphanage where they were just infants with challenges of all shapes and hide your cephalitis and that we talked about earlier and some of the other things. So loved having you guys on the show and love the work that you're doing. It's so critical. You certainly are some of the heroes of healthcare, for sure. Typically, as we close each one of these episodes, I always love to ask my my question, which is who is your hero? So so if you guys will mind sharing that with us, we'd love to hear you know, currently growing up. There's no right answer. Who is your hero for you guys? Yeah, so we appreciate that chance to give someone a shout out. One of 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 you know, parents expect things to be normal and when things go not normal during a pregnancy it can be scary and a big surprise. This organization supports provides research and provides hope for parents that will get a fetal diagnosis along the way and it's a group of several high risko be centers across the country that patients can 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 in touch. We want to continue to hear I think it's going to be important down the road that we update people as new information becomes available. So we consider you part of the podcast family and look forward to having you on again in the future. Sounds Great. Thank you so much, Ted. Thanks again for being here. You've been listening to heroes of healthcare for more subscribe to the show in your favorite podcast player or visit us at heroes of healthcare podcastcom.

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