How does a smart company stay one step ahead of the trends transforming healthcare delivery? One can look to the Waltham, Mass.-based Alere, which has followed an acquisition strategy that has positioned it well, as healthcare transforms itself into a more results-driven, patient-focused care delivery system. Alere’s evolution has been marked by a combination of foresight and astute timing, which has allowed the company to combine its technologies onto a unified platform focused on better outcomes.
That evolutionary journey was put into perspective in a recent discussion that HCI had with Sumit Nagpal, president and CEO of Wellogic—now Alere Accountable Care Solutions (Alere ACS)—which was acquired by Alere in December 2011.
Alere got its start as a diagnostics company focused on the patient’s home and the point of care. The diagnostics business represented $2 billion in revenue; yet as the business grew, the company realized that many patients didn’t quite understand the diagnostics, meaning that compliance was an issue, Nagpal explains. That led to the company’s expansion into care management services, to help patients become more aware, more engaged, and to get the help they needed, he says.
Nagpal compares diagnostics and care management to two legs on a three-legged stool. While care management was successful in improving outcomes beyond what standalone diagnostics could achieve, “We realized that our care mangers were acting in isolation from the care team, typically primary care physicians and other providers, who were treating the patients, so they weren’t necessarily well coordinated with the care plan,” he says.
Two years ago, Alere acquired Wellogic to add health information technology—the third leg of the stool—as an integral part of chronic care management, which Nagpal characterizes as a vital part of achieving better outcomes. With Wellogic’s IT capability, Alere has been able to tie the patient’s information together across all venues of care. Rounding out the portfolio, the Lowell-Mass.-based DiagnosisOne, Inc., a clinical analytics solutions vendor and a longstanding partner of Wellogic, was acquired by Alere in July 2012 to enable decision support at the point of care.
Nagpal notes that what had been DiagnosisOne’s decision support engine encompasses over 25,000 evidence-based guidelines that can be directly applied to patient data and can be delivered proactively to doctors before they see patients, and to care managers who are monitoring the data for deviations from care plans. All of which helps care givers attend to patients’ conditions ahead of when those patients might otherwise fall off their care plans, he says. Altogether, Alere’s integrated offering is focused on the entire spectrum of patients, from average patients, to those with chronic conditions or with co-morbidities and multiple chronic conditions, he says.
Empowering Physicians at the Point of Care
Alere’s acquisition of what is now Alere ACS roughly coincided with the emergence of health information exchanges (HIEs). At the time, Wellogic was seeing a rapid growth in demand for its services, which happened to also coincide with Alere’s search for an IT partner, Nagpal says.
Alere ACS has a track record in building HIEs, most notably with the North Hawaii HIE, a Beacon Community that became fully operational in March 2012. Susan B. Hunt, M.H.A., Beacon Project Director and CEO of the Hawaii Island Beacon Community, gives credit to Wellogic in laying the IT foundation for the HIE. Wellogic connected together the HIE’s participating groups, including the local hospital, physician group, a federally qualified health center (FQHC), two laboratories, and a radiology group.
Hunt notes that Alere ACS has been instrumental in helping the North Hawaii physicians meet Stage 1 meaningful use requirements, and also notes that it has allowed the Hamakua FQHC to coordinate care by sharing discharge summaries and obtaining laboratory results. She hopes to continue to work with Alere to help it identify patient populations that are at high risk of diabetes.
A Focus on Better Outcomes
Alere Wellogic changed its name to Alere ACS in January, a step that Nagpal says reflects the company’s individual components coming together as a single, unified platform. “Both our vision and the reality at Alere is that this is one platform with one team delivering change in healthcare, rather than a bunch of standalone businesses,” he says. “We are all about improving outcomes.”
That is a key factor in a healthcare environment where pay for performance will be the guiding rule under which every hospital CEO and hospital CIO, and every doctor will be dealing with, he says. In Nagpal’s view, the concept of paying for value, based on outcomes achieved, is here to stay, whether it’s known by accountable care or by some other name. “That concept is not by any means going away, and it will be the foundation on which our healthcare economy is built over the next decade,” he says.
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