Three years ago, physicians fought insurance companies for telehealth payment and patients were often reluctant to connect via laptop or phone, yet technologists, vendors and a few infrastructure companies heard the siren call of future adoption, profitability and demand. One of these early advocates was Cox Communications.
In 2015, the operator acquired a number of home-health vendors and service companies, including Trapollo -- which provides nationwide, remote patient monitoring and telehealth services. Early this year, it hired Mike Braham as Trapollo's vice president and general manager, responsible for Trapollo's profit and loss, company strategy and execution.
This is not Braham's first time at Cox. In fact, he spent seven years with the cable operator in its Hampton Roads, Va., market where he worked closely with healthcare providers' c-level executives, producing many of Cox Business' largest customers and paving the way for the provider's healthcare success and strategy. That experience fueled future roles at Magellan and Aetna, before eventually leading back to Cox's unit Trapollo.
Braham spoke recently with Broadband World News Editor Alison Diana about his role, the importance of healthcare to Cox and why this market is a "local sport" to the MSO. Read on for an edited version of the conversation:
BBWN: You were an early leader for Cox into healthcare, I understand?
Mike Braham: I started leading, as an evangelist, for telehealth back in 2009, 2010, right as DOCSIS 3.0 was being introduced. I saw the world was about to change, to go from the ability to connecting to homes with a drinking straw amount of data to the fire hydrant which was delivered through broadband to all of the homes as a brand new dynamic which would enable telehealth. I had been meeting with some of our largest customers -- at the time we were the only part of Cox, really the only part of the MSO industry that was focusing on really large healthcare providers -- we were providing OC1-type level connectivity for these large healthcare systems. It was really integral to the introduction to Epic, to some of the large healthcare systems as well and how they were going to be bringing in their doctors' offices, how they were going to be bringing in some of their different satellite organizations as healthcare was starting to work toward consolidation and work toward a healthcare system rather than a hospital.
BBWN: And from those early days, today Cox has how many healthcare customers?
MB: Cox Business then focused on healthcare, starting really at about 2011-2012... Today, we have over 40,000 facilities are connected with a host of different healthcare providers across the Cox franchise.
BBWN: What do MSOs and specifically Cox bring to healthcare, especially telehealth?
MB: MB: I think the delivery of the greatest promise of the MSO right now is to... deal with mission-critical solutions... to those who are either dealing with short-term illnesses and/or they're dealing with long-term illnesses, or they're the caregiver of those that are in distress. As we're looking through the enabling of the healthcare-related system, when I was asked to come back to Cox, [it] was to pull all those components together, to have a really rich understanding of healthcare, to have a really rich understanding of what Cox specifically and the MSO industry can deliver to healthcare. And now with the enablement of telehealth really coming on strong -- the technology's really been there for a very long time but what has not been in accord has been the payment structure and how things are going to be reimbursed, the workflow to making telehealth work. That's the promise yet of the future. That's where I think Cox is taking a very strong step, going forward, by enabling all these elements.
BBWN: How does your understanding of healthcare translate into Cox's ability to help customers -- healthcare providers, home-based patients and caregivers?
MB: These tools are in place... to equate it to the IT stack, we're looking at what I'll say is the application layer. We have the infrastructure already there; now we're looking at clinical applications that all can be delivered into the home or into a business environment for those folks who are ill but are still working -- but still need access to information -- or the caregiver who's at work but still needs access to information, that is worried about a child or a mom or dad and how can they keep up with them in a patient engagement or monitoring solution set.
What we are trying to do is leverage these assets that have already been involved and people are familiar with, to now provide access to both information that would be delivered from a healthcare provider and/or we're looking at wellness form a wellness perspective or acute as in where you need to go for help right now. [Maybe] it's the long-term solution set of engaging with somebody who needs to have their different medical symptoms and/or stats monitored to see whether or not there can be early intervention by a clinical environment. Instead of coming back in a month, this provides real-time or near real-time information sharing about the status of a patient to a clinician so we ultimately can do is provide a level of healthcare that is timelier and strategically be more cost efficient. We're trying to be sure we can provide improved clinical outcomes, to be sure hospitals can use resources more efficiently and effectively, and financially it makes sense both for the individual patient, the caregiver and/or the payers themselves to be sure the dollar spent is most effectively used.
BBWN: What will mark telehealth's success?
MB: The real challenge that telehealth has been presented with is in the next several years, if telehealth is to be successful, it's just going to be a part of delivering healthcare. Its not going to be a separate solution set. It's going to be a modality.
BBWN: Why is being local so important to Cox's view of healthcare?
MB: As we're working toward a more patient-centric model, patients and/or their caregivers need and want to be able to receive healthcare when they want, where they want, how they want. By having the availability that folks like Cox do, by having such a focus on the community, Cox really sees healthcare a local sport. You're going to be providing healthcare in the same community that you're working and you're living. Cox provides an exceptional focus on localism and how we're able to connect that patient to local doctors and the healthcare communities themselves. We're also working in that environment. We can bring the practice of healthcare to a more convenient modality; that's one of the true elements the promise of communications, of IT, can do to the healthcare world.
BBWN: You mentioned D3.0 earlier. Have you moved up to D3.1?
MB: It very much depends on the locations. Metro Ethernet, optical Internet, any of the managed services we provide today, the healthcare environments, they all take whatever we as Cox provide in that tech bundle. Then taking a fiber close type of strategy. We're building more and more resilience into local communities and then the last connection we're using HFC, primarily. I can't speak definitively to what's using 3.0 or 3.1, but they're both there.
What started off as evangelism of the promise of healthcare back in Hampton Roads back in, say 2010, in eight years this has swept across all of the areas of Cox and I think Cox is seeing this as a focus going forward and a reason, I think, for bringing me back and a major focus going forward.
— Alison Diana, Editor, Broadband World News. Follow us on Twitter or @alisoncdiana.