This past Sunday through Tuesday, the legendary Joslin Diabetes Center hosted its first-ever "Diabetes + Innovation" conference at the Crystal City Hyatt hotel in Arlington, VA. (They tell us this DC location was more convenient for the many government and large healthcare orgs participating than Joslin's home base in Boston.)
As you might imagine, no one could have been more excited than I about the world's leading diabetes clinic organizing a high-level conference on INNOVATION — bringing together all the relevant stakeholders. About 400 people attended, and speakers spanned the gamut from physicians, researchers and pharma executives to government policymakers, technology specialists, health insurers (Blue Shield/Blue Cross, UnitedHealthCare, Kaiser, etc.) to innovative regional clinics and patient advocacy organizations, to big retailers with a big impact on public health: Target, Walgreens, Wegman's Food Markets, and yes, in all seriousness: McDonald's.
Our own patient community hero Manny Hernandez delivered the lunchtime keynote on Monday, eloquently explaining what online connections mean to us PWDs, and highlighting all the great advocacy work of the Diabetes Hands Foundation and beyond. (Thank you, Manny, for a shout-out on the DiabetesMine Innovation Project, our own 5-year campaign to push for better D-care tools!)
I also had the pleasure of participating on a "Patient Engagement" panel alongside Manny, Adam Kaufman of dLife Healthcare Solutions, and Timothy Moore, Chief Medical Officer of WebMD (!)
Overall, I walked away from this event with the words on my lips: "We've come a long way, baby!" Imagine just a few years ago how little anyone in the Diabetes Establishment knew or cared about patient blogs or social networking... Imagine the idea of a diabetes conference featuring the likes of the United States Chief Technology Officer Todd Park gushing on about "data-paloozas" and "code-a-thons" and the audience eating it up!
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On the other hand, this conference definitely illustrated how far we still have to go to sort out the health/diabetes crisis in this country. Why should the world's most influential nation rank No. 37 in healthcare...?
The tagline for the Joslin event was "it's not just a conference — it's a call to action." I love the sentiment! But I do believe this inaugural event was more about convening all these groups for the very first time to share information than anything else. Making the right connections is always a precursor to any kind of meaningful change. If there was a call to action from this conference, it was: Do more of this! Bring together the organizations and passionate individuals who are already working to improve health and diabetes in their own niches — give them a forum to connect and start conversations about what needs to be done, and how they can accomplish it together! Exactly this (in a more intimate setting) is what we at the 'Mine hope to accomplish with our 2nd annual DiabetesMine Innovation Summit at Stanford in November.
I didn't catch all the talks at Joslin's big event, because I was running around meeting with people and spent some time getting interviewed by Insulin Nation, plus I had to head home Monday afternoon. But here are some highlights of what I did experience:
Joslin has the sway to bring in all the top brass! The two most famous speakers were (as noted) Todd Park, White House Chief Technology Officer; and Ann Albright, Director of the Division of Diabetes Translation at the Centers for Disease Control and Prevention, both of whom light up the room with their passion about the potential of technology to help fix the country's healthcare mess.
But the speaker lineup also included senior executives from (take a deep breath) the ADA, NIDDK, FDA, PCORI (Patient-Centered Outcomes Research Institute), US Department of Health & Human Services, Weight Watchers International, Nestle Nutrition, Partnership for a Healthier America, the National Business Coalition on Health, EMC Corp., CMS, WellPoint, Southeast Texas Medical Associates, Montana Chronic Disease Program, Hawaii Island Beacon Community, University of Washington, University of Michigan, the Cleveland Clinic, Abbott Diabetes Care, the Robert Wood Johnson Foundation, Sanofi US, Animas Corp, Archimedes Inc, Veralight, Comcast and more — many of which were not obvious choices for a diabetes event. I love that Joslin is thinking outside the D-box.
What I learned is that there are LOADS of programs going on around the country in disease management, lifestyle coaching, nutritional training, combating obesity, financial assistance for the underinsured, introducing healthier foods in schools and restaurants, etc., etc. — much of it delivered via the latest technology (think cellphone integration). It's just that they're all regional or "proprietary" and disconnected, which limits access. As Todd Park noted in his opening remarks: "The future is here, it's just not evenly distributed yet."
Tech/Life Done Right
Two impressive "applications" presented that represented the best-of ways to utilize technology to assist with healthy lifestyle were:
Omada Health, a brand new spin-off of IDEO design. It offers a social platform to support small groups that are mentored by a vetted coach — someone who has "walked in the patients' shoes." The groups support each other on healthier eating, exercise and other lifestyle changes, first through an intensive 16-week period, and then they stay in touch using the platform over the long-term. Omada has had great success testing this in people with pre-diabetes, and plan to build out the program for diagnosed type 2s going forward.
BANT — a support app created by the Centre for Global eHealth Innovation at Toronto's University Health Network. It offers teens with type 1 diabetes iTunes rewards for frequent testing, lets users upload food photos to get nutritional information, and connects users via a mobile social community cleverly called "Banter." Again, excellent success so far within the target group, and the developers hope to build it out for other groups of PWDs.
Also impressive was Project Not Me, a new reality TV show brought to you by none other than the National Diabetes Prevention Program. For 16 weeks, they follow six people at high risk for developing type 2 diabetes — including their emotional ups and downs, doctors visits, family tensions, and all-out efforts to lose weight. There's also a set of online "tools" available to help viewers follow the healthy steps the participants took. The Senior VP of Comcast who introduced the program says people who viewed it were inspired to take action in their own lives "because they could relate so well to the folks in the show."
The FDA's New Moves
Without making excuses, the three speakers on the FDA Innovation Panel emphasized the fact that "the agency's workload and responsibilities have grown faster than its budget." In other words, they're overwhelmed.
But they are making efforts to streamline their processes and "be more responsive," according to (a very pregnant) Courtney Lias, who's a director in the FDA's CDRH division. A few examples she cited:
- The FDA has recently reorganized and consolidated their review team
- The new Food and Drug Administration Safety and Innovation Act (FDASIA) introduced this summer, with the aim of helping the agency "maintain a predictable and efficient review process"
- They're currently finalizing FDA guidelines on medical mobile apps (the open items are "mostly technical questions, rather than regulatory questions," Lias says)
- The FDA's Guidance on Artificial Pancreas technology should also be "finalized very soon," she says
- They're working hard to be more transparent, and open up direct lines of communication to their different followers. Check out these new channels:
- The new FDA "For Consumers" web page (catchy title, ay?)
- New FDA email update services, including Diabetes Monitor — with over 5,500 subscribers already
- The new MedWatch e-list — that provides "clinically important medical product safety alerts, delivered via e-mail and/or SMS text messages"
Walmart and Target and McDonald's, Oh My!
Q. What business did these mainstream retailers and restaurants have at a diabetes conference that also addresses stem cell research and bariatric surgery?
A. These ubiquitous companies touch the lives of waaaay more patients than stem cell research and bariatric surgery.
Arguably, they have the biggest potential to influence lifestyle changes across America en masse.
Walmart talked about their $4 prescription program (which does rock!), and their efforts to offer healthier food choices and even specially labelled groceries to help shoppers make good choices (buy more green stuff!).
Target also now offers pharmacy services and sells groceries in-store, and they have a magic way of making whatever they sell seem fresh and fun, IMHO. Here's hoping they can translate that magic to diabetes supplies and veggies.
And then there's McDonald's, which sent a very polished woman executive to give their spiel about reducing salt and fat in their menus and offering healthier ingredients. Ummm... kudos to them, I suppose, for being the worst perpetrator of unhealthy eating habits who's now trying to do things a little bit less worse. Every little bit helps! And clearly, they can't afford to ignore growing consumer consciousness of just how bad fast food actually is.
New Models of Care
Finally, there was a whoooole lot of talk about the healthcare reimbursement mess and "new models of care delivery" — including the patient-centered medical home (which I am told is more realistic than it sounds).
All I can say is that the executives present all seemed to have their hearts and minds in the right place. I loved that Dr. Sam Ho, CMO & EVP of UnitedHealthCare, said, "We have to be more patient-centric, and less disease-focused!"
He also said all the insurers need better integration: "Even the best physicians in our network are unaware when their patients have gone into the ER, for example."
And he called for "transparency in how doctors, clinics, and hospitals perform compared to their competitors." Amen to that! When it comes to healthcare, who ever knows about the quality of the services we're getting, or what the heck they're going to cost, until some unintelligible multi-page bill shows up in your mailbox?!
Yeah, we've got a long way to go there. But it's exciting to see the brightest minds working on this stuff from all angles getting together and agreeing that something must be done. I for one am thrilled that Joslin has kicked off this program. As they say at another ubiquitous retail chain: I think we can expect great things.