After a four-fold expansion during COVID, the Perth business expects increasing support for home care in the health sector.
A decade ago, pharmacist Julie Adams and nurse Lorna Cook took a big punt on a new kind of healthcare business.
The concept was simple: provide chemotherapy treatment in the patient’s home.
The reality has been far more complex and challenging than either anticipated.
“I thought this beautiful service would be embraced,” Ms Cook told Business News.
“I feel like we’ve been almost ostracised for trying to rock the status quo.
“It’s a very difficult industry to bring a new niche service to.”
While it has been tough going, the chemo@home founders have achieved major growth and see trends that should support further expansion.
It was COVID lockdowns, which made it difficult for people to visit hospitals, that transformed their business.
Before COVID, chemo@home had about 30 staff, mostly in Western Australia.
That has grown to 120 staff across Australia, with about 20,000 patient visits a year.
The growth has been substantial but that is still a tiny percentage of the cancer therapy market, which will have about 1 million chemo administrations this year.
Ms Adams estimates that between 50 per cent and 70 per cent of cancer sufferers would opt for home treatment if they had the choice.
One sector that has become supportive is the health insurers, which recognise a larger role for home-based medical care.
“It started to change as we were going into COVID,” Ms Adams said.
“They [insurers] were really working with us. For instance, we needed special dispensation to treat patients who couldn’t go to hospital.
“Their philosophy changed. Initially it was just saving money.
“[Then] they saw home services as a way of giving value for their members.”
That shift has been reflected in some of the insurers setting up their own health service ventures. Medibank Private operates Amplar Home Health and Amplar Allied Health to provide services such as nursing, physiotherapy, occupational therapy and podiatry in the home.
nib Group has started Honeysuckle Health, which provides telephone and digital health services. However, there are no other providers like chemo@home.
“Even now, there is not another service like ours,” Ms Adams said.
“We are truly the only major provider in the market.
“That shows it is not easy to set it up. You need particular expertise and skills.”
While the insurers and some governments have been more supportive, it’s a different story with the hospital sector.
“The industry has been very difficult, very closed, and very slow to adapt,” Ms Cook said.
“It’s all based around bringing patients into the hospital. They get funded to have patients in the hospital, the doctors are attached to the hospitals.”
Dual brands
Growth in the chemo@home business has been aided by a widening of its services.
The business started by providing chemotherapy for cancer patients as its only service.
It later added immunotherapy treatments, both for cancer patients and people with chronic illnesses such as multiple sclerosis and arthritis.
To support this diversification, the business has adopted dual brands and now prefers to be known as View Health chemo@home.
That is a bit of a mouthful, but it affords more flexibility, depending on the target audience.
“It’s hard to market chemo@ home for people who have multiple sclerosis,” Mr Cook said.
Another notable move was the recent switch to national firm Midas Healthcare as its preferred pharmacy provider.
“That’s to give us greater flexibility on the east coast and to help us expand our operations with better logistics,” Ms Adams said.
That meant switching away from Bayview Health, a Perth pharmacy business half-owned by Ms Adams.
“It was for the benefit of chemo@ home,” she said.
“When I’m in this position, I have to put my chemo@home hat on and I don’t do the negotiating on the other side.
“I declare my conflict of interest and step away from that so we can negotiate what we need for the company.”
New management
The founders have put in place a larger leadership team over the past two years to support growth of the business and ensure a succession plan.
Ms Adams leads finance and governance and tends to work ‘on’ the business, while Ms Cook leads people and culture and works ‘in’ the business.
They have promoted three of their staff to the leadership team with responsibility for clinical delivery, corporate services and strategic engagement.
“It means Lorna and I don’t have to do everything ourselves. We have a great team around us,” Ms Adams said.
The founders drew on advice from local consulting firm Adapt and also learned from past experience.
“COVID was all hands on deck, it was crazy times,” Ms Cook said.
They have also pursued professional development, with Ms Cook being a member of the CEO Institute, while Ms Adams has completed an Australian Institute of Company Directors course.
“That was fantastic, I loved doing that,” Ms Adams said.
Staffing, systems
While the business has faced, and overcome, many challenges, securing staff has not been one.
Ms Adams said they had been inundated with people wanting to join and even had to turn away potential recruits.
One reason, she believes, is that the business accommodates the needs of people who want more flexible work arrangements.
Another, she said, was having a no-blame culture.
“We’re a female-led business and we employ pretty much ninety-five per cent women,” Ms Adams said.
“So we’ve worked really hard at trying to look after women in the workplace, including during COVIID when it was diabolically difficult to get childcare.
“Our culture is one thing that has allowed us to keep staff and attract staff.”
While growing the business, Ms Adams and Ms Cook have also focused on maintaining high standards of clinical governance to ensure the quality of medical care in the patient’s home is equal to anything available in a hospital.
That has meant big investments in training and education, along with electronic health records to enable detailed tracking.
“We’ve invested buckets of money and time into electronic systems,” Ms Cook said.
“Keeping in touch with staff in other states and managing everything, it revolves around our information and communications technology.”
The company has also developed some bespoke solutions, helped by a $145,000 grant under the federal government’s Boosting Female Founders program in 2021.
The grant was used to support development of a system to enable engagement between consumers and medical specialists using an intuitive enquiry, referral and management process.
That was particularly important during COVID when the business was battling to cope with a surge in demand for its services.
The future
Ms Adams anticipates future growth will come from delivering new immunotherapy treatments for dementia and Type 1 diabetes.
“They are going to revolutionise new areas of medicine,” she said.
“We understand the market, we work with specialists in those areas to identify those treatments early so we can get in on the ground floor.”
Ms Adams also believes the hospital sector will eventually come around.
“It’s only in the past eighteen months where they have come out and said home care is the future,” she said.
“They were brought kicking and screaming to this point.
“They know this is where it is heading, so they are caught.
“They either support it and try and develop the services or they work with companies like ours to deliver services to their patients.
“The government is forcing it, the private health insurers are forcing it.
“But they don’t have the infrastructure set up to do it.”
