Enabling At-Home Lab Testing at Scale
Q&A with Mamta Patel from ixlayer
As health care delivery models evolve, diagnostics serve as a foundational element, influencing the direction of patient care. It's estimated that about 70% of medical decisions rely on laboratory testing, a statistic that underscores the sector's indispensable role. Against this backdrop, Mamta Patel recently offered her perspective during our MBA course. Serving as the Senior Director of Commercial Market Strategy at ixlayer, she navigated a nuanced discussion on diagnostics as a service. In this Q&A, she shares her career journey, key market trends in the diagnostics space, and the role ixlayer plays in enabling at-home lab testing at scale.
Tell us about yourself and your career journey
I joined ixlayer - a diagnostics as a service business - in 2023 where I lead Commercial Strategy for ixlayer’s Retail Pharmacy business and own several key strategic partnerships.
I began my career consulting for health systems focused on implementing hospital-wide technology integrated with the EMR, building and aligning process between administrative and clinical staff, and managing change across each project - all in order to successfully reduce average patient length of stay.
I then came to Wharton for my MBA as part of the Healthcare Management program and shifted my focus to learning about healthcare technology innovation. Upon graduating, I joined Flatiron Health in 2014 in a pharma partnerships and delivery role identifying and building technology integrations that jointly brought value to pharmaceutical companies and community oncology clinics; I later shifted into an Operations leadership role building the Business Operations function and also overseeing the Product Operations function.
Across each role, I have been passionate about working across ecosystems that require multiple healthcare stakeholders to align incentives to drive innovation and change forward - most recently with ixlayer bringing together labs, diagnostics vendors, and consumer facing retail pharmacies to lead innovation in the at-home testing space.
What are key market trends that are shifting the diagnostics market?
We are seeing shifting trends across care delivery, cost structures and affordability, and consumer preference:
Care delivery models: With the use of at-home testing for Covid in recent years, consumers are more willing to utilize and try at-home testing when available; we are shifting from a world where one can only get labs done in a brick & mortar lab to one where we need to meet patients where they are – whether that be in their home, at a lab, at a hospital or physician’s office, etc.
Cost structures & affordability: Transparency in healthcare pricing remains an issue. In the traditional model, a patient must visit a physician (incur a visit cost that is either a copay or pure out of pocket cost), receive a lab requisition, visit a lab, and then receive additional billing for lab services after the fact. With at-home testing, the lab test pricing is provided up-front including clinical review for test eligibility and a physician visit (with copay or out of pocket costs) is only incurred if the patient requires follow-up care due to an abnormal result. As each individual has differing coverage from insurance (or no coverage) and their own set of health factors, the optimal approach for each individual is different and the costs structure and/or savings will look different. There is no one size fits all approach.
Consumer preference: Consumerization of healthcare is all the rage these days and diagnostic testing is not an exception – as we continue to see the shift of consumers wanting healthcare to be a service delivered like any other good, we should expect to meet consumers where they are and we should expect options like at-home testing to continue to grow over time.
How is the diagnostics spacing changing when it comes to laboratory testing?
There has been a surge of innovation in diagnostics in recent years - especially with the Covid-19 pandemic - and as confidence in testing rebuilds after stalling from the blunders of Theranos in the mid-2010s. We are seeing rapid innovation & increase market investment across multiple areas:
Sample collection device innovation: Sample collection devices have advanced offerings that improve patient experience and amount of sample that can be collected. For example, several new devices have hit the market that can collect larger samples via capillary blood paired with increased comfort for a patient - this opens to the door to testing for analytes or biomarkers that require more blood than a dried blood spot card can obtain and a better patient experience.
In vitro diagnostic (IVD) manufacturers innovation: IVD manufacturers are investing more dollars towards broadening the types of tests available and the accuracy of those tests across screening, diagnosis, and prevention – we are moving towards a world where labs can be more precise and can enable more directive guidance on how to treat and/or manage a disease areas. Below are just a few examples of recent breakthrough innovations:
○ A Blood Test for Alzheimer’s Disease is Almost Here
○ New blood test may help predict worsening disability in multiple sclerosis
○ New Blood Tests Offer Possible Early Detection of Cancer and Alzheimer’s
Can you tell us about ixlayer and what the company does?
At ixlayer, we create customer-specific programs with an end-to-end testing process all managed through one digital platform serving health plans, biopharma, and retail pharmacy customers.
We enable healthcare companies to meet patients where they are with engaging health testing experiences. Our cloud-based platform seamlessly connects the entire ecosystem of testing services to revolutionize the health testing journey for patients and healthcare stakeholders. Our configurable platform enables patient education, contextualized lab results, remote program monitoring, medication adherence protocols and diagnostic testing regimens. Here’s a graphic that shows the various touchpoints along the process:
How has at-home diagnostics changed since the Covid-19 pandemic?
The use of at-home testing for Covid-19 reignited the belief that testing can be done in the home, affordably, conveniently, and as a useful tool for screening. Most notably, at-home STI testing saw a surge of utilization during the pandemic which has continued as Covid-19 moves to the endemic phase. This is largely a result of key factors: rising cases of STIs, the shift from in-person visits to rising use of telemedicine, the shut down of many community programs for STI testing, and the alleviation of stigma-based factors due to privacy gained by having an at-home option.
As we continue to see more consumers gain comfort in testing in the home & recent trends focused on overall health & wellness in the population - there is more appetite and willingness to try other tests available in retail, pharmacy, online, or other locations.
What are some of the challenges and opportunities ahead for at-home diagnostics?
For a test to be available and useful as an at-home diagnostic - it needs to be accurate, easy to collect, affordable to a consumer, and actionable once a result is received. Not all lab tests are the same and not all can meet each of these requirements. There is an inherent challenge here to educate consumers on which tests meet this criteria today, which are being innovated upon and can be available soon, and which are simply not there yet. Given the evolving nature of diagnostics, this is a big ask for consumers to be aware, to build trust in, and to continually educate upon. You can see this as both a challenge - that all at-home diagnostic companies must overcome - but also an opportunity for those that do this well.
Affordability is impacted by many of the market trends noted above – while we see innovation in sample collection devices, while this may broaden the set of tests & accuracy of results, these devices are likely more costly than the traditional modalities we use today (e.g. finger prick, urine). A key challenge - but opportunity for those that solve it - will be determining how to make these patient-friendly options affordable enough to be utilized in the home.