Seminar report: Alere Masterclass 7 June 2011

[Disclosure: Alere paid Steve’s travel costs]

Following its acquisition of Home Telehealth Ltd (HTL) in February, Alere began its UK telehealth marketing efforts with a ‘masterclass’ at the King’s Fund, London yesterday, 7 June, repeated in Manchester today. (Alere is pronounced ‘a-lear’ rather than ‘al-ere’, by the way.)

If your definition of a masterclass is an update on the latest evidence and current issues relevant to implementing a remote patient monitoring telehealth programme, plus the opportunity to talk to clinicians and managers who have implemented some large scale services, then masterclass is what is was. It was refreshing that the speakers were not the ‘usual suspects’ heard to date in the UK. Most importantly, although one was conscious that it was a marketing event, it was not the kind of pitchfest indulged in by some companies. All the 20 or so people attending were made to feel that they were welcome even if they were not directly a prospective customer.

David Morgan, a surgeon and associate professor at the Clinical Research Institute, University of Warwick, introduced the day. (His connection with Alere is in relation to the possible future use of mobile phones as data collection and transmission devices.) Then it was straight into the evidence of the ROI from several programmes now in the Alere portfolio.

Dr Craig Keyes, newly appointed CMO of Alere Health, presented data from some of Alere’s US programmes that currently involve 645,000 patients a month. Drilling down to the heart failure patients’ data, Dr Keys apologised (to some amusement in the room) that the outcomes were limited to reductions in hospital admissions. These data show for people on Medicare using telemonitoring devices, a reduction of in ‘all cause’ inpatient admissions of 28% after participation in the heart failure program.

However, being able to deliver such benefits hinges on being able to stratify patients according to likelihood of future healthcare resource usage so that they can be managed appropriately. Although Alere has software to do that, pulling patient information from a number of sources, UK purchasers would need to look hard at the availability of equivalently useful source data.

Dr Alexander Molnar of Gesellschaft für Patientenhilfe (GPH – acquired by Alere in 2008), presented even more striking results from remote monitoring and management of congestive heart failure (CHF) patients in the Cordiva programme, with impressively reduced healthcare costs, hospitalisation rates and fewer deaths.

Paul Murphy, ex-HTL, now Operations Director for Alere Connected Health, then moved the focus from the evidence to ‘how to conduct a managed telehealth programme’, based on their experience of running the service in Northern Ireland (in the three years while the sightly larger scale service, yet to get off the ground remote monitoring service, was being procured by ECCH). Never mind the estimated ROI of 180%, the main takeaway for this editor was the demonstration that it is more efficient for a dedicated provider organisation to deliver the whole managed service and just alert community nurses when a patient needs their attention (‘clinical triage’) than it is to provide only a data-monitoring service (‘technical triage’):

Following lunch, Tricia Kalloo of Wellness International talked about the detailed health screening service and follow-up lifestyle and nutritional intervention programmes they provide to various high profile companies. I must confess that, interesting although it was, it took me a while to connect to the relevance of this. Then it hit me – the percentages of working-age people who have high, undiagnosed risk factors for heart disease, diabetes, etc. that their testing is revealing and who are subsequently referred to their own GP is, frankly, shocking – 30% in the case of ‘top office’ staff and managers in the banking industry, for example. Never mind the rising numbers of older people on health services, there will be a ‘double whammy’ as the health of these younger people deteriorates.

The session finished with questions and discussion.

Conclusion

Would I recommend attending another such masterclass if they run more?

Bearing in mind a) that I’ve only mentioned above the points that particularly interested me, and that there was plenty of other material for people with different perspectives to get something out of, and b) in view of the refreshingly soft sell – which amounted to “We are here” – I think I would recommend it to people who are already running small telehealth services and who are wondering whether, and how, to scale them up, and to service commissioners (do we just say GPs and hospital staff these days?) who are just at the ‘thinking about it’ stage.