Irvine-based Kareo Inc., a homegrown software firm that serves about 60,000 independent medical practitioners and providers, has produced one of the first data sets on the spread of coronavirus in Orange County.
After moving its entire workforce to remote operations and providing care packages and meals for employees, Chief Executive Dan Rodrigues decided to try a different type of employee perk: offering serology tests to all employees.
Unlike molecular diagnostic tests, serology tests detect antibodies in the blood serum of both infected and recovered patients and provide valuable information on a population’s potential immunity levels. Antibodies to a virus like COVID-19 are generally produced five to seven days after infection.
Over the weekend of April 18, Rodrigues organized a drive-thru test site with Dr. Jennifer Armstrong, a board-certified physician and surgeon in Newport Beach.
The results? Out of 415 participants, including employees and family members, the study revealed a contraction rate of about 10% or 40 participants (see story, this page). About 25% of local employees declined to participate.
“Our main goal was to show employees that we care,” said Rodrigues, who announced the findings from the testing on April 20. “But there’s also a lot of questions about how we return to work and restart the economy.”
He continued, “We’re in this age of big data and analytics, yet we’re facing a crisis with no data or analytics. We need data to answer questions about ‘How prevalent is exposure to COVID-19 in our community?’ and ‘To what extent do we have immunity?’”
Following the tests, Kareo opted to keep its workforce remote because the accuracy of antibody tests is still improving. Officials hope to get to a point where antibody tests can be used to safely bring employees back to work.
The CEO said he’s willing to work with other area companies and business leaders to share notes, with a goal of helping to scale COVID-19 testing in Orange County, as well as in the communities where Kareo’s customers are based.
Kareo launched in 2004, and began as a cloud-based provider of electronic healthcare record software, before adding modules for billing and marketing. These three modules make up the core of the business today, while add-on options include telemedicine, payment services and advanced analytics and reporting.
Services are offered for $300 to $600 per doctor/provider per month. Based on a $500 per customer per month average, the Business Journal estimates the company’s 2019 revenue around $360 million.
Privately held Kareo declined to comment on revenue.
Over the years, the company has raised about $130 million in funding; sold off a managed billing business unit to Health Prime International, which remains a close partner; and has grown to about 460 employees, the majority of whom work in Orange County.
Since mid-March, the company has witnessed a steep drop in patient volume across its customers.
“It makes us nervous, given that all of our customers are small businesses,” Rodrigues said. “But we’re now seeing a sudden demand for telemedicine, which has allowed us to bring on some new business.”
Lead volume is down, but its decline in sales is not as severe as expected. While patient volume remains an uncertainty, Kareo is moving ahead with virtual services for its customers.
COVID-related actions included updating its product to support virus-related insurance codes; refining its telemedicine module amid rapid adoption; and offering webinars and resources on Small Business Loans and additional financial assistance for hospitals and health providers via the Coronavirus, Aid, Security and Economic Security Act.
The company said its telemedicine offering has seen about 50 times higher volume in virtual visits since mid-March, and its mental health segment is experiencing more business.
Rodrigues added, “I don’t know about you, but I think all of us will need a bit of mental health relief after this.”
Rodrigues said he has received “tremendous interest” from local executives since publishing the results of the serological study.
As for the company’s next steps, a second phase of testing isn’t out of the question, Rodrigues said.
Kareo isn’t the only one. University of California-Irvine told the Business Journal last week it is awaiting approval to kick off its own serology study with up to 5,000 participants from UCI Health and UCI School of Medicine personnel.” Irvine-based WytCote Inc. and Children’s Hospital of Orange County also plan to conduct a serology study with about 250 healthcare workers.
For more on Kareo’s COVID-19 test experience, visit https://bit.ly/3eNjCTs.
COVID-19 ANTIBODY RESULTS
Kareo Inc.’s serology test looked for negative antibodies; antibodies with no infection, indicated by IgG; and antibodies with possible infection, indicated by IgM. Antibodies, also known as immunoglobulins, present in the body as infection spreads; studies have shown that IgM is the first antibody generated in response to the virus that causes COVID-19, while IgG replaces IgM over time.
• Out of 415 participants, about 10% or 40 participants tested positive for antibodies.
• Out of the 40 participants that tested positive, 25 or 6% tested positive for antibodies with no active infection.
• Out of the 40 participants that tested positive, 15 or 3.6% tested positive for antibodies with possible active infection.
• 88% of the 25 with no active infection remember being sick in the past 8 weeks.
• Only 1 out of 15 with possible active infection reported symptoms on the day of the test.