Driving Value, Delivering Innovative Care: An Interview with Wellogic CEO Sumit Nagpal

Date: 05.15.2013 | Zach Urbina">Zach Urbina


Sumit Nagpal
is the Founder, President and CEO of Wellogic (an Alere company). Wellogic provides health information exchange, EHR certified for meaningful use, and care coordination solutions. We recently discussed the history of Alere and its plans for the future as the healthcare industry strategizes ahead of transformational change.

 

Zach Urbina: Alere began as a point-of-care diagnostics company. How has this heritage informed your strategy to help ACOs better manage at-risk populations.

Sumit Nagpal: Alere’s leadership has always been committed to the vision of connected health, where home and point-of-care diagnostics enable early detection and allow for interventions that prevent disease progression.  Our model of connected health is designed to strengthen the relationship between individuals and their care providers in ways that lead to better outcomes and reduced costs. Over the years, Alere has invested tremendously in this vision. Our diagnostic products are used in a variety of settings that range from the patient’s home to acute-care environments, delivering rapid results that lead to earlier health interventions and facilitate more effective treatment decisions for a host of chronic conditions.  We’ve also developed data and service solutions around our products that allow individuals to be actively engaged in their own care and help healthcare practitioners make decisions that are grounded in the best science and evidence-based learning.  These data solutions enable us to measure the impact of our interventions, identifying opportunities for future innovations that will improve outcomes and help manage costs.

Like so many others, we anticipated that our industry would experience fundamental changes in response to unmanageable costs, greater consumer demand, and market trends toward value-driven purchasing and personalized decision making – all of which are ACO cornerstones. At Alere, we have all of the assets under one roof to support this change, and we are uniquely positioned as an established healthcare company, not as a payer or standalone technology supplier, to deliver on the promise of accountable care.

ZU: Health Information Exchanges and analytics are recognized as the fundamental building blocks of care coordination. Once these are in place what are the next steps toward improved care coordination and improved population health outcomes?

SN: You are right to name HIE and analytics as the fundamental building blocks that enable care coordination – assembling data to facilitate decision making, then studying it to validate and iteratively improve care delivery and health outcomes. They are the logical foundation for the iterative “implement, measure, and improve” cycles that have led to efficiencies and customer satisfaction in most industries. Our industry, however, continues to struggle from self-inflicted wounds. Serious challenges still exist that prevent the meaningful exchange of measurable data. Without this exchange, you can’t analyze and improve outcomes proactively on an individual or population level. Many HIT vendors continue to hoard data, and their end user applications are not developed to organize it in a consistent, structured way. Ultimately, this lack of consistency leads to poor care coordination, and the misaligned interests of payers, care providers, and their trading partners only add to the problem by perpetuating a circle of distrust that impedes the sort of basic data exchange that would enable safer and more cost-effective decisions. Agility at the point of care continues to suffer. Despite hundreds of millions spent on technology, advocacy and implementation, we’ve seen most federal and state data exchange efforts scale back to simple point-to-point messaging – which doesn’t allow us to get smarter and actively prevent avoidable hospitalizations, adverse events, or unnecessary testing. We have all the technology to solve these problems, here and now, but we need to be more aggressive in implementing it to deliver the level of care coordination that will produce meaningful improvements in health outcomes and costs.

ZU: The final rule for Meaningful Use Stage 2 means that we are seeing an increased focus from vendors on their patient portal capabilities. From your experience working with providers, what is your advice in optimizing patient engagement and improving health outcomes around the implementation of patient portals?

SN: Many very successful companies have struggled with patient portal adoption. Important and well-funded initiatives have failed because of lack of adoption, low utility, and incomplete business models. At Alere, we understand that patient empowerment and patient-provider collaboration are the prerequisites for improved outcomes and are thrilled to see Stage 2 increase the focus on patient engagement via HIT. In order to be successful, however, we cannot develop fragmented solutions and must build portals that address the whole patient.  They should capture data from all venues of care, including in-home devices and self-reported information. They should offer patients a holistic view of their conditions and histories and provide the same view to caregivers who may be working in disparate organizations or settings. They should be smart and customized to the needs of each individual, providing patients with actionable alerts, reminders, and recommendations that help them remain on plan. And, for those individuals with more acute conditions, these portals need to be integrated with care management services, so that skilled professionals can help these patients live healthier lives while optimizing the cost of their care.

ZU: The ability to share medical information has changed dramatically in the last five years. Where do you see it going in the next five years and are those coming changes driving Alere Wellogic’s work with Hawai’i Island Beacon Community?

SN: Our work together with the Hawai’i Island Beacon Community, and the local hospitals and providers is truly ground breaking. We have achieved data fluidity and created a “community-wide, semantically-integrated patient history” across unaffiliated hospitals, practices, regional labs, pharmacies, and imaging centers. Doctors are openly thrilled with how easy this information is to access and use in a secure manner. In their offices, they rely on it daily to prepare for appointments, and, in the ED and inpatient settings, they use it to fill knowledge gaps in their patients’ histories. We are now building on top of the foundation we’ve created, layering in point-of-care visit planners that highlight health risks and care gaps. Our users are also starting to identify and stratify high-risk patients, which will enable us to review performance measurements on demand. We have implemented community-wide secure messaging, so referrals and other provider communication can be easily facilitated.  We are now expanding this to enable referrals and collaboration with hospitals on other Hawaiian islands, and our PHR is being implemented to support similar collaboration with patients. All these initiatives are helping to create one of the most sophisticated connected healthcare communities anywhere—one in which care coordination, measurement, and iterative improvement are just part of the daily practice of medicine.

ZU: Farzad Mostashari, National Coordinator for Health IT (ONC) made a statement recently at a briefing organized by the Alliance for Health Reform that “Technology is not enough.” How can doctors enable patients to take a more active role in their health outcomes beyond technological solutions?

SN: We first we need to understand the consumer’s incentive to change behavior. For some, even the strongest incentives – both rewards and costs – may not be enough to spur them to be actively involved in the management of their personal or family’s health. We need to recognize that individuals respond to different learning methods and motivations differently. Technology alone will not compel consumers to be engaged in their own healthcare.  We must draw from the arts and sciences to understand what motivates consumers, segment them appropriately, and apply behavior-change techniques that speak specifically to them.   Some of us, for instance, are excited by the ability to monitor our health status multiple times a day on a mobile device, while others need nurses or care managers to stay on plan.  When it comes to engagement, one size doesn’t fit all, and for any approach to be viable it must be multi-modal.

 

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Sumit Nagpal joins our Fall 2012 Accountable Care and Health IT Strategies Summit to discuss Connected Communities: Alere Wellogic’s successful HIE Expansion with Hawai’i Island Beacon Community. conference information

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