Fullscript’s New Goal: Minimize Dx Lab Test Hassles

Diagnostic testing is an essential element of modern clinical practice. But for many practitioners, it is also a major source of headaches.

Multiple accounts with different labs, opaque pricing, variations in insurance coverage, tracking patient compliance, compiling and interpreting results, scheduling follow-up visits, translating data into patient-friendly treatment plans….let’s be honest: diagnostic testing is fraught with hassles.

Fullscript, the tech company that transformed dispensing of dietary supplements, now aims to minimize the lab test hassle factor by consolidating a wide array of tests—both conventional and “specialty”—on a single easy-to-use platform.

The new Fullscript diagnostics component also provides practitioners with advanced tools to monitor patient engagement and interpret results. The diagnostics platform dovetails with most common electronic medical records systems.

Put simply, Fullscript wants to simplify the gnarly world of lab test management in the same way that it was able to improve the process for dispensing of supplements, herbs, and nutritional products.

Unifying a Fragmented Field

“Fullscript started out in supplements because that was one of the biggest burdens for functional and integrative practitioners,” says Jeff Gladd, MD, Fullscript’s Chief Medical Officer.

Traditionally, clinicians who dispensed in their clinics had to set up multiple accounts with different brands, each with its own product catalog, own fulfillment system, and billing process. Those who maintained in-clinic formularies had to manage inventory, a daunting task.

Over the last decade, Fullscript, with offices in Ottawa, Ontario and Manchester, NH, has worked hard to change that by creating a comprehensive platform for recommending and dispensing supplements delivered directly to patients. The platform handles billing, tracks orders and reorders, and provides guidance tools to help practitioners optimize supplement protocols while minimizing product and ingredient redundancies.

Dr. Gladd said client surveys and ad hoc requests gave Fullscript a clear signal that many practitioners found lab test management to be similarly burdensome, tedious, and in need of consolidation. A primary care physician himself, he says he recognized the problems.

“You have to deal with all these different labs, and set up different accounts. And then you recommend tests, but how do you know if the patient actually received the kit or did the test? You have to log into different dashboards to get the results. And then there’s scheduling the follow-up visits to review results, which come in from the labs through different portals. It creates a very fragmented experience for patients and practitioners alike.”

He added that practitioners who do not have staff to track down and collate test data prior to a follow-up visit, will end up doing this work themselves, usually during the visits. This detracts from time and attention given to the patients.

“Labs was the next step for us,” Gladd said in an interview with Holistic Primary Care.

“We asked ourselves: How can Fullscript give providers and patients the same streamlined experience they have with supplements, in diagnostics? We wanted to give providers the ability to manage end-to-end patient care from diagnostics to treatment maintenance all in one place. Our overall goal is to streamline the workflow and deliver whole person care at scale.”

Streamlining Workflow

Fullscript announced the advent of its new diagnostic testing component in early July, and quickly amassed a waiting list of more than 11,000 interested practitioners. After weeks of beta testing with a small cohort, the company enrolled those on the waiting list in mid-August. A full roll-out is expected by the end of October.

The platform provides a one-stop where clinicians can order and track “specialty” functional diagnostic tests from diverse labs including Genova, Precision Analytical (DUTCH test), Diagnostic Solutions, Doctor’s Data, as well as conventional blood tests. Fullscript has a relationship with Quest Diagnostics, so the entire catalog of Quest tests is available.

Dr. Gladd noted that Quest now has “a huge focus on whole-person care. They’re pushing toward what’s the best way to assess pre-diabetes, cardiovascular health. They have an incredible evidence base for their cardiovascular assessments. So, we have the Quest catalog that we’re leveraging. To be able now to order labs, review those labs, and build your treatment plans all on the same platforms, removes a significant amount of burden from practitioners.”

Fullscript will add new lab partners as use of the platform grows, and the team gathers feedback and requests from customers and key opinion leaders in the field.

While insurance plans will cover some of the basic conventional tests, they generally exclude things like stool testing, microbiome analysis, food allergy testing, genomics, and other types of functional medicine testing. These end up being big out-of-pocket cost for patients. Gladd stressed that Fullscript’s lab partnerships will ensure transparent and competitive pricing that will minimize the financial strain on patients.

Minimizing Guesswork

Tieraona Low Dog, MD, a member of the Fullscript advisory board said in a webinar that the platform’s ability to consolidate diagnostic testing has the potential not only to improve practice efficiency, but to positively impact clinical outcomes.

“Supplementation without testing would be like prescribing a statin drug without knowing what a patient’s cholesterol levels are,” she said. “I’m an advocate for testing what you can. Having the labs all in one space so it is easy for me to see, and easy for me to evaluate is so crucial.”

But the diagnostics platform is definitely not a “test-to-treat” scheme where doctors order tests that inevitably drive supplement sales and practice revenue. The tests offered on Fullscript are not in any way linked to supplement brands or product sales.

Nor is the diagnostics platform intended to create a revenue source based on testing. Dr. Gladd stressed that practitioners cannot add a profit margin on tests ordered via Fullscript. However, the system does offer the option of charging interpretation fees, to compensate for time and work involved in reviewing and analyzing test results.

Not the First

Fullscript is not the first company in the functional medicine space to take on the challenge of simplifying lab test management. 

Professional Coop Services began doing just that in 2001, providing licensed medical practitioners convenient access to a carefully curated list of tests. By aggregating the purchasing power of thousands of smaller relatively low-volume clinics, PCS’s co-op model enabled its practitioner clients to obtain tests at the sort of discount prices the labs usually reserve for large institutions. PCS has a sterling reputation for integrity and client support that has won it a dedicated and loyal practitioner cohort.

More recently, Rupa Health entered the market with a high-tech, one-dashboard system providing practitioners with access to over 3,000 tests from 33 different functional medicine specialty labs. Rupa, which raised $20 million in venture capital in 2022, has high visibility in the personalized medicine and concierge clinic space. Their system is designed to interface with commonly used EMRs, and boasts a large and ever-expanding library of webinars and educational materials.

But Fullscript has several advantages over the established players in the functional diagnostics space. For one, it has a massive base of loyal practitioner clients already using the platform to manage dietary supplements dispensing.

Essentially an IT solutions company, Fullscript greatly expanded its client base by merging with or acquiring its main supplement distribution competitors: Natural Partners and Emerson Ecologics. Both of those companies had deep and longstanding roots in the naturopathic, holistic, and functional medicine markets.

Those acquisitions also gave Fullscript five product distribution centers located all over the country. In addition to myriad supplement products, the centers can now stock and deploy a wide array of test kits, meaning that patients of Fullscript practitioners will get the kits and related materials very quickly.

Fullscript is also well-funded. In November 2021, two venture capital firms–HGGC and Snapdragon Capital Partners–invested $240 million the company. 

Dr. Gladd emphasized that Fullscript’s entry into diagnostics is not motivated by a desire to push more tests. Rather it is one more step toward the company’s overall goal of optimizing practitioner workflow, making health-centric medicine more viable for practitioners and more accessible to patients.

Meeting the DTC Trend

Fullscript’s foray into diagnostics comes at an interesting time, when consumer interest in self-care and self-testing is surging. The shift toward direct-to-consumer (DTC) home testing had already begun before Covid. The pandemic turbocharged this movement, by making sophisticated virological tests a quotidian household item.

Since then, the public has clamored for at-home tests for many other disorders. The appeal is obvious: people like the freedom, privacy, and convenience they get with home testing, and the diagnostics industry is responding in kind. In May, the FDA approved Teal Wand, the first self-test kit for human papilloma virus (HPV). According to the FDA’s website, there are now approved home tests for assessing cholesterol, detecting HIV, gauging ovulation, measuring prothrombin time, and of course pregnancy. Many more DTC tests are in the works.

Dr. Gladd says he and his Fullscript colleagues see the DTC testing trend as inspirational.

“Fullscript believes that a patient’s health journey is a life-long journey. It is best in partnership with a healthcare practitioner. Seeing the growth in the number of DTC at home tests now available, we want to help support our practitioners in being able to offer that experience, so that the patient has some guidance on what’s appropriate, clinical utility of the tests, how they impact health.”

No More Giant Bags of Supps

One feature of Fullscript’s updated platform is a tool to simplify the pre-consult intake and supplement review process. In addition to the patient’s medical history, family history, nutritional status, medication use, the system has a feature for capturing detailed information on patient supplement use.

“To make sense of someone’s supplements, you really need all the details. You need to know not just “fish oil,” but which type of fish oil? What brand? What dosage? What delivery form,” she said. Of course, this is also true for every other category of supplements someone might be taking, such as probiotics, herbs, specialty items like melatonin or SAMe.” In the past, gathering this information was usually a tedious process.

“I ask my patients to bring in the supplements they’re taking,” she continues. “They come in with a shopping bag, and I’m looking at each of these products, and most of these bottles have anywhere from 8-16 ingredients in them. And I’m trying to keep track of it all. Yes, we have the labels database now (NIH’s Dietary Supplement Label Database). But I’ve got to take photos of what each patient is taking and look up all those products on the labels database. This could take all day long!”

Fullscript’s platform has a supplement ID tool that allows patients themselves to scan product labels right into the system, which is linked to the NIH labels database. On the practitioners’ end, this translates into a comprehensive, detailed list of everything patients are taking, including the specific ingredients and dose levels.

“You no longer need to go through that giant bag with each patient,” says Dr. Gladd. “We have built a way to simplify this supplement intake problem by delivering a detailed real-time look at what your patients are taking, whether you’ve prescribed them, or they’ve pulled them off the shelf.”

The system’s treatment plan optimization feature will alert practitioners about duplicative, redundant, or unnecessary ingredients in the various products a patient is taking. “It can suggest product swaps or eliminations that will save the patient money, align more closely with preferences, and potentially improve clinical outcomes.

It can also track the products that have the highest repurchase rates—an indicator of patient satisfaction.”

Whole Systems Research

Fullscript’s IT platform and its vast database of supplement utilization patterns puts the company in a strong position to undertake research on the impact of supplementation. Gladd says research projects are already underway.

Beginning in July of 2021, the company partnered with clinicians at the Texas Center for Lifestyle Medicine (TCLM)–a multidisciplinary insurance-based functional medicine clinic in Houston, and with University of Maryland epidemiologist Chris D’Adamo, PhD, to compare outcomes between patients who followed practitioner-recommended Fullscript treatment plans versus similar patients from the same clinic who were not on such treatment plans.

The project involved 672 patients treated at TCLM for a wide variety of disorders and conditions.  The vast majority—91% of the patients—were recommended a Fullscript supplementation plan of some sort, and 70% had placed orders via the Fullscript platform (69.8%).

The researchers made some broad-stroke comparisons between those who were on treatment plans and those who were not. Generally speaking, the patients on Fullscript plans were far more engaged with the clinic: they had an average of 13.5 clinic visits over the 2 year study period, versus 7.8 among those who did not have a treatment plan.

Though this preliminary study was not designed to measure specific disease outcomes, the researchers did measure a number of key serum biomarkers, which suggested a shift toward better overall health among the patients who actually ordered the supplements included in their treatment plans: serum triglycerides decreased by 38%; folate increased by 45%; iron levels increased by 22%; B12 increased by 36%; and zinc improved by 44%.

“This was a “wide view” lens of the impact of utilization of the Fullscript platform on practice engagement and lab outcomes across all conditions and areas of health focus within a large practice,” Dr. D’Adamo told Holistic Primary Care.

He added that this review is just a first step. “We will likely be breaking the findings down for specific conditions in future studies, but this first study demonstrated proof of concept across all conditions in functional/integrative/lifestyle medicine.”

Fullscript’s entry into the diagnostics space is ambitious to be sure. It is coming at a time of considerable economic uncertainty, and rapid change in clinical practice patterns and patient preferences.

Reflecting on the fragmentation that characterizes so much of American healthcare, Dr. Low Dog pointed out that “Fullscript is well positioned to build bridges between practitioners and patients, so that patients feel like they’re being seen as individuals and getting personalized care, and practitioners have the tools they need to practice more efficiently and effectively, to deliver the whole person care they’re committed to deliver.”

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Eyeing Practice Evolution, Fullscript Acquires Emerson

Fullscript CEO Kyle Braatz is on what he calls a “forever” mission: to establish a comprehensive technological infrastructure for the transformation of integrative and functional medicine into simply “medicine.”

With the acquisition of its main competitor, Emerson Ecologics, Fullscript has taken a major step toward fulfillment of that mission.

The deal, announced in mid-March, will consolidate the nation’s two largest practitioner-channel dietary supplement distribution into a single entity. It will integrate the data processing, practice support, and educational resources developed independently by both companies, and will greatly expand the possibilities for bringing nutrition-based medicine into the medical mainstream.

Combined, the two companies currently serve an estimated 70,000 healthcare professionals, and approximately 5 million patients. They distribute products from more than 400 distinct brands.

Braatz, who recently spoke with Holistic Primary Care, says that’s a solid starting point, but he envisions a much greater expansion.

“There’s about one million practitioners in North America today, and 80% of them recommend supplements in one way or another. So, when you look at those 800,000 practitioners and you hear about 60% transitioning their practices to focus more on prevention…that’s a market which we want to be readily available to support,” Braatz said, referring to a recent Deloitte analysis of physician practice patterns.

“So what does that mean in 3-5 years? That means that the market number could be hundreds of thousands of practitioners .”

The financial terms of the Emerson acquisition have not been disclosed. But the sum is likely sizeable. Fullscript and Emerson are both backed by private equity groups—Fullscript by HGGC (Huntsman Gay Global Capital) and Snapdragon Capital Partners, and Emerson by Liberty Lane Partners.

According to Braatz, Liberty Lane will maintain “a substantial minority share” in the combined company, and several Emerson executives will remain in place. “They’re very bought-in to our vision and mission…which I think is a testament to the opportunity we have in front of us.”

Beyond Supplements

Fullscript’s leader is eager to reframe public perception of the Ottowa-based company.

“A lot of people see Fullscript as strictly a supplement dispensing platform. But what they don’t see is the work we’ve put in to building a user experience that makes it easy for a practitioner to deliver a comprehensive treatment plan, to leverage our education and evidence-based library of nutrition articles, exercise, mindfulness content. We’ve done a tremendous amount of adherence work, to really be a partner to practitioners.”

Jeff Gladd, MD, a functional medicine physician in Ft. Wayne, Indiana, serves as Fullscript’s Chief Medical Officer. Over the years, he has been a customer of both companies. “When I started a hospital based integrative practice, and early on in my own practice, Emerson was my in-clinic dispenser. Then I started bringing in online dispensing through Fullscript. So, I’ve seen the advantages of both.

He, too, emphasized that the combined entity will be much more than a supplement vending machine.

“We want to offer everything related to health optimization. Yes, supplements play some role in that. But it’s more than that. Like I tell my patients, if I do my job right and provide you the tools to execute nutrition, movement, and mindfulness, you’ll need less of me and my care, because you have tools to take that proactive journey.  We want to provide practitioners and their patients with those tools.”

A Massive Integration

The integration of Emerson and Fullscript will no doubt be fraught with logistical challenges. Once achieved, though, there will likely be major advantages for practitioners, including:

• Access to the broadest catalog of professional-level supplement products under a single umbrella
• Ease of ordering and fulfillment from a single entity
• Better integration into daily workflows via interfaces with electronic health record systems
• A wider range of educational materials and patient support tools
• Future integrations with telehealth platforms

In the near term, practitioners who have accounts with either Fullscript, Emerson, or both, won’t notice any changes other than a new statement under the Emerson logo indicating that it is now “a Fullscript company.”

According to Dr. Gladd, “Emerson is a very strong brand with a great reputation, extremely strong in the in-clinic dispensing space. We know that for lots of practitioners, their practices are really built on that. We have no interest in changing that. Kyle and everyone here recognize that practicing integrative medicine is difficult. So, we don’t want to add complexity to something that is already complex. Keeping those existing workflows in place is critical.”

A key step will be the harmonization of the product catalogs. Gladd says a near-term goal is to ensure that practitioners with Fullscript accounts have access to everything on the Emerson side, and vice versa.

He adds that the Hippocratic ideal of “First do no harm” guides all decision-making at Fullscript.

“We don’t want to do harm to your work flows, to your patients’ healing journeys. So, it is not going to look different or function differently until we feel really confident that “different” is better. He added that the company is seeking input from current practitioner-customers.  “We promise you that we will be transparent all along the way.”

Seeds of the Deal

Emerson Ecologics was established in 1980 by nutritionist Joe Emerson and his brother Bill as a system for distributing high-end vitamin products to practitioners. The company has a long and entwined history with Fullscript.

Ten years ago, the nascent Fullscript–then called HealthWave–was born out of a partnership with Emerson.

“Our entrance into the US market was as a partner to Emerson,” says Braatz. “We built a software platform, we launched it in Canada, and saw strong success with the naturopathic doctor market. We ended up partnering with Emerson to be our distribution partner, and we launched the same software platform in the US in 2012.”

That early iteration he says was, “a complete failure, but probably the best mistake we’ve ever had. It allowed us to step back and broaden the vision. We started off just building a virtual dispensary platform, an e-commerce platform for practitioners to sell products. Then we realized we needed to build something bigger than just e-commerce for doctors.”

What was missing, says Braatz was an integrative care-delivery platform that facilitated practitioner-patient relationships and dovetailed with existing practice patterns.  

“If you look at conventional medicine there’s been trillions of dollars spent on infrastructure. Whereas in integrative medicine there’s really nothing. And no big companies were trying to solve that. We have this belief that if we can build a better patient care experience, we can help drive better clinical outcomes.”

Braatz and Fullscript eventually broke away from Emerson and in 2014 acquired Natural Partners, an Arizona-based distributor founded by entrepreneur Ty Smith, which was at the time Emerson Ecologics’ main competitor.

Fran Towey, Emerson’s former CEO and President from 2008 to 2011 had become CEO of Natural Partners at the time it was acquired by Fullscript. Towey became CEO of Fullscript in 2018, and was the company’s executive chairman until last January.

Braatz says that despite the competition, executives at Fullscript and Emerson have kept in touch and relations have been friendly over the years.

“We’ve always talked about the fact that ultimately, we have the same vision, the same mission. We’re both aligned with helping doctors to provide better care. We would talk about, what if we put our collective resources together to really build this industry up and be that rising tide that lifts all boats, which is what integrative medicine really needs. We’ve been having these conversations for a long time, and finally the timing was right.”

EHR Integrations

Prior to the acquisition, Fullscript and Emerson were both working toward interoperability with electronic health record (EHR) systems. It’s an effort that will remain top-priority.

Dr. Gladd pointed out that Fullscript already has over 20 EHR partners, with more in the works. EHRs, he says, are “where clinical decisions get made. That’s where the treatment plans are created. So, we want to live there. We’re not trying to be another window that practitioners have to open on their screens. We want to be inside that first window.”

Practitioners who have Fullscript built into EHR workflows use the system almost 40% more frequently than they did before. “It’s because we’re right there, top of mind,” says Braatz, adding that the company has invested heavily in its Application Programming Interface (API) and recently launched a fullscript.dev site to make it easy for EHR developers and programmers to incorporate Fullscript into their systems. 

Telemedicine is also on the minds of the executive team. The Covid pandemic sparked spectacular growth in remote visits, and though utilization has tapered from its mid-pandemic peak, there’s no question that teleconsults have become standard practice.

Fullscript did not have any direct telehealth integrations at the time of the acquisition, but Emerson’s Wellevate platform does have a telemedicine partnership. Moving forward, Fullscript’s leaders envision growth into telemed by making it as easy as possible for existing platforms to integrate Fullscript, rather than by trying to build teleconsult capabilities directly into the Fullscript system.

An Eye on the Mainstream

While fully committed to serving Fullscript’s core of naturopathic and functional medicine practitioners, the executive team intends to grow the company into the medical mainstream.

Braatz points out that Fullscript has already made inroads within major hospital systems. But typically it has been siloed in the integrative clinics of those hospitals, somewhat isolated from the broader clinical networks. He wants to break through those constraints. The good news, he says, is the groundwork has already been laid.

“We’ve also gone through all of the contracting, the security assessments, the privacy assessments, the sign-offs from the CEO. When it does come to the expansion, we’re really well-positioned to do that.”

Gladd sees growing interest within hospital systems. “They want a couple of things: First, they want some basic education and evidence base for making supplement recommendations. We have that, and we’re building it to make it even more reachable for those practitioners who are just starting. Second, this has to be integrated into the workflow. So that’s why we’re working on building interfaces toward the bigger EHRs.”

A Win for Clinicians

The fusion of Fullscript and Emerson will be a big win for clinicians and their patients, predicts Paul Mittman, ND, President of Southwest College of Naturopathic Medicine.

“The naturopathic community has close ties to both companies. Many prominent naturopaths have worked at or represented both, and both companies have done so much for the profession,” he told Holistic Primary Care. “The core values and missions are so strong and aligned. The merger will mean everyone will be better served.”

Mittman has had extensive experience with each company. When he was practicing in Connecticut in the early 1990s, he used Emerson to stock his medicinary. Throughout his tenure at SCNM, Natural Partners which then became Fullscript has been a steady presence at the school.

Mittman says online dispensing is “strong and only going to grow” in the coming years. “We do have a brick and mortar medicinary at the SCNM clinic, but in-person sales have dropped in recent years, especially since the pandemic. Sales via the school’s ShopSCNM.com website have increased.” That store is powered by Fullscript.

Does Merger Mean Monopoly?

The Fullscript-Emerson fusion will no doubt have significant impact on supplement brands. Both companies make money by purchasing products from the supplement companies at a substantial discount. Fullscript’s acquisition of Emerson consolidates the market, and concentrates a lot of bargaining power into the new entity.

This raised concerns about a potential monopoly—so much so that the Department of Justice had to review and clear the acquisition before it could proceed.

“I was called before the DOJ about this, as were a number of other heads of companies,” says Chris Shade, PhD, founder and CEO of Quicksilver Scientific, a leading practitioner-focused supplement brand. “Just about all of us did see anti-competitiveness issues.”

Sales via Emerson and Fullscript represent “a substantial portion” of Quicksilver’s total revenue.

“This is a massive consolidation. I frankly didn’t think DOJ would let it happen,” Shade said. “This is going to put a lot of pressure on us and the other brands. If there’s nowhere else to go, they (Fullscript) can pretty much set their own course as far as the discount they demand, and you’ll have to agree or else you won’t get that scale of distribution. There will likely be a loss of margin for us, hopefully not all that much.”

There are, in fact, several smaller distributors that do provide other options for the supplement makers. But they are considerably smaller than Fullscript.

Doctors Supplement Store (DSS), a St. Louis-based distributor that currently serves approximately 3000 practitioners, is one of them. Dave Preis, the company’s president says he, too, was interviewed by the DOJ. Understandably, he sees cause for concern.

“It does seem like, practically, this creates a monopoly situation. But on the other hand, consumers aren’t necessarily going to be negatively impacted. It is not like they’re (Fullscript) saying they’re going to limit the number of brands, and so now consumers won’t have access the way they did before. It actually may open up greater access, so that’s a good thing. But from my standpoint, and that of other small players, this could be potentially damaging to us.”

That said, Preis says the situation won’t change his business strategy. He’s confident that if DSS continues to cultivate its core values and its direct customer service, it will grow and thrive even in a rapidly consolidating market.

“We can’t compete with Fullscript on their level. That ship passed long ago. So, we have to play to our strengths. We’ll be promoting the extremely high level of personalized service we provide, as well as our order accuracy rate and shipping times. We get the products out on the day they’re ordered almost 100% of the time. That really matters to people. We have a ton of practitioners that love what we do for them and their patients. That’s our largest growth driver.”

Preis also pointed out that there are many smaller supplement brands providing condition-specific products for specific patient niches. These sub-markets may be too small, volume-wise, to interest titans like Fullscript but they can provide ample opportunities for DSS and other smaller distributors.

Aaron Bartz, president of Ortho Molecular Products, contends that a deal as big as the Emerson acquisition reflects a maturation of the nutraceutical market, and a recognition among investors that holistic, functional, and naturopathic medicine have legitimacy.

“It shows there’s a lot of interest in our channel when you see that kind of money roll through,” Bartz told Holistic Primary Care.

“One of the areas that I don’t think anybody has tapped is how to get to that ‘blue ocean’ of conventional doctors and enable them to access, integrate, and utilize our products. A lot of conventional docs are in managed care systems where they can’t have a formulary. The Fullscript platform gives them opportunities. There’s a lot of potential growth in the conventional space, and Fullscript is going after it.”

But Bartz is also concerned about market dominance by a single distributor. “I’m cautious on the lack of competition. Competition is good for innovation, and for a lot of things. You need competition for things to remain healthy. Now, Fullscript will have almost no competition.”

Kevin Brown, Sales Operations Manager for Standard Process, sees the deal as a big win for the field.

“I have worked with both organizations for many years. They have both been excellent partners. Fullscript has been the leader in direct-to-patient fulfillment and Emerson has been the leader in wholesale fulfillment to practitioner offices. Combining their expertise under one umbrella will create a powerful teammate for supplement brands, and practitioners.”

Kyle Braatz is quick to quell concerns about monopoly.

“That’s just not our agenda. Our objective is to build this industry up, and create economies of scale that we share in with our practitioners, our patients, our supplier partners.  This is not a problem we can solve alone. This is a big enough problem that it’s going to take a village, an entire ecosystem of organizations and individuals dedicated to this belief. So, we always felt that we’re doing this together, there’s enough room for all of us.

Pricing is important, he says. But the company has no intention of driving the supplement brands into untenable discounts. “If we only think short-term and just try to extract as much value as we can out of this space, we’ll never be able to build the infrastructure needed to make integrative medicine simply medicine. We’re focused on the ecosystem, and a big part of this ecosystem is the suppliers.”

He added that once the Emerson and Fullscript catalogs are fully integrated across both platforms, supplement makers will quickly see big advantages. “From an operational perspective it will be much easier for these supplier partners to work directly with just one group when it comes to purchasing, procurement, forecasting, and everything else.”

The Long Game

What is Fullscript’s long game? Ten years from now, will we see the company go public? Will it be acquired by an even larger corporate entity?

It is far too soon to tell, but Braatz says his strategic decisions will all center on the main objective of establishing a solid practice infrastructure for integrative medicine.

He says he wants Fullscript to eventually be “to be IPO-ready. But that doesn’t mean that an IPO is the best outcome for the company. Ultimately if that helps us get to our ‘forever’ mission, and continue this journey, then that’s something we’re going to consider. Whatever allows us and enables us to deliver on our vision, that’s what we’re going to do. So that could mean taking more funding, that could mean going IPO.”

When we started this company, we started it…I had done a couple of other entrepreneurial gigs, but didn’t have any purpose when we were building that. We ended up selling one of the companies, and we said, “Whatever we do next has to be something we can do for the rest of our lives.” It has to be a forever mission. It has to have purpose. So we are on this forever mission. Everything we do is thinking long term.”

Today’s practice landscape looks very different from what it was 30 years ago: the internet has made it possible for ordinary people to access the world’s medical literature, to connect with other people who share their health concerns, and to easily purchase a vast array of health products. And now home diagnostics and teleconsults have entered that mix.

Dr. Gladd feels strongly that there will always be a place for physicians, nurses, and other health professionals in peoples’ lives.

“We look at all these direct-to-consumer tools, home testing, and diet plans that patients do on their own as great opportunities to started on their journeys. But then people are always going to want a trusted practitioner to guide them. We want to be able to arm all levels of practitioners who are talking to the patients about integrative medicine, and that journey of health.”

He believes integrative medicine is the best healthcare investment we as a nation could make, whether that is via insurance companies, federal payers, or private out-of-pocket expenditures. “I’ve seen the outcomes with my own eyes, thousands of times. So, has every integrative medicine practitioner.”

By providing services that increase the efficiency and economic viability of integrative care while simultaneously gathering and sharing data on best practices, the now-augmented Fullscript plans to be a major influence on the future of the field.

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With New Platform, Fullscript Streamlines Practice-Based Dispensing

Virtual practice has become a necessity in the COVID era, and telemedicine will likely continue to expand even after the pandemic wanes.

For practitioners of holistic and functional medicine, the dispensing of supplements and other products is a vital component of both in-person and virtual practice. But managing dispensaries whether online or in-clinic, can be tedious and time-consuming.

Fullscript, one of the world’s leaders in online dispensing and product distribution, is working to simplify the process.

With the launch in October of its new comprehensive platform, Fullscript is making it possible for clinicians to manage their direct-to-patient online dispensaries and their in-clinic product procurement “all from the same account, in the same browser tab,” says Bruce Smith, Fullscript’s senior manager of public relations.

Full Integration

The new platform represents a complete integration of the original Fullscript system with Natural Partners’ distribution and dispensing capabilities. The two companies merged in 2018, but have maintained separate dispensing platforms and distinct branding.

The new platform is part of a broader effort to streamline, simplify, and optimize the systems, so they best support practitioners and their patients.

“We have a lot of practitioners who like virtual dispensing. It is simple for patients, there’s no inventory to manage, nothing goes out of stock or out of date,” says Smith. At the same time, many clinicians continue to maintain in-clinic dispensaries, even in the wake of COVID. 

The new platform provides an easy way to administer both.

“There are lots of technologies and apps out there (to support virtual practice),” Smith told Holistic Primary Care. But managing them can be problematic. Our aim was to design something where you can do everything via one account.” The platform is built around the Fullscript – Natural Partners catalog of over 300 practitioner-facing supplement brands.

He added that, “This is the most significant upgrade we’ve done on the Fullscript side.” The company launched the new platform after several months of beta-testing with hundreds of practitioners and their patients.

Comprehensive Practice Support

The new platform is designed to be much more than simply an online dispensary; it is a comprehensive practice support system that facilitates ongoing communication between practitioners and patients, Smith explained. This can increase patient adherence to treatment suggestions, potentially improving clinical outcomes.

It can be integrated with electronic health record systems, and offers a number of “one-to-many” care tools. Practitioners can also use it to disseminate automated wellness-oriented self-care content to patients.

System users get access to the Fullscript Knowledge Center , which compiles scientific content and commentary from leading holistic, functional, and integrative medicine practitioners.  There’s also a feature called Shareable Wellness Protocols, that enables practitioners to share specific treatment protocols, product instructions, and support messages to their entire patient database.

Fullscript has a fully-dedicated in-house support team to help practitioners implement and trouble-shoot the new system, which was developed with input from the company’s medical advisory board: Tieraona Low Dog, MD; Jeffrey Bland, PhD; Joseph Pizzorno, ND; Robin Berzin, MD; Cheng Ruan, MD; and Jeffrey Gladd, MD.

Founded in 2012, in Ottawa, Fullscript has was already experiencing rapid growth when the company merged with Natural Partners in 2018. The alliance brought together Fullscript’s technological strengths with NP’s distribution capacity and its long legacy as one of the mainstay distribution channels in the holistic and naturopathic world.

Since the COVID pandemic hit the US, Fullscript Natural Partners has experienced 20% to 30% growth in the number of new practitioners signing up each month, says Alex Keller, ND, Fullscript’s medical director, in a webinar hosted by the Council for Responsible Nutrition last July. The strongest growth has been among medical doctors and chiropractors.

Poised for Rapid Growth

That surge is strongly linked to the sudden embrace of telemedicine that has happened in the wake of COVID. “Prior to COVID only about 5% of our practitioners worked completely virtually,” Keller said reflecting on data from a survey of 500 Fullscript practitioners. “Now, 60% are exclusively working virtually.”

Fullscript currently has 75,000 registered practitioner accounts, and now serves close to 1.75 million patient accounts.

For the time being, the merged companies will maintain both the Fullscript and the Natural Partners brand identities, though they will both operate via the unified platform.

Eventually, though, the company will sunset the Natural Partners brand. “There’s no firm timeline yet on when that will be,” says Smith. “When the time does come we’ll give Natural Partners customers all the personalized support they need to use the improved experience on Fullscript.”

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