Ivan Bartolo, CEO of health IT solutions company 6PM, speaks to Anthony Manduca about his drive to revolutionise the health market and the progress of 6PM’s emCare subsidiary company.

Malta must wake up to the fact that its health service will soon become unsustainable – unless major changes are brought about in the way such a service is provided, according to Ivan Bartolo.

“Our vision at 6PM is very clear. We provide IT solutions in the health sector and are focused on making health affordable in the 21st century. This can be done through technology and how this technology is applied.”

“I can save the government €6 to €7 million with my proposals,” he insists.

He stresses the importance of transforming the way we do things, like emCare – an electronic and mobile care provider which 6PM acquired 100 per cent last January – has done.

“When the telecare service was introduced by the government in 1987 the technology consisted of a big box in a house and if you press a red button somebody would speak to you. However, if an elderly person fainted or fell down they would not be able to press that red button. Since emCare got involved with the local telecare service it upgraded its technology; you can have fall detectors around you, temperature detectors and intruder detectors. An elderly person can be supported at home and given confidence to remain at home.

“We also have devices at home that can monitor a person’s blood pressure and heart, an app which tracks a person’s whereabouts so their relatives can keep track of him or her, pill packs so we know exactly what pills the elderly are taking and the ability to use a mobile phone to look into a relative’s home continuously and execute basic tasks such as helping an elderly person to switch on their television.”

He explains that a patient at an elderly home today, unless subsidised by the government, pays a minimum of €1,300 a month. “If you live at home with this new technology, it will cost €130 a month, which is only 10 per cent of the cost. If you fall, we’ll know, if you are running a temperature we’ll know, if you are not taking your medicine we’ll know because there is a pill dispenser. If you are not moving in your bed we’ll know because we have a mattress sensor.”

Mr Bartolo says that when an elderly person connected to emCare at home presses the red button, the call centre in Santa Venera – run by the government – responds within 30 seconds. He says people at the centre do “an excellent job” and are a very dedicated experienced team. He announces that his company will soon be having its own call centre, which will be up and running in the next three months. This, he points out, will allow then to broaden their care services.

He appeals to the government to team up with 6PM in the interest of Malta’s health service, saying that Mater Dei needs somebody to run the hospital on a day-to-day basis and somebody to focus on the change programme over the next two to three years.

“I really wish the government would work with emCare to keep elderly people at home – that would free up a lot of beds at Mater Dei which are used for social cases.

I have spoken to ministers and consultants, all for nothing

“We have been involved in emCare from when it was first set up. We had a 25 per cent shareholding, then 50 per cent and then we acquired it all last January. EmCare started operating in Malta with telecare – which we invested millions into to upgrade its infrastructure. There is a community of 10,000 telecare users and we are looking at extending the scope of our service – to provide them with things like fall detectors and much more. We have started this process, but it is all private, we are doing it on our own.

“We are trying to convince the government to offer this service, which would lead to fewer people applying to stay in government homes and thus save money. Unfortunately we have not got very far as people are not understanding that applied technology, transformational thinking and a digital society are the future.”

If Mr Bartolo has not yet succeeded in working with the government here, it’s a different case in the UK, however, as 6PM is present in 140 NHS hospitals. In fact, 95 per cent of his companies’ revenue comes from abroad.

“In the UK we work closely with the UK government and we are running a lot of transformed sexual health programmes. Through 6PM people can go online and order self-tests and fill in questionnaires, such as when was the last time they had sex, in the privacy of their home. These services will soon be available through a mobile application. People can therefore order a kit, which will arrive at home within 24 hours, and test themselves for sexually transmitted diseases. Videos online show them how to do the test which they then send to a laboratory by post,” he explains.

Mr Bartolo would like to introduce such a service in Malta. Young people, particularly teenagers, he says, are shy to go to the sexual health clinic at Mater Dei, so emCare using 6PM’s proven online service could help matters.

“A 15-year-old girl with an STD which goes untreated because she is too embarrassed to go to hospital is going to have serious problems later on in life when she wants to get married and have children. The probability of her resorting to IVF treatment is very high, which means she will cost the health service a lot of money. It is therefore very important that these people are brought in for testing.”

He adds: “If anyone with HIV has sexual intervention with anyone with an STD the probability of this person contracting HIV is 98 per cent. An HIV person in Malta costs about €12,000 a year to treat, and this is for life. In the UK, for example, 100,000 people with HIV consume 30 per cent of the medicines budget. HIV is on the increase in Malta, so we should do whatever we can to manage the spread.

“I have offered to have the same testing facility available in Malta, for free, as part of the company’s corporate social responsibility, but I never received a response. I also offered to have a mobile clinic going around the country to do tests. Malta has become much more cosmopolitan and sexual promiscuity has increased. If we do nothing, HIV and IVF will increase, putting more strain on the health budget. We need to test more people, we need to stop the spread of STDs and we must provide this privacy.

“I tell the Prime Minister: 6PM will give the government the HIV IT solution in Malta for free. We’re happy to do sexual health, work with us so together we’ll go to the WHO; Malta and 6PM will undertake a corporate social responsibility project in Africa, for free. Let’s put Malta on centre stage.”

He gives another example of how 6PM in the UK is tackling the spread of STDs – people who use escort services will soon have the right to see a digital certificate, (which can’t be more than 24 hours old) on a sex worker’s mobile which states that he or she is healthy.

“These are today’s realities, if we ignore them people will end up in the casualty department.”

Mr Bartolo explains that operation waiting lists – a problem in Malta – could be reduced through the use of an app.

“Patients in the UK will be told to download an app and three weeks before an operation the patient will be asked to submit information every day. This will ensure that doctors have a clear picture of the patient’s health before they operate and thus prevent cancellations which cost a lot of money.

“In Malta no one seems to be doing anything about the problem of waiting lists. The only report, the one written by John Dalli, focused on change pertaining the clinicians, which is not fair. What is needed is to speak to the doctors to see what can be done together in the transformation process, in other words automate care pathways.”

Mr Bartolo gives other examples of how 6PM in the UK is transforming the health service. The company will very soon be launching ‘My emCare’ which captures people’s complete medical history, so when a person goes to hospital all his medical background will be available in a digital format.

I can save the government €6 to €7 million with my proposals

Mr Bartolo again stresses how he would like “governments” to co-operate with him.

“I have spoken to ministers and consultants, all for nothing. I think everybody is trapped in tactical thinking. Nobody is thinking about what projects we can implement to improve our lives.

“There is so much to do in this area, do we want to create another economic pillar in Malta like we did with gaming? Or do we just want to build towers? What added value do such towers create?” he says with reference to the mega projects sprouting up all over Malta.

“Why are foreign start-ups not coming to Malta? 6PM was a start-up in the UK. We have grown the business to €15 million per annum in 15 years. We are present in 140 hospitals in the UK and in Malta we are not present in hospital. We have sold emCare in Italy. Everybody pays lip service to change. Let’s enter into a PPP (public-private partnership). We are ready to invest. We are committed to what we do. Our mission is to make a difference.

“Our 180 employees in the UK, Malta, Ireland and Macedonia are committed, they have seen what we do; they have gone to hospitals and seen newborn babies with AIDS. A woman recently fell in the bathroom and knocked her head at 3am, the fall detector was alerted, we contacted her son and she is forever grateful to us as we saved her life.

“We are present in 140 UK hospitals; in sexual health we are market leaders with 60 per cent of the UK market; in substance misuse we have 27 per cent of the UK market, we are very strong in the tracking of medical records, medical devices, people in hospitals and vulnerable patients; we have an office in England, Malta, Macedonia and Ireland,” he says.

6PM also has an investment in a company called Javali, based in the US, a product which looks at medical coding, “so we will be focusing a lot on the American and Canadian markets”.

Mr Bartolo believes Malta could become a hub for modern health services which would be a showcase for Europe.

“I have been telling the University authorities for a long time to introduce specialised IT courses in healthcare for example, or financial services, but to no avail. In Macedonia, for example, I can go to the rector of the University and tell him that in a couple of years I would need graduates in particular specialised courses, and he will agree to introduce such courses, because he knows that I will employ some of them.”

Why did he enter the Macedonian market?

“What caught my eye about Macedonia in 2011 was that the Americans invested heavily in that country so it must have had potential. Also, it’s a very different cost base. If I look at the average salaries in the UK, Malta and Macedonia, the average salaries in Macedonia are lower. What is really worrying is that the average salary in Malta in IT is higher than the UK, excluding London.

“Nobody here is thinking about our competitive edge. And if we think that our English language is an advantage, forget it – these young graduates in Macedonia speak very good English. I have been to the Macedonia equivalent of Malta Enterprise and realised what a lot of catching up we have to do.”

He concludes with a warning to Malta’s politicians: “I would not like to be the next Prime Minister after the next election, because that person is going to have a very difficult task. It is useless saying how well the economy is performing. Are we creating new quality jobs and what new business sectors are we trying to develop?”