Danielle speaks with Mark Russell and Janson Lanier from Vitalograph about Remote Patient Monitoring (RPM) and Respiratory Diagnostics. Tune in for an overview of specialty RPM devices and a discussion of how they can be used to monitor chronic and acute conditions.

Welcome to a virtual view.

A telehealth podcast brought to you by the upper Midwest telehealth resource center.

This is Danielle ley, your host.

And today I am joined by Mark Russell and Jansen Lanier from bat Telegraph.

Thank you so much for being here today.

Thank you for inviting us.

Could you both tell me a little about yourselves?

I'm Mark Russell.

I'm the marketing communications manager for vital Telegraph.

I've been with the company for five years.

I've been in healthcare for over 25 years and I joined the company.

At a really really exciting time right before COVID at least a year and a half.

We were involved in lots of conferences and trade shows

and then basically COVID hit.

And we had to transition a lot of our marketing strategy to be more remote.

And and this year we've got a plethora of new products that

we're getting ready to launch.

Yep.

And I'm Jan Lanier national sales manager, respiratory therapist for vital Telegraph.

I've been in respiratory sleep diagnostics since 2006.

In every capacity you could think of for a couple different companies.

I joined vital Telegraph three years ago this week.

And like mark was mentioning lot of transitions and changes in.

Just from the view of the company to how do you change the outlook

of what you're doing on a day to day basis because of the pandemic?

So tell me a little bit more about VI Telegraph.

What do you

The Telegraph products and services are chosen

by medical professionals over 113 countries for healthcare,

occupational and clinical trials.

We manufacture and supply quality spirometry and respiratory

medical devices, which are.

Used as a to detection and diagnosis and control of respiratory conditions.

We also deliver successful clinical trials for many of the world

leading phar world leading pharmacy, pharmaceutical companies, biotech,

and contracted research organizations.

Right now we have probably over 69 live Clinical trials worldwide.

Yeah.

I like to say, we started in 1960s as a respiratory diagnostic company, we were

in Occupational health is where we got started and branched out from there.

When I say respiratory diagnostics, it is everything from occupational

health to primary, secondary health, even into clinical trials.

So we basically provide.

The assistance to staff to help diagnose respiratory illnesses.

And we're based in the UK.

That's where our corporate we're family owned company.

And we have offices in Germany, Japan, and of course here in the us, our

devices are manufactured in Ireland.

Wow.

Working from multiple countries.

Sounds just a massive undertaking, like the U T.

We operate in four states.

And I know that even for us, like time zones are incredibly annoying.

So I'm sure that coordination and planning is really important

to make sure everyone's on the

Absolutely.

We're working with six and seven hour differences for meetings.

So we'll have something at 7:00 AM and it's their 3:00 PM, for their time,

they're getting ready to finish their day.

We're not even in the office yet.

So it's just those things that you have to logistically deal with.

But I think that we all work pretty well together.

As a company, whole because we have one goal, one mission and that's to

bring integrity to to the industry.

It's pretty cool.

So I have done the requisite amount of Googling over respiratory devices, cuz

I am not a medical professional in that sense, but I'm sure you could give a much

more succinct explanation of what exactly they are and what they do than I could.

So I will leave that

Respiratory diagnos.

Devices, basically they help diagnose everything from asthma to cystic

fibrosis, pulmonary fibrosis, you can be used to help identify,

cancer screenings, things like this.

And it's across the board.

It goes everywhere from.

Your home monitoring systems that are basically handheld pieces that people

take a deep breath in and blow into.

But overall respiratory diagnostics is lung function, right?

It's basically how the lungs are doing.

And is there any restrictions in the lungs?

So a patient can come in and do what we consider a maneuver or a.

They take a deep breath in and blow really hard.

Almost like you're doing a breathalyzer.

I hope none of you have done breathalyzers, but if you have you

get the idea, you've seen it on TV.

But it's also even as far as breaking it down for inhaler use.

So you know that people are diagnosed inhalers for any respiratory illnesses.

Whether it's allergies during, the fall and the spring or it's upper

respiratory infection, you get an.

We have a device, that tracks that to make sure people are utilizing the inhaler

properly, getting the amount of medication they need because far too often a, an

inhaler is prescribed and the pharmacist.

Oh, do you know how to use an inhaler?

Oh yeah, of course.

Whatever.

Guess what?

More than likely they're not doing it.

Correct.

The device basically helps you walk through the typing mechanisms or if it's a

dry, powdered inhaler, making sure you're forcing, inhale fast enough and so forth.

So it's little things like this that we work with throughout either

pharmacy primary care, secondary care allergy asthma clinics.

I even said we work with occupational health

Gotcha.

So generally these are gonna be used for more chronic conditions.

possibly.

Yeah.

Yep.

Yeah.

Okay.

These devices, you mentioned briefly that some of them do function as

remote patient monitoring devices.

Absolutely.

So we've had remote patient monitoring devices for quite

some time in the late nineties.

So they've been around for a long time.

What hasn't happened until the pandemic was it wasn't really

being adopted at a hospital level.

It was more of the.

practice and allergy asthma care centers would provide a lung monitor that would

basically just track the patient post lung transplant or post asthma diagnosis.

But what happened is that when the pandemic came along remote

patient monitoring became a need.

Before it was a luxury.

Now it's a need.

And so now we're moving into the next stages of what are we doing

to track set patients post COVID.

Pulmonary fibrosis, post lung transplant patients and so forth.

We're working with a lot of different three PIs, which are third party

integrators that have apps for iPhones and Samsung, galaxy or whatever the

Google play, that, whatever newest applications there are out there.

Working with those guys to ensure that we're bringing the right options to the.

Yeah.

RPM is a, just a massive market right now.

I think it's something like 14 million users in the us alone,

and I know it's expected to grow and just continue to grow.

Attended the American telehealth association this year in may.

And it was the first time that we had attended the live show and so many big

companies there that are looking at remote patient monitoring which naming Amazon

Walmart they are all out there looking at for opportunities to help improve.

He.

Yeah.

When it comes to remote patient monitoring a lot of times it has been pulse Sox,

imagery things like this, the basics weight, scale temperature, things that

have been tying into an application.

Now it's gotten so far as they want respiratory rate, they want

FEV one and peak flow and so forth that are coming across.

So you can track true respiratory related in illnesses.

That's why since the pandemic that has come on quite strong, so respiratory

remote monitoring has been, or remote respiratory monitoring has

been quite popular the last two.

Oh, I'm sure.

And obviously it's not ideal for every device.

Some do need like a medical professional

Oh, yeah, absolutely.

Absolutely.

So there is, so that's exactly why we call it a monitor instead of a spirometer

is something that they do in the lab with a technician that, that coaches

them to do a proper and maneuver.

It's it's like when you're lifting weights and you're pushing hard.

But when you have a coach over there trying to push you even harder and harder,

you're gonna actually get that weight up.

So imagine blowing out as hard as you can.

If you have a coach sitting next to you or talking to you over telehealth.

They're blowing it through.

They're telling you go.

You're gonna get more of an effort to get better numbers.

When we do the remote patient monitoring, when it's just a patient at home,

they're gonna get solid results, but they're just a monitor so they

can tell their day to day numbers.

If they start to decline or a trend of declining, they know that

they can come into the, to the hospital and do a full workup.

right.

And that's good from the sense of we're saving the effort of those

patients having to come in every day and get tested, but there's still.

Especially during the pandemic when people are afraid.

I promise you, people are still on that leery edge, imagine first wave

COVID patients they were feeling ill.

They come in, they get diagnosed with COVID they're in the hospital for two

weeks, three weeks, whatever it may be.

And then all of a sudden they're discharge.

They're still having symptoms, but they're afraid to come back.

They're afraid to say anything because they don't want to be in the same boat.

They just.

Okay.

So we want to try to capture those patients again, to continue

to make sure they're doing okay.

And I've had this discussion with pulmonologists all across the country

on follow up post COVID follow up.

What are you doing?

How are you making sure those patients are really taken care of.

And honestly, majority of the docs that I talked to said, there's not

enough time in a day for them to follow up with as many patients that came.

So it's one of those where we have to put more focus on it, or even put

the hospital systems more unchecked to get those patients checked.

Oh, for sure.

And I'm sure when we talk about quote unquote long COVID,

it's gonna continue to be

Absolutely.

It comes more prevalent than we know.

Because of the people that don't wanna say anything, there, there are patients

that I talk to on, on a frequently basis that they're saying they struggle

going up and down stairs when they're talking about six or seven stairs.

I'm like, have you talked to your doctor about it?

Not really.

I just, I don't wanna bother cuz it's not that bad.

That's the only time it happens.

Is it the only time?

How do you know if you're not just walking down the hallway and you're

getting breath, or what happens if something else is not going to work as

properly, if you don't get that Lu lung function going, if you're not using

your lungs, then everything suffers.

So

oh, for sure.

so I know that innovation is an important aspect of what you do

as well as an important aspect of just healthcare in general.

So how do you think that innovation will impact healthcare in the

think two words go together, innovation and evolving.

You have to evolve.

So if you look at, like I had mentioned if you came in.

To see vital Telegraph's business plan prior to the pandemic it is completely

180, it completely different direction.

But by doing so we've figured out what.

What is needed in the field, by us going out there and having customers that are

telling us, Hey, this is what we need.

This is how we need to evolve into the new healthcare.

So we bring the innovations to them.

They tell us what we need.

We put it on paper, we develop it and really release it.

So last year we introduced a new device this year.

We have four devices that we're introducing.

We just released one.

We're getting ready to release three more here at the end of the year.

So it's one of those where we have heard everything that's needed.

We are going to market with products that have been asked for.

And updated with the ATS standards.

Yes.

So 2019 ATS S came out with new standards for barometry, which they

hadn't been changed since 2005.

oh, wow.

Yeah, 14 years of change in healthcare.

If you can think of how you changed in 14 years.

I know I changed a lot.

Mark's the same guy as he is always been.

So but yes so the change that came was very much needed.

And as a manufacturer, you see these changes and you're

like, okay, let's grab it.

Let's make the adjustments and release products because we want.

Our end users the customers, the hospital systems, the doctor's offices

to have everything at their hands that's compliant as well as give the

options for the patients to, to have the tools available, to get better.

It's all about patient care.

Everybody wants to talk insurances and payments and whatever like that.

No it's about patient care.

It should always be about patient care.

and in the realm of patient care, I'd be interested in looking

at how medical devices, including like these respiratory diagnostic devices

could be used more as preventative care, at least early warning systems.

percent.

Yeah.

I think the pandemic has really opened up healthcare in a lot of different ways

because in one, one way it put a strain on In a sense that we had so many patients,

but in the other, it opened up other opportunities like pharmacies being more,

a part of the team and healthcare used to be, you just got your prescription

now, you get your shots and and.

There are some pharmacies that are doing spirometry.

Yep.

The mini clinics as well.

And so basically I think that because of this pandemic, there's a lot of good

things that have come out on it, test the system and open up our opportunities

in different industries to help the system because we've got, shortages.

We had shortage of nurses and respiratory therapists before this pandemic.

Now it's even worse.

It's even worse.

So I think you, you really hit it on the head Danielle

with, the preventative piece.

We really have been a reactive culture, if you will.

Not just in healthcare, but in the United States we're a reactive group.

But being more preventative on healthcare in general, whether it's with diabetic

patients or, whatever it may be.

It's not just a respiratory thing, but I think the pandemic

made light even more of.

Your preexisting injuries were preexisting illnesses or anything like that.

I think that we need to get back to healthy life develop instead of reactive.

And I do like earlier, how you said mark, about how it put

a strain on our healthcare system.

And I think while it did identify a lot of weaknesses that do exist, it

also identified a lot of areas for opportunity and a lot of areas for growth.

And I think RPM devices and just respiratory devices in general, there

was probably a lot of that there.

So we talked earlier about innovation.

So would you say telehealth is going to be part of that healthcare innovation in the.

I agree a hundred percent.

I think that going back to payers are gonna actually be putting more emphasis

on telehealth as your first line.

Instead of the patients coming into the office, they're gonna do a telehealth

visit to isolate what needs to come in the urgency of how bad it is and so forth.

I know that with our insurance, we can call doctors on demand and it's a free

service for us through our insurance.

Doctors on demand will do that triage appointment to see how severe it is.

And if it is severe, more severe than they're able to handle, they'll make

you a, an appointment with a local P.

I think also they also have other features such as they, they track a

lot of your your medical journey with physicals and screenings and such.

And they reward you with that.

Our insurance company gives points out, which you can re.

For gift certificates and such.

I have a Fitbit that I didn't think I'd ever had before, and it monitors

all my steps and I, basically utilize that as to, to be more healthier.

And then also it's an incentivizer for the gift certificates and I can

see telehealth doing the same thing in the future with our monitors and

such as the payers see the benefit.

Yeah, I think that's great from an standpoint

of health literacy as well.

Just understanding more about your own health.

Cause I know that's something that you would think people would be aware of their

own health, but really that's not the.

But innovation in telehealth, like we talked about, it's something that

I'm really passionate about from a standpoint of health, equity and access.

Like when we look about specialized care, like what you do with respiratory

diagnostic devices, that's something that can be inaccessible to folks who are

for whatever reason, unable to travel.

And that's everyone from aging populations who just are not able to travel

anymore or to rural populations where travel would just be unfeasibly long.

But we look at telehealth and RPM devices, and I think it's really promising from

the standpoint of access and getting folks just access to specialized

care that they might not have other.

Yeah.

We work with a few programs that actually do a lot of rural health screenings.

And so instead of actually sending somebody out on site to do a house

visit, they'll send a box of.

RPM devices.

Usually it's a blood pressure cuff.

It's a SPO two weight scale respiratory monitor and thermometer.

Okay.

So you do all those screenings and then they'll have a telehealth visit once

you've done those screenings in that day.

And it's pretty solid.

no, that's awesome.

From an access standpoint, I think so to go off topic a little bit.

This is something you mentioned earlier that I wanted to touch on.

I know that interoperability can be a challenge when working with

medical devices and like data systems.

Is that something you have to contend with in your work?

Yeah.

Yes.

It's one of those where we work with either the third party

integrators or working with the EMR systems and trying to get those

involved for formal communication.

But overall it's gotten a lot better than it has say, even five years ago.

Where at one point wifi and Bluetooth technology was shunned upon.

It was one of those where we can't control the data that comes across,

but Bluetooth technology and wifi technology has gotten so strong with

the securities that it groups are just asking, what's your wifi picture, if you

will, or what's your Bluetooth protocols.

And as soon as they see those.

They are putting the stamp of approval and moving it on to the next stage.

I promise you, five years ago, you come in and say, Hey, this is a wifi device.

Sorry.

We're not a wifi center.

And we partnered we noticed at ATA we partnered with about five

different companies that have apps.

Phillips is one of them and they've been around for a long time in medical field

and very lead the way and in technology.

And they have their own health.

Program we've worked with other companies such as vital flow and pull, manage.

They all have apps that are secure and have their specific information

that they're pulling from for whatever diagnostic they need for respiratory.

Yep.

Gotcha.

. And so what do you think the future of RPM and diagnostic devices as

well as telehealth and that kind of thing in general might look.

Oh, I think that technology such as this Fitbit, 10 years ago, wasn't.

Existence little company called Garin over here started here in

Kansas city has grown very vastly.

And I think that the technology in healthcare is gonna go right along with

it, with the apple watches and such.

I think that eventually we'll have monitoring.

On a daily basis.

Yeah.

And it'll be connected with a healthcare professional and we will have, daily

information going into them and then we'll be checking it probably in a hub center.

And it will go to your primary care doctor and keep you keeping posted

on, whatever element you may be having or could have in the future.

I think it, it may be even going a little further in the fact that a lot of.

Clinical time was in sleep medicine.

So it went from people going into a sleep lab, doing an overnight sleep study

to people doing home, sleep testing.

Okay.

So home sleep testing, they have a device they wear at home it's been delivered

to them or they go in and pick it up.

But I feel like respiratory diagnostics, maybe going this direction, where prior to

you coming into the lab and doing a full workup, we're gonna do a precursor test

on a lung monitor, whatever it may be just as a, give me a snapshot of your lung.

And this is, this could become a requirement by insurances like HST home

food testing is for sleep medicine.

So I see that this could be the way that insurance pushes

it, but also I see that as.

Know, the pandemic slows down and increases slows down and increases.

It's just one of those things that I don't feel like it's going away.

Yeah.

The future is gonna continue and we're gonna be more innovative on our offerings.

More streamlined, more cost effective as these things come out.

I think so.

I think with our air quality, is very questionable, in the future

asthma and C O P D on a rise.

You just, we've got the baby boomers on the end are really

getting hit hard on C O P D.

It's gonna be something that's gonna be a necessity.

I always like asking this question about future of

healthcare, because even with folks in very similar fields, you tend

to get really different answers.

The future of healthcare and technology in healthcare specifically is

something like that's just so broad.

And we talk about increased connectivity and more accurate and reliable technology.

And I.

That'll be great for all fields of healthcare in just so many different

ways that you could take a whole day and you wouldn't be done talking about it.

You get five people from five different healthcare industries and

talk about innovations that are coming out and talk about, oh, that's fantastic.

We should have thought about that as a market strategy or something

like that, which is fantastic.

I don't know why we don't do these more often as a manufacturer.

I would love to sit with other manufacturers outside of just

respiratory, but in other areas and say, Hey, how can we all come together?

For one global mission.

Yeah.

And it's yeah.

It's like the invention of calculus.

A lot of the time where you've got like a bunch of different people who are

probably inventing the same thing, even though they're working independently.

But I always think that's interesting how folks are coming up with all these

different solutions for the same problems and addressing them in the different ways.

Yeah.

But I know you guys have a podcast as well.

Could you tell me a

We do.

Yeah, because of the pandemic.

We had to switch our, like I said earlier our marketing strategy and we

wanted to become more of a resource.

Our website is visited all over the world.

A lot of.

Great information on respiratory diagnostic and white papers and such.

So we developed a program where we have webinars that are C E approved by

arc for information out there on, on respiratory diagnostics and other issues.

And and then we developed a podcast.

Our podcast is called exhale.

With vital Telegraph, it's on all the platforms.

And again, it's just a resource of information.

We've had physicians on there that have written books to a respiratory therapist

to tell us about last year, about their day at in the hospital with COVID.

Yeah, that's one of my most proud features that we had of the podcast.

It was the follow the respiratory therapist and it was a.

Four or five part series where we talked to a director of respiratory

and ER, direct, ER, respiratory therapist travel a traveling therapist

as well as a ICU therapist during COVID and what their daily, routine

looked like and the burnout rate.

And it was just one of those raw.

Emotional times that I felt really compelled to get the message out.

And I still feel that way.

And when mark says resources, I am big since the pandemic is that

people don't want somebody to come in and sell them something.

Okay.

They don't want a rep to come in and say, Hey, or buy my product

because you need this product.

Guess.

Let's be a resource.

Let's be a resource for each other to grow.

Okay.

Whether I help you with something here, or if I put a, a.to dot connection

that this is a resource for you.

So with the podcast, it is across the board, respiratory related.

But it is, it could be an advertisement for a product.

It can be just a story of how somebody came from this point.

To this point.

It could be anything respiratory related, but I can promise you out of the 30 or so

podcast that we've done, anyone can find one of the subjects that they tie to.

That really relates to what their everyday life is.

And I want to continue that and I look for different podcasts and mark looks

for different podcasts on a daily basis.

We'll see somebody on LinkedIn that shares a message.

Facebook, Twitter.

Last one was TikTok.

There's a young lady that does, that has CF and she does her daily.

TikTok for CF and talks about her journey.

It's fantastic in, in really motivating and I love that story.

So it's one of those, we're gonna get a podcast with her later this year.

These are the people that I want to talk to and just like your group too.

These are pieces that I love to share with, and I never realized how much.

We would enjoy doing podcasts, but we really do.

If you go back to episodes, one, two, and three, we are raw.

Yeah, it is.

It's ugly, raw.

And I know you guys can attest, but it was a microphone and that was about it.

And we did our own.

And then we had a partner that we got in with that could do the

editing and Jade does a fantastic job with that and cleans it all up.

And we had a, we had just a share quick note.

We had a podcast with a a woman in Uganda and they Of course, you wanna

make sure you're in a secure, quiet room?

She had a rooster in the background and that rooster was growing about

two or three times during our interview and our editor sure.

Had a hard time editing that out.

Just like at first we had identify it.

It's what is that?

What is that sounded like a Kyle for a minute.

It was like, okay It happened to be just a rooster, but it was one of those amazing

things that they could edit it out.

And then time difference, it was early in the morning here

technology

and in Uganda, it was late evening when rooster were.

no, that's incredible.

And I do like how you touch on how social media and.

Just connective platforms that we didn't have 20, 30 years ago are just helping

folks from all sorts of professions.

Just connect and share information.

I think that's so

I'll be honest.

When we first started the podcast, we only had LinkedIn is what we were doing.

We had Twitter, but we just weren't actively doing anything with it.

No Facebook, nothing else.

It became one of those places where we could expand out to and.

Even if it's just a post it's nothing, it's just a post, but it happened to be

reaching a lot more people than we expect.

They were sharing it and so forth and it meant a lot.

So we continued with that avenue.

I could see us doing, maybe not TikTok, but just, you know what I'm saying?

It's I would rather see mark do some nice dances and not at all.

me know.

I'll watch

My dancing days are over with, but yeah, it's, basically

it has grown and I'm sure you've seen the same thing in the last six months.

We, it took us a year to get so many downloads and in the last

six months we've doubled it.

And it's only.

Because of content, you have to get good content and interesting

guess, and it is a challenge.

And we like, I, like Janssen said, we get it from a lot of social media posts.

We've run into a couple of doctors uh, a doctor and a respiratory

therapist, a doctor who has a book.

Called exhale.

And and so we interviewed him, he was a transplant doctor and he

wanted to share his experiences with the challenges of transplant.

And then we just interviewed just recently a young lady that

has a website called exhale.

And it is a it's a respiratory.

It was a website where it's a training program training program for

respiratory therapy outta Oklahoma city.

Yep.

And and such, so its a popular name and I'm glad I picked it.

So I'm just waiting for Jada pig Smith and queen Latifa

from waiting to exhale to call.

You guys are the exhale family.

oh, I love it.

digress.

So again it's exhale with VI Telegraph.

Thank you so much for joining us today on a virtual view.

I think we had a great conversation.

I really appreciate you both taking the time to be here today.

that's great.

Thanks.

Thanks for inviting us.

Thanks.

Yeah, of course.

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