MATTER member Alertive Healthcare acquired by Carbon Health

As remote and in-person care converge, MATTER member Alertive Healthcare was acquired by Carbon Health. The Seattle-based company’s remote patient monitoring will be integrated into Carbon’s rapidly expanding, next-generation clinic network.

Alertive CEO and Co-founder Dr. Nirav Shah sits down to share the journey to acquisition and what lies ahead.

Responses have been edited for length and clarity.

What was the inspiration to start Alertive?
Nirav Shah, MD, CEO and Co-founder of Alertive Health: “I’m a stroke neurologist by training. I trained at the University of Miami for residency, then UCSF for a stroke fellowship and then moved to Seattle to become the director of Swedish, a large healthcare system owned by Providence. I observed difficulty getting stroke patients to return to the clinic, hindering our ability to monitor them and provide the care they need. A large obstacle to caring for stroke patients is that some patients are hemiplegic (paralyzed on one side of the body due to brain damage or a spinal cord injury) and in need of a wheelchair or other transport support. However, with the ubiquity of wearable devices, the potential of connecting with patients at home and extending the point of care seemed promising.

“Stroke is a top five cause of both mortality and morbidity in the U.S., yet there is a lack of stroke-trained physicians. For every stroke specialist there are 10 cardiologists — while heart attack and cardiac disease are more common than stroke, it is certainly not 10 times more common. This scarcity led to earlier adoption of video-based care by stroke specialists than other areas. However, what is missing from this form of care is a collection of vital signs and real longitudinal data.

“Stroke is a top five cause of both mortality and morbidity in the U.S, yet there is a lack of stroke-trained physicians…This scarcity led to earlier adoption of video-based care by stroke specialists than other areas. However, what is missing from this form of care is a collection of vital signs and real longitudinal data.”

“With this in mind, I started piloting remote blood pressure monitoring in my stroke clinics. Alertive’s co-founder and chief medical officer, Dr. Jorge Sanchez, started using the same technology in nursing home facilities to see if we could make an improvement in stroke patients. Our thesis was that if this technology were to work in a nursing home, then there would be potential to use it with patients at home. We started with stroke and took on more complex diseases over time.

“Once reimbursements came out for remote patient monitoring, it became clear that it was the right time for us to leave our jobs and pursue Alertive as a full-time endeavor. We wanted to make healthcare within reach as there were fiscal incentives, and we knew we needed to prove both clinical merit and cost savings as part of our business case.

“In 2019, we raised a seed round from Pioneer Square Labs in Seattle and gained momentum. Our growth rapidly accelerated with the start of the pandemic because we aligned three incentives: quality care, low costs and better patient outcomes.”

What challenges did Alertive face on the journey to acquisition?
Nirav: “We were about to fundraise in early 2020, and then things got really tricky. On one hand, the pandemic solidified the need for remote patient care. But the funding environment had radically changed. Investors we met with in February and March stopped responding, and at that point investors were unwilling to commit over a conference call.

“It was nerve wracking, especially in the pandemic when we had just a couple pay periods of runway. But that’s when you have to stay focused and have the confidence to keep executing on the plan. Our whole team thought of it less of risk than opportunity cost, and we were fortunate to have supportive families.

“It was nerve wracking, especially in the pandemic when we had just a couple pay periods of runway. But that’s when you have to stay focused and have the confidence to keep executing on the plan. Our whole team thought of it less of risk than opportunity cost, and we were fortunate to have supportive families.”

“Also, I learned that ​​many investors are relatively adverse to a physician CEO, because physicians don’t have traditional business backgrounds, so I had to overcome that stigma.

“Despite these challenges, Alertive grew 3X in 2020. Then, we met Carbon Health, and it was really just a meeting of the minds; they valued a clinically-oriented founding team. We had a choice to go out and raise another round or join Carbon Health — the decision was simple.”

How did MATTER help Alertive along the way?
Nirav: “We joined MATTER through our relationship with Vituity and Inflect Health. MATTER’s global membership offering and ability to deliver their services in a virtual capacity was helpful. MATTER’s network and events were also very valuable. They allowed us to meet like-minded people in this ecosystem across the country and have deep, meaningful conversations. We certainly benefited from being surrounded by a community in which everyone is trying to innovate and make a positive change.”

What does this acquisition mean for Alertive?
Nirav: “Carbon Health is a clinic network that has built virtual capabilities, lab services and data insights about our patients from it’s proprietary software and electronic medical records (EMR). This omni-channel care approach is really compelling, as it allows us to take care of patients across their care journey.

“We are all struggling to care across entities with different EMRs to take better care of patients. Carbon Health’s approach gives us the opportunity to tackle some of these challenges and provide exceptional care. We’ll continue to grow the portfolio of services under our new relationship, and the future is exciting to bring healthcare home.”

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