Tech firm delivers medical care around the world

The Seattle Times (MCT) - If you see Andrew Cull hunched over his iPhone, don't bug him.

The 30-year-old paramedic-turned-chief executive may be dispatching a helicopter to rescue a fallen mountain climber in Nepal or overseeing the evacuation of a sick scientist from a research station in the South Pacific. In just under seven years, Cull has built a company called Remote Medical International that provides emergency-medical services around the globe. It has 67 employees and medical personnel who rotate so the company has staff on every continent. They're coordinated by phones and online software systems from an industrial building in Seattle. Remote Medical provides telemedicine services around the clock from offices in Washington, D.C., and has a big presence in Canada, providing medical services around Alberta's ice road, which is the main winter road between Yellowknife and Alberta for motorists and suppliers. The company also provides first aid and rescue training _ ranging from wilderness first aid for local hikers to teaching combat medics rope-rescue techniques to help them quickly reach soldiers trapped in Humvees that have gone off cliffs in Afghanistan. Customers include expeditions, Special Forces, researchers, oil companies, travelers and wealthy people seeking medical services for their superyachts and vacation homes. Finally, it runs a Web site that's like an REI store for medics, selling medical kits and supplies, plus such rescue gear as climbing ropes and harnesses. Overall company sales are on track to expand 300 percent this year, after growing 400 percent to nearly $10 million in 2008, Cull said. Although it's providing extreme services in exotic places, Remote Medical might also be offering glimpses of new ways that medical services could be streamlined, coordinated and delivered in the future, especially now that the government has committed billions to accelerate the use of electronic health records. It's also another example of how aggressively the latest technology helped an entrepreneur build a global business with minimal overhead, in less than a decade. Remote Medical's gains haven't come from any particular device, although its doctors and medics share information via iPhones, MacBooks, BlackBerries and satellite phones. A medic may transfer EKG readings to an iPhone and send them ahead to the hospital, or connect a laptop to a satellite phone and videoconference with a physician in the U.S. When talking to Cull, you get the sense he almost takes these communication tools for granted. What's striking is how easy and inexpensive it has been for him to build and run a company providing medical care to people around the world, distributing supplies, filling prescriptions, handling billing, working with private medical records _ and making money in the process. This is done with an information-technology department of two people: Cull and his pal Chris Kenney, director of Remote Medical's equipment and supply group. The company actually began on a Dell laptop, when Cull was a student at Western Washington University and working on the side as a paramedic. He built a Web site and began offering wilderness first-aid training. "I was planning to go to medical school," he said. "The more I started mapping out a business plan, the more interested I became." An uncle loaned him $15,000, and Remote Medical became a full-time job. A key to the success, Cull said, has been having strong business systems. The laptop eventually gave way to servers and a SQL-based system that he customized himself, until switching three years ago to NetSuite, an online business-software suite. About the same time, the company switched to Macs, but it continues to use a single Windows machine for government contracts that use a particular piece of software. Using online, subscription software kept the company operations lean and freed up management time, but Cull's thinking about adding a few in-house servers again. One reason Cull handles the technology directly is because he doesn't like meeting with contractors. He said it's quicker for him and Kenney to fix things themselves. That hands-on philosophy carries over to the medical side of the business, where the company continually tests new medical devices, which are then sold on its Web site. Having used the products directly also helped the company win exclusive distribution agreements. "We can honestly tell if it works," Cull said. "If we haven't used it directly, somebody in the medical-support group has." When he's not managing the business, tweaking its software or flying to meet customers in places like Norway and Chile, he'll rotate onto the paramedic team. He even reviewed a new product offered on the company's site, SWAT Tourniquets, billed as "the latest in 'Care Under Fire' bleeding control." Cull said it's "easier to self-apply than any tourniquet I have seen." But the business is getting to the point where the chief executive may have to spend more time managing the business and less time tinkering. Cull expects that he'll need to hire a chief technology officer within a few years. "I pity the person who that would be," he said. "They'll be coming into a company where the CEO has been doing the tech stuff." ___ © 2009, The Seattle Times.

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