Nicholas Chepesiuk of OnCall Health: “Don’t be afraid to try new things”

High impact touchpoints do happen with telemedicine. It’s really up to the provider to understand and learn how to make healthcare work in different ways. For example, our customer Trafalgar Addiction Treatment Centers developed a virtual only program in 2020 to ensure that patients were able to access important mental healthcare services while isolating during […]

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High impact touchpoints do happen with telemedicine. It’s really up to the provider to understand and learn how to make healthcare work in different ways. For example, our customer Trafalgar Addiction Treatment Centers developed a virtual only program in 2020 to ensure that patients were able to access important mental healthcare services while isolating during the pandemic.

One of the consequences of the pandemic is the dramatic growth of Telehealth and Telemedicine. But how can doctors and providers best care for their patients when they are not physically in front of them? What do doctors wish patients knew in order to make sure they are getting the best results even though they are not actually in the office? How can Telehealth approximate and even improve upon the healthcare that traditional doctors’ visits can provide?

In this interview series, called “Telehealth Best Practices; How To Best Care For Your Patients When They Are Not Physically In Front Of You” we are talking to successful Doctors, Dentists, Psychotherapists, Counselors, and other medical and wellness professionals who share lessons and stories from their experience about the best practices in Telehealth. As a part of this series, I had the pleasure of interviewing Nicholas Chepesiuk, entrepreneur and CEO of virtual care software provider OnCall Health.

Nicholas Chepesiuk is the founder and CEO of OnCall Health, a technology company that provides best-in-class software to healthcare organizations, startups and clinics to launch and grow their own telemedicine programs. Under his leadership, OnCall Health is growing rapidly and today hosts over 1 million telemedicine appointments annually through its telehealth solution.

Thank you so much for joining us in this interview series! Before we dive in, our readers would love to “get to know you” a bit better. Can you tell us a bit about your ‘backstory’ and how you got started?

I was born and raised in Toronto and built my career in the local technology startup community. I started out “smiling and dialing” on the sales floor at Top Hat, an education technology company, and then worked my way over to Turnstyle, a marketing technology company which was eventually sold to Yelp. I learned a great deal through my time at those companies, watching and supporting their growth, and applied what I learned to my own entrepreneurial journey when starting my own company.

Can you share the most interesting story that happened to you since you began your career?

My team and I were traveling to meet with a potential client, a very large healthcare organization in the U.S. Our flight was cancelled, twice, and we missed our meeting. At the time, I was horrified, but I learned that people are really flexible and understanding. We came back to the office and had a virtual meeting with their team. This was right around the time when remote work took off and everyone began working from home. Despite the operational challenges of an entire company working from home, our team was resilient. We all want to make a difference in healthcare, so that is motivating.

Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?

The quote that stands out most is this one: “Always go with the choice that scares you most, because that’s the one that is going to help you grow.” This quote reminds me how important it is to give your people a clear career path and let them own projects. At some point, you need to let go and trust in your team to get things done their way. Over the years I have learned that the people who will help get a business from 0–1 may be different from the people who will get you from 1–2. The first group of people are hands on, wear multiple hats, and can grind on their own. The second group of people are experienced, strategic thinkers, and project managers who can orchestrate input from multiple departments to get things done at scale. As a CEO, I’ve learned to delegate and manage my time so I’m efficient; this approach also makes my team more efficient. When my team has the autonomy and authority to make decisions, we all feel more connected to the business, our values, and overall mission.

None of us are able to achieve success without some help along the way. Is there a particular person who you are grateful towards who helped get you to where you are? Can you share a story about that?

Something that I am really passionate about is improving access to healthcare — it underlies our mission at OnCall. Most people don’t have an employer that pays for a virtual healthcare plan. Plus, living in a city makes it easy to forget that there are still many underserved communities that don’t have internet connectivity and there are also individuals who don’t have personal devices to be able to access virtual healthcare. This idea of accessible healthcare came from a friend who was experiencing mental health challenges, but was unable to access an affordable provider for therapy. This friend really helped me understand the needs of patients seeking care, and it inspired me to develop the foundation for OnCall based on the value of telemedicine for providers and patients alike. I’m really grateful that I was able to learn from my friend and use that challenging time in their life as the inspiration to start OnCall, with the goal of enabling better outcomes in the future.

Ok wonderful. Let’s now shift to the main focus of our interview. The pandemic has changed so many things about the way we behave. One of them, of course, is how doctors treat their patients. Many doctors have started treating their patients remotely. Telehealth can of course be very different from working with a patient that is in front of you. This provides great opportunity because it allows more people access to medical professionals, but it can also create unique challenges. To begin, can you articulate for our readers a few of the main benefits of having a patient in front of you?

In-person patient consults are beneficial and necessary for high-impact touchpoints, like certain types of mental health therapy. For example, seeing a patient’s physical reactions and engaging with their body language is important in that regard. As well, some healthcare, like blood tests, imaging, and diagnostics will continue to be done in person. OnCall is built on the belief that in-person care and telemedicine can work together to change how healthcare is provided. We’re not telling people that telemedicine is the be all and end all, but we’re showcasing the benefits of each so that providers and patients are better informed about the various scenarios when in-person care or telemedicine can make the greatest impact on patient outcomes.

On the flip side, can you articulate for our readers a few of the main challenges that arise when a patient is not in the same space as the doctor?

There are a number of telemedicine solutions available that provide patients with access to random healthcare providers based on availability. In this scenario, continuity of care can be challenging since a patient may be given advice and recommendations that don’t take into consideration the patient’s healthcare history. Challenges could also arise when patients visit multiple providers that are not connected through technology. In this scenario, there may be no easy way for medical records or test results to be shared, which can also impact continuity of care.

Fantastic. Here is the main question of our interview. Based on your experience, what can one do to address or redress each of those challenges? What are your “5 Things You Need To Know To Best Care For Your Patients When They Are Not Physically In Front Of You ? (Please share a story or example for each.)

  1. High impact touchpoints do happen with telemedicine. It’s really up to the provider to understand and learn how to make healthcare work in different ways. For example, our customer Trafalgar Addiction Treatment Centers developed a virtual only program in 2020 to ensure that patients were able to access important mental healthcare services while isolating during the pandemic.
  2. Don’t be afraid to try new things. Trafalgar found that patients and providers were actually connecting in more meaningful ways through telemedicine, because they felt free of the judgement that comes with in-person therapy. Patients were connecting with group telemedicine appointments because they could not see their fellow group members tap their toes in frustration or seemingly lose interest during a conversation. For them, telemedicine allows them to be in a really safe space during difficult sessions, and patients were happy with this advancement.
  3. Enhanced technology, such as OnCall’s expanded API, helps to reduce complexities and strengthen continuity of care between patients and their providers. Although the patient is not in front of you, you still need their personal history and information to provide care. With an API, providers can connect disparate technology, whether that’s an EMR they are using for in-person care and OnCall for telehealth, to easily connect the dots between patient appointments to see their whole health picture. APIs make it a lot easier for providers to break down barriers between data and technology and use in-person and virtual care together for better healthcare outcomes.
  4. Investing in software to run your organization, clinic, or startup is often less expensive in the long run than hiring several extra people to fill in the gaps left by cheaper software. Also, invest early in branded apps; it is key to acquiring more patients and building a better business in the future.
  5. Make sure that you have a system for technical assistance set up prior to virtual appointments with patients. This ensures you won’t be wasting time troubleshooting during an appointment. For example, OnCall has a technical support team that is available 24/7 to onboard patients, providers, and admin staff prior to virtual care, and to provide ongoing support to ensure the platform works for everyone. You don’t want to waste time when someone’s healthcare is involved.

Can you share a few ways that Telehealth can create opportunities or benefits that traditional in-office visits cannot provide? Can you please share a story or give an example?

Telehealth really allows healthcare organizations to think outside of clinic walls, by offering remote care when and where patients need it most. For example, patients with chronic health conditions or who live in remote areas greatly benefit from telehealth. Telemedicine removes these challenges by eliminating time and space barriers for providers and patients, by opening up opportunities for more accessible care. For example, Trafalgar Addiction Treatment Centres telemedicine program has a much lower cost than their in-patient program, and allows patients from all over Canada to access important mental health and addiction counseling that might not otherwise be available in their town or city. Right now, Trafalgar has patients enrolled in their program from Ontario to British Columbia and beyond, which was just not possible with their in-patient facility that is in Ontario. The OnCall team believes that adding telemedicine to a provider’s healthcare toolbelt is an obvious prerequisite for both healthcare business growth and better patient outcomes, especially as 1 in 5 patients say they would see a provider who uses telehealth over a provider who doesn’t. For our customers, launching a telemedicine program is more than just “virtualizing” their old delivery model. It means transforming healthcare delivery into a collaborative, secure, and robust option for patients, providers, and business for the long-term. Adapting their care model to better serve patients, and to align with our ‘digital world’ is important to stay competitive and remain at the forefront of healthcare delivery.

Let’s zoom in a bit. Many tools have been developed to help facilitate Telehealth. In your personal experiences which tools have been most effective in helping to replicate the benefits of being together in the same space?

There’s one that I think is really helpful, which is instant messaging. Rather than having to schedule a video appointment, patients can connect through instant messaging with their provider at any time to ask questions or follow up about their health. This tool is used quite a bit by providers in addictions and mental healthcare. Having immediate access to a provider when going through addictions counselling is comforting and important. If a patient needs care immediately, they can quickly and securely access their provider through instant messaging and get the care they need. It’s that easy.

If you could design the perfect Telehealth feature or system to help your patients, what would it be?

As I mentioned, interoperability is extremely important. Patients have always experienced a fragmented health system, and it’s time to break the status quo. How many times have you had to tell the same health story to providers, just because they don’t have access to your health history and information? For me, it’s too many to count. The perfect telehealth feature connects systems and people for increased interoperability. We can liberate patient data and break down data barriers so providers have access to a patient’s full health profile and can provide care based on the patient’s history and overall needs. At OnCall we just released an enhanced API that does just that. Healthcare organizations and startups can integrate our API with their EMR, CRM, or whatever they use, so patient data seamlessly flows from one system to the other. Healthcare organizations and their providers can revolutionize how they provide care with a connected system powering their patient care and operations.

Are there things that you wish patients knew in order to make sure they are getting the best results even though they are not actually in the office?

It’s important for patients to set themselves up for success before their telehealth appointments. This means making sure their internet connection is stable and troubleshooting any technical issues they might be experiencing. OnCall makes it so easy for patients to get technical support at any time with our 24/7 technical support feature. This means that patients are asking for help from technical experts before their appointment, so time is not wasted with these challenges during an appointment. It also means that providers don’t have to worry about helping patients figure out a solution, but can rely entirely on our technical support experts for help.

The technology is rapidly evolving and new tools like VR, AR, and Mixed Reality are being developed to help bring people together in a shared virtual space. Is there any technology coming down the pipeline that excites you?

Remote patient monitoring technology is always evolving, and it’s exciting. There’s remote diabetes monitoring, exercise monitoring, and more. This technology enables patients to take control of their health outcomes.

Is there a part of this future vision that concerns you? Can you explain?

Remote patient monitoring technology comes with its drawbacks. There’s security and privacy risks with devices that do not meet compliance standards or requirements. There’s also something to say about patients taking control of their health outcomes. I am all for patients knowing and understanding their health data, but professional and expert opinions are necessary so patients have realistic and safe healthcare plans. We can’t forgo the expert opinion just because we see calories burned on our watch. The information is not always right, and we should continue to seek medical expertise for our health.

Ok wonderful. We are nearly done. Here is our last “meaty” question. You are a person of great influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. 🙂

I’m extremely passionate about increasing access to healthcare. There’s been incredible fallout from the pandemic relating to mental health and, as a result, so many more people now require access to mental healthcare services. I strongly advocate for the government and insurers to create more equitable access to virtual healthcare appointment options, especially in every workplace. This helps erase the stigma of mental healthcare and increases access for people no matter their socioeconomic status.

How can our readers further follow your work online?

The best way to reach me is on LinkedIn.

Thank you so much for the time you spent doing this interview. This was very inspirational, and we wish you continued success.

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