Latest / Breaking the ICE / Episode 13 - The Operational Backbone: How Helm Connects Vets, Claims and AI

Transcript

Episode 13 - The Operational Backbone: How Helm Connects Vets, Claims and AI · Breaking the ICE

• 0:00
  SPEAKER_00: Hello and welcome back to the Breaking the Ice podcast.
• 0:03
  SPEAKER_00: This is season one, episode 13.
• 0:07
  SPEAKER_00: We have somehow made it a quarter of a year through this, which is a remarkable accomplishment.
• 0:13
  SPEAKER_00: I'm joined by my co-host, Mark Colonese.
• 0:15
  SPEAKER_00: Mark, how are you doing today?
• 0:17
  SPEAKER_00: I'm very well, thank you.
• 0:18
  SPEAKER_00: Um yeah, it's Friday.
• 0:20
  SPEAKER_02: That always helps.
• 0:21
  SPEAKER_02: So yeah, feeling good.
• 0:23
  SPEAKER_00: Yeah, Friday afternoon for you.
• 0:25
  SPEAKER_00: Fantastic.
• 0:25
  SPEAKER_00: I've still got a full day ahead of me, but uh uh you won't hear me complain.
• 0:30
  SPEAKER_00: Uh or at least I'll do it after we finish recording.
• 0:33
  SPEAKER_00: Uh we have a special guest today.
• 0:36
  SPEAKER_00: So uh Mark, I'm gonna let you sort of take over and introduce our guest.
• 0:40
  SPEAKER_00: Um yeah, kick it off.
• 0:43
  SPEAKER_02: Okay.
• 0:43
  SPEAKER_02: Um well um yes, super excited to have um Mike Jackson on from Helm.
• 0:51
  SPEAKER_02: Uh we've been doing some work together and Mike's um Yeah, been doing some interesting stuff at the moment, but I won't steal your thunder, Mike.
• 1:00
  SPEAKER_02: Why don't you introduce yourself and give us um a little bit of potted history?
• 1:06
  SPEAKER_01: Sure thing.
• 1:06
  SPEAKER_01: So, first of all, thanks for having me on.
• 1:08
  SPEAKER_01: I'm I'm delighted to be here um and and to be able to kind of talk about all the things that we've been working on, Mark, and and some of the interesting conversations we've been having.
• 1:17
  SPEAKER_01: So my name's Mike.
• 1:18
  SPEAKER_01: As we've said, I'm first and foremost, I'm a vet, and I've been a vet for over 20 years.
• 1:23
  SPEAKER_01: Um and I've kind of found myself into the into the technology space, which is which is kind of strange.
• 1:29
  SPEAKER_01: And you know, I'm lucky enough to be a person who's kind of spanning history.
• 1:34
  SPEAKER_01: I uh I'm old enough to remember, you know, when when we did veterinary work and wrote down our clinical notes onto paper, you know, paper cards, uh, right up to uh I I grew and built my own multi-site practice in in Scotland.
• 1:50
  SPEAKER_01: Um and we got to the point where we were doing keyhole surgery, stem cell stuff, you know, and and and all of that.
• 1:58
  SPEAKER_01: And uh and so uh I exited that uh and and we sold uh our practice in 2021.
• 2:05
  SPEAKER_01: And since then, you know, I've been kind of following up the thing that really excites me, which is solving the problems in veterinary practice.
• 2:14
  SPEAKER_01: And uh that's where that's what's taken me to tech.
• 2:17
  SPEAKER_01: Um so yeah, so now we are uh I'm well I'm a co-founder in Helm, and we're we're building a solution that uh that looks after the communication and collaboration piece in veterinary practice, really as the operational backbone uh of practices.
• 2:35
  SPEAKER_01: So that's who I am, and that's what I'm doing.
• 2:37
  SPEAKER_01: Thanks, Mike.
• 2:38
  SPEAKER_02: Um one thing that you quite often say, which I think resonates quite strongly with me, is you have all of these uh veterinary hospitals or practices, and they run practice management systems.
• 2:51
  SPEAKER_02: What's your view on practice management systems?
• 2:53
  SPEAKER_01: I I love them.
• 2:54
  SPEAKER_01: I think they're brilliant.
• 2:55
  SPEAKER_01: I think they are brilliant.
• 2:57
  SPEAKER_01: I, you know, I as I say, I saw before practice management systems, and I think that you know they've come in and and they started.
• 3:04
  SPEAKER_01: I mean, practice management systems have have have gone through some growth and not, right?
• 3:09
  SPEAKER_01: I was I was speaking to somebody yesterday who was telling me that one of the American PMSs, practice management systems, is is 34 years old, you know.
• 3:18
  SPEAKER_01: So these things, you know, and and relatively unchanged.
• 3:21
  SPEAKER_01: Some of them started out actually as window cleaning software, uh, you know, for for for window cleaners, and it kind of morphed into this.
• 3:29
  SPEAKER_01: That's what I thought you said.
• 3:30
  SPEAKER_01: They're great, they're great, they're great, but you know, you you cannot, I think, I think what we're finding now is that it's the butt button.
• 3:40
  SPEAKER_01: Let's talk about the butt.
• 3:41
  SPEAKER_01: Yeah, yeah.
• 3:42
  SPEAKER_01: So so veterinary, I mean, look, veterinary practice is uh an incredibly complex business in so many ways, really complex.
• 3:49
  SPEAKER_01: And I don't think one system can look after each of the different elements perfectly.
• 3:54
  SPEAKER_01: So what we're seeing, or we have been seeing for a few years, is kind of breaking out of individual parts and having those parts interact with the practice management system.
• 4:03
  SPEAKER_01: Now, the the the bit that's a little bit difficult to get your head around, I suppose, is they're called practice management systems.
• 4:10
  SPEAKER_01: Actually, they're clinical systems that have accounting software bolted on.
• 4:15
  SPEAKER_01: And, you know, they do lots of other good things as well.
• 4:18
  SPEAKER_01: But really, you know, over time, we've found that the the client communication part has been broken out and done separately.
• 4:25
  SPEAKER_01: You know, the the dealing with the advanced imaging and how we deal with that has been broken out.
• 4:31
  SPEAKER_01: And slowly but surely there's various different bits kind of being broken out and hopefully connecting back into the practice management systems.
• 4:38
  SPEAKER_00: How how well suited our 34-year-old systems to interoperability uh you know across a landscape of platforms?
• 4:48
  SPEAKER_00: I mean, you know, are there are there solutions that are are being developed to enable uh you know a legacy platform to sort of be the hub of an ecosystem?
• 5:00
  SPEAKER_00: Or is that a is that a major pain point?
• 5:02
  SPEAKER_01: So so listen, Ellie, it's different for you than it is for us over here in the in the UK.
• 5:07
  SPEAKER_01: So uh the UK is is uh is is mainly cloud-based, and that, you know, and so the the systems are are are much more adaptable to that, and you know, uh plugging in through API is uh is is perfectly possible.
• 5:22
  SPEAKER_01: Um in the States, you've got a lot of server-based uh systems, and that's much more difficult, obviously.
• 5:27
  SPEAKER_01: Um and a problem, you know, two different problems, right?
• 5:30
  SPEAKER_01: Two different sides of the problem.
• 5:32
  SPEAKER_01: Um but yeah, you know, it's a challenge.
• 5:34
  SPEAKER_01: It's a challenge, and and and we talk a lot about that, and uh access to APIs and how that all works is is difficult.
• 5:42
  SPEAKER_01: Um but I think I think we're looking down a kind of uh we're looking to for towards a future where, as I say, you know, things are going to work much better together.
• 5:51
  SPEAKER_01: We hope that, you know, with guys like you on it, that interconnectability between all these different systems is going to be much smoother.
• 5:58
  SPEAKER_01: That's the hope.
• 5:59
  SPEAKER_01: It certainly would help.
• 6:00
  SPEAKER_00: So, Mike, can you talk a little bit more about Helm and what you're building with Helm and sort of where it fits within that ecosystem?
• 6:07
  SPEAKER_00: Sure.
• 6:07
  SPEAKER_01: So so Helm is uh is a system that's all about context.
• 6:11
  SPEAKER_01: So in uh in veterinary practice, we we've got you know we've got all sorts of things going on at the same time, and we and we need to have all sorts of information available, whether that's clinic clinical information or information about, you know, we'll talk about insurance later on or or or whatever it is.
• 6:30
  SPEAKER_01: So we've built Helm, which um sits alongside, literally alongside the practice management system, and it allows operators to be looking at the clinical system whilst uh dealing with the operational piece.
• 6:42
  SPEAKER_01: So they can pull context from the practice management system into that, into that, uh, into Helm.
• 6:48
  SPEAKER_01: And then, you know, we've got uh AI underlying the whole thing.
• 6:52
  SPEAKER_01: And so once you have everything in one place, and once you've got AI involved, you start to be able to pull information and to use it in different ways and to really speed up process and make things better.
• 7:03
  SPEAKER_01: So we have uh a lot, you know, our system is uh is about communication between people working in veterinary practices, setting tasks and making sure that people aren't working on things on their own, but that they're getting the support.
• 7:16
  SPEAKER_01: But we also have workflows.
• 7:18
  SPEAKER_01: And those workflows, uh in in the UK we're we're dealing just now, uh, you know, the final orders have just landed, but the competitions and marketing marketing authority have had a real good look into veterinary practice.
• 7:31
  SPEAKER_01: And what they're basically saying is that our operational systems need to be a lot sharper.
• 7:35
  SPEAKER_01: We need to be able to say why we've made decisions, when we've made them.
• 7:38
  SPEAKER_01: We need to be able to prove that.
• 7:40
  SPEAKER_01: So we have we have workflows that allow for that, whether that's around about complaints, uh around about discussions uh around complaints or around about clinical decisions.
• 7:51
  SPEAKER_01: We uh we also have uh a workflow that that allows insurance uh to come much closer to the point of care.
• 7:59
  SPEAKER_01: So uh we call that um helm elk echo, whereby eventually we'll be able to just pull in the items that we need to claim for, and AI really takes care of the rest.
• 8:10
  SPEAKER_01: Um and uh a much closer link between the insurers and the and the vets, we hope.
• 8:16
  SPEAKER_01: Um and all sorts of other cool stuff.
• 8:18
  SPEAKER_01: You know, we're we're holding on to the we're providing a central place for the for the veterinary practice to store its um its uh standard operating protocols, whether they're clinical or or more to do with equipment or or or how we act in practice.
• 8:33
  SPEAKER_01: And of course, with an AI underly there as well, you can pick out and find things so much more easily.
• 8:40
  SPEAKER_01: So it's all connected, and once it's all in one space, we're finding that we can do amazing things with all that information.
• 8:45
  SPEAKER_02: So so from a vet's perspective, Mike, what what are the kind of biggest pain points with respect to insurance and how you interact with the client in that regard?
• 8:56
  SPEAKER_01: Sure.
• 8:57
  SPEAKER_01: So um the first thing is that you know, I think vets are very grateful for insurance.
• 9:01
  SPEAKER_01: We really get it.
• 9:02
  SPEAKER_01: And and I think, you know, the more the more that I uh spend time uh with with insurance, uh pet insurance companies, and and with my experience having you know put in probably tens of thousands of claims over my years, you know, insurers are great for veterinary practices and to allow that care to happen.
• 9:20
  SPEAKER_01: Um, but there are there are a lot of pain points.
• 9:23
  SPEAKER_01: I mean, at the moment, you know, the the main thing which I would would see as a problem is not having the information that's required in the place that we need it, i.e., we're standing there in a consult trying to give our clients the best possible advice, trying to give the pets in front of us the best possible care.
• 9:44
  SPEAKER_01: And really nobody in the room knows what the financial situation is because you know people have gone out and they've got their policy, but you know, as we say in our website, nobody has time really to you know memorize a 25-page policy document.
• 10:00
  SPEAKER_01: So not having the information in the right place at the right time is an issue.
• 10:05
  SPEAKER_01: Um the the return, which is a real shame, the return to multiple portals is a pain point.
• 10:11
  SPEAKER_01: And if you speak to those doing admin and veterinary practice, that's difficult.
• 10:15
  SPEAKER_01: I think that the back and forthing with clinical questions to very busy clinical people and that holding up, you know, uh claims being paid, uh, that's a difficult piece for us because we're not very good as that at that.
• 10:28
  SPEAKER_01: You know, as I as I've said, veterinary practices, if you want to speak to me in practice and you you call and you you you know at the moment, it's probably going on a post-it note.
• 10:39
  SPEAKER_01: You call them post-it note some can of course, yeah.
• 10:42
  SPEAKER_01: It's probably being stuck stuck to my to the side of my uh to the side of my monitor.
• 10:47
  SPEAKER_01: Now, if I don't get to it in that day, or you know, if I have an emergency come in, or if the glue comes off and it floats and goes under my desk, it might be three or four weeks before you get that response.
• 10:58
  SPEAKER_01: So we you know, so so there's all sorts of issues in there, and some of them are on the veterinary side, and some of them I think are on the the insurer side, um, and the clients are kind of in the middle.
• 11:08
  SPEAKER_01: So yeah.
• 11:10
  SPEAKER_02: Um so you mentioned you know the utility of of understanding the kind of financial context.
• 11:20
  SPEAKER_02: Um that's a very buzzy word at the moment.
• 11:23
  SPEAKER_02: So let's talk a little bit more about that, Mike.
• 11:26
  SPEAKER_02: Um I was at the PIA conference on Wednesday, which was great.
• 11:30
  SPEAKER_02: There was a lot of talk about contextualized care.
• 11:33
  SPEAKER_02: So let's have let's have your view on on what that means, where we are today, where we might be tomorrow, and how technology like Helm and integrations with insurances can can help support kind of that shift.
• 11:48
  SPEAKER_01: Sure thing.
• 11:49
  SPEAKER_01: So contextualized care.
• 11:50
  SPEAKER_01: So, first of all, for anyone who doesn't know, um the definition would be um that the care should be adapted to the individual circumstances of each animal and the owner and the circumstance or the wider context, right?
• 12:06
  SPEAKER_01: So, in other words, right information, right person, right moment.
• 12:12
  SPEAKER_01: And how good you want to get?
• 12:14
  SPEAKER_01: Are you guys squeamish?
• 12:15
  SPEAKER_01: Or can I talk to you about really?
• 12:16
  SPEAKER_01: No, love it, love it.
• 12:18
  SPEAKER_02: Yeah, the more disgusting, the better.
• 12:20
  SPEAKER_01: So okay, all right.
• 12:21
  SPEAKER_01: Well, okay, really disgusting for you.
• 12:22
  SPEAKER_01: I mean, that's that's that's my kind of uh bread and butter, as they say, pushing the vet, right.
• 12:28
  SPEAKER_01: So uh so a really common problem, right?
• 12:32
  SPEAKER_01: You you you've you you bring your cat in to see the vet, you say, My cat's limping a little bit, okay?
• 12:38
  SPEAKER_01: The vet has a look at your cat, looking over the cat, and you you you're you're examining the hind legs, you press the hind legs, and you feel there's a little bit of a swelling there, okay?
• 12:47
  SPEAKER_01: So when you've been in that position, when you've got the experience, as a vet, you know, really common for cats to have what's called a cat bite abscess.
• 12:55
  SPEAKER_01: Essentially, cats fight, one cat punctures the other cat's skin with its canine tooth or with its teeth, right?
• 13:04
  SPEAKER_01: And almost immediately it pulls its it pulls its tooth out, but the skin closes back over.
• 13:10
  SPEAKER_01: But then it's left in there from the cat's mouth, and mouths are incredibly dirty places, it's left bugs under the skin in the cat, right?
• 13:18
  SPEAKER_01: So now you can tell a brave cat because it gets bitten in the face, you can tell a scaredy cat because it gets bitten in the back, right?
• 13:24
  SPEAKER_01: So you always you always kind of get a feel for it for what the cat, what the cat is uh is is like.
• 13:30
  SPEAKER_01: So in that situation, you've got a kind of a bag of pus growing under the skin, right?
• 13:35
  SPEAKER_01: And there are a number of ways of dealing with that.
• 13:39
  SPEAKER_01: So you can deal with that well depending, and this is very general, but depending on all sorts of things about the circumstance, how deep the abscess is, what the cat's demeanor is like, you know, uh, and and uh and various other things I'll come to.
• 13:52
  SPEAKER_01: You could deal with that by holding down the cat and just clipping the hair and nicking the skin with a scalpel blade, and what you get then is an explosion of pus, right?
• 14:03
  SPEAKER_01: There's green goo dripping off the ceiling, and you know, we're all covered in it.
• 14:07
  SPEAKER_01: But you squeeze it out, you get a syringe, you flush out that the pocket that's been formed, and uh and then you uh give the cat some antibiotics, and the cat will probably recover.
• 14:19
  SPEAKER_01: Okay.
• 14:20
  SPEAKER_01: Now, that's probably not the best way to deal with that situation.
• 14:24
  SPEAKER_01: The best way to deal with that situation would be to give the cat an anaesthetic, to clip the area to the area, surgically prepare the area, to create two incisions, one at the top and one at the bottom, to feed through what we call a Penrose drain, to stitch in that drain so that the so that the um so that the area can continue to drain, to sorry, and to flush it out first, to stitch in the drain, and then to put the cat on antibiotics, and then to monitor that drain over the course of a number of days, either as an inpatient or an outpatient, and potentially, if you're really going for it, to take a sample of the pus and to send it off to the lab to find out exactly what bugs are in.
• 15:07
  SPEAKER_01: So that you can definitely match the antibiotics to the bugs that are under the skin.
• 15:10
  SPEAKER_01: Okay?
• 15:11
  SPEAKER_01: You may also want to, if you really, if you really need to, take an x-ray of that hind leg, because a bit of tooth might be broken off and left in there.
• 15:19
  SPEAKER_01: It may not be a cat by abscess, the cat may have a foreign body of other sorts that's uh found its way in there, uh, uh, uh, unfortunately, you know, a BB gun pellet or something like that, which I've seen many times actually, unfortunately.
• 15:33
  SPEAKER_01: So, in terms of the contextualized care piece, you have to, as a vet, stand in that room and say, right, what am I looking at with regards to the cat?
• 15:44
  SPEAKER_01: Is this cat of a pleasant demeanor?
• 15:46
  SPEAKER_01: Is it gonna allow us to do this whilst it's on the table?
• 15:49
  SPEAKER_01: Is it already too worked up?
• 15:51
  SPEAKER_01: How old is the cat?
• 15:52
  SPEAKER_01: Is his heart gonna stand me doing that?
• 15:54
  SPEAKER_01: Is his heart gonna stand the anesthetic?
• 15:57
  SPEAKER_01: If an older cat needs an anesthetic, we're gonna be adding a blood sample onto that sedation as well, for instance.
• 16:02
  SPEAKER_01: You know, and then is the client going to be able to come in and out to have the Penrose chain checked and flushed and cleaned and whatever else?
• 16:11
  SPEAKER_01: Is the cat going to tolerate that at home?
• 16:13
  SPEAKER_01: Does the client have uh the financial ability to pay for that?
• 16:19
  SPEAKER_00: Is it yeah, so can I can I just interject there, Mike?
• 16:22
  SPEAKER_00: I mean, can you quantify what would the cost of A be versus what would the cost of B be?
• 16:28
  SPEAKER_01: It's really hard to say, but in in A, we're looking at uh consultation, the cost of some sundries.
• 16:36
  SPEAKER_01: So that's you know, the the scalpel blade, uh syringe, and some flush.
• 16:41
  SPEAKER_01: We're talking maybe between five and fifteen pounds for that.
• 16:45
  SPEAKER_01: Consultation, I mean you guys will know better or than me, you know, that that can be anywhere from 50 pounds to 75 pounds in the UK at the moment, probably, or if it's out of hours, much more.
• 16:55
  SPEAKER_01: And then the antibiotics, and as you know, that that would vary greatly.
• 16:58
  SPEAKER_01: But you know, so we're talking, I would say probably somewhere around about 120 pounds.
• 17:04
  SPEAKER_01: And option B, you could be at 500 pounds quite easily.
• 17:09
  SPEAKER_01: So this is a good thing.
• 17:10
  SPEAKER_00: So again, I mean there's there's yeah, a huge difference, right?
• 17:14
  SPEAKER_00: And and I think that also feeds into the contextualization uh piece that you're just describing, right?
• 17:20
  SPEAKER_00: I mean, at the end of the day, uh what's the owner's circumstances as well from a financial standpoint, but also from an insurance standpoint.
• 17:29
  SPEAKER_00: And and if they have coverage, you know, does the coverage cover B, which would be the sort of optimal care outcome?
• 17:37
  SPEAKER_00: What 100%.
• 17:38
  SPEAKER_01: And I think but I think that, you know, so you're exactly right.
• 17:41
  SPEAKER_01: And you're ex and and to bring it back down to that one point, contagionalized care covers a huge number of things.
• 17:47
  SPEAKER_01: But one of the big pieces in terms of what we're trying to work out is what what is the financial you know possibilities here and and playing one piece off against the other.
• 17:57
  SPEAKER_01: Now, if we want to focus on that, and I think it's a good idea to do so, you know, who has that information in the room?
• 18:06
  SPEAKER_01: Who knows what what the what in, you know, with usually, you know, my my understanding in the in the consult room is the answer to one question, are you insured?
• 18:17
  SPEAKER_01: And the client says yes or no.
• 18:19
  SPEAKER_01: Yeah.
• 18:19
  SPEAKER_01: And if they say yes, that's about all they know.
• 18:22
  SPEAKER_02: Yeah, and we know that you know that's that is potentially misleading.
• 18:25
  SPEAKER_02: Yes, I'm insured, but I've got a 2,000 pound limit, uh, and I've only got 50 50 bucks left.
• 18:32
  SPEAKER_02: Exactly.
• 18:33
  SPEAKER_02: So, you know, you you're then going down the 500-pound route, but insurance is not going to cover it.
• 18:39
  unknown: Exactly.
• 18:40
  SPEAKER_02: And I think that's really you know where we need to get to from a technology sharing point of view.
• 18:44
  SPEAKER_01: I think I think I mean that would make a huge difference to Vit.
• 18:48
  SPEAKER_01: I mean, you know, in terms of understanding at the moment, the way the way that the the sort of uh the whole thing is set up is that clients expect that when they bring their their ill pet in that the whole thing will be looked after.
• 19:02
  SPEAKER_01: In the same way as it would happen if if you know if if uh you know a tree fell on their car or or their or their house was burgled, you know, like it's just done for you.
• 19:11
  SPEAKER_01: Um whereas that's not actually the the veterinary model.
• 19:15
  SPEAKER_01: Well, certainly from the veterinary point of view, we would like to be paid by the client and the client to be reimbursed by the insurance company.
• 19:21
  SPEAKER_01: And and and certainly, you know, that's even something that that's quite often offered by insurance providers.
• 19:28
  SPEAKER_01: Oh, we pay the vet direct.
• 19:30
  SPEAKER_01: I don't remember anyone ever asking me if that was okay and suited my cash flow.
• 19:34
  SPEAKER_01: And certainly in that situation, without all the context there, I'm taking quite a big risk.
• 19:39
  SPEAKER_01: Somebody says that they're insured.
• 19:41
  SPEAKER_01: I don't have any way, you know, certainly, you know, we used to we used to be in the practice or we used to consult until seven o'clock.
• 19:49
  SPEAKER_01: Often that was eight o'clock, nine o'clock.
• 19:51
  SPEAKER_01: If that's the case, I'm not going to be able to get hold of anyone at that moment very easily to say, is this pet insured or not?
• 19:57
  SPEAKER_01: And I'm having to sometimes make life and death decisions based on, you know, hopefully it will be paid.
• 20:03
  SPEAKER_01: You know, the client doesn't have the money, the animal is in front of me and needs my help.
• 20:09
  SPEAKER_01: I I'm, you know, I've got to take the risk.
• 20:11
  SPEAKER_00: So we'll say the case might so sorry, Mark, just a quick question there.
• 20:15
  SPEAKER_00: Mike, how often would it take?
• 20:16
  SPEAKER_00: I mean, in those circumstances where um you're just sort of operating on good faith uh from an insurance standpoint, how long would it take to get those you know, sort of claims settled?
• 20:28
  SPEAKER_00: And uh, I mean, how arduous is that process with the insurer as well?
• 20:32
  SPEAKER_00: You know, it do you run the risk of the claim being denied and then you know you're sort of you're you're out on your own?
• 20:38
  SPEAKER_01: Elliot, I'm I'm gonna be totally honest with you and say this is if we were having this conversation 15 years ago, I could tell you stories about waiting three months to be paid, you know, to be reimbursed.
• 20:50
  SPEAKER_01: However, things have got much, much better.
• 20:52
  SPEAKER_01: And I actually think that most insurance providers are doing a pretty good job in getting back to us pretty quickly and and paying and uh reimbursing the practice pretty quickly.
• 21:01
  SPEAKER_01: But yes, I have had many, many circumstances where the policy did not cover the care for whatever reason.
• 21:09
  SPEAKER_01: And it be and it came as a bit of a shock to both uh practice and owner.
• 21:15
  SPEAKER_02: And then I assume in that situation, Mike, you have to go back to the owner and go, oh, by the way, it's awful that wasn't covered, and now you need to go find the money.
• 21:26
  SPEAKER_02: It's it's awful.
• 21:27
  SPEAKER_01: It's awful, and and and for for the owner it's awful, and for the practice it's awful, and it's more work and more work, more work that you didn't need.
• 21:34
  SPEAKER_01: More work and and you know, you know, the goodwill that you know may have gone into you know, you know, keeping a practice open, operating after hours, looking after that pet, nurses coming in on their time off to make sure that you know that I don't know, that pet got an extra cuddle or whatever it was that goes on all the time in veterinary practices, all that goodwill's out the window because now we're talking about money and fluffy animals.
• 22:00
  SPEAKER_01: Which really don't go well together, right?
• 22:02
  SPEAKER_01: So it it could be better and be it'd be lovely if if money just didn't come into it, you know?
• 22:08
  SPEAKER_01: If you have an insurance policy, everybody could see what's going on.
• 22:11
  SPEAKER_01: We don't, you know, of course we have to talk about it and we have to make decisions.
• 22:15
  SPEAKER_01: All that other contextualized care piece needs to be taken care of.
• 22:18
  SPEAKER_01: Is this the right treatment for this animal and for this owner at this moment?
• 22:22
  SPEAKER_01: But if money didn't come into it, I think you know things would be a whole lot easier and actually more along the lines of what everybody wants.
• 22:30
  SPEAKER_02: Yeah.
• 22:31
  SPEAKER_02: Well, um if we if we fast forward to like the Nirvana state, which I think is, you know, it's realistic.
• 22:39
  SPEAKER_02: It's you know, we can see it's there, we're definitely working towards it.
• 22:43
  SPEAKER_02: We're sharing medical records, we understand the policy implications, you know, AI and other automation approaches are going to enable us to process claims super quick.
• 22:56
  SPEAKER_02: Um one thing that I I I I'm interested in and interested to get your thoughts on it, the sharing of medical records is absolutely key for the insurer to understand kind of the context of the claim and whether or not it's valid.
• 23:10
  SPEAKER_02: Um there any actually I mean I I'm curious because I don't know.
• 23:16
  SPEAKER_02: Today, are there any is are there any protocols around sharing that information uh with the insurance?
• 23:22
  SPEAKER_02: Like do you have to seek permission from the policy holder?
• 23:26
  SPEAKER_02: Or if an insurer asks, you just give it to them?
• 23:29
  SPEAKER_01: So I I I hope I've uh to be honest with you, Mark, I we always gave it to the insurer.
• 23:35
  SPEAKER_01: Um I think that with GDPR, so there's some so there's some interesting legal bits around about all of this.
• 23:40
  SPEAKER_01: First of all, the so the clinical notes on the animal belongs to the practice, doesn't belong to the owner.
• 23:48
  SPEAKER_01: Interesting, which is interesting.
• 23:50
  SPEAKER_01: There's no GDPR for pets.
• 23:53
  SPEAKER_01: However, there are there may well and probably will be items in clinical notes that will identify or lead towards identifying.
• 24:02
  SPEAKER_01: And certainly if you talk about an insurance uh claim, then then yes.
• 24:06
  SPEAKER_01: I suspect that there should be some practices should check that the that uh practices are happy to sorry, the owners are happy for practices to share the details, um, but uh, but you know, they're absolutely vital for for insurers to have that.
• 24:24
  SPEAKER_01: So it would be.
• 24:25
  SPEAKER_02: But I think again, technology can come into play there.
• 24:27
  SPEAKER_02: I think you know technology is smart enough now that if we're sharing clinical history and the technology on the way out identifies that there's PII information on there, it can uh redact that before it even gets the insurer.
• 24:40
  SPEAKER_02: So so we're just dealing with the pure clinical stuff.
• 24:42
  SPEAKER_02: It's interesting.
• 24:44
  SPEAKER_01: Yeah.
• 24:45
  SPEAKER_01: So but I think in the future, if I think if there was you know much closer, we we need the information where the where the care is taking place.
• 24:53
  SPEAKER_01: We need we need the the the the vets and the insurers, we we we need to work together.
• 24:58
  SPEAKER_01: You know, I think I think that at the moment it feels as though we're we're we're trying to do the same to get to the same end, but but just not talking.
• 25:06
  SPEAKER_01: And crazy.
• 25:08
  SPEAKER_02: I may have actually answered the question that I've just asked in my head slightly differently, because today, in general, the claims process and in terms of understanding the history of the animal, it's very reactive.
• 25:21
  SPEAKER_02: You could have a policy for three years and the insurer knows nothing about the medical history of that pet prior to that claim.
• 25:28
  SPEAKER_02: Clearly, what we need to get to, and technologies like Helm would be central to that, is actually as soon as we've purchased a policy, we can then contact the vet practice, pull those medical records, and get that clinical position prior to that policy inception, such that when there is a claim three days through three years down the road, you know, we can see that you know they've had cover in that place.
• 25:54
  SPEAKER_02: We understood what they were like before, and we can just go ahead and look at that claim.
• 25:58
  SPEAKER_01: I think I think it's even better than that, Mark.
• 26:00
  SPEAKER_01: I mean, I think I think with AI and everything else, why why isn't why don't we just keep the insurers up to date with what's going on?
• 26:07
  SPEAKER_01: Why don't we start to form an understanding of what's likely to happen uh in the next year of this pet's life?
• 26:13
  SPEAKER_01: You know, it's really interesting.
• 26:15
  SPEAKER_01: And do you know, um I I know that there's now some talk around about geriatric policies and the fact that a lot of people are dropping out of insurance when their pet gets older.
• 26:24
  SPEAKER_01: Well, how about if if the practice, we've got all of the context and the knowledge, how about if we were able to help by saying, look, all right, your cut your pet's coming up to being a a a geriatric pet.
• 26:35
  SPEAKER_01: Here's what we think, you know, you need to look out for in the next year.
• 26:39
  SPEAKER_01: And actually, when you're looking for a policy, this is the sort of policy that you might be looking for.
• 26:44
  SPEAKER_02: So that was a very hot topic um on Wednesday.
• 26:47
  SPEAKER_02: Yeah, absolutely.
• 26:48
  SPEAKER_02: Yeah.
• 26:48
  SPEAKER_01: And and I'm not surprised because, you know, uh it it can be heartbreaking, you know.
• 26:54
  SPEAKER_01: That's interesting.
• 26:56
  SPEAKER_01: I've had clients before uh clients before something happened.
• 26:59
  SPEAKER_01: I just stopped the insurance.
• 27:01
  SPEAKER_01: We've had it for 15 years, and I stopped it last week.
• 27:03
  SPEAKER_01: And you know, that that does happen, and I've seen it, you know.
• 27:07
  SPEAKER_01: Um so it feels like, you know, if the insurers and the vet were able to kind of join up their thinking to essentially advise, which is what vets want on what is going to be best for the pet's health going forward, including the sorts of costs that we might be looking at and the sorts of things that might happen, then gosh, couldn't we do a better job?
• 27:27
  SPEAKER_01: You know, better policies that suit better, premiums that make more sense, um, clients who understand their cover better, and vets who know what they're dealing with.
• 27:37
  SPEAKER_01: I mean, that that's what we're looking for.
• 27:39
  SPEAKER_00: Well, I think I think there's also this trend in a lot of other personalized insurance products of uh insurers trying to take more of a prescriptive approach to things.
• 27:49
  SPEAKER_00: And I mean, I can imagine a world where, look, I mean, I take my dog in for routine care, get the heartworm medication, get, you know, tick all the boxes to keep him healthy, right?
• 28:02
  SPEAKER_00: Uh they're gonna weigh him, they're going to do a general like if you can feed that information back to the insurer, you know, Fido uh got uh got a gold star this this evaluation.
• 28:14
  SPEAKER_00: The insurer can then incentivize the policyholder as well.
• 28:17
  SPEAKER_00: Great, we're giving you 5% off.
• 28:18
  SPEAKER_00: You're doing all the right things.
• 28:20
  SPEAKER_00: You're preventing future claims on this policy by by doing all the right things.
• 28:25
  SPEAKER_00: Um, so you can create a positive incentive structure.
• 28:28
  SPEAKER_00: I mean, we see it with telematics and driving, we've seen it in the human health side now.
• 28:32
  SPEAKER_00: Yeah, like vitality in the UK.
• 28:34
  SPEAKER_01: Yeah, exactly, right?
• 28:36
  SPEAKER_01: I think it's really it's a really interesting point.
• 28:38
  SPEAKER_01: Actually, Mark and I have spoken about this before.
• 28:40
  SPEAKER_01: I think that you know, there you you've mentioned some interesting things actually.
• 28:44
  SPEAKER_01: I I think that in terms of incentivizing clients to do the right things, I think that's a great idea.
• 28:50
  SPEAKER_01: Um and and you know, even uh even just you know get it down to the vet vet visit, it's a great idea.
• 28:56
  SPEAKER_01: In terms of bringing the likelihood of illness down, I I you know I think there are some there are some specific situations, but I'm not sure that there's as many benefits as there might be with people, for instance.
• 29:09
  SPEAKER_00: Um I I imagine but I imagine obesity is a is a is an I mean it's a it's a universal you know you're right, you're right, and that's a great example.
• 29:18
  SPEAKER_01: It's a great example.
• 29:19
  SPEAKER_01: And and and you know, over over in uh in Canada and the States, you know, heartworm medication, you know, extremely important.
• 29:26
  SPEAKER_01: Over here we do have some nasty uh worms, but we we we don't have quite the same levels of uh of of that over here.
• 29:36
  SPEAKER_00: Here's a fun anecdote for you on the vet side, Mike.
• 29:38
  SPEAKER_00: Do you know that now they're prescribing heartworm medication year-round because of of just the change in temperature patterns here?
• 29:46
  SPEAKER_00: So they're spinning the ticks aren't really dying out over the winter.
• 29:50
  SPEAKER_00: It used to be just a six-month thing, right?
• 29:51
  SPEAKER_00: I mean, you you take the heartworm medication spring to fall, but now because you know, sometimes we can get I mean, I'm in Toronto, which is pretty cold in the winter traditionally, but that might not happen until January now, right?
• 30:04
  SPEAKER_00: So yeah, it's it's pretty interesting.
• 30:07
  SPEAKER_01: It is interesting.
• 30:08
  SPEAKER_01: It's crazy.
• 30:08
  SPEAKER_01: Crazy.
• 30:09
  SPEAKER_01: It just shows how multifactorial everything is, you know?
• 30:12
  SPEAKER_01: And in terms of contextualized care, there you are, Ellie.
• 30:14
  SPEAKER_01: You've got an example right there.
• 30:16
  SPEAKER_01: And that's the sort of, you know, we're trying to think of these thousands of points that could affect how you know the treatment for the animal.
• 30:23
  SPEAKER_01: It's really interesting.
• 30:24
  SPEAKER_02: Is do you think controversial question now?
• 30:28
  SPEAKER_02: Do you think pet insurance has driven up the cost of veterinare and the behaviors inside practices?
• 30:34
  SPEAKER_02: Mark, this is a huge question.
• 30:37
  SPEAKER_01: A huge question.
• 30:38
  SPEAKER_01: That's why I asked it.
• 30:38
  SPEAKER_01: So here's here's what so here's what I think.
• 30:41
  SPEAKER_01: I think that there's an interplay here, and it's quite it's quite a difficult piece.
• 30:45
  SPEAKER_01: Basically, um vets are uh we're this group of uh perfectionists, right?
• 30:52
  SPEAKER_01: So so in order to get into into veterinary school, you you have to have sort of certain grades and you have to, you know, all the right work experience, and you have to be, you know, well, I think that well, when I was going through vet school, there's only six places to study in the UK and Ireland, you know, between those all.
• 31:09
  SPEAKER_01: So it's really quite uh an elite uh course to get onto.
• 31:14
  SPEAKER_01: And so you've got a bunch of people who are real high achievers and who are real perfectionists, and we are also animal lovers and super caring, right?
• 31:23
  SPEAKER_01: And I'm generalizing, but most vets I meet are the are that, right?
• 31:27
  SPEAKER_01: So you've got those people standing in a room with uh with a client and their animals not well.
• 31:37
  SPEAKER_01: Now that person has now, you know, we've kind of been trained to say, right, here's the options.
• 31:43
  SPEAKER_01: And we're very good at the contextualized care piece already.
• 31:45
  SPEAKER_01: That's not new, right?
• 31:47
  SPEAKER_01: That's not new.
• 31:47
  SPEAKER_01: We've been doing it for for as long as vets have been vets.
• 31:52
  SPEAKER_01: But now the options are getting bigger and bigger and more and more.
• 31:54
  SPEAKER_01: We're we're kind of aiming for human medicine, right?
• 31:57
  SPEAKER_01: So I talked about stem cells before.
• 32:00
  SPEAKER_01: Like, like some people might say, a vet has no place putting stem, you know, using stem cell therapy in a pet.
• 32:06
  SPEAKER_01: You know, or likewise, I I once gave an injection.
• 32:09
  SPEAKER_01: I mean, this is a long time.
• 32:10
  SPEAKER_01: So this is when I first qualified.
• 32:12
  SPEAKER_01: So 2005, maybe I gave a chemotherapy injection, a single injection to uh, I remember it, a Rhodesian ridgeback, and that was 1500 pounds 20 years ago for that one injection.
• 32:23
  SPEAKER_01: But what's happened is a vet is good in front of Did it work?
• 32:27
  SPEAKER_01: Well, it it it extended the dog's life.
• 32:30
  SPEAKER_01: I'm sure it did.
• 32:31
  SPEAKER_01: I'm sure it did.
• 32:32
  SPEAKER_01: Um but so you've had a vet standing there saying to some people who deeply love this animal, well, we've got option A, B, and C, and we can probably save your dog's life, but it's gonna cost you 1500, 2000, 3000.
• 32:47
  SPEAKER_01: And as the as the treatment options get bigger and more advanced and whatever else, they get they get more and more expensive.
• 32:55
  SPEAKER_01: So I and you know, my parents are a good example of this.
• 32:58
  SPEAKER_01: They've got uh uh they've got two elderly poodles, and one of them had a condition, a blocked gallbladder.
• 33:05
  SPEAKER_01: Now, Hobbs is 15, just turned 15.
• 33:09
  SPEAKER_01: So it was last year, and basically Vet said, we can put him to sleep or we can do this operation.
• 33:15
  SPEAKER_01: And off the top of my head, and and forgive me, my parents are very well insured, by the way, but they ended up paying on top of their insurance about 5,000 pounds because they wanted to keep the dog alive because he's an important dog to them.
• 33:28
  SPEAKER_01: So insurance allowed my parents to go halfway and they had to pay the rest.
• 33:33
  SPEAKER_01: Now, d you know, insurance insurance uh cover has expanded to allow for that, but I don't think one thing is I I don't think it's as simple as one thing is driving the other, if that makes sense.
• 33:45
  SPEAKER_00: No, I think well, I think just to you know to weigh in my two cents, I I do think it's sort of multifactorial.
• 33:52
  SPEAKER_00: I think there's obviously been medical technology and innovation that costs something to somebody at some point in time, right?
• 33:59
  SPEAKER_00: Um so as medical advancements are made, I mean there's a tremendous amount of research and development that goes into that, right?
• 34:06
  SPEAKER_00: And and again, somebody has to pay for it.
• 34:08
  SPEAKER_00: So I I I I would imagine that the clinical options that you have today are vastly different than what you had 15, 20 years ago, Mike, right?
• 34:17
  SPEAKER_00: Um it might not have been an option to do the surgery on the 15-year-old dog 20 years ago, whereas you know, now it is an option.
• 34:25
  SPEAKER_00: And I also think there's been uh from my perspective, just a bit of a societal shift uh or societal perspective shift, where I think it would have been more uh society would have been more inclined, pet owners would have been more inclined to opt for euthanasia, uh, you know, a longer time ago, and and partly because the the clinical interventions weren't available back then.
• 34:52
  SPEAKER_00: But now there just there seems to be a bit more willingness to to do these things, um, particularly later on in in the pet's life as well, right?
• 35:01
  SPEAKER_02: So that's really and Elliot, again, you make a really interesting point.
• 35:05
  SPEAKER_02: So we were at Mintel.
• 35:06
  SPEAKER_02: I don't know if you know those guys, big market research global organization.
• 35:09
  SPEAKER_02: They've done a whole bunch of studying uh about pet insurance uh behaviors, and the fastest growing segment um for pet owner adoption is the Gen Z um age group.
• 35:26
  SPEAKER_02: Um and kind of their attitude, so they're they're gonna get a dog before they get kids.
• 35:31
  SPEAKER_02: Um, and you know, they were sh showing up, quotes, you know, I'll spend whatever it takes to keep to keep the animal alive, you know, and and their attitudes towards their pets um uh are are definitely different to perhaps someone of my generation for sure.
• 35:50
  SPEAKER_01: Well uh when I started, I mean it's in stark contrast.
• 35:53
  SPEAKER_01: When I when I started my uh veterinary journey, you know, you'd you'd kind of go in and and and the the family would bring in the old dog and and the vet would more or less say, he's not he's not great, and I don't think he's gonna do well, and they'd agree to to put that animal to sleep.
• 36:09
  SPEAKER_01: The animal would be put to sleep there and then, the family would obviously be very upset, but the next week they'd be in with a new puppy.
• 36:17
  SPEAKER_01: And it was kind of the attitude, oh, that last dog didn't last very long.
• 36:20
  SPEAKER_01: Hopefully this one will last longer.
• 36:22
  SPEAKER_01: But it wasn't, it was a completely different mindset.
• 36:24
  SPEAKER_01: Change, isn't it?
• 36:25
  SPEAKER_01: Yeah.
• 36:25
  SPEAKER_01: Interesting.
• 36:26
  SPEAKER_01: And and you know, and and you know, I mean, listen, vets have been extremely successful.
• 36:31
  SPEAKER_01: I mean, extremely successful in sort of improving the options and to and and and and the the opportunity to to improve animals' lives and to keep them around for their owners for longer.
• 36:44
  SPEAKER_01: But but it comes at a cost, as you said, like you know, specifically a cost.
• 36:48
  SPEAKER_01: And that that is a real problem.
• 36:50
  SPEAKER_01: From the veterinary point of view, I'll be honest with you, I mean, it it's it's a difficult place.
• 36:55
  SPEAKER_01: You know, you will see up and down the internet, you go into any forums, you know, they they they they say that vets are are ripoff merchants and they're terrible and they're you know taking money left, right, and center.
• 37:08
  SPEAKER_01: The truth is that you know, vets are just responding to, well, in general, I mean, listen, there's always some outliers, but in my experience, vets are just responding to what the clients want.
• 37:18
  SPEAKER_01: But vets also feel that they have to offer all options.
• 37:22
  SPEAKER_01: And and and a huge majority of people are gonna say save my animal or fix my animal or do whatever it takes.
• 37:29
  SPEAKER_01: And uh and so it's it's an extremely difficult piece.
• 37:32
  SPEAKER_00: I think this might be uh this might be an unpopular opinion, but uh, I mean my background is more on the the human health side, and and I'm actually shocked at how how low or how little treatment costs are uh on the vet side compared to to humans.
• 37:47
  SPEAKER_00: I mean, you know, you describe complex medical procedures in in you know the the the three or four digits uh and and on the human side, I mean it's six, seven, right?
• 37:58
  SPEAKER_00: So uh, you know, I I think give give your history some credit there, yeah.
• 38:03
  SPEAKER_01: Well listen, and and and obviously in the UK we've got the NHS, so so people don't pay for care at the point of delivery.
• 38:09
  SPEAKER_01: Yeah.
• 38:09
  SPEAKER_01: But I'm just saying that they really have no idea what it costs.
• 38:13
  SPEAKER_01: Um and and that's a very difficult piece as well.
• 38:16
  SPEAKER_01: And and it's not so long ago, I've said that we're getting lots of bad press about how expensive we are.
• 38:20
  SPEAKER_01: It's not so long ago that I remember seeing an article which was talking about how how the NHS should should deal with with uh or should be organized more like veterinary practices.
• 38:29
  SPEAKER_01: You know, in the UK, if you've got a, I don't know, a sore leg, uh, let's say a sore knee, chances of you walking into a GP's practice and on the same day having the X-ray on your knee and maybe a scan, and then for the following day or the day after having your cruciate surgery repair, I mean, it's not a happen.
• 38:51
  SPEAKER_01: But vets are doing that every single day, every week, day in, day out.
• 38:56
  SPEAKER_01: And as you say, Elliot, for well, listen, in in that scenario, thousands, not hundreds, but you know, uh, relatively you know, compared to human human care, relatively low amounts.
• 39:09
  SPEAKER_01: Um, but but it's but it's a difficult space.
• 39:11
  SPEAKER_01: Really difficult.
• 39:13
  SPEAKER_01: Yeah.
• 39:13
  SPEAKER_00: Mark, any any final uh question for for Mike here?
• 39:17
  SPEAKER_02: Well, I could talk about this for a very, very long time.
• 39:20
  SPEAKER_02: I think we'll we'll need to save it for a beer, Mike.
• 39:23
  SPEAKER_02: Um and and we can put the worlds to rights.
• 39:25
  SPEAKER_02: But I I think I'd just like to thank you.
• 39:28
  SPEAKER_02: I mean, your insight is is you know, it's unique.
• 39:31
  SPEAKER_02: Um, it's kind of, you know, the scales have fallen away from my eyes to a large extent.
• 39:36
  SPEAKER_02: And I think what you're trying to do with Helm and getting that transparency, which is going to be critical going forwards between the vet practices and the insurers is going to make a huge difference.
• 39:46
  SPEAKER_02: And, you know, wish you all the very best.
• 39:49
  SPEAKER_01: Thanks, Mark.
• 39:50
  SPEAKER_01: And listen, all I can say is, you know, I think we can do this.
• 39:53
  SPEAKER_01: Yeah, we can really do this.
• 39:55
  SPEAKER_01: We can we can change all of this.
• 39:57
  SPEAKER_01: You know, that this is a tech problem, right?
• 39:59
  SPEAKER_01: And we should fix this.
• 40:00
  SPEAKER_01: So I'm I'm extremely sort of optimistic about all of this.
• 40:04
  SPEAKER_01: I think that that we will sort this out.
• 40:06
  SPEAKER_01: And and likewise, I've really enjoyed sort of getting to know ice tech and what you guys are doing.
• 40:10
  SPEAKER_01: I think between us, we have the solution, you know.
• 40:12
  SPEAKER_01: We we have most of the solution.
• 40:14
  SPEAKER_01: It's a question of sort of joining, joining up the two spaces.
• 40:18
  SPEAKER_01: So let's do it.
• 40:19
  SPEAKER_01: Absolutely.
• 40:20
  SPEAKER_00: Mike, Mike, where can people follow along with Helm?
• 40:22
  SPEAKER_00: Uh you have a website, uh, LinkedIn.
• 40:26
  SPEAKER_01: You'll you'll find us at helm.vet.
• 40:29
  SPEAKER_01: Um, and then you know, we're we're on LinkedIn all the time.
• 40:33
  SPEAKER_01: So you'll find us if you search Helm hyphen vet on LinkedIn, you'll find us.
• 40:37
  SPEAKER_01: Uh and we'd love to hear from everybody.
• 40:39
  SPEAKER_01: Actually, you know, our main our main thing is we're we're our our the problem we solve is we're trying to sort out all these problems in veterinary practice.
• 40:47
  SPEAKER_01: So insurance is a piece of it, but there are there are so many bits and pieces that we want to get to.
• 40:53
  SPEAKER_01: So, you know, we'd love to hear from vets out there or insurers or anyone who feels that there could be a better way of of of providing that veterinary care.
• 41:01
  SPEAKER_01: And we're gonna do our very best to tick them off one at a time.
• 41:04
  SPEAKER_00: Brilliant, brilliant.
• 41:05
  SPEAKER_00: Mike, it was lovely chatting with you.
• 41:06
  SPEAKER_00: Really nice to meet you today.
• 41:08
  SPEAKER_00: And uh, yeah, all the best in the future.
• 41:10
  SPEAKER_00: I'm sure, I'm sure we'll reconnect soon.
• 41:12
  SPEAKER_00: Really appreciate that.
• 41:13
  SPEAKER_00: And to you.
• 41:14
  SPEAKER_00: Thanks, thanks for having me on.
• 41:16
  SPEAKER_00: Cheers, Mike.
• 41:17
  SPEAKER_00: Take care, guys.