Aimed at accelerating the adoption of integrative medicine by building the necessary infrastructure for health practitioners and their patients, leading care delivery platform Fullscript completed the acquisition of Emerson Ecologics, a 40-year old solutions provider for integrative health professionals, in mid-March.

Fullscript said the deal provides opportunities to further scale the business and drive product innovation that allows practitioners to spend more time caring for patients while enhancing their patients’ engagement with their own wellness.

The transaction nearly doubles Fullscript’s annual revenue and doubles the number of integrative medicine patients and practitioners Fullscript supports to more than 70,000 healthcare professionals and over 5 million patients.

Scope and Impact
Kyle Braatz, CEO of Fullscript, told Nutraceuticals World the acquisition represents a “once in a lifetime” deal when you consider “the size and scope and impact we could have to improve the integrative health industry.” 

In a statement announcing completion of the deal, Braatz said: “This acquisition is a giant step toward bringing integrative medicine into the mainstream. It provides Fullscript with the scale and technology to arm practitioners with the tools they need to practice health promoting medicine. Both Fullscript and Emerson Ecologics have always been committed to supporting practitioners in the delivery of care, and we know that as one entity we can create tremendous value and growth for the entire ecosystem, from partners to practitioners to patients; we are going to help a lot of people get better.”

The Fullscript platform now offers access to additional professional-grade dietary supplements and wellness brands, diagnostic testing, and an expanded distribution network. In addition, Fullscript will continue its investment in treatment adherence, personalized care, and cutting-edge clinical research to support the advancement and spread of integrative medicine.

“With the continued rise of chronic, often reversible diseases, the conventional model of patient care is ripe for disruption, and Fullscript is helping drive that change,” said Dr. Jeff Gladd, MD, chief medical officer at Fullscript. “Integrative medicine, a philosophy of care built on a foundation of health promotion rather than simply the management of disease, allows providers to partner with their patients and guide individual health journeys founded on the core principles of health: nutrition, movement, and mindfulness.”

Building Momentum for Mission & Vision
Braatz told NW that Fullscript is positioned to continue to accelerate momentum. “We’re going to continue to look at ways we build out the care delivery platform both by building with our large team here, by partnership, and by more M&A.”

In big-picture terms, Fullscript is just getting started, he added. Every day is day 1. “No matter how big we get, we want that insurgent mindset. You’re probably going to see a lot more momentum and acceleration of growth within the Fullscript ecosystem.”

Since its founding about 10 years ago, Fullscript has been focused on building the infrastructure needed for practitioners and patients. Fullscript says its mission is ultimately to help people improve their health. That connects to three core beliefs, according to Braatz: “First, healthcare should be preventative; it should be health promoting. It incorporates nutrition, supplements, exercise, mindfulness, comprehensive diagnostics.”

Second, healthcare is a life-long journey. “It’s not episodic. It’s not a point in time. It’s something a practitioner and patient are contributing to for the entirety of that individual’s life,” said Braatz. “And third, it really is best with a practitioner.” Not just any practitioner, but one who “sees their patient as a partner—not a practitioner who sees their patient as a number, or a one-time visitor, or an obstacle in many cases.”

Braatz referenced a report from Deloitte that indicated a majority of practitioners were transitioning their practice to focus on preventive medicine. “But there’s a reason it’s not part of the mainstream,” he added. “When we started Fullscript it was really with that vision of how do we arm these practitioners with the tools to practice healthcare within that framework. How do we help them practice health-promoting care, and practice integrative medicine?”

Initially, Fullscript focused on getting one component right, namely dietary supplements, which represent one component of care delivery and treatment protocols. “The goal was to build a platform that made it really easy to prescribe and dispense supplements from a practitioner to a patient.” From there the company started integrating electronic health records (EHRs), and building other tools to simplify the practice of integrative medicine.

The Rising Tide
Fundamentally, Braatz said the company believes “If we create a better care experience, we’ll actually create a better outcome (for patients). We see this becoming a part of the standard of care. We see nutrition and supplements and all these components as part of the standard of care, but our perspective is that it’s going to take a village; it’s going to take an entire ecosystem of individuals and organizations dedicated to that. So this combination is just one step in the right direction. We’re taking our collective resources and aligning them to make more impact together. It’s the idea that we can be the rising tide in this industry, lifting it up and driving it forward.”

While many companies are focused on driving economies of scale to extract value and grow, Fullscript has a different long-term focus, a “forever mission,” Braatz said. “Our objective is to create these economies of scale so we can share them with our supplement partners, our EHR partners, our practitioners and patients, because we truly believe that we’re positioned to be the ones bringing this industry forward to build that infrastructure.”

So why Emerson and why now?

Braatz said the stars have aligned organically. “I think we’re starting to see a world where integrative medicine, nutrition, all these things are being taken seriously. So for us to come together and accelerate the value within this market so that we can help bring integrative medicine to the standard of care, I think the stars just kind of aligned.”

In terms of migration, Emerson’s Wellevate platform, including all the components and customer base, will be migrated to the Fullscript platform. “Emerson Ecologics has a long history of market participation and have built a great brand that practitioners trust in,” said Braatz. “We talk internally about the Hippocratic oath we all take, which is ‘first do no harm.’ Ultimately, we want to make sure we continue to create the best experience for our practitioners moving forward. So we have no plans of shutting Emerson Ecologics down. We’re going to keep that available for all of our practitioners to be able to support their in-office clinic needs. The Fullscript platform also provides a very similar service but we believe it makes sense.”

The Integrative Care Model
Jeff Gladd, MD, chief medical officer at Fullscript, is a practicing physician in Indiana who completed the University of Arizona Integrative Medicine Fellowship program under the direction of Dr. Andrew Weil.

Gladd told NW that integrative medicine really means incorporating the best practices from all the different disciplines, including conventional, functional, lifestyle, naturopathic, etc. “We believe that’s how medicine should be delivered. Let’s take the best practices, let’s take a very core focus on the foundation of that care, which should always be nutrition, mindfulness, movement. But then let’s now build beyond that and have those tools to lead doctors to be able to hand that off to patients.”

“It’s the core value of healthcare, which is health promoting and preventative,” he added. “So that’s where we see this journey taking us, into simply being the way medicine is delivered.”

There’s a wide spectrum of how dietary supplements align with integrative healthcare, Gladd noted. Many practitioners are just in the starting phase of understanding how they fit into healthcare, but many more are, for example, recommending vitamin D and then checking those levels to demonstrate effect. They are talking to patients about omega-3s, understanding the value of the microbiome and specific strains of probiotics.

However, in terms of patients going into their local store by themselves without guidance, some dietary supplements are “pretty poor quality,” Gladd said.

“For those practitioners our focus is really what quality supplements mean, and who to align with in this industry that’s doing it right,” Gladd said, noting the importance of third-party testing and certification. “So when you make that recommendation for a patient it really should be considered as if it’s a pharmaceutical. That level of quality is really what you should be leading your patients toward.”

The next level of supplement understanding, knowledge, and application of integrative medicine may include issues like medication-induced nutrient depletion, Gladd said. “There’s a lot of data that supports the potential loss of nutrients by the pharmaceuticals that a patient takes. If we can help that practitioner understand what those potential needs are, that patient is significantly better off. Rather than take that symptom as a side effect that needs another medicine, maybe there’s a nutrient depletion that can be addressed.”

With more frequent use of supplements the quality story gets even more important, he continued. “That’s why we have curated our catalog and focused on only putting professional grade supplements in the catalog; that’s both Emerson and Fullscript, that’s not unique to either of those companies. So bringing that together now really enhances the catalog offering to the practitioners.”

Fullscript has a large team of engineers building and optimizing its platform. But the company also has an internal team focused on gathering an evidence base of supplement use, and creating content for protocols and recommendations for how to address certain conditions. The company has also partnered with major educational institutions to understand the evidence base for integrating supplements and lifestyle factors into practice.

“It also then descends down to the patient,” Gladd noted. “We have the handouts so that providers don’t have to write this content out themselves, and they don’t have to send patients off to the internet to find something they’re not sure is quite right.”

Good Care = Positive Outcomes
Research on adherence to protocols is another important part of the formula. “How do we get patients to adhere to their treatment recommendations, which is now the next big gap,” said Gladd. “You’ve got provider education about what supplement to use, patients interested in integrated medicine, but now how do we keep them adherent to that journey and stay on top of what their provider is recommending?”

In the end, “a good care delivery service gets good care outcomes,” said Braatz. “That ultimately is what leads integrative medicine to being part of the standard of care—or being the standard of care potentially. I think it comes down to, in simplistic forms, how do we get objective data about the patient, a baseline, a protocol, time period, another baseline.”

Diagnostics are therefore an “essential piece of care delivery,” Gladd noted. And they can drive adherence. Data supports patient motivation, and people are more likely to stick with a protocol when they know an objective measurement or analysis is around the corner. “It really drives that long-term proactive health journey for the patient,” Gladd said.

From an industry perspective, diagnostic tools help validate protocols by proving out the clinical outcomes. “One of the biggest criticisms of integrative medicine that conventional doctors tell patients is there’s no evidence for it, which isn’t true,” Gladd continued. “There’s tons of evidence for the things that we’re recommending, for the supplements we have on the platform. But now we need the evidence to drive outcomes in terms of how we’re truly changing someone’s health, and health trajectory, at scale. And how do we use that data to support the industry and not just the individual patient journey?”

The growth of direct-to-consumer (DTC) companies that, for example, pitch personalized nutrition and health assessments, are exciting from Gladd’s perspective, because they represent a starting point for people focusing on their health, including how diet and supplements impact them.

Still, “this journey is best guided by a practitioner,” Gladd added. “While it may not start with a practitioner, we believe these DTC plays are rallying patients in terms of ‘I want a practitioner to help guide me in that journey.’ And as we arm more practitioners, we’re bringing those things together and I think this is how ‘integrative medicine’ really moves into becoming ‘medicine.’”