Ep. 137: The Future of Telehealth - Interview with Joe Brennan from TytoCare

Patient Care Marketing Pros (00:00)
What's up everybody. You're listening to another episode of Walk -Ins Welcome. We're glad to have you. We're here with Nick and Michael. I'm Nick. That's Michael. And we have a special guest, which I'm excited about. But before we do that, let me just tell you, we are all about helping you get more patients, get repeat visits, better care and scale. That's what we're all about on Walk -Ins Welcome. Michael, tell us about our guest today. Absolutely. We have Joe Brendan today with Tito Care. He's been in the world of telehealth for over 11 years.

And he has a love for technology. And between those two loves of telehealth and technology, we have TaitoCare, which to me is the perfect merge of technology and telehealth. Telehealth in most people's minds is like a phone call or a simple video call, but this takes it to a whole nother level. We're excited to talk about that. I remember seeing it at the Urgent Care Association and I was jacked about it. Yeah. Without further ado, Joe Brennan, say hello to the audience and tell us one thing about you that nobody else knows.

Joe Brennan (00:58)
Guys, pleasure to meet you and thank you for having me and everybody listening. It's a pleasure to have this conversation. Something that people don't know, I set a goal back in 2017 to run 10 marathons in 10 years. And I'm on number seven, about to do number eight next week.

Patient Care Marketing Pros (01:16)
Man, I love it. You will live and die by the goals you set. That is so good. You are seven ahead of me. So you're doing good. I ran one because there was this girl that I liked in college and she was all fit and finished. And I still at the time looked like a stick of butter. Yeah. I made it to the finish line. I think it was next to last and I'm pretty sure that person was in a wheelchair.

Joe Brennan (01:38)
I only started running to impress a girl who I eventually ended up marrying. So I'm writing.

Patient Care Marketing Pros (01:43)
There you go. There you go. So you now always have to run. Yeah. Now you're forced. You can't, you can't let that go now. I don't know if I dodged the bullet or not. I'd probably be in better shape. All right. Let's get into it. Joe, man, you spent the last 11 years focusing exclusively on telehealth. Can you share some of the key challenges that you've encountered? What you guys have overcome in developing and scaling the telehealth?

Joe Brennan (01:47)
Yeah.

Yeah, so I actually, I came into telehealth through the business development arm of a large health system. And there was some grant funded equipment that nobody really knew what to do with. And so it was my job in BD to figure out what are we going to do with this and how are we going to connect provider to patient. And so we had a single cardiology use case going to a rural, a rural clinic that didn't have cardiology.

Patient Care Marketing Pros (02:34)
Right.

Joe Brennan (02:34)
And that single use case grew into one of the most robust telehealth programs in the country. But that experience and building and scaling, there are still deficits within telehealth. I think having a conversation through audio video technology is very good for behavioral health. It's very good for certain types of follow ups. But telehealth ultimately falls short when a physical exam is required. And so

coming from a large health system and then also I have a consulting background. When I initially saw TitoCare, that's when I noticed that they're bridging that gap. They're what I believed to be telehealth 2 .0. What is the next iteration of virtual care? And it's doing that remote examination either in the home or in a clinic where it can't be done.

Patient Care Marketing Pros (03:30)
So basically, like if you were to sum up exactly what is TIDOCARE, what is it?

Joe Brennan (03:37)
So it's unique in that it is software. It's a platform that allows providers to connect to patients, but it's also hardware. It's a device. It's about the size of half of a baseball. And it has tips that allows it to become an otoscope, so you can look inside the ear. It becomes a stethoscope, so you can listen to heart, lung, and abdominal sounds. It's a derm camera. And it's also an infrared thermometer.

And that can also be paired with a Bluetooth enabled blood pressure cuff, pulse ox, and weight scale. So you can take the hardware, which is the TITO device and the other peripheral devices that run on our proprietary software that allow the provider to do everything they do within the clinic while the patient is remote, wherever they choose to be.

Patient Care Marketing Pros (04:28)
Joe, I saw a picture the other day come across my social media feed and it was a desk and the desk had like a computer and a telephone and a fax machine and a notepad and all these different things. And the picture was like, now all of this stuff is in your phone and what it sounds like TitoCare and the device that you guys have created, which I think is just fascinating. It's like, it's the stethoscope, the scale.

All of these things that you have at your is now in this baseball sized device that people can take home with it. Is that about right?

Joe Brennan (05:02)
That is it. If you go back on YouTube and look at when Steve Jobs introduced the iPhone, his pitch was that he introduced it as three separate things. I think Taito is very similar in that it's taking all those disparate devices and putting it into one single form factor. And that's a huge win because when it's individual peripheral devices, they run off separate apps, or if they are integrated, there is some clumsiness there.

Patient Care Marketing Pros (05:03)
You guys are awesome.

yeah.

Joe Brennan (05:32)
This TitoCare allows it to all be in one device.

Patient Care Marketing Pros (05:38)
Well, and I say too, and the device itself doesn't look like a medical device. No. It's very clean. I would say toy -like, but just very, it reminded me something of like, okay, this is like nothing medical at all related, right? Like just the color, the form factor of it. So it's very inviting. It looks super intuitive. And honestly, I'll be honest, the video on your website of it actually live usage, I was like, that's pretty cool.

When I see software and hardware marry up, like it's to me, I just geek out over that stuff. I geek out over it. So the relationships with this device and let's just say our urgent care clinics, physicians, healthcare providers, how do they get connected in all of this? Or is this a standalone, like you come to us, you don't go to them.

Joe Brennan (06:30)
So the relationship that Taito has would be with the organization. So that is where our customer is. And then that organization determines how they want their patients to engage. Whether it's giving them a device that lives in their home because they want, you know, there are certain use cases where that makes a lot of sense, or we have quite a few urgent care use cases that are specific to load balancing. If you have multiple locations and one location has a two and a half hour wait and another one,

Patient Care Marketing Pros (06:34)
That's what I thought. Right.

Joe Brennan (06:59)
never has a weight, well those providers that are sitting there in the clinic that has no weight, can they help out the clinic that has a two hour wait? And so load balancing, covering for lunch seems very simple, but it's there allowing a provider to connect virtually but still do that physical exam. So it's ultimately up to the provider how they want their patients to interact.

Patient Care Marketing Pros (07:21)
That's good.

kind of why I never thought about the load balancing part before, right? Because we have an urgent care right now that's experimenting with that where, because the reality is like, there's a, we work a lot of urgent cares and you know, physical locations, a pretty big deal. Like that's a big component, keeping it staffs a big deal. But then ultimately, like it would be ideal if they're, like you said, like there may be a look because we see us all the time, there's a location or two that is slammed.

and they cannot get any more providers that they wanted to. And then you have locations that just aren't. And so like having the opportunity to load balance some of that, but not having to send people all over the place on a constant basis. I mean, that's a huge, just logistics gain. Right. I got it's kind of fantastic.

Joe Brennan (08:13)
And where we see that grow is when a patient goes into that urgent care and has the TIDO experience. And then after that visit, someone from, whether it's front desk or the provider themselves, to say, we can actually provide you this same device, but it would live in your home. So I can see you, you just don't have to come in to our location. So that transition, they already have a really cool experience when they're in the location. And if the organization chooses to do in -home care,

That's that point where you can then transition from what you've done in the clinic to what they can now do.

Patient Care Marketing Pros (08:49)
So that was in that transition on that, like the in home part, like I want to I'm curious what that looks like for a patient. So let's say that you have an urgent care that's engaged with TIDOCARE. And I'm a potential patient, and they want me to utilize the TIDOCARE hardware. What's the product like? How does this all look from like a patient standpoint?

Joe Brennan (09:12)
So again, we customize to how they want the patient experience to be. But let's say this organization has their own app. We would integrate our technology into their app so that they would go through the front door they normally would. But then when they go into a TITO visit, it would then trigger our experience and allow that provider to do the full examination through their smart device.

Patient Care Marketing Pros (09:22)
Okay.

I'm fascinated that. Yeah. So let's talk about that. So bridging the gap. What I've heard you say so far is somebody goes into an urgent care, they have an experience, whatever that clinic's experience is meant to be. Okay. And I don't know if you've been into a few of them, it's different from clinic to clinic. Right. They all have not a chick fully experience every time. It is not. It is not. Just because it says urgent care doesn't mean you're getting the same thing. So you take that they have an experience and they want you to take this device home.

Who bears the cost of it? How does that work? Is that an insurance based product? Is this something that me, the patient has to purchase that to get it in my home? Help me understand that.

Joe Brennan (10:15)
Well, I think it helps to understand what you as an organization are solving for. If you're at risk, probably not applicable to most urgent cares, but for organizations that are at risk or bear some risk on that patient, it makes sense for them to stay in the home, to lower that total cost of care.

Patient Care Marketing Pros (10:33)
When you say risk, real quick, I want you to go with that thought. But what do you mean when you say risk at risk?

Joe Brennan (10:40)
So if it's not fee for service or cash pay, if they are in a risk -based arrangement to take care of that patient. But alternatively, like in the urgent care example, you can charge the entire retail price to the patients because of the convenience. You can subsidize some of that cost if you choose to to encourage them more.

Patient Care Marketing Pros (10:43)
Okay.

Okay. Okay.

Joe Brennan (11:06)
We've actually had behavioral scientists study what we do and give us feedback on what makes sense. And what we found is there's a certain threshold that patients are comfortable paying. Giving somebody something for free, they're not going to value it because it's just this thing they gave me, I put it in the closet, I didn't pay attention to it. If you have a price point of between $49 and $99, there's some skin in the game, but it's not so expensive that they would be turned off.

Patient Care Marketing Pros (11:27)
Yeah, totally agree.

Joe Brennan (11:37)
But there's other organizations that will have the patient pay the full cost of the device, which is roughly about $300. And there's plenty of things. Exactly.

Patient Care Marketing Pros (11:46)
That's actually not as expensive as I was expecting. Yeah. I was honestly going, I was waiting on 1500 to 2000 all day long. Maybe five years ago. I was excited for the call just to go like, how much is this going to cost? I can't wait to find out. And the price.

Joe Brennan (12:02)
It is all what makes sense for you as an organization and what problems are you solving.

Patient Care Marketing Pros (12:11)
Well, connecting those dots, you know, you say it works with their app or their software or whatever they're using. How do you connect that up? Is that through APIs? Is that, are you working directly with like schedulers and platforms and all of that? How are you connecting those dots?

Joe Brennan (12:27)
So we have a very talented technical team who evaluates what they're working with and understands how we're going to build those tunnels into the customer's app and experience. But really, again, I think you started to touch on it earlier. It's built in a way that someone who has zero medical training can use it the first time they touch it. Like, the experience of someone who first has Taito

Patient Care Marketing Pros (12:31)
Okay.

Okay.

Joe Brennan (12:54)
That's most likely the first time you've ever seen the inside of your own ear. Like before I started here, I didn't even know what a tympanic membrane was. But now when you go in, you're getting arrows in the app that is guiding you to find your own tympanic membrane. So they make it as easy as possible so that someone with no medical training can find what is medically relevant. Because we all know if you don't have provider buy -in, you're dead in the water.

Patient Care Marketing Pros (12:59)
Yeah.

that's cool.

Joe Brennan (13:24)
And so to have a provider to say, I know I'm going to get what is medically relevant. I know I'm going to get valuable data and make an informed decision. So we've built the experience from a patient end to make it as easy as possible, but also provide things that are relevant for providers.

Patient Care Marketing Pros (13:24)
Right. yeah.

Okay. Well, let's transition over to demand real quick. So, man, I bet people are just tired of talking about 2020 and COVID at this point. But what we know is - The capability has been five years. Yeah, it's hard to believe. It's been five years. That's so wild. We know that the demand for telehealth, remote, even video was just through the roof during that season, which means by default it's fallen off dramatically for telehealth, or at least that's what the numbers show. So,

How are you making up for that with this device and progressing the telehealth narrative with what seems to be an opposite direction on demand?

Joe Brennan (14:23)
Yeah, I would look at it a little different and say that it potentially is right sizing. We went from less than 5 % utilization for telehealth overall before the pandemic. COVID hits and it spikes to 75%, 80%. And then we dip back down to 10 % or 15%. And from my perspective, and I would think that most in Tito believe

Patient Care Marketing Pros (14:29)
Okay.

Right.

Joe Brennan (14:51)
It was an introduction to the masses that this is what virtual care could look like. But it quickly exposed what the flaws are to virtual care, specifically those organizations that only do the one and done visits. I think what we learned as patients is this is incredibly convenient. It's very helpful for my day to day. And I can get quality care, but where it falls short is it's not with the people that I normally receive my care with.

And I don't have that trust that's established with the other health systems or clinics that I'm already accustomed to going to. And so I think as we move into this next iteration of what virtual care is, it's a hybrid approach. Does it make sense today for me to go into the clinic? Does it make sense for me today to do a virtual visit just for a quick checkup? And I think establishing that trust with

the organizations that you already have a relationship with, and then to take it a step further with tito care, we can do more now that we have the ability for the physical exam. There are more equities that can be treated.

Patient Care Marketing Pros (16:01)
You know,

Well, and I wonder too, so, and you can tell me if this is already a thing or not, but like in my head, like I see this opportunity for you now have a family care situation where you now can take care of your family at home with that device where you're not having to take off work, do whatever, you know, make all these adjustments. We're like, well, I got this device. I'm going to contact whoever provides this to me and just get it taken care of where it kind of, it does, it kind of.

progresses from a one time use type of patient to like now you're taking care of multiple people because you've now added a convenience factor that other people can't add. Well, I'm assuming it's person agnostic, right? Like I could hand it to the five people in my family.

Joe Brennan (16:51)
Absolutely, and we don't sell device per person. We sell device per household. So think of it almost like Netflix. When you turn on Netflix, you have profiles for everybody in the family. Title care is the same way. So when you open up the app, each person in that family or in that household has a profile. And based on what their conditions are, the journey may be different. So...

Patient Care Marketing Pros (16:56)
Right. Yeah, that's pretty good. Yeah.

Joe Brennan (17:15)
Mom and dad may not have any concerns and it's just low acuity primary care concerns, but daughter may have asthma. And so we have a separate asthma pathway that asks her different questions or has a different journey because she has asthma. And as we get more into the artificial intelligence that's baked into our experience, as those technologies grow stronger, each pathway for each family member is gonna be a little different.

Patient Care Marketing Pros (17:44)
That's very interesting. So that brings me to the pricing model. You talked about the device cost. Is there a subscription to the software that these clinics and the people are bridging through?

Joe Brennan (17:58)
So the subscription is on the organization, not the customer. Exactly. So the clinic has the relationship with us. We have the contract with them. And it's up to them how they want to charge, again, for the actual device, or if this is baked into some type of membership. Or you understand the values of what this brings to your patients, and you choose to not charge them.

Patient Care Marketing Pros (18:02)
So the clinic manages that. Okay, the clinic manages the profession.

Joe Brennan (18:25)
Again, it's what problems are we solving for and what are the outcomes we're looking for.

Patient Care Marketing Pros (18:28)
Mm -hmm.

How are these medical practices, how are they currently marketing this product at their clinic?

Joe Brennan (18:41)
Well, multiple ways. So obviously email is usually the first, but when you get 10, 15 emails from a clinic, you're probably going to start to ignore them. Signage within the clinic makes a lot of sense, but I think talking about it, whether it's being used in the moment to say this is what it is and you have the opportunity to use this in the home if you choose, I think that

Patient Care Marketing Pros (18:45)
Okay.

Yeah.

Okay.

Joe Brennan (19:10)
conversation with a trusted provider makes all the difference in the world. Yes, we have plenty of templates and we have an entire digital marketing strategy and we have the resources to do that. But I think the experience itself speaks volumes.

Patient Care Marketing Pros (19:26)
So at the end of the day, it's between that patient and that doctor, that physician, or even nurse practitioner, whoever it is, it's for them to make a decision on whether or not that's the right fit for them through education.

Okay, and love it. So grab it onto the education comment you just made. It shows that you guys have been expanding into the school world a little bit. Well, not a little bit, a lot of bit. A lot of bit. A lot of bit. And so tell us about that. I mean, because I, to me, this is kind of game changing where you're not relying so much on the school nurse to be the person's well, you Yeah, you're sick. Now there's like a deeper level to it. So explain to me what the how how

TaitoCare looks inside of a school system, what you guys are doing there, like, cause it's super fascinating to me.

Joe Brennan (20:16)
Well, so there are different models, but the basics of it is you take our TITO device. We have a professional version and this is what would live in an urgent care clinic as well. But it is the TITO device paired with an Apple iPad on a stand that has a lockable drawer and keeps powered all the time. But we put those in schools in areas where there is already a shortage of care for those students.

But the technology allows that school nurse or whoever is associated to that district to be virtual and to connect to multiple locations as opposed to what some school districts are doing with a nurse traveling between building and building in a car. And so again, we're built in a way that is for anybody to use. So you can trust the main office staff to help that child with their visit and be able to connect to a provider. And so

the ability for those limited school resources to be spread across multiple locations because TitoCare is in place.

Patient Care Marketing Pros (21:25)
Well, I mean, if you have a school district rule, maybe it's got four, five, six schools, different types, elementary, middle, intermediate, high. You take all of those and you only have the resources to hire one person and you put a $300 TitoCare unit in each of the schools and that one person can have a facility. That's fascinating. Well, and then like, and then you go like a step further and then you have the physician on the back end that's processing some of the data that's coming in like.

an opportunity for that position to grow their practice. Well, you know, just going into a school system, it kind of reminds me slightly like an Ok Med situation where I do you guys go into the Ok Med world much with your device and software where they can go into an employer situation so the employees always come into the clinic. I don't think you can pee in the Tyco care. That's true. It doesn't have that functionality yet. We're working on that. That's the bucket that's coming later. It's the urine test.

Joe Brennan (22:24)
But to that point, on -site clinics are very expensive.

Patient Care Marketing Pros (22:25)
Sorry

Joe Brennan (22:31)
It provides the opportunity to put an on -site clinic at a significantly lower cost. And you don't have to have a nurse seven days a week. Specifically, manufacturing third shift, when there is the capability to have someone to connect, if there is virtual care provided 24 hours a day, it makes total sense.

Patient Care Marketing Pros (22:37)
Yeah. Yeah. yeah.

Well, I mean, my ultimate goal isn't to take people's jobs, but when you can come up with a device like this, that'll streamline certain, you know, parts of jobs and, and start reducing overhead. I think it's brilliant. Right. Because at the end of the day, you're removing travel time. You're removing, well, exposure, right? Right. Because you don't need your doctor to go down because of something they picked up from a patient. And then you're allowing, you're kind of giving them time back, right? Cause it's all inside the device. So things are being recorded more automatically.

from an automation standpoint, it's not as much handwritten notes going on. It's just, to me, it's easier. Like, well, I agree, like there's always that fear that technology will replace people. Yeah, I mean, that's real. Like, we're sitting here today on technology that didn't exist 15 years ago, right? And it's replaced and things have changed. But like at the moment though, like this technology is now going to empower people to get more done and be less stressed about it.

Joe, let me ask you this. Do you have anybody that's working exclusively off of these devices where they've just transitioned their business model to, we're going to send these devices to the house and that's how we're going to be our main point of doing business.

Joe Brennan (24:11)
Well, we have, I can think of one customer who pivoted their model and it's more of an expansion than anything. But with bricks and mortar, they were limited in their reach and they pivoted their strategy to say, well, why do we have to be stuck in just this specific geography? I think we can go larger, but they wanted to have the experience and replicate what they had in their bricks and mortar clinics.

Patient Care Marketing Pros (24:16)
Okay.

Joe Brennan (24:40)
And you can't do that with just a conversation. And so they incorporated TitoCare, because this is direct primary care, so there's a membership base. And every membership that they sold, you get this TitoCare kit as well. And so that is the platform in order for them to be reached.

Patient Care Marketing Pros (24:40)
yeah.

yeah, sure. That's perfect.

I mean, that's borderline concierge medical at that point, right? So like the med VIPs and the stuff like that, MD VIPs. Yeah, like the concierge model is coming hard and fast, right? Like people can have a luxury out of it. And up to this point, it's always been, okay, for concierge, here's a private app tied to our medical facility. But now it's like, here's a device which they can brand it, I'm sure, to a certain degree, like it becomes part of their model. But yeah, I think.

Honestly, I think Concierre benefit quickly from it because that particular patient's already bought into a return long -term visit patient that wants convenience all day long. So, because that's the ultimate model of Concierre is like, I don't have to get in a, you know, I don't need to explain who I am. Like I am a patient, you guys know everything about me. Let's just go through this. I'm not here trying to beat down the door. Like you're going to take care of me. And then like this adds an extra layer, which is kind of fantastic.

Joe Brennan (25:55)
high touch, high tech. I think it's there and it's at a price point that is affordable for most.

Patient Care Marketing Pros (26:03)
I think the price point is actually spot on for what you get out of it. So when you, when you had thrown that price out there, I was actually a little shocked to be honest with you. All right, Joe, let's wrap this up in a bow for everybody. What's the best way for them to learn more about TitoCare? And if there's a clinic that says, Hey, we want to incorporate this in there. What's the process for them to be able to do that?

Joe Brennan (26:27)
So we have someone dedicated to this vertical. We see the value in urgent care and the value we can provide them. So we have an individual who's dedicated to just these organizations. And so if you reach out through our website, we'll make sure that you get in contact with him. But just come through titocare .com and then we'll be able to get someone in touch with you.

Patient Care Marketing Pros (26:45)
Mm -hmm.

Joe Brennan (26:56)
Just to have the conversation, because I think it's important to understand what the needs are and again, what are we solving for? What problems are we trying to address and how are we going to measure success?

Patient Care Marketing Pros (27:08)
Yeah, that's good stuff, man. I've really enjoyed having you on the podcast today. I think that this product is going to have a big impact and push to what in my mind was a rolling back industry and start pushing it forward again. Obviously, we'd rather push it forward with good technology and experiences than having a worldwide pandemic. So let's keep doing it this way, a little slower, a little better. I like that. And I like, I don't even imagine like...

military usage out of this, like on the field diagnostics, you know, that type of stuff. Like, I'm sure there are things out there too, that we couldn't touch on today, but it's really cool to see this level of technology that small, that affordable and that effective that's available right now, which is amazing. Awesome.

Joe, thank you so much for being on the podcast with us, man. We appreciate you coming on, spending time with us, dropping some value to our audience. I would love to have you on again as this device and software progresses. We want to hear more about this and definitely some special use cases. I appreciate you coming on. Yeah. Thank you, Joe.

Joe Brennan (28:15)
Absolutely, it's been a pleasure and yeah we'd love to come back and give an update on our progress.

Patient Care Marketing Pros (28:21)
All right. Well, thank you everybody for listening and we will catch you next week. Have a great week.