Besides the cool factor of "let's take health mobile," one of the recurring themes at the AADE conference this year was recognition of the fact that while the diabetes population continues to mushroom, the ability of healthcare professionals to care for the ever-growing numbers of patients is stagnating. (There are currently 30,000 CDEs working in the US, but at least 43,000 are needed to match the workload of 24 million PWDs; by 2025, at least 54,000 will be needed!) Clearly, there's a demand for tools that can help patients better manage their diabetes on a day-to-day basis.
Here are some mobile tools highlighted:
WellDoc's DiabetesManager: Teaming Up
WellDoc, a mobile diabetes management company we've been following for years, had a chance to show off their stuff in a "Product Theater" at AADE. Boy, has their interface come a long way! Remember, this is the company that recently partnered with Ford to show off a future vision of a car-based glucose monitoring and management system.
They've just received FDA clearance for their WellDoc DiabetesManager System, which is marketed to patients and healthcare professionals together as a team effort. That means patients will not be able to use this phone-based system completely on their own, but will have to do so in tandem with their healthcare providers.
Patients enrolled in WellDoc's clinical study have experienced some pretty amazing results: a full 2% drop in A1c in a matter of months, compared to just a .7% drop in the control group. The system is primarily mobile-based, with patients automatically receiving text reminders to test their blood sugar or get lab work done, and requiring patients to upload their blood sugar results via their phone. Information from the phone and a Bluetooth-enabled glucose meter are sent to the WellDoc system, which allows their healthcare team to track all of the data and make recommendations.
So far, users have only included type 2 patients, which probably makes sense because type 1 patients are far too "spur of the moment" to have automated texts become anything but annoying, no? But for folks with type 2 diabetes, or maybe even very newly diagnosed type 1 PWDs, these automated prompts could help develop a solid diabetes routine, something which is exceedingly difficult (some might even say impossible!).
WellDoc hopes to roll out the system to clinics and patients later this year, but the rep we spoke to wasn't sure about an exact date. WellDoc is also still working on pricing and insurance reimbursement, so much remains TBD.
Telcare & PositiveID: Mobilizing Your Glucose Meter
Glucose meters with wireless capabilities were also an "it" trend at AADE. Two companies, Telcare and PositiveID, were on the expo floor showing off their own spin on these tools.
Telcare, a relatively new company out of Bethesda, MD, has received FDA clearance for their new Telcare Blood Glucose Monitoring System. The Telcare meter automatically uploads your blood sugars to the MyTelcare.com clinical server, which allows you and those you authorize to view your data on the MyTelcare.com web portal. It takes the painstaking task of logging out of the picture. MyTelcare.com also comes with a mobile app, so you can view your graphs on the go. All the features of the system — the wireless BG meter, the data at MyTelcare.com, and the mobile apps — are free when you purchase the meter.
The meter is not yet available (boo!), but VP Matthew Tendler tells us that they plan on rolling out distribution sometime this Fall. They also don't have any pricing info yet, though he says it should be "comparable to one of the higher-end blood glucose meters" already on the market. If you're wondering about insurance coverage for this new meter, for the time being, you're on your own submitting the paperwork with your insurance, so you'll probably want to check with your carrier before you put down any money on a new system.
PositiveID is a Florida-based company that specializes in both medical and security devices. It has introduced a mobile solution that does away with need for the cell phone in your BG management altogether: iGlucose, an add-on device for your glucose meter. It has not yet been FDA approved, but the way it's supposed to work is that patients would attach this device to whatever glucose meter brand they use, via a universal cable, and then automatically download and transmit the most recent data to a server, where BG readings can be viewed on a web portal (similar to WellDoc and Telcare) by you or an approved third party, like your doctor or a family member.
If you're married to your glucose meter brand, for example as many Animas Ping users are, PositiveID could be a great option. But if you're more flexible with your hardware, keep an eye on the Telcare meter. PositiveID has only recently submitted their 510(K) application to the FDA, so it'll be a while before we see any approvals there.
GreatCall: Simple, Helpful Phone Apps
Another thing showcased at the AADE expo in a little corner called the "Emerging Technologies Pavilion" was a set of mobile health services from a company called GreatCall.
They offer five different services, from phone-based coaching (offered in partnership with WellDoc) to weekly "wellness calls" to an emergency service called 5Star Urgent Response, that in case of emergency any time of day or night, puts you in instant touch with a "highly trained response team" out of their call center in Carlsbad, CA.
Limitation: Most of GreatCall's services are currently based on a super-simple Samsung-made cell phone called the Jitterbug. Featuring big, easy-to-read buttons and limited bells and whistles, it is aimed at an older population that might not be ready for intimidating smartphones.
One of their apps, however, is now available for the iPhone: it's a free medication reminder called MedCoach. So if setting alarms on your BG meter isn't cutting it for you, you can install this pill reminder on your iPhone. It also allows you to access some pharmacy websites to order refills.
AperMotion: Monitoring What Patients Do
Finally, a German organization called Apermon was distributing an English-language press release on its AiperMotion 500 tool, a "three-dimensional activity sensor" that "measures your physical activity during the day and informs you and your coach at regular intervals about the intensity of your activity, your calorie intake, and your walking distance." Funny, it looks so much like an insulin pump...
Aimed at type 2 and pre-diabetics, the monitor is part of its ABC (Active Body Control) program. According to the company, "a first study with 'healthy' obese participants led to a mean weight loss of 20.5 lbs after 3 months, which is rarely achieved with conventional diet programs or even with drugs." They've concluded that "telemonitoring is the most effective factor (in behavior change)." Hmm, I'd wager that any kind of intense attention and coaching helps patients do better.
Although not exhibiting at AADE, we also want to remind you of Massive Health's upcoming diabetes app for the iPhone. This San Francisco-based startup is now beta testing for an app that's unusually consumer-friendly and fun. Actual impact on life with diabetes TBD.
Confession: although fun to test, I personally find it hard to stick with any of the diabetes mobile apps I've tried so far. A lot to fuss with, yet very little value-add to my glucose management. Anybody feel differently out there? Found a "best-of" mobile tool yet? Do tell.