Latest / Ben Taylor Podcast / Medical Risk Mitigation for Superyachts | Emma Deal from MedAire
Transcript
- Hi, everybody.Welcome back to the Ben Taylor Podcast, the home of marine industry insights.Uh, this podcast is brought to you by Super Yacht Services Guide, a worldwide trusted directory of super yacht services.And you can only be in it by a captain's recommendation, so you know they're the real deal and they can support you.One of those companies in the directory is MedAir, which is what we're gonna talk about today.Uh, we're here with guest Emma Deal.Welcome to the podcast.Thanks for coming on.Thanks for having me.So, let's have some context first.What is MedAir about?What do you guys do?Yeah, so, uh, at its core, MedAir is a travel assistance company, medical and security.Um, so we look after around 1,400 yachts, um, looking after the crew and guests on board, their medical, health, mental health, um, and travel security as well.Right.And you've mentioned about 3 massive topics in the industry already.But c- so, uh, as MedAir, you're also kind of beyond yachting as well.It's quite a- Yeah.quite a massive organization.Absolutely.And then you have kind of a specialist branch which is for yachting.Yeah, absolutely.So, so I work in the luxury yacht division, um, of MedAir.MedAir is the aviation and maritime arm, if you like, of International SOS.Right, okay.International SOS is the world's largest- That's the big group.medical and, uh- Right, okay.security assistance company.Right.Pretty busy at the moment with everything going on- Oh, yeah.in the world.Sure, yeah, yeah.Um, but yeah, so it's im- I personally work in the, the yachting side.Right, okay.And w- what's the, what's the kind of typical situation?Why do you guys exist?What's, wha- what are the kind of the core bits-of remote medicine and why is this- Yeah.why is it so important?I suppose this is the obvious-but just a bit more detail would be good.Every day is very much different from the day before.Mm-hmm.Um, we really exist as a, as a risk management company, um, so our role, if you look at anybody that enjoys yachting, they have one thing in common and that's exploring what's beyond the horizon.They're not happy to just- It's an adventure.stay in the cave.It's, it's- Yeah.You- Yeah, you always gotta do something.You want to adventure, and, and adventuring is not without risk, um, whether that's planning some epic adventure to travel the globe or whether you're somebody whose health is not particularly great and you'd just like to go a little bit down the coast.Yeah.Risk looks different for everybody, um, and our role is really to, to help look at those risks, help mitigate them, and let everybody go off, explore what's beyond, and come home safely at the end of it.Yeah, so I suppose there's then a bit of a peace of mind, of whoever's- Yeah.on board and kind of enjoying it, and then the crew side peace of mind for them.But then also from like aYeah, I suppose it's also risk mitigation, so when it comes to insurance, when it comes to the reality of things that can happen on board, 'cause that's a reality.Yeah, 100%.And i- It's peace of mind, yeah.the more that we can support clients with their, their planning and their preparation, the better the outcome is likely to be as well.Um, so it's really just helping people to understand what those risks are, where they're going, um, whether that's from a medical perspective, understanding, you know, what vaccinations the crew need to have, planning in advance to make sure that those are in place- Yeah.and we're not sending somebody- Yeah, of course.Yeah.off without their- Things you don't think about.You just kind of- Yeah."Yeah, let's go to that country.That'll be fun.""Well," you know, "Let's make sure it's safe," and- As long as you're allowed in.'Cause you've got the right bit of paperwork- Yeah, yeah.et cetera.Um, but also, you know, what, what is going to happen if, if there is a medical emergency- Mm-hmm.on board?You know, have we got the, the right people in place?Have they got the right training?Have they got the right equipment?Um, and do they know who to call?And, and, you know, then at the f- furthest end, you know, if they are needing to be seen shoreside, what are those facilities like?And, um, you know, is it somewhere that we can actually have treatment or do we need to get them evacuated for further treatment elsewhere?Yeah, so when there'sYeah, this, this point was really interesting when we were talking about it.The, um, the, the destinations that these yachts are in are not necessarily fitted with top facilities that could, that could give world-class treatment.And so, when things do go wrong, actually part of your scope is to say, "Well, is it like a get somebody stable and then transport them?Or are they, are there sufficient facilities in the area?"And working out all those logistics when it's time-critical- Yeah.when it matters most.Yeah.That's also part of your remit.Absolutely.So- Yeah.um, yeah, we, we pride ourselves.We've got a, a network of around 90,000 providers globally, and that's everything from air ambulances, security specialists, medical correspondents, dental clinics, physiotherapy, CER centers.So we, we vet around 10,000 of those, are what we call managed in our network.And that means that we send a team to go and audit.So- Oh, okay, wow.when a facility says, "Yes, we have a CT scanner here," we know when it was last serviced.We know the, you know, the hours of operation.Um, so we can be really confident when we send somebody somewhere, of the capabilities.Um, and, and likewise, when it's not somewhere that we would recommend that they go.That's equally- Yeah.as important.Yeah.Um, and it, you know, it, it takes a lot of effort to, to maintain a network like that.But it's really crucial to, to make sure that we're sending people to the right places and setting the right expectations.Yeah.As you rightly said, not everywhere that these yachts are going have excellent facilities that we would expect, you know, in a Western, civilized world.Yeah, yeah.So it's really difficult to-to have that conversation when it's an emergency, whereas beforehand, you can have that, set those expectations, you know, "Yes, there is a facility on this lovely island you're going to."Yeah, yeah.However, it's not got anything, you know- Yeah.there's no imaging, there's, th- they can't do the tests.Yeah, it, it's basic.It's very basic.So it's a stabilized move.Yeah, yeah.It's stabilization, a hundred percent.Yeah.And I suppose with, with a lot of the expedition yachting, and going to exciting, wonderful places, you're like, well if you go to Antarctica, then there's going to be less facilities-than, you know, off the South of France.It's gonna be different.Yeah.Yeah, yeah, yeah.Absolutely.But you need, need to know that you're supported and safe in the middle of the Caribbean, or transatlantic, all that kind of thing, like, you need this because- Yeah.of, of crew, crew welfare, but then also guests.They're, they're gonna be pretty important people on board that are used to very top service, especially when it comes to healthcare.So, that's where the expectation is.I- And this allows yachts to actually- And I think that's, that's one of the things that's-that's almost most challenging in our role, is- Mm-hmm.is having to set those expectations.And one of the, the questions least asked, but probably the most important question is, what does the owner expect to happen- Yeah.if there were to be a medical emergency on board?And it, it's gotta be like, the last thing they wanna think about.Let's, let's get a yacht.It'll be great for recreational time- Yeah.turning off, whatever.Relax.Probably one of the last things is, "Well, what happens if I have a medical emergency whilst on board?"And it's very easy for them to assume, saying, I'm on a super yacht.I'm gonna have excellent-" "medical, medical treatment," when actually, the reality might be different.And so, MedAire kind of facilitate that, that and this joint- Yeah.and make sure that it is up to their expectations.A h- a huge part of our, our role, um, and particularly for, for myself and the team is, is understanding the risk appetite of the owner, um, and, and their expectations.And i- we can do everything.If they want to have a doctor able to come and see them within 5 minutes, that's no problem.Yeah.We can do that.Yeah, yeah.We can place the doctor- Yeah.on board for the duration of their trip.Yeah.And they can be as discreet as you like.Yeah.Um, we can do all of that.We do need to have the conversation up-front.Yeah, and you say that- There's no point- You need to know, yeah, yeah.At the point that they need a doctor- Yeah.they're going, "Well, why have I not got a doctor here?"Yeah, yeah.Um, so it's, it's, it's about having those conversations nice and early.The earlier we have the conversation, the more we can do in advance.You know, we can, we can put in place- That's why it's possible.training programs, you know, for all of the crew.Because the most, in most situations, it's not the most medically trained person that finds an injured or, or ill person.Right, 'cause it could be anybody on board.Absolutely.Yeah, yeah.You know, if, if a guest has slipped in the shower, it's not likely to be the captain that's, that's popping in.Yeah, it might be another guest.Yeah, the captain is the most medically well-trained.It could be any member of the crew.Like, it could be anybody.Yeah, yeah.Yeah, so- And, and, and I know there's a good story because we were we were preparing for the podcast.But th- th- there's a story, obviously we're gonna, uh, keep them anonymous, but the, these kind of expectations of medical care on board.Can you tell us the story of the, the person who kind of had, uh, a lot of medical, uh, conditions ongoing- Yeah.which previously meant they had to leave the boat, and it was logistically an issue, and obviously quite a pain point for them.But then as a result of your service, meant that they could actually stay on board and enjoy their leisure time, and just be a lot more comfortable whilst being safe and cared for medically?Yeah, absolutely.And actually, it's, it's, it's a year almost to the day.Oh, right.Okay.Yeah, yeah.Uh, so it, it was at last year's technology show.Oh, right.Um, we, we did a presentation on, the, the use of blood analyzers and other pieces of technology to provide more information, um, to make better assessments earlier.Um, and a lot of this equipment can be carried on board.Um, and this, this particular captain, um, the, the owner i- is elderly, um, has a, a, a number of medical conditions that require regular testing, uh, regular changes to the medication.Um, uh, and after last year's event, they, they decided to, to purchase some of this equipment to be able to, to take tests and analyze on a regular basis.They invested in bringing a physician on board to be able to do that, and where in previous years, they'd really seen quite a decline of the owner's health over time, you know, every time they would go into hospital, they'd come back just, just a little bit less well than they had going in.Yeah.A little bit stressed out, a little bit just- Yeah, absolutely.Yeah.Um, and they'd not really been able to enjoy their yacht, and why you get a yacht.You want to go out and you want to enjoy it.Um, and purchasing the equipment and changing the way that they could then proactively monitor, tweak, make changes to the, the care plan and the treatment that was being provided allowed for their first uninterrupted guest season in as long as he could remember.And what a difference.I mean, what a diff- Yeah.I mean, that's what we're trying to do, right?I bet everyone was happy about it as well.We're tryingLike obv- obviously them personally.But then, like, crew logistics, and, and- Absolutely.You know-logistics of moving around going, "Well, we need to go here for an appointment, and they've got this facility," and journalist sounds Yeah You don't buy a boat to have it sat there.You know, you want to go off- Yeah.and you want to use it, so, um, that was, that was a really nice story for us to hear- Yeah.because just thinking about things in a bit more of a proactive manner really made all the difference.Yeah.And this brings us wonderfully onto-um, I'm gonna say vital signs monitoring.Yeah.Yeah, that's great.And, and so what is this?We're not gonna get it out and kind of-go into all the details.Yeah, we can get it out at some point.But what it's about, what, what is this, uh, solution?Yeah.So, so I mean, and it's called vital signs monitoring is, is taking vital signs, so blood pressure- Yeah.um, respiration rate, et cetera, and transmitting that to people that know what they're talking about.So- Right.in our case, the data goes through to our medical team.They can analyze and they can help make some more accurate decisions based on accurate information.So, this isn't new.Um, vital signs monitoring has, has been around for, for many years, and we previously sold the Tempus IC2.Um, that was discontinued.Um, it's been given its end of life from February 2027.So this is really our- So the next generation is the new one, right?Yeah, absolutely.And, you know, what, what's great is that, you know, whilst the Tempus was a fantastic piece of kit, it was, it was quite big and bulky, this is a small wearable.It's very discreet, um, which means that you can put it on more regularly.So there may be somebody, you know, an 0 older guest on board who you're just not quite sure.They don't seem to be quite themselves.Yeah.This allows us to attach a nice discreet wearable monitor.They can continue with their day.They can sit and read a book in the sunshine.They can go and watch a movie.Uh, and this is just really- Yeah, they're still comfortable.It's not disruptive to- Yeah, absolutely.everything else they wanna do and just relaxing, right?Yeah, exactly.So it means that we can just get that data on an ongoing basis, and what that really helps us to do is to make decisions that, as to whether we need to disembark this person.Operationally, it's always challenging to try and take somebody off the boat.Yeah.And depending on where they are, we may not even want to take them off.The facilities shore side might, might not be as good as they have on board in some cases.Yeah.Um, so it's really just helping us to understand, okay, is this person safe to stay where they are, or do we need to get them off and do we need to, to move to the next step?Yeah.And I suppose a bit of a before and after comparison would be whether these kind of various observations made when we think this, it looks like that, okay.And rather than being, making decisions off that kind of description- Yeah.you can actually just have hard data in real time?Is it, yeah?Absolutely, yep.Real time data straight away?It's, it's real time.So, so you can see- Yeah."Well, this is exactly what's going on.This is the state of the patient."Absolutely.So you can make good decisions, yeah.And if you consider who's taking vital signs, I mean, don't know if you've done any first aid training, but you know, you get taught to take a blood- The most basic of basic, but yeah.Yeah.a blood pressure reading- Yeah.uh, and then you don't do it for, you know, maybe a year.The chance of that being accurate pretty slim.So- Yeah, especially something to constantly taking the blood pressure.Yeah.So we want to make sure that we're getting accurate information.This is all medical grade.It's exactly what you would be using in a pre-hospital setting, so ambulance services, et cetera.Um, this is exactly what they would be using- Right.to assess.Um, our escort nur- nurses also use this, so if we ever send any of our nurses out to, um, escort a patient commercially- Yeah.um, they, they would take this.Uh, they, they come with one of these and say, "This is-" Yeah." useful bit, bit of equipment on the move."So, they, they, they take it- Yeah, yeah.so that they can see exactly what's going on a- with their patient, um-you know, obviously flying, um, messes with all sorts of things.Yeah, sure.So we wanna make sure that we're, uh, we're assessing that patient throughout in case there's any change.Right, okay.And I d- and I wanna get an understanding.So the, in terms of a plan for medical care- Yeah.what does a, a yacht have maybe before they engage with someone like MedAir, and what do they end up with, and what, w- what's the big differences there in terms of, uh, obviously we mentioned risk, risk mitigation, but what exactly do they have in place?Yeah.What's good practice here?What should yacht management companies be concerned about and have an understanding of to make sure it's done- Yeah.in a, in a pretty ideal way?Big question.Big question, yeah.No, I think- I think the key difference w- with the- the clients that- that do this well is it's all front-loaded.There's a lot more planning and preparation.So it's- it's knowing where you're going, understanding the level of- of healthcare, if there are any security risks in the area, knowing what to do if that changes as well.So MedAir clients have alerts.Uh, so they can sign up for alerts in the location that they're going to.Oh, right.Yeah, so a situa- You know, if there was a protest- Yeah, yeah.going on down the road- Yeah, yeah.there, my phone would be pinging now.Well, there's a risk.Avoid that.There's a- There you go.Yeah, yeah.you know, outbreak- Whatever.of a certain disease.They're getting that real-time information.So I think understanding, okay, well, great, I've now got this information, what- what does that change?So having clear protocols that are well-communicated on board, they know who to contact when, what are the likely scenarios, so doing a bit of scenario planning, what-if situations.So just understanding, okay, well, who am I gonna call, and what information are they going to need?Yeah.Do I have everybody's visa and, you know, documents?Do I have their passport information?If we need to evacuate- Yeah.somebody- Yeah.you'd be amazed how often that's the bit- Yeah.that causes the delay, is, "Oh, well, I've got this crew member over here that's fallen off a scooter-" I know." and needs to be evacuated-" Yeah, yeah." for treatment, but their passport isn't with them."Their passport's on the boat."Yeah."Okay, well, do we know where on the boat is?"That's it.Yeah, so it's- it's trying to be ready for those scenarios.Um, I think the- the other critical part of planning is understanding what equipment have they got available to them on board- Yeah.and how to use it.Y- you're nicely going down this list- Okay.of points here.We've got owner expectations and mapping, the first response compet- uh, competence, and having that kind of plan, escalation pathways- Yeah."Okay, it's got worse.What do we do now?"Um, medical kit governance, having the right kit on board.And, you know, none- none- Yeah.of this is rocket science.Yeah.But it- it needs to be addressed beforehand.There is no point in getting to a medical emergency and then going, "Right.So-" Okay, let's make a plan." what do we-" A bit late now." what do we do?"Yeah, yeah.Um, so- so certainly, you know, the clients that we have that really spend a lot of time on that planning, on that communication so that everybody knows where they stand, everybody knows what they're meant to be doing, they know who they're meant to be calling, um, and getting some of the- the boring bits out the way of things like financial approval.So if somebody needs to be evacuated out of the Caribbean, we know it's going to cost upwards of 15, 20,000- Yeah.for their ambulance.So who do we call for that authorization?Who's able to give that?Do they realize that we could be calling at any time of day, of night?Yeah.Um, do they want to put in place something like a delegated authority?Do they just want us to crack on and do it?Um, so it's having those conversations nice and early.Um, we're- we're one of the few companies that, we have our own treasury.We can place guarantees of payment with providers for our ambulances, et cetera.Yeah.Now, 10 minutes' time, 10 minutes' time- Yes.10 minutes' time.S- so from the emergency services perspective- Yeah.they're happy to provide the service- Yeah.because they're familiar with MedAir- Mm-hmm.because you have that relationship- Exactly.Yeah.rather than a boat somewhere kind of -you know, me ringing up, going, "Can you help?"Well, there's a bit more of a- a question mark on the finances compared to- Exactly.existing relationship all set up, kind of could all be facilitated.Exactly.Yeah.Yeah.And theAnd I- I want to talk about crew welfare- Mm-hmm.especially with mental health.Big topic at the moment, and I suppose always will be.Yeah.So what do you guys do in that space?Where are your focuses?Yeah, so we- we were actually pretty early on the, uh, the mental health services provision.Um, so about, uh, Yeah.11 years ago now- Awesome.um, we, we realized that as employees of International SOS, we had access to an employee assistance program that offered us counseling sessions.That's really good.Yeah, yeah.Like, for us, for our family, uh, and it occurred to us, um- It's like, this is quite good."This would be really good-" Yeah." for our crew members."Yeah.Um, because unlike us, you know, at the end of a bad day, I get to go home and, you know, start thestart my other job.And, you know, I can decompress with my family.Yeah.Our crew members don't have that opportunity.Yeah, it's a different environment.It's quite a difficult environment from a mental health perspective.Exactly.Yeah.Exactly.So, we, we added an extension product to our membership, called em- emotional support.Nobody talked about mental health 11 years ago.Right, okay.It wasn't a thing.Yeah, yeah.Um, and, and it does exactly that.It, it providesIt's the same, same number, so they call in, they speak to our medical team, and that's really important from a triage perspective, 'cause there may be some medical symptoms that we also want to be treating- Okay.at the same time.Um, they will then be referred to a counselor, and they will get 5 sessions per incident per crew member per year.So-pretty much unlimited.Yeah, right, okay.But it, but it's a really good starting point.Yeah.So rather than feeling- Absolutely.feeling isolated and being, "Where do I go for this?Where's the support?"- Yeah.it's at least something, and actually it's quite extensive by the sounds of it.Absolutely.So, tho- those 5 sessions are pre-authorized, so we're not gonna call anybody for authorization.Um, the, the crew member's gonna have confidential access to professional counselors.Perfect.Yeah.Um, and that can be telephonic, it can be, um, know, in person if they're in the right area, and that happens when they're on shore as well, so when they're on rotation.And that's really important, 'cause then we can start being proactive again.So, you know, imagine a situation where, you know, somebody's gone home, perhaps there's a bereavement in the family.As they start getting to the point where they're going to have to come back to the boat, that anxiety level is going to be increasing.So what about starting your counseling sessions whilst you're at home, and then you have continuity once you get onto the boat, you've got that same counselor, that same point of contact, and we can start having a far more structured approach to making sure that somebody's mental health remains good- Yeah.rather than waiting until- Yeah, I think proactive-they have a mental health issue- Yeah, yeah.and then trying to address it.Yeah.And proactivism is quite a nice term, because then you can-You can preempt what's likely to happen, manage it early- Yeah.and so it's more like preventative rather than reactive- 100%.We all have mental health.of going, "Okay, it's a terrible situation.Well, how, how can we prevent that from happening in the first place?"And then it's continuity for everybody.For the crew member- Yeah.their welfare is better, but also- Unbelievable.from crew management, from owner expectations, everything.Yeah.It, it, it sh- it should be smoother, so you get happy stakeholders everywhere.Yeah.And so, so it makes a lot of sense, yeah.You make a really good point there, like, the, the operational consideration of having crew members poor mental health or mental health issues is significant.And we know from our data that you're far more likely, I think it's about 2 thirds more likely, to have to disembark somebody because of a mental health issue than any other medical consideration.Wow.Um, 'cause you just have to get them off.Yeah.It, it's not a safe place for them to be.Whereas if we can start nice and early- Yeah.and we can put in place those measures- And the crew retention is gonna go up.Absolutely.That's better for everybody.Like, yeah, that works.The, the, you know, the captain's not having- Yeah.to suddenly replace a deckhand, a stewardess, uh, last minute.You know, trips aren't affected at all, and we can try and make sure that, you know, operationally, that's, that's better.Yeah.And so, closing question.Hope it's not as-as long as my, my question earlier, but, um, and I think this is a really clear question around s- d- what, what's the, what's the question that people should have in their head as like a, the first question they should ask?So they're thinking about medical care on board, what is, what's that number one?Is it kind ofThat's turned into a big question.TheIs it what do we do if something goes wrong?Is it who are we gonna call?What's, what's the one question that yachts should have in their head when it comes to medical care, and what should they have in place?think it actually goes back to that expectations.Okay.I think everything hinges on what does the owner or what, what, as a charterer, what do they expect to happen, and do we have everything in place- Yeah, could we meet that?to make that a reality?Okay, yeah.Um, and if you don't, that's when, you know, consulting with people like ourselves to just understand, okay, what's, what's possible?What can we do here?And how do we do that?Perfect.Emma, thank you so much for coming on the podcast.Thanks for having me.Very insightful.Really nice to spend time with you.Wonderful speaking to you.Thank you.Everybody, if you enjoy content like this, make sure you follow in here to see plenty more of it.This podcast was brought to you by Super Yacht Services Guide, a worldwide trusted directory of super yacht services.MedAire are one of them.Uh, and all being well, we'll see you again on the next podcast.Bye for now.