Mobile health tools for diabetes1
Last week, 100+ entrepreneurs, venture capitalists, executives and engineers attended Diabetes Management: Devices and Data Driven mHealth Tools , a conference featuring mobile health experts held at the San Francisco office of Pillsbury, a leading Silicon Valley law firm.
For workers’ comp organizations, diabetes management is important because it frequently complicates recovery from workplace injuries and increases medical expenses and disability durations. For employers, it is also a health and wellness issue which impacts a growing number of workers. How big is the diabetes problem? Incidence has tripled since 1994, and it is estimated that in 20 years 1/3 of the U.S. adults will suffer from the disease.
Furthermore, the predictive analytics, passive monitoring and remote imaging technologies which power diabetes management tools are also used to treat workplace injuries and other conditions which complicate return-to-work. Below are summaries of the talks by the four speakers at the conference.
1. Predictive analytics plus passive monitoring – Karan Singh is Co-Founder of GINGER.io a behavioral analytics platform that turns mobile data into health insights. With the motto “Big data, better health”, Ginger.io is backed by major venture firms including Khosla, has won a major innovation prize offered by major pharmaceutical firm Sanofi and has been written up at DiabetesMine and other publications.
Singh’s team uses a cell phone app to capture a patient’s movements, phone calls, text messages and internet surfing and then develops a behavioral signature for each patient. For instance, one patient might typically start the day with two or three quick phone calls to relatives. When these calls are not made, it may indicate that the patient is depressed and may not be taking their medications. Using this information, a case worker or caregiver can be alerted to contact this patient immediately. Patients and caregivers are provided with feedback through a mobile app, while providers access the data through a special portal.
2. In-home tools to head off foot ulcers and amputations – David Goodman, MD is co-founder and Chief Medical officer of FirstVitals Health and Wellness Inc. In partnership with AlohaCare, they have a $4.0 million CMS grant to use telemedicine, remote imaging and other tech tools to manage Medicare recipients with diabetes.
The FirstVitals program initially flags high risk patients via screening and then uses telemedicine sessions via Samsung tablets together with remote glucose monitoring/reporting and an innovative remote imaging system built into a bathroom scale. This imaging system checks the patient’s feet for neuropathy and early stage foot ulcers which can lead to amputations. Note – neuropathy is similar to the lack of sensation experienced when your feet fall asleep.
3. A mobile health app reduces surgical complications — Robert J. Rushakoff, MD, is a Professor of Medicine and Medical Director for Inpatient Diabetes at UCSF. His group is focused on improving outcomes for diabetics who undergo surgery.
To improve surgical outcomes, diabetics require a very complex pre-operative regimen with medication dosages adjusted at specific times prior to the operation. It is easy to miscalculate since each patient is different and requires a schedule based on their own medications, dosages and many other factors. Dr. Rushakoff’s team addressed this problem with the Diabetes Pre-Op app which uses the LogicNets decision engine. The algorithms behind this app took over a year to code and are helping to improve surgical outcomes for diabetics. Based on his experience with this and other mobile health solutions, he suggested six “musts” for new apps:
- Easy for the patient to use; the less inputting the better. No more work!
- Work on all devices – iPhone, Droid, iPad, other tablets.
- Tie to the patient’s Electronic Medical Record.
- Easily scale up to handle more users.
- Fits into the workflow for the physician or the patient.
- Cost effective.
4. A diabetics perspective – develop patient-centered solutions! Janet Kramschuster is the tech savvy Director of Programs for the Diabetic Youth Foundation (DFY) and also was diagnosed with Type I diabetes at age nine. Her current position makes her an excellent spokesperson for the patient’s point of view.
According to Janet, today’s solutions require that patients interrupt what they are doing many times daily to administer tests and the tests in turn generate overwhelming amounts of information. She feels that developers need to take more time to understand patient lifestyles and to build apps that require less work and provide meaningful information.
She noted that she belongs to three Facebook groups which provide social support that is important to those with a chronic condition. In the ensuing discussion a participant (speaker Dr. Goodman) noted that the Second Life website lets people join online interest groups for people with diseases and Steve Denys of Epocrates pointed out that building games into apps (“gamification”) is a tool being used to engage patients.
Workers’ comp organizations are working hard to find new and better ways to address workplace injuries and the chronic conditions which accompany them. The technologies discussed at this conference including predictive analytics, passive monitoring, behavioral signatures, telemedicine, remote imaging and complex algorithms delivered via Smartphone are just a few of the tools which can help.
Note - Tech Talk is located in the heart of the Silicon Valley where entrepreneurs, venture capitalists and technologists are feverishly working on solutions for medical issues. Part of our mission is to identify cutting edge technologies and to point out their applications for the workers’ comp world.
Diabetes Management: Devices and Data Driven mHealth Tools was sponsored by the SF Bay Area Chapter of The Health Technology Forum. The group’s next event is the Health Technology Forum Innovation Conference: Platforms for the Underserved (www.healthtechnologyforum.com) , organized by Pronoy Saha. Sessions include – Codeathon- April 13 and 14 and all day Conference- Apr 19 (8AM-8PM); Venue – UCSF Conference Center, San Francisco.