BioIQ: Self-testing kits for heart disease and diabetes
What:
BioIQ offers easy-to-use self-testing kits for diabetes and heart disease. At-risk workers receive the kits by mail, as directed by their health plan manager or employer.
When:
Originally founded in 2005 as a consumer retail site. Re-tooled, began pilot programs with large health plans, disease management companies and employers in January and July of 2009.
Where:
Currently distributed through 100 employers nationwide. Partner health providers and plans include Summit Health, United Health and Maxim Health. Disease management companies: HMC, Optum Health, Alere. BioIQ won't disclose a number of individual users.
Who:
Justin Bellante and Raja Jindal.
Why:
At-home-screening is a critical part of self-care programs. Self-care is an important cost-saving tool in any worthwhile reform plan, especially when modeling for aging Baby Boomers. But pre-screening requires participation, which makes it particularly tricky among the populations that need it most; “at-risk” groups are typically the very ones most disengaged from healthcare in the first place. We like that BioIQ is taking a stab at the difficult task of reaching them. It is unclear whether the convenience of self-testing at home on your own schedule (no more waiting in a lab!) is enough to induce behavior change. BioIQ is wise to try to reach this crowd through the funnel of employers, who have a vested interest in it succeeding. We are less optimistic about BioIQ's retail strategy, but we view their attempt to reach consumers the 'Amazon way' as a valuable first step in the slow process of educating the public on what "retail health" may look like down the road.
Cost:
$ Test kits are less than $70 if purchased directly off BioIQ.com.
BioIQ cofounders Justin Bellante and Raja Jindal weren't natural healthcare entrepreneurs. Both PhD-candidates in materials engineering at UC Santa Barbara, when a turn with tragedy led them to found BioIQ in spring 2005. Earlier the same year, Jindal's father died from complications of diabetes that had gone undiagnosed for years.
Despite the breadth of healthcare services available to consumers, Jindal's father, like many other at-risk individuals, remained disengaged from the system. And why?
“This is the question we asked ourselves when we started,” says Bellante. “Too much of healthcare is not convenient, not user-friendly and not easy. Health solutions are available, they’re just not brought to people the way that Amazon brings them books, or Dell brings them electronics. Healthcare companies do not market their products the way that Apple markets to its customers." The nut of the problem, says Bellante: "How do we bring healthcare level with the way people purchase books and music and everything else in their daily lives? This is the future of consumer-directed healthcare. It is retail healthcare.”
The BioIQ founders attacked this challenge with an engineer's framework for problem solving: You can’t improve what you can’t measure. Thus, test kits.
Self-monitoring isn't a new concept. But Bellante and Jindal figured if they could make self-testing for conditions like heart disease and diabetes as easy as testing for pregnancy, and as non-intrusive as purchasing goods on Amazon.com, they might move the needle.
They released their first mail-order kit in December 2005. Priced then at $29.95, it allowed users to self-test for blood sugar (A1c) and cholesterol (LDL and HDL) levels, by taking a simple blood sample. Consumers ordered the test kit off BioIQ's website. It arrived by mail a few days later, with simple instructions to guide them through the sampling process. Pop the kit back in the mail, the test went to a certified lab, and customers would recieve their results five business days later.
Easy as it was, direct sales off the company website disappointed. Consumers weren't ready for BioIQ, says Bellante. “They just aren't used to going out and spending their own dollars to purchase healthcare. We have a long way to go to get them there.”
BioIQ adjusted. To reach larger audiences faster, it began forming distribution partnerships with employers, health plans and wellness companies. In November 2008, the Santa Barbara-based software company, QAD, made BioIQ test kits available to 600 of its U.S.-based workers. In December 2008 the wellness program provider, Alere, added BioIQ kits to its product portfolio. In January, health care network Scripps Health, an Alere customer, made BioIQ’s kits available to its 11,000 workers. Since January BioIQ initiated pilot programs with UnitedHealth and the disease management company, HMC (WellPoint). In a third pilot in Florida, doctors are partnering with BioIQ to get self-testing kits into the hands of Medicaid patients.
The BioIQ program remains simple: an employer’s health plan administrator mines claims data to identify covered workers who might be at-risk of heart disease or diabetes. These workers are directed to BioIQ’s website (and in some cases, to a co-branded site created with the partner for the express purpose), and are encouraged to order a self-testing kit. BioIQ tracks compliance, following-up on targeted workers with automated emails that remind them to complete the kits (screen shot below). The punch line: health plans may then use the test results and BioIQ’s compliance data, to focus their marketing initiatives and “pull back in to the health system” these self-testing (read: newly engaged) groups.
Progress is slow, but the needle is flickering. HMC’s pilot includes 8,000 workers at one client-employer. Claims data indicated about 200 of the 8,000 showed some risk of heart disease or diabetes. Mailers were sent to these "candidates" to encourge them to opt-in to the BioIQ testing program. The pilot is nearing completion, and based on current results, Bellante believes as many as 20 percent of the workers will order and complete the self-tests. HMC’s pilot began in June and ends this month.
These are not staggering results, but considering no material or financial incentive was offered to induce participation, Bellante is happy. (Cash incentives are common to wellness initiatives and can spike participation north of 50 percent. Bellante says BioIQ neglected such incentives to avoid biasing its own results.)
“For the [employer] the ROI is evident,” Bellante insists. “These 20 percent are people who are not being treated now. They’re ticking time bombs."
Bellante says BioIQ test kits reach 100 employers through health plans now. He won’t disclose the number of workers who have actually used them, but the company is rolling on. Next month UnitedHealth will roll out BioIQ kits through its disease management subsidiary, OptumHealth. (Optum claims a customer base of 58 million of people.)
BioIQ raised $2.5 million in venture capital in 2008, its second round, but won't disclose its total funds raised. It is using some of the recent money to build-out its IT platform and extend its communications services beyond automated email reminders. With a technology partner, BioIQ wants also to integrate its test data with physician billing, patient records -- the entire EMR. The company has ambitions for a “more central role” in coordinating wellness programs for employers, Bellante says.
BioIQ will revisit the direct sales strategy, too, he adds. Next time they’ll reach customers by partnering with relevant affinity social networks, such as dLife (diabetes) or PatientsLikeMe. This year BioIQ also plans to expand their kit portfolio with test that screen for prostate cancer and the protein microalbumin (another indicator of diabetes).