Although Max House was never directly involved with Fonemed himself, Brophy calls the late doctor and former lieutenant governor of Newfoundland and Labrador not only the eminence gris of her company but also the primary reason the fledgling international telemedicine firm chose St. John’s as the launching pad for its future business.

Thanks largely to House, in fact, Newfoundland has long been recognized as a global pioneer in telemedicine, which essentially involves using telecommunications technology to diagnose and treat patients.

Let’s rewind. In the early 1950s, when House was still a young country doctor in Baie Verte, then a remote community accessible only by boat and seaplane (and not even that in the worst month or so of winter), he began pestering provincial politicians to find ways to provide equal access to medical services to residents in Newfoundland’s many remote communities scattered over a lot of rugged coastline and difficult geography, and buffeted by an unforgiving North Atlantic climate.

Although House himself would go on to become a specialist in neurology and helped establish Memorial University’s school of medicine in the late 1960s, he never forgot—or stopped trying to figure out ways to overcome—the medical trials created by Newfoundland’s challenging environment.

Which is why, in 1976, he also started Memorial’s telemedicine/telehealth program.

What began as distinctly non-interactive classes (using one-way television to provide training for doctors in remote areas) evolved slowly but inevitably.

“There were so many challenges, both technical and human in those early efforts,” Memorial University’s Erin Keough, who worked with House at the time, would recall in an interview with IT World after his death. Although Memorial was able to deploy then recently launched satellites, one-way TV and telephones via satellite, Keough noted “this was an analog world with the new digital technologies simply too flaky for any kind of reliability. Amidst all of the chaos of dropped connections, lost data and solutions needed on the fly, Max would say, ‘It is no use goin’ to work if it ain’t fun.’”

House not only made it fun but he also transformed Newfoundland into a world leader in the fledgling field of telemedicine. Memorial’s telemedicine centre, in fact, remained the only one of its kind in Canada until the early 1990s. As a result, House became an in-demand national and international speaker, presenting his medical and technological research in more than 35 countries while consulting even more broadly.

That is what brought him to the 1995 American Health Net Conference where he had been invited as one of the event’s keynote speakers. The conference came at a propitious moment: earlier that year, at the Summit of the Americas, hemispheric political leaders had unanimously called for action to improve access to medicine. Just as importantly, the chair of the Health Net conference that year was Ken Bleakley, who’d previously been U.S. President George H. W. Bush’s senior deputy coordinator for international communications and information policy. While occupying that position, Bleakley had met with House, who had been able to “open Ken’s eyes” to the potential of telemedicine.

Further inspired by House’s talk at the conference, Bleakley had soon cobbled together a group of American physicians, philanthropists and business people who, together with some Toronto partners, formed Fonemed LLC in Missouri in 1996.

Tthe company chose Newfoundland as the site of its first health information center, Charlene Brophy explains today, “because St. John’s and Dr. House’s programs at Memorial were felt to be the heart of telehealth.”

They still are. Now including Fonemed itself.

In the early days, Brophy admits, a lot of Fonemed’s administrative functions—human resources, finance, accounting, IT—were still based in the United States, where most of the shareholders, primarily physicians and investment bankers, and many of its customers were located. But after Brophy became president and CEO in May 2015 (she succeeded Bleakley, who is now Fonemed’s chair of the board and chief development officer), “I gradually moved the staff back to Newfoundland.”

Today, with the exception of sales and business development, she notes proudly, the head office functions are all located in St. John’s, and most of them are supporting the company’s international operations. There’s even a team of locally-based software engineers who have developed the company’s proprietary software platform “to operate all our service lines.” The software even boasts “a robust database [supporting] various clinical protocols to deal with a pandemic situation or a bioterrorist attack.”

Brophy wants the staff to feel welcome and appreciated. “I want my team to end their work life with us,” she says flatly. “It is important they have a sense of ownership and see a future in their position. I measure the cost of turnover and look for ways to attract the best and brightest. Simply put, I want my employees to come to work, to be authentic to themselves and our culture. I will say, however,” she adds with a smile in her tone, “it also doesn’t hurt that I offer each a week at a beachside condo in Florida every year.”