An interview with Mr. Emmanuel Opati, CEO of XpertCare.

Please tell us about yourself and XpertCare!

My name is Emmanuel Opati. I am the Chief Executive Officer of XpertCare. I am originally from Uganda and came to the US in 2005 for school at Johns Hopkins University. XpertCare is a telemedicine company based in Baltimore, Maryland and we provide subspecialty care to pediatric patients. We do this primarily through e-Consults.

What inspired you to start a telemedicine company?

XpertCare was inspired out of a personal experience of one of my co-founders. When his son needed to see a pediatric subspecialist, the next available appointment was six weeks away. We are talking about a doctor who was working at Massachusetts General Hospital at the time. This personal experience not only exposed the broken nature of the healthcare system in the US but also highlighted the shortage of pediatric subspecialists in the country.

As parents, we started XpertCare to help other parents get timely access to pediatric subspecialists when needed. When your child is sick, there is no way you are going to wait six weeks to see a doctor. So we decided to build a network of pediatric subspecialists who provide consultations remotely.

What is an e-Consult and how does it work?

e-Consult is short for ‘electronic consultation’. e-Consult is a modality where a primary care provider gets input from a specialist or subspecialist on the care of a patient. It is a widely used modality in Academic Medical Centers and large healthcare systems in providing care and training. For example at XpertCare, we have pediatric allergists/immunologists in the network who work with pediatric primary providers to manage kids with Asthma. This is a more efficient way of providing high-quality care than sending the patients to the Emergency Room. The challenge for primary care providers is that if you are not part of the large Academic Medical Centers or Healthcare Systems, you don’t have a network of experts to consult. That is why we had to build a network of subspecialists who can be consulted by pediatric primary care providers.

How big is the problem of accessing pediatric specialists?

According to the American Academy of Pediatrics, there are less than 30,000 pediatric subspecialists in the US. The challenge is compounded by the uneven geographical distribution of the subspecialists. For professional or lifestyle reasons, most of these subspecialists are based at Academic Medical Centers and large cities. There are places in this country that are ‘dead zones’ for pediatric subspecialty care where parents have to travel long distances to access to pediatric subspecialists. For example, the whole of Nevada has only one pediatric dermatologist based in Las Vegas. That is how big problem access to pediatric subspecialty care is. In addition to the shortage of subspecialists, research shows that demand for pediatric subspecialty care has increased partially due to the increased number of children with chronic conditions. So access to subspecialty care is a big challenge for many parents.

Who pays for the e-Consult?

This is a great question. In our current business model, parents for our services. Imagine you are a parent and you have been referred to a child psychiatrist by your pediatrician. But then when you call to make an appointment, they tell you that the next available appointment is six months away. What do you do? So, parents pay XpertCare to be able to access a child psychiatrist within 48 hours. In this case, our child psychiatrist can work with their pediatrician on medication management while they wait to be seen.

Your company is based in Baltimore, MD, a national hub for medical research.  How has this community embraced Xpertcare?

Baltimore is one of the best cities in the world. I say this as a person who moved to Baltimore for school and didn’t think I was going to end up staying. Baltimore is one of the best healthcare institutions in the World. In Baltimore, we have more pediatric subspecialists than we need. Many doctors around the world have been trained in Baltimore and as a company, we are leveraging the unrivaled expertise that Baltimore has compared to any city in the World. Because Baltimore controls the supply side of doctors, we believe that Baltimore will be the Telemedicine Capital of the world. People travel from all around the world to come to Baltimore for medical care. However, with telemedicine, people from anywhere in the world will be able to access top specialists in Baltimore. XpertCare is just one piece of that plan and we are helping build that ecosystem. This is the kind of story you do not see in the headlines.

Are you funded by any investors?

Yes. We have funding from an Angel Investor to help us our customer acquisition efforts, recruit more subspecialists, and improve our service delivery. This funding was critical for us because it has given us a valuation metric for the company and capital to focus on growing our market share.

How much was the investment?

There was a commitment of $100,000 dollars with the possibility of $200,000 additional funding.

Telemedicine is commonly considered a resource that helps patients in rural communities access vital health care services. Can you talk about the importance of e-consults in today’s healthcare landscape?

Research has shown that telemedicine increases access to care especially for patients in low resource environments or rural communities. Rather than taking off work to drive long distances to the city and sometimes book a hotel to be able to see a specialist, telemedicine provides an option to get access to subspecialists remotely where appropriate. Sometimes travel to see a specialist is absolutely necessary but with telemedicine, it is possible to take the specialist to the patient via video conference rather than the traditional approach of the patient going to the specialist’s office.

As I noted earlier, e-Consults as a modality has been used in Academic Medical Centers and large healthcare systems in providing care and training. For pediatric subspecialty care, e-Consults are especially important because of the shortage of pediatric subspecialists in the country. In addition, wait times for certain pediatric subspecialties are really long and e-Consults have become the most efficient way to help patients at the point of care.

There are a number of telemedicine companies out there, what makes XpertCare unique?

This is a great question. What makes XpertCare unique is we are laser-focused on increasing access to pediatric subspecialty care because of the shortage I mentioned earlier. In addition, we have created one place where parents can access any pediatric subspecialist. Currently, what happens when a parent needs to see more than one subspecialist, they have to call multiple offices, talk to multiple people answering the same questions. What we have done at XpertCare is that you do this on one platform in less than 15 minutes.

What also makes us unique is that we are a physician backed company. What this means is that most of the equity holders are also subspecialists in our network. This is powerful because our providers are invested in the success of the company.

As a technology startup that is also a health company, what are some of the unique challenges that you face?

The unique challenge we face in our space is that physicians do not want more technology in their practices. We knew that from the beginning because two of my co-founders are physicians. With that said, we were very clear from the start that the issue we are trying to solve is an issue of shortage of pediatric subspecialists. In order to succeed we needed to build a network of providers before focusing on the technology. So what we are bringing to pediatric practices or community health centers is not technology, it is access to subspecialists and this has worked very well for us.

How much time have you spent on recruiting subspecialists?

If you know something about physicians, you know that it is really hard to recruit physicians if you are not a physician. I am not a physician and do not spend much of my time recruiting physicians. Luckily for us, we have physicians on our leadership team who take lead on recruiting physicians to join our network.

To join our network a physician has to be board-certified and credentialed to practice medicine in the US, be in good standing with their institution or practice, be known by peers as one of the best in their specialty, and finally must be referred to us by another provider in the network.

What’s the most rewarding aspect of what you do?

The most rewarding aspect of what I do is to see how helpful we are to people. When a parent reaches out because their next available appointment is weeks or months away and we are able to help them access high-quality care, that is rewarding. Another rewarding aspect of what I do is to see how helpful XpertCare is to the primary providers. Primary providers are very busy people and many of them do not practice as part of large hospital systems. So they can be isolated and being able to give them access to a network of subspecialists they can tap into very valuable to them, their patients, and their practices.

What is next for Xpertcare?

What is next for us it to get to a point where we are a one-stop-platform for pediatric subspecialty care. Imagine a world where a parent who needs to make appointments with multiple subspecialists can do it in five minutes and get access to care in 48 hours. We want to be the ones to do it and we are on track to bring this to reality.

Who is your biggest inspiration?

My wife. When people get asked this question, they jump to the famous, rich, or successful people. My experience is that the people in your inner circle are always the biggest inspiration. They are the unsung heroes and in many cases, they don’t want to be known However, they can make you or break you. For me, it is my wife. There is absolutely no way I would have been able to quit a job and start a company if I didn’t have my wife, Edith. She is the reason I wake up every day to do this even though it is a hundred times harder than having a regular job. My wife a pediatrician at Johns Hopkins Bayview Campus and has been very influential in the way I make decisions.