At MediGuide, it is our mission to bring our Members answers and peace of mind. Furthermore we provide value and cost savings to our clients. Getting our Members answers to their questions in times of medical uncertainty is a responsibility we take very seriously, we are relentless in our pursuit. This edition we would like to share one of our many success stories and the life changing impact we are making in our Member’s lives every day.

Another example why MediGuide is Closest to the Cure.

Recently we had the absolute pleasure of working with a Member named Julie who had been bravely battling several chronic conditions for over a 10 year period including a bleeding disorder, high blood pressure, high cholesterol, gout, and chronic kidney disease of unknown origin. She had been prescribed a combination of medications by her treating team to help manage her conditions that she was taking during this period of time. Overall Julie was feeling well.

In 2013, after many years of treating her chronic kidney disease with diet, exercise, and oral medication, Julie required acute hemodialysis (an invasive medical intervention to treat kidney failure, the process removes waste and restores proper balance of electrolytes in the blood) after it was noted in routine bloodwork by her treating team that her kidney function was very poor. This period of hemodialysis was only temporary and after a few weeks she was able to discontinue treatment and start taking her oral agents again.

In April of 2015, during routine check-up and despite feeling no symptoms at all, it was noted that Julie’s kidney function had worsened again. At this time she was started on a round of oral steroids to try and improve her kidney function. In May of 2015 during a follow-up visit her kidney function was noted to have worsened again. She was admitted to the hospital in June and a renal biopsy and bone marrow biopsy were performed which resulted in a diagnosis of acute interstitial nephritis, condition that causes swelling within the kidneys which can cause them to stop functioning. Julie was treated inpatient with hemodialysis for 2 weeks and was then discharged home on oral steroids again. After this second round of hemodialysis Julie decided to call MediGuide for help.

In July of 2015, Julie reached out to MediGuide and requested a medical second opinion (MSO). Julie worked with a MediGuide local partner who reviewed her entire medical history including the timeline of events, her history of present illness, current medical concerns, symptoms, medications, recent tests, and interventions. With Julie’s consent MediGuide then collected all the necessary medical records, pathology slides, and imaging studies. MediGuide also collated all of the medical information before sending it to the World Leading Medical Center (WLMC) Julie chose for her case review, in Julie’s case it was the Brigham and Women’s Hospital in Boston At the Brigham and Women’s, it was reviewed by a team of experts including; a renal specialist, a pathologist, and a radiologist. During the comprehensive review by the team, specifically the pathology reanalysis, it was determined that the Julie was suffering from a drug induced rhabdomyolysis, a condition that can cause kidney failure secondary to drug toxicity. In this case it was the combination of medications taken for gout and cholesterol.

This was a change in Julie’s original diagnosis from her treating team as well as a change in treatment plan.

The Experts from Brigham and Women’s also suggested that Julie discontinue taking any steroids as not only were they not helping, they were actually contraindicated with this condition. Next steps suggested by the Expert team at Brigham and Women’s were stop taking the toxic drug combination Julie had been taking for years and that be followed closely with blood work and surveillance. Julie shared the information with her treating team and a new plan was made for her care. Julie’s treating team was incredibly grateful for the new information and immediately discontinued the steroids and cholesterol medications.

Today Julie is feeling well. Her kidney function is stable. She remains off steroids and had not required any further hemodialysis.

This case is a shining example the power of a comprehensive medical reivew and collaboration. Prior to Julie’s first call to MediGuide for a MSO she was being treated with medications that were causing her kidneys to fail. In addition the steroids prescribed to help her kidney function were inefffecive and also potentially toxic. Medication like steriods are not only very costly but over time can be very toxic on the body causing long terms side effects or complications such as glaucoma, weight gain, high blood pressure, difficulty fighting infections, osteoporosis, and increased blood sugars. Not to mention the costly setbacks with hemodialysis.

When we reached out to Julie during our routine six week follow-up review, we received the following repsonse from her. Julie believes that taking part in the MediGuide medical second opinion program saved her life, please see her email below:

MediGuide,

It’s good to hear from you! I gave the Second Opinion to my general practitioner and my renal doctor, I believe in August. They both felt that made COMPLETE sense and I was taken off the Crestor and Prednisone immediately. Since then, I have been monitored every three weeks with bloodwork, and frequent office visits to keep on top of it, in case it continued to nose dive as it had before. As of January of this year, my numbers have remained level and stay fairly consistent. At my last office visit, I was told I didn’t have to have bloodwork for four months! The Second Opinion, I believe, saved my life. It wasn’t in time to change the damage already done, but I believe that it has extended the time I do have…which certainly would be shorter without MediGuide’s wonderful, top-notch physicians and the diligent work your company did to give those doctors a thorough picture of my case.

If you need any more “testimonial”, I will praise it from the roof (and I’m afraid of heights)!!!!

Best Regards,
Julie

Happy New Year!
Bonne Année!
¡Feliz Año Nuevo!
Godt Nytår
– שָׁנָה טוֹבָה.
Geseënde Kersfees en ‘n gelukkige nuwe jaar
Gung hay fat choy
新年快樂
Hyvää joulua ja onnellista uutta
สุขสันต์วันคริสต์มาส และสวัสดีปีใหม่
عام سعيد

Our best wishes to you for a happy and wonderful New Year! We look forward to helping you make 2016 your best year ever!
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We Care
At MediGuide, our customers and members are our only priority. This December, we would like to introduce to you two examples of how we’re working to serve you better.

My MediGuide Casebook
We are very excited to introduce a new addition to our current service offerings: the My MediGuide Casebook, which provides our members with a tangible takeaway that they can share with their treating physicians and also use as a reference in the event they need to travel for care. This addition to our MSO service sets us apart as a leader from our competitors and brings our members even closer to the cure.

The My MediGuide Casebook will consist of the following items;

• The member’s Medical Second Opinion (original and translated version if necessary)
• Medical center and expert physician biographies
• Related journal articles referenced by the expert physician(s), and
• Contact information for MediGuide.

The file will also include a USB flash drive containing all of the member’s medical records collected by MediGuide during the MSO process. This tool is an invaluable resource comprised of sometimes decades of medical records, lab results, and reports to be used by the member and their treating physicians. The member can continue to add to the flash drive and store documents for years to come to ensure all of their medical information is easily accessible and also all stored in one place. The flash drives are password protected and are compatible with both macs and pcs. The review packet will be sent to our members within one week of the conclusion of their case.

In the coming weeks we will be sending example case files to our customers and service providers. These packets are sample only and are meant to provide insight into what our members will receiving in the coming weeks. MediGuide is pleased to announce that it will be providing our members My MediGuide Casebook starting in January 2016.

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Michael Rowan named CFO

We are pleased to announce that Michael Rowan joined MediGuide as our new CFO on November 1, 2015. Before welcoming him into our family, we want to thank John Burris for doing such a great job over the last so many years.

Michael will be responsible for all financial activities of the company including accounting, treasury, receivables and payables, and foreign exchange management. Michael has a wealth of experience in various companies, such as Styron, GMAC Mortgage, Merrill Lynch and Siemens.

Michael resides in Newtown, PA.

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Qualifying Medical Condition List
At MediGuide we are our Members’ first choice for support when they are faced with medical uncertainty. When our Members are dealing with a new diagnosis or a chronic medical condition, we are committed to connecting them to leaders in the healthcare industry in order to ensure they have access to the most up to date medical information available, and a plan for treatment moving forward. So we are pleased to announce that MediGuide is able to review ANY medical diagnosis with a MSO with the exception of the following circumstances:

1. No diagnosis
2. No evaluation by a treating physician for >1 years
3. Condition is acute or life-threatening (requires immediate medical intervention)
4. An in person evaluation is required (e.g. mental illness)

We strive every day to put our members at the forefront of everything we do. Because we know when they need us the most, we’ll be ready.

At MediGuide, our member’s health and wellness is our top priority.  Which is why, when one of our members is faced with a new diagnosis or dealing with a chronic medical condition, we are always there to help. In today’s world there is no limit to the stream of information on medical disorders on the internet. Members often find themselves surfing the web looking for answers to questions about their medical condition and plans for treatment, “Dr. Google” is possibly the most popular doctor on the face of the earth. This technology allows members to have access to diagnoses, symptoms, laboratory data, medications and their side effects, and images at their disposal 24 hours a day. However, often times this information can be inaccurate, misleading, or members are unable to manage this data unassisted. This is where MediGuide can step in with its expertise in Medical Second Opinion (MSO) and simplify the process for the member.  MediGuide will manage all of the logistics in an efficient and timely manner and provide the member information they can trust.

One of the many benefits of the MediGuide MSO and related program offerings is that members have access to the most advanced and cutting edge medical treatments and procedures in the world, regardless of the member’s physical location. We work with World Leading Medical Centers and Expert Physician in the US, Europe, and across Asia alike. Through our all-inclusive and comprehensive case review of member medical data including; medical records, pathology, and diagnostic imaging, we truly bring our members ‘Closest to the Cure’.

MSO case example:
In 2009, a 56 year old woman contacted MediGuide after she was diagnosed with breast cancer. Knowing time was of the essence, the clinical team at MediGuide leapt into action and immediately began to collect her medical information.  A short time later, our team was able to direct her case to the Dana-Farber Cancer Institute in Boston, Massachusetts.  At Dana-Farber our member’s case was reviewed by a multidisciplinary team led by Dr. Erica Mayer, MD, MPH, breast oncologist and board certified medical oncologist.   The MSO recommended a change in treatment; adjuvant chemotherapy post-surgery vs. the treating physicians recommendation of a surgical approach only.

To this day almost 6 years later, our member is doing well and has been declared cancer free.

MSO Expert Assessment and Treatment Recommendations:

November 13, 2009
PT: Xxxxx Xxxxxxx
DOB: XX/XX/XXXX
MRN: USG10-TESTCAL
Presentation:
In 1/17/08 she underwent a stereotactic right breast biopsy, finding invasive ductal carcinoma, well differentiated, ER+/PR-/HER2 2+ with FISH testing negative at 1.5.
Oncotype DX testing was offered but deferred, and she then initiated adjuvant anastrozole in 3/08 and underwent adjuvant RT.
Assessment:
Appropriate adjuvant therapy should focus on endocrine agents. Estimated benefit from adjuvant chemotherapy for a T1bN0 HR+/HER2- grade 2 cancer in a postmenopausal woman is slim. However in general, deferral on Oncotype for a T1b cancer a postmenopausal woman and selection of endocrine therapy alone is a very appropriate decision.
Sincerely,
Erica L. Mayer, MD MPH

Email Follow-up from MediGuide Clinical Staff:

From: Polly Girard
Sent: Wednesday, February 04, 2015 12:36 PM
Subject: Breast Cancer XXXX XXXXXXXX
Dear Jack,
I am very thrilled to have just spoken to XXXX XXXXXX. We worked very closely together on her MSO and enjoyed doing so. She told me that she is doing exceedingly well and has been cancer free for seven years now. She stated that “it feels like a life time ago” and feels that working with MediGuide helped to make the difference. Everything, she said, seemed to fall into perfect place for her recovery.
We had a wonderful conversation and she couldn’t thank me enough for calling to see how she was.
Sincerely,
Polly

MediGuide strives to bring our members “Closest to the Cure”.  The above case review is one of many that MediGuide is proud to have coordinated. While no one can promise a cure, we deliver on the promise that MediGuide members will have access to the world’s finest medical researchers with the most up to date clinical knowledge and experience with similar cases.

• As opposed to having a single doctor review the medical file, MediGuide’s hospitals employ the “Consultative Team” approach. This approach joins together a number of different specialists at the WLMC (World Leading Medical Center), each of whom brings separate and expert knowledge to the review of a single patient.
• Giving your Insured, your employees, or your member access to an independent review from a World Leading Medical Center (WLMC) – at no cost to them, is the right thing to do and a critical first step in keeping them healthy.

A study based out of Harvard reports that 90% of the time, Harvard experts changed or enhanced a treatment patients were originally told to follow. This is a staggering fact, and it represents one of the many serious differences between MediGuide and its competitors.  This is why MediGuide says that we put the Insured “Closest to the Cure”. The secret is that the WLMC’s attract the most research dollars. Those dollars allow those Centers to purchase the most up to date scientific equipment, to attract the most dedicated scholars, and to hire the most highly regarded and focused researchers. Furthermore, as opposed to having a single doctor review the medical file, MediGuide’s hospitals most often employ the “Consultative Team” approach.  This approach joins together a number of different specialists at the WLMC, for a more comprehensive review of a single patient.

Another critical distinguishing factor that sets MediGuide well apart from all competitors is that MediGuide gathers the medical records for the patient/Insured. Remember that the Insured has just been told that he has been diagnosed with a life threatening disease.  The Insured will be fearful, confused, and worried about the well-being of her/his family.  To now require her/him to go and collect his medical records before he gets his second opinion, is asking too much of the patient at this difficult time in her/his life. 

That’s why – even with Dr. Google around – providing a Medical Second Opinion from MediGuide is the best benefit option for your Insured, Employees, and members.

When an Insured is diagnosed with a serious medical problem, he/she will try to find the treatment plan that will bring him/her closest to a (cutting edge) cure. Obtaining a Medical Second Opinion from MediGuide is logical step. Why?

Did you know that the original diagnosis in the U.S. can be wrong between 1% and 18% of the time? In Asia the error rate for a diagnosis is higher, ranging between 3% and 24%.  These error rates vary based upon the particular disease, the geographic location of the insured, and the stage of development of the medical infrastructure in that location.

During the Medical Second Opinion process, we quickly tell the Insured the names of the three best hospitals in the World on our list of World Leading Medical Centers (WLMC) which are renowned for specializing in the Insured’s precise disease. We explain to the Insured why each of these three hospitals is so highly regarded for its knowledge of the Insured’s particular medical condition.

As found by a Harvard study, 90% of the time, Harvard’s scientists changed or enhanced the treatment the patient was originally told to follow. This is a staggering fact, and this is why MediGuide says that we put the Insured “Closest to the Cure”. The secret is that the WLMC’s attract the most research dollars. Furthermore, as opposed to having a single doctor review the medical file, MediGuide’s hospitals employ the “Consultative Team” approach.  This approach joins together a number of different specialists at the WLMC, each of whom brings separate specializations to the review of a single patient.

Many of our members have asked us, after they received a treatment plan that was very different from their original treatment plan – whether they can go for treatment to our WLMCs often situated overseas. Until the creation of the LifeLink product, we were able to organize admittance for our members, but most of the time had to inform them that their local insurance plan excluded overseas treatment, and therefore the members would have to pay for the treatment themselves.

LifeLink has integrated the peace of mind provided by MediGuide Medical Second Opinion, into an insurance concept that provides cover for medical expenses, as well as a vast area of services that facilitates treatment in a foreign environment. The Medical Second Opinion process is pivotal in the process as it will opine on the diagnosis and provide a treatment recommendation.

LifeLink will provide cover for a selected number of conditions, all life threatening situations that can be summarized in the six treatments listed below (*):

• Cancer treatment this means all treatments of a malignant tumor that is not being encapsulated, i.e. all cancers diagnosed to be stage II, III or IV.
• Neurosurgery: surgery that involves the nervous system: brain, spinal cord or peripheral nerves.
• Coronary Artery By-Pass Surgery: includes open heart surgery, in order to restore normal blood supply to the heart.  LifeLink will cover treatments that correct at least 2 coronary arteries.
• Heart Valve Replacement meaning a surgical procedure during which surgeons remove a malfunctioning valve from the heart and substitute it with a normal functioning valve.
• Living Organ Donor Transplant includes the transplant of a single kidney, pulmonary lobe (lung), a segment of liver or a portion of pancreas. The Insured’s organ is replaced with another of the same kind, donated by a compatible living donor.
• Bone Marrow Transplant means the transplant of bone marrow, originating from either the Insured or donated by a living donor.

(*) insurance policy wording may vary from country to country.

In order to assist the Insured with the process of getting ready for treatment overseas, MediGuide will make the following services available to the Insured:

• MediGuide will organize admittance to the WLMC on the shortest possible notice.
• Travel Arrangements:  the Insured can travel to the WLMC in Business Class. MediGuide’s local service center will make the travel arrangements which include Air, Land or Water transportation in Business Class (when available). LifeLink pays for the travel and accommodation expenses of one companion (a sublimit may apply). In this time of great distress, the Insured will have a loved-one by his/her side.
• Upon arrival, the insured will be picked up at the airport and escorted to the WLMC and/or hotel where the companion will reside.
• During the stay abroad, the Insured will be given access to a translation service. It is important that the insured can express himself in his mother tongue.  This service is provided for by medically skilled interpreters. This service can be accessed 24/7 and will facilitate the meetings with the medical teams for instance. A dedicated telephone number will be given to the Insured prior to his/her trip.
• Repatriation of the mortal remains: In the event of Death of the Insured Person, MediGuide will facilitate the repatriation of his/her mortal remains to the Country of Residence or will organize the funeral or cremation if the body is buried or cremated at the place of Death.

The entire process is cashless for the insured; all expenses are covered by the LifeLink program with the exception of out of pocket expenses abroad (subject to any sub-limits that may be applied by the local insurer.).

To summarize, the benefits for the Insured are clear: the Insured will obtain a Medical Second Opinion from selected World Leading Medical Centers. Furthermore, they can purchase up to One Million Dollars (US) insurance limit should Policy Holder wish to pursue the recommended medical treatment performed by the World Leading Medical Center that rendered Medical Second Opinion.

This new insurance concept will soon go live in three markets in Asia and the Middle East, and many more are in preparation stage of being launched in the near future.

In case you are interested please email pvermeulen@mediguide.ie or call us at +1 302 425 5900 or +32 12 67 13 54.