itb asia - travedoc presentation

“A Doctor in Your PocketTM”

Marcel Muenster, CEO & Founder TraveDoc Glenn Hirsch, CMO TraveDoc

TRAVELING We share the passion for

Discovering LANDSCAPES

Enjoying FOOD

Meeting PEOPLE

STARTED How everything

Traveled to HONG KONG

Ate a MOLDY PINEAPPLE

Felt SICK afterwards

ANALYSIS Market

:

Source: Han, P., Yanni, E., Jentes, E. S., Hamer, D. H., Chen, L. H., Wilson, M. E., et al. (2012). Health challenges of young travelers visiting friends and relatives compared with those traveling for other purposes. The Pediatric Infectious Disease Journal, 31(9), 915-919.

880 million travelers a year

Source: Patel, D. (2011). Occupational travel. Occupational Medicine (Oxford, England), 61(1), 6-18Rack, J., Wichmann, O., Kamara, B., Gunther, M., Cramer, J., Schonfeld, C., et al. (2005). Risk and spectrum of diseases in travelers to popular tourist destinations. Journal of Travel Medicine, 12(5), 248-253.

880 million travelers a year

563M with health impairments

Source: Lerdal A, Harding T, Kjolstad S. Illness and injury presenting to a norwegian travel insurance company’s helpline. Travel Med Infect Dis. 2007;5(3):165-170.

880M travelers a year 563M

with health impairments

88M seek medical care

Source: http://www.mint.hr/UserDocsImages/08-C-Wohlmuther.pdf

1.6bn International arrivals by 2020 563M



1.02bn with health impairments

563M with health impairments 1.02bn 1.6bn

travelers a year



source: xyz

88 seek medical care

47.5!MILLION PATIENTS

Source: Van Herck, K., Van Damme, P., Castelli, F., Zuckerman, J., Nothdurft, H., Dahlgren, A. L., et al. (2004). Knowledge, attitudes and practices in travel-related infectious diseases: The european airport survey. Journal of Travel Medicine, 11(1), 3-8.

73.3%!had sought general information about destination

52.1%!had sought travel health advice


20.2%!were not aware


18.7%!no risk to health


6.3%!too busy


THE MAJORITY

did not know what to do!

DISEASES and why travelers are more likely to get sick

Pre-Travel Travel Post-Travel

Pre-Travel Review of the itinerary

Immunizations

Past medication history

Prevention and self-treatment

Prescriptions and medical records

Source: Bomsztyk M, Arnold RW. Infections in travelers. Med Clin North Am. 2013;97(4):697-720, xi.

Allergic Rash

Blood Clot

Dengue

Diarrhea

Encephalitis

Heart attack

Hepatitis A

Hepatitis B

Hepatitis C

HIV

Leishmaniasis

Leptospirosis

Meningitis

Malaria

Pharyngitis

Pneumonia

Sexual Assault

Schistosomiasis

Sunburn

Skin Abscess

Trypanosomiasis

Tuberculosis

Typhoid fever

Yellow fever

Source: Bomsztyk M, Arnold RW. Infections in travelers. Med Clin North Am. 2013;97(4):697-720, xi.

Diseases

Enjoying FOOD

Bacteria!

Enjoying FOOD

33% !

Gastrointestinal

Source:: Field V, Gautret P, Schlagenhauf P, et al. Travel and migration associated infectious diseases morbidity in europe, 2008. BMC Infect Dis.

2010;10:330-2334-10-330.

Diarrhea

Giardiasis

Amebasis 33% !

Gastrointestinal


2010;10:330-2334-10-330.

45%!

Diarrhea

: Source: Patel, D. (2011). Occupational travel. Occupational Medicine (Oxford, England), 61(1), 6-18Rack, J., Wichmann, O., Kamara, B., Gunther, M., Cramer, J., Schonfeld, C., et al. (2005). Risk and spectrum of diseases in travelers to popular tourist destinations. Journal of Travel Medicine, 12(5), 248-253.

45%!

Diarrhea 40% change travel plans

:

Source: Patel, D. (2011). Occupational travel. Occupational Medicine (Oxford, England), 61(1), 6-18Rack, J., Wichmann, O., Kamara, B., Gunther, M., Cramer, J., Schonfeld, C., et al. (2005). Risk and spectrum of diseases in travelers to popular tourist destinations. Journal of Travel Medicine, 12(5), 248-253.

40% change travel plans

20% are confined to bed

45%!

Diarrhea


40% change travel plans

20% are confined to bed

1% require hospital admission

45%!

Diarrhea


Mosquitoes!


Malaria Dengue Viral Hepatitis

Febrile Illnesses

20% !

Source:: Field V, Gautret P, Schlagenhauf P, et al. Travel and migration associated infectious diseases morbidity in europe, 2008. BMC Infect Dis. 2010;10:330-2334-10-330.

100+ countries worldwide Affects 500M people 80-90 million travelers

Deaths per Year

Malaria

1M+!


Bacterial Infections Rash Sunburn

Skin Conditions

12% !


Skin Conditions

40%

Source: Hochedez P, et al. Changes in the pattern of health disorders diagnosed among two cohorts of French travelers to Nepal, 17 years apart. J Travel Med. 2004;341-346.

Bacterial

25% Fungal

Tuberculosis Influenza Legionnaires disease

Respiratory Illnesses

12% !


Expatriates higher risk Latent TB risk ~1 to 4 cases per 1000 person months. Health care expats 8 cases per 1000 person months

Sources: Lim P, Han P, Chen LH, et al. Expatriates ill after travel: results from the Geosentinel Surveillance Network. BMC Infect Dis. 2012;12:386. Dijkstra J, Chappuis F, Loutan L. Vaccine-preventable diseases in long-term expatriates. J Travel Med. 2005;12:S47–57. Gardner A, Cohen T, Carter EJ. Tuberculosis among participants in an academic global health medical exchange program. J Gen Intern Med. 2011;26:841–5. ��

Only 30-66%

receive appropriate screening and counseling

Tuberculosis

Meeting PEOPLE

STIs!

Meeting PEOPLE

HIV Syphillis Chlamydia

0.6% !! !

STI


2010;10:330-2334-10-330.

of travelers report sex with new partner

STI

50%!

60+% report inconsistent condom use

59% of Dutch expatriates paid for sex at least once


HIV Post-Exposure Prophylaxis

Reduce HIV transmission by reducing HIV in bloodstream

Sources: Otten, R. et al. (2000). Efficacy of postexposure prophylaxis after intravaginal exposure of pig-tailed macaques to a human-derived retrovirus (human immunodeficiency virus type 2). Journal of Virology, 74(20), 9771-9775. Smith, D. K., et al. (2005). Antiretroviral postexposure prophylaxis after sexual, injectiondrug use, or other nonoccupational exposure to HIV in the United States: Recommendations from the U.S. Department of Health and Human Services. Centers for Disease Control and Prevention, Morbidity and Mortality Weekly Report, Recommendations and Reports. Retrieved from http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5402a1.htm Awareness and use of nonoccupational HIV post-exposure prophylaxis among people receiving rapid HIV testing in Spain. HIV Med. 2013 Apr;14(4);252-7.

CDC recommends post-exposure prophylaxis after high (or moderate) risk exposure.

22% at rapid HIV testing aware

Chronic Illnesses

of all travel-related death due to cardiovascular disease

70%!

Avg age of people who die during travel is 60 22.5% of international travelers are >60 Sources: Carl J. Lawson, MPH, Deaths in International Travelers Arriving in the United States, July 1, 2005 to June 30, 2008, Journal of Travel Medicine 2012;

Volume 19 (Issue 2): 96–103

“It is essential that travelers are aware of mortality risk associated with their underlying diseases and that they are properly prepared to handle them while traveling.”

“Persons with chronic medical conditions and the elderly should promptly seek medical care if they become ill during travel.”

Age

Length of stay

Season of travel

Climatic and cultural contrast

Level of travel experience

Gender

Destination

Medication adherence Physical

exertion

Excess alcohol

Dietary indiscretion

Delays in seeking

medical care

Reasons for Sickness

Sources: Novaro GM et al. Cardiovascular emergencies in cruise ship passengers. Am J Cardiol 2010; 105:153–157. Lawson CJ et al. Deaths in International Travelers Arriving in the United States, July 1, 2005 to June 30, 2008. J Travel Med 2012; 19: 96–103. ��

TraveDoc The idea of

How TraveDoc Works

Kathleen, an American expat, wanted to find a pediatrician in Accra to renew her child’s vaccinations

Patient Experience

Patient Experience

Kathleen heard about us on Twitter

Visited our website to search for a pediatrician in Accra

Patient Experience

She found Dr. Tuakli Booked an appointment with

her online

Used her text message reminder to find directions to Dr. Tuakli’s practice

Patient Experience

Video Testimonial

Physician screening User feedback Onsite evaluation

How We Vet Physicians

TraveDoc’s Goals

Serve 800.000 traveling patients by 2018

Save 5% of traveling patients

by 2018

Carefree travels – “A Doctor in Your PocketTM”

Marcel Muenster, !M.D., M.P.H. CEO & Founder

Glenn Hirsch, !M.D. M.H.S., F.A.C.C Chief Medical Officer

Ken Herron, !M.I.M. !Chief Marketing Officer

The Team

THANK YOU! Xiexie

www.travedoc.com

[email protected]

@TraveDoc

itb asia - travedoc presentation

Travel

occupational travel

journal of travel medicine

travel health advicesource

change travel plans

spectrum of diseases

bn travelers

occupational medicine

infectious diseases