The Nurse Is In

Lorna Cook, Syndicate 82, is the Co-Founder and Co-Director of Chemo@home. Lorna started this niche health company with her business partner, Julie Adams in 2013 after they identified a need in the health sector for an at-home chemotherapy service for patients with cancer. With her background in nursing and oncology, (and an MBA), she formed a perfect partnership with Julie, whose experience as an oncology pharmacist had given them the right skills to start such a service.

Changes in legislation in 2012 opened the door to the funding of a home chemotherapy service by private health insurers, and for the first time, allowing home chemotherapy to become a feasible business option.

Lorna and Julie understood the implications of this change for the future of cancer care. It meant that home care was the way of the future, and so, decided that they would undertake the incredibly complicated and stressful journey of starting a company providing a service that was the first of its kind, having to overcome  complex legislative and regulatory hurdles, and then negotiate individually with the myriad of different health funds for financing, doctors for referrals and patients to trust in the safety of the process.

“This was a huge risk that we didn’t take lightly, but we backed ourselves and committed. We mortgaged our family homes to use as collateral and just plunged our whole lives on this enterprise.

“We always had this sense of purpose, and we believed we could change the whole paradigm of chemotherapy treatment for patients, making it less stressful and safer for patients. Patients and their families were, and still are, becoming very aware of their rights and the old-fashioned way of having to go into hospital and hang around all day every time they needed treatment (which can be for years), wasn’t really the way patients wanted things to be. The writing was on the wall. Like all other aspects of life people wanted services in their own homes feeling supported and safe and less inconvenienced”.

When they first started, many of the doctors and hospitals were sceptical of using their service although private health funds supported chemo@home because they could see this was the way of the future and they were looking for better services for their customers. There was definitely reluctance among the doctors to refer their patients for several reasons, mostly because they did not know the company well, and this was not how the medical system was set up to work - patients too were nervous because to them it seemed dangerous.

However, over time the tide has certainly shifted. Barriers have been broken down one at a time and chemo@home now has a strong reputation in the health care arena.

“Our mantra has always been to be better and more professional than any potential competitors and to remain ahead of the curve in healthcare. We have invested heavily in our ICT infrastructure and early-on commissioned an Australian company with a software program that needed to be rebuilt in a bespoke manner for our company (because there hadn’t been any need for such software previously). This enabled us to create our own electronic health records, which was also an oncology management system. It encompasses all sorts of recording, auditing communication and as such allowed us to become a fully cloud based digital company. This is important when you have such a geographically dispersed team of nurses managing chemotherapy in the community across Australia.

“We also use technology such as Google glasses, which is like a Zoom meeting in a pair of safety glasses. We use these with the nurses on site when new training is being instigated or when auditing the care.  During lockdown, this IT infrastructure allowed us to pivot quickly, and our business boomed as hospitals were unable to cope with staff shortages and COVID-19 restrictions".

The work required to steer the helm of a female founded and entirely female run business has thrown some obstacles in the way that at times have seemed insurmountable. Lorna explains, “Other than the regulatory and legislative hurdles that underpin the health sector, there have been many examples of the general bias towards women, which has been incredibly frustrating. For example, there was a government minister who, in trying to help us, suggested we hire a male doctor to be the figurehead of chemo@home so as to give us a better chance of getting government contracts, or another example where a bank lender asked Julie if she could get a husband or even her ex-husband to co-sign on an application for a small loan. Another time a news channel ran a story about the fantastic service we were offering patients. When the clip aired, they had changed the wording from ‘two experienced health professionals’, to ‘two Perth mums’. These are only a few examples of the many times when we have had to overcome the perception that we somehow did not know what we were doing or were not just as capable as a man would be, to run a medical business”.

During the last nine years after starting chemo@home, the company has received numerous awards in both the medical and business fields, including two AIM Pinnacle Awards, The WA Government Innovator of the Year Award (growth category) and in 2017 Julie was named as the Telstra Business Woman of the Year.

In 2020, in the Year of the Nurse, Lorna was one of three finalists in the prestigious Federal Health Ministers Nurse Trailblazers Award, and most recently it was announced that chemo@home was one of only three West Australian companies to receive a 2022 Boosting Female Founders Grant from the Federal Government. With this grant the plan is to invest the money into further IT infrastructure which will continue to enhance the processes of the services chemo@home offers.

Lorna believes this award gives chemo@home further credibility and validation in the medical community. “This is an incredibly prestigious but difficult grant to receive, and we had tried in the past with no luck. This year, however, we were well-prepared with our application, and our desire to improve our IT infrastructure fortunately saw us being successful in being announced as a recipient of the grant. We are not only leaders in our field, but we can continue the progress that has already seen us expand from one small office in Perth, to Melbourne, Sydney, Adelaide, Canberra and Queensland. There has been interest from New Zealand and Singapore, but we really want to use this grant to forge up our IT and consolidate our work here in Australia before we grow internationally. But it really is just a matter of when, not if chemo@home expands its services abroad”.

With over 250 different therapies on offer, their highly trained nurses perform over 1500 treatments per month across Australia and these numbers are increasing all the time. The treatment numbers have increased not just because of word of mouth, or because of COVID-19, but also because in 2013 a new form of cancer treatment known as immunotherapy was approved worldwide. These medications are like chemotherapy but instead of the use of chemicals, they are called biologicals. They allow the patient’s own immune system to be ‘modulated’ or changed. These medications were game changers. They work incredibly well and many of these drugs used for cancer treatment, can now be used for chronic illnesses such as multiple sclerosis, rheumatoid arthritis and Crohn's disease and similar.

Although these drugs are extremely effective, they need to be given every two to three weeks, sometimes for years which is incredibly disruptive to people’s lives. Furthermore, because their immune systems are modulated, the patients may be at risk of being immune compromised. This makes them more susceptible to becoming really ill if they come into contact with infections. Now 50% of chemo@home’s work is treating patients with immunotherapies.

Along her journey of running a complex health service, Lorna has found great support in her Syndicate at The CEO Institute. “Steve Stanley in Perth has been a great mentor to me, and I have also had two truly excellent Syndicate Chairs from whom I have learned so much".

The confidentiality and supportive nature of The CEO Institute network are two factors that Lorna holds as being valuable aspects of her membership, “I have reached out to other members through the years, and we have helped one another in all aspects of business. We speak about deeply personal issues all the way to highly sensitive business topics. Nothing is too big or too small to share, and I have come to really enjoy the spirit of comradery and support I get from the other members”.

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