Guest: Paul Elmslie
Presenter: Wayne Bucklar
Guest Bio: Born in Australia, Paul has almost 20 years work experience with a focus on skin cancer. He was a pioneer of the original sub-specialised skin cancer business model and established 18 clinics between 1999 and 2006 across four states in Australia. He also owns the Redcliffe Skin Cancer Centre, a highly respected referral centre and training facility in Queensland, Australia. In 2006, Paul founded HealthCert, a global organisation dedicated to changing the lives of doctors and patients in the area of skin cancer medicine. With the vision of a world where nobody dies from skin cancer, the company operates in five countries through three distinct business units: Medical Education, Skin Cancer Referral Centres and TeleDermatology Services.
Segment overview: In today’s Health Supplier Segment, we are joined by founder and CEO Paul Elmslie of Healthcert International. They are a Singapore based company that delivers the latest research and practical knowledge with a unique model of online learning and assessment with practical workshops. With more than 6,500 GPs trained across 15 countries, Paul has taken HealthCert to become the world’s leading provider of primary care skin cancer diagnosis, treatment and education. More recently, Paul set up the Skin Cancer Institute, a multidisciplinary organisation focusing on research, education and a better availability and delivery of diagnosis and treatment in skin cancer medicine.
Health Professional Radio
Wayne Bucklar: You’re listening to Health Professional Radio. My name is Wayne Bucklar and my guest today is Paul Elmslie. Paul is the founder and chief executive officer of HealthCert International. Welcome to Health Professional Radio Paul.
Paul Elmslie: Good day Wayne. How are you? Pleasure to be here.
W: I am very well, thank you. Paul it’s not a name HealthCert International, it’s not a name that instantly tells me that what it is that you do. Can you give me an idea of what your products and services are and what geographical footprint you are in?
P: Yeah, definitely. So we work in three distinct areas. We have a medical education arm of the business, primarily based in Australia but we do deliver courses in the US and online as well. And those medical education courses are post graduate courses in collaboration with the major universities like the University of Queensland or Monash, etc. focusing on skin cancer but we also do general office procedures, GP updates the number of other educational offerings, the CPD requirements or CMA requirement, depending on which part of the world you live. The second arm of the company is skin cancer clinics so these are subspecialized general practices focusing on being sort of referral sources or being able to manage skin cancer screening and diagnostic services. They’re based in Australia but currently looking to expanding in the United States. And the third arm is teledermatology so this is telemedicine but focus on dermatology and what we have is a piece of bank level security software where photographs and history can be taken of a dermatology condition and then send to a dermatologist to then reports on it and sends the report back to where the case originally came from. And that actually is currently deployed in the NHS in the UK to try minimize unnecessary hospital referrals, that’s how it’s being used at the moment.
W: Paul let me unpick those just a little because I’m confused why would a highly educated doctor want to do a post graduate certificate focusing on skin cancer?
P: Well mostly the core reason is that as an undergraduate level dermatology is typically let’s say is not very well taught, it’s just like all areas in primary care you got a little bit of a lot of topics. And dermatology is in most market is about 10% of all conditions and most doctors are probably lucky to get lectures in dermatology. So it’s something that we found from our experience that doctors are looking for education, I mean there’s 2,000 different dermatological conditions and we obviously not looking to teach all of them but we wanted to teach the most common ones because we’re looking for primary care physicians or doctors and/or nurses for that matter to be able to identify these cases early and then obviously try and help the patient, rather than obviously letting it become much worse. And then by the time they get seen by the dermatologist, it’s obviously a lot harder to manage. That’s the main reason, I mean particularly in Australia when you have a market where 2/3 of the population will be diagnosed with skin cancer by the age of 70, in America it’s 1/5. And skin cancer is the most common cancer in the world and the fastest growing cancer in the world, so that was the other reason for focusing on it. And most of our business is focused on skin cancer but we do obviously we do other education and other areas of medicine.
W: Now Paul you talked about subspecialty clinics. These are general practitioner level clinics or subspecialist clinics?
W: Yeah, so in Australia they’re general practitioners. In Australia there’s a 450 dermatologist typically with long waiting list. So the development of the subspecialized clinic was around getting doctors or GPs could have an interest in obviously dermatology, dermatology clinicians such as skin cancer and then putting in through a university certified post graduate training program to up skill them to be able to manage the low level cases. So probably your patient have a level 4 melanoma and needs chemotherapy they’re obviously in a hospital, but most skin cancer isn’t life threatening and it’s typically small in nature, so it’s more than able to be managed by a primary care physician in an office type environment with the vast majority of the cases that do exist out there.
W: And those clinics are in Australia only at this stage Paul?
P: Yeah. So I built chain of clinics from 1999 to 2006 and then chose to then focus on education side of it, thinking it would have a much larger multiplier effect as well in the community.
P: And then in 2009, go back into building clinics and…built for the documentation etc. for the United States is our next step. So basically taking the subspecialized model into other markets and we have been doing work in England for a number of years and we’re also currently negotiating to put a similar model into South Africa this time as well.
W: I see. And the third thing you spoke about was telemedicine. Now telehealth and telemedicine have been a frequent topic for us on the radio. What are you doing there?
P: Yeah, so about 7 or 8 years ago I started developing a piece of software and it really was around giving people in the remote areas access to a specialist’s opinion. And I mean there’s nothing worse and having to drive 600 miles to go and wait for a 15 minute consult, to find out what you’ve got is rather unnecessary. So my sister actually lives in Darwin and suffers from skin condition and for her to get help she had to fly to Adelaide or Brisbane. And for your listeners been there that is hundreds and thousands kilometers and probably spend three days of your life for 15 minute consult. So we developed a software around the ability to be able to take photographs and then basically bank level security data transfer, taking those photographs and the history and sending it to a dermatologist to get their opinion and then send it back. And the idea really was around, the good thing about dermatology is it’s an external condition so it’s on the outside of the skin, it’s easy to see. Typically most dermatology conditions are treated with the oral or topical preparations, so it’s fairly easy to also manage, but the doctor just needs to know what it is. So the goal on developing it was to provide people in remote areas access to the same specialist opinion that someone living in Sydney could get. But realistically I mean it is the future of medicine in quite a significant way, because for example in the United Kingdom it’s being deployed in NHS to help minimize unnecessary hospital referrals. We did a research project which got published in the BJD about four years ago that showed 57% of all skin cancer referrals to the hospital were not skin cancer and 82% of melanoma referrals were not melanoma. So there was a large amount of dermatologist’s time being taking up by cases that were completely unnecessary. And the goal is to use the system like this to just help once again just the waiting lists and specialists doesn’t really want to sit down having to manage cases that are complete unnecessary or perhaps don’t need their level of expertise. And what we’re trying to do is to help filter that and of course the next step in the teledermatology side of it will be the direct consumer, were the consumer obviously takes the images and will send them directly to the specialist is something which obviously we can foresee in the future.
W: You’re listening to Health Professional Radio with Wayne Bucklar. My guest today is Paul Elmslie. Paul is the founder and CEO of HealthCert International and we’ve been talking about the range of services that HealthCert offers. Paul most of our listeners are clinicians at one sort or another often in acute care or aged care, if they are listening to us today what’s the key message that you’d like them to take away?
P: Well I think that, well the key message for me is that as I said before skin cancer is the most common and fastest growing cancer in the world and we need every clinician and whether that’s a nurse through to a plastic surgeon or anybody in the profession to understand what a melanoma does look like. Because of course you might be there threating the patient for something else, inevitably when if you take the patient shirt of and you look at their back you’re probably the only one whose actually looking at their back and you might pick up something that is unusual. And the skill of diagnosing skin cancer which is called “Dermatoscopy” or “Dermoscopy” depending on which part of the world you’re in, is a very simple skill to learn. I mean in probably two hours you would more than enough to be able to identify an obvious melanoma. So I think for us is that traditionally this knowledge is sort of stayed in the realm of dermatologist and obviously that’s a great place for it to be but we do believe that all medical professionals have do come in contact with their patients, it is important that having this basic skill is available and that the scope that is used to look at the skin is basically your hand-held scope, there for us we believe it should be as common as a stethoscope. This just got a 10x magnifying plate and some LED light, cheap and can buy one and have it for the rest of your life. And to have that around so that when you do find something suspicious you can look at it, look at the specific features, melanoma has very specific features. And inevitably when you do find that unusual thing the patient wasn’t aware of and point it out, you could save that patient’s life. And for us we do believe it’s an important skill but traditionally it’s sort of being that situation where that knowledge is being unable to be obtained and that’s what we’ve been focusing on obviously with the education is to make that knowledge available to anybody all the time.
W: It does sound like a very simple intervention with a very big payoff.
P: Yeah, look it is. And it’s one of those things that you learn it once, and that’s a skill for life and you’ll use it every day. And as I said if you pick up something that the patient wasn’t aware of and the difficulty is I can see the front of me but I can’t see the back of me and to be honest I can’t see all the frontal behaviors so it is really important. We believe that everyone in the profession, nurse and even surgeons, I mean if you’re doing a procedure on a patient and find something unusual, it’s very simple to look at it then be able to make a visual assessment and then determine where that might need a biopsy. Skin cancer is relatively easy to diagnose because it is of course it’s on the outside of the body so we can all see it rather than just have someone looking for it and then they obviously don’t know what to look for.
W: Paul Elmslie, founder of HealthCert International. My favorite question in every interview, in every occupation and profession there are misconceptions. What’s the biggest misconception amongst your clients and customers that drive you nuts and keeps you awake at night?
P: Well I think the main one for me is the misconception that skin cancers have. Skin cancer actually is really quite easy as far as and obviously once again in the most common cases or of course there’s one in a million which probably most dermatologists would never see in their lifetime. But the key thing for me is really is that it’s very simple to diagnose, it’s very simple to treat in most cases than it’s something will have a massive impact on the community. And as we have aging populations, most of the skin cancers that we’re diagnosing and managing was sun damage from 20-30 years ago when getting a tan to look healthy was still part of our culture and to be honest in most western worlds, it is still part of our culture that you have to get a tan for us to look healthy. So I think the main thing for me is that a lot of what I do with different…physician groups, most of them sort of see it as not their domain and it’s not a skill that they could learn or would be too hard to learn. But my view is that if you are a clinician and you come into contact with patients, then having this particular skill is important but the misconception is that it’s difficult to obtain. As I’ve said even in two hours could be taught, something that would move the needle very significantly in your ability to be able to diagnose skin cancer.
W: Now Paul if people that have been listening to us today and would like to get in touch with you, is the website the best way to do that?
P: Yes. If they go to healthcert.com, so health and then C E R T as in certification, so healthcert.com you’ll see the range of courses but you can also once again do the “contact us” section and that would come through to me personally. If you do want to contact me directly, then it’s just firstname.lastname@example.org and obviously I would love to be of assistance to any of your listeners at any point in time, very happy to help.
W: Thanks Paul and thanks for your time today. I’ll just mention that website again because I’m constantly getting into trouble for not giving people enough warning when we talk about websites. So pencils ready listeners, it was www.healthcert H EA L T H C E R T dot com (www.healthcert.com). My name is Wayne Bucklar, this is Health Professional Radio. If you’ve just missed my conversation with Paul Elmslie founder and CEO of HealthCert International, the good news is we have a transcript on our website at www.hpr.fm and you can also find the audio archive on SoundCloud or on YouTube. This is Health Professional Radio, my name is Wayne Bucklar.