 From theCUBE Studios in Palo Alto in Boston, connecting with thought leaders all around the world, this is a CUBE Conversation. Hi, I'm Stu Miniman and welcome to this CUBE Conversation. Of course, during the COVID-19 pandemic, lots of businesses and industries have been upended. One area where there's been a real acceleration of the use of online technology, of course, has been telehealth and telemedicine to help us look into what is happening in that space. We have Eric Gray. He is the Chief Solutions Architect with NetScout. Eric, thanks so much for joining us. Thanks, Stu, it's great to be here. All right, so as I teed it up, obviously, telehealth, telemedicine, I've had most of my family have done virtual visits, if you will, talking to doctors and the like online has been a real shift, not something that is pervasive today. Help us understand a little bit how your customers are dealing with this and the changes that are happening in their world. Well, it's certainly becoming a significant paradigm shift in our industry. You think over the history of medicine, people have been going in and seeing a doctor, sitting in that waiting room and going through all of the permutations to spend 10 minutes with the doctor to diagnose their symptoms. And the shift that we have and driven, the fact that it's been driven by a global pandemic is maybe it's unfortunate, but at the same time, it is pushing the industry strongly in that direction. They say that by 2021, this is a $66 billion industry or business. So healthcare organizations be it hospitals and clinics, local providers, anybody that's having to deal with medicine back and forth and an interaction with their patients is going to make this shift over a very short period of time. Yeah, in general, Eric, how prepared was the typical practitioner to be able to support this kind of environment? You know, we've seen what's happened with local elementary school educations. Most of them aren't set up for remote as opposed to if they looked at secondary school universities usually had some component of online learning. But when it comes to the medical industry, do you have anything you can share as to, you know, what segments of the market were ready? How many just had to scramble and say, oh my gosh, I need this by Monday? So there were certainly, the larger healthcare providers that I spend my time with here in the Western US, they were ready to go. They had been looking forward into this field for quite a while. They had the technology in place, but that was certainly not the case for all. I've spent more time in the last three months talking to university healthcare organizations, local healthcare organizations who weren't at all ready to roll out the technology necessary to be able to provide that doctor patient interaction in a successful and high quality way. All right, well, let's drill in a little bit because most people think, oh, I'm going to move to an online experience. It doesn't just mean, if I was a restaurant, it doesn't just mean that I have an app or an online portal. If I was school, it's not just, oh, let's throw Zoom at the solution. If you're talking telehealth and telemedicine, I'm sure there's a lot that needs to be done ahead of any visits. Obviously, heavily regulated industry. So let's walk through if we could the full landscape there. So the biggest concerns that a lot of the healthcare organizations have that are trying to roll this out, probably the biggest one, by far, is maintaining a level of HIPAA compliance so that the data that's moving back and forth between the doctor and patient is staying exactly there. It's private. It's not exposed, even though it's going across public internet, in many cases from someone's home to the location of the physician, that that information remains confidential. Second, it really needs to be high quality. As the doctor is interacting with the patient now and is kind of the same fashion that you and I are right now, over a webcam, over their local ISP, quality might vary. So if a doctor is gonna make an accurate assessment of a patient and assess their symptoms without actually having them come into an office, they need to have an exceptional experience. The quality of the audio needs to be great, quality of the video needs to be excellent, the entire interaction needs to be pristine. And then there's the things that wrap around that patient-doctor experience. The things that give us the, call it the infrastructure that makes it happen, that's the DNS connections and the underlying network. But it's also prior to the call, making sure that you have the ability to set it up, access medical records after the call, being able to get to a pharmacy, to get to your prescription, or see the test results that came from the experience. Even billing, I'm gonna go pay my bill, I need to be able to get to something reliably and have a secure transaction. All of this stuff together sort of makes up what is modern telemedicine. Though most of the time, the telehealth experience is what's considered everything, whereas telemedicine is really looked at as the doctor-patient conversation across that new digital media. Yeah, what if companies had to deal with, if they had really a toe or they were starting down this path and all of a sudden they need to go from something that they do as an exception to now this is what they've been doing for the last few months. How do they scale that up? Oh, it was a shock for many of them. Some had some basic level of video interaction capability, but I've had customers that have talked to me about a 20 to 30 X increase in the amount of bandwidth necessary and the amount of technology needed in order to facilitate these conversations. The market is skyrocketing. Doctors are making this dramatic shift because they need to protect their patients, they need to protect themselves. And as the need has gone up exponentially, IT teams are really scrambling. They're having to provide this technology very, very quickly, standing up new concentrators for VPN connections, lots of new service provider connections so that they have additional bandwidth capable. And then going out to the different companies who provide direct telemedicine and telehealth connectivity so that they are maintaining that high level of security as well. So all of this together has just created this explosion in this industry as people rush to deploy this stuff. It definitely sounds very challenging. I've talked to government agencies that get emergency funding for this. What's the impact on from a financial standpoint? I think from a patient standpoint, you say it's not like all of a sudden you're going to be able to bill more. If anything, they're like, hey, I'm not coming to the office, is a little bit less to go there. So what are the financial implications of all of this? Well, that's really interesting. As many of the healthcare companies, especially the hospitals ramp up to fight COVID-19 and the coronavirus epidemic, getting access to the appropriate PPE and emergency room technology, making sure they had enough ventilators, all that stuff was a big drain on the emergency funds. When they looked at what was going on with telemedicine, it's really a dramatic savings. So the surveys say that somewhere in the order of the United States healthcare industry overall, as we shift into a primarily telemedicine-based system, it'd save up to $4 billion a year. So it's significantly less expensive for those healthcare companies to be able to provide this kind of interaction. Not only money, but also from a quality of the interaction as well. As I said at kind of the beginning, I know when I would go in and talk to a doctor, maybe I would get 10 minutes. There's a lot of time that you spend sitting in the waiting room, waiting in the actual room, and the interaction is very short and maybe not such great quality. Now, as I've been spending a few sessions with doctors online, it's really great. I've got no waiting. I've got a long window of time with my physician. I think it's probably a better interaction for me and overall it's gonna save the healthcare company a significant amount of money. Seems like it makes a lot of sense. Yeah, that's an interesting silver lining, if you will, that we can really kind of change it from, it was almost a just-in-time manufacturing methodology as we maximized the utilization of everything with all the scheduling and the like, and we're really building it more like a distributed system now. So I'm curious, Eric, what is the thinking around these people, these companies, if you're scaling this up for remote, eventually there will be the new normal. Let's say we have a vaccine and going back to the office visits will be more prevalent. What is the thinking about what this will look like in a hybrid mode or will the telemedicine dial back a little bit in the next year or so? I think the general consensus is that it's here to stay. This isn't the first pandemic, it won't be the last. And putting the proper technology in place right now, that's available. This is not something that's years in the making, it's out there. It's just that a lot of companies weren't quite ready to take the leap, either from an investment standpoint or just doing things the same way and making that paradigm shift. But I believe not only are we seeing this significant shift just in this timeframe, but it's gonna be here for a long period of time. They're gonna be certainly people that will want to go back to the old way of visiting the doctor and as at-home diagnostics become more prevalent, things from like a blood pressure monitor or pulse ox monitor, various ways that you can actually take vital readings from your home and have that data transmitted into your EMR, EHR system, that makes it even more sticky. So I believe the time's gonna come where we'll step a couple of steps back, but those 10 steps that we've made forward, it's something that the industry's been waiting for for a long time. And now we're gonna get there really quickly. Yeah, it's fascinating to think, Eric, if this had been 10 years ago that we would be having a very different conversation, if you would take us in a little bit, the learnings that you had, where is NetScout finding that it's helping its clients the most when it comes to telehealth and telemedicine solutions? Well, it's one of the things that's really gotten us excited at NetScout. We've been in this business of being able to secure and monitor enterprise and service provider networks for the last 35 plus years. NetScout's been in this business to keep the customer's networks alive, keep them healthy, and help them to troubleshoot problems when they occur. So as we look at applying our technology towards this telemedicine's experience, it seemed like a perfect fit for us. We can break it down in kind of three categories. First, what happens prior to the experience? We wanna make sure that we can maintain a high level of availability for the healthcare organization's network to make sure that the telehealth software is functional, that the network is robust, that the response times are low. So understanding what that experience is like in advance of the call is probably, you know, a little bit of a slam dunk, but we wanna make sure that we're always ready and able to handle the load. Second, and probably most important, is during the call. Once that patient is talking to the doctor and they're ongoing through video, audio chat, we wanna make sure that the quality of the experience is exceptional. About 10 years ago, NetScout acquired some technology that gave us the insight into how unified communication protocols function and gave us the ability to measure MOSCores, jitter and loss, even in a secure RTP kind of payload environment. So even with encryption, we can still give you a high understanding of how good that session is to make sure that the patient, the doctor are seeing each other, they're hearing each other and it's pristine. Then finally on the back end, what happens after the call? So once the physician and the patient are done, I still need to go see my records and need to put my bill. As I said before, we wanna make sure that all of the systems that make that happen are up functional and capable of being used every day. Our ability to monitor these sessions, baseline their performance and triage in the event of an issue helps us to keep EMR systems like Epic and Cerner and McKesson up and running, the billing systems that make things happen. HL7 protocol, tying everything together, giving a patient access to their records, their medical images, et cetera. And the network that makes all this happen, probably already monitored by NetScout as our customers are very loyal and have been for many years. All right, Eric, I'll give you the final word. If customers wanna learn more about what you're doing in this space, what would you recommend for them? We're very excited about what we're doing with all of these solutions for our customers. First, we've published a white paper that you can find at netscout.com. We show up on a telemedicine landing page. You can read all about how NetScout's products are being used to help in all of these areas of telemedicine. Also, on July 21st at 10 a.m. Pacific, we're gonna be offering a live webinar demonstrating how our technology can be used before, during and after a telemedicine call for the customer. All right, well, Eric, great. Thank you so much for joining us. Really important stuff around the telehealth and telemedicine. Really appreciate all the updates. Thanks, Stu. Have a great day. All right, and thank you for joining. I'm Stu Miniman. Thank you for watching theCUBE.