Last month, our team was thrilled to host the world’s first Diabetes Closed Loop Systems Showcase at our Fall 2019 “DiabetesMine University” innovation event held in San Francisco.
This two-day happening included our bi-annual DiabetesMine D-Data Exchange technology forum (#DData) and annual Innovation Summit.
For the first time ever, on our #DData day in early November, six of the leading companies creating new “Artificial Pancreas” (aka Automated Insulin Delivery or AID) systems came together to share a collective “show and tell” session. Attendees were a group of roughly 150 leaders in the diabetes world. Our DiabetesMine Innovation events gather a mix of savvy patients and DIYers; pharma and medtech execs; leading clinicians and designers, and the key diabetes regulatory folks from FDA.
We were also able to hear from several patients with experience using some of these new systems that are expected to hit market over the next few years – talking about how the technology changed their glucose control, and listing their personal Pros and Cons of existing system design.
You can peruse the slidesets from participating companies here:
- Medtronic (Mimimed 780G)
- Tandem Diabetes Care (Control-IQ)
- Tandem Control-IQ trial participant – Sally Southard
- Insulet (Horizon)
- Tidepool (Loop)
- Beta Bionics (iLet)
- Beta Bionics trial participant – Rachel Mercurio
- Bigfoot Biomedical (Unity system – integrating smart insulin pen tech)
“Wow, was this an awesome look at the next-generation of automated insulin delivery!” write our friends at diabetes consultancy Close Concerns.
Note that Beta Bionics user Rachel Mercurio chose to close her presentation with this powerful call to action: “When it comes to this groundbreaking technology that we’ve heard about today, all the hard work, time, and effort will be for nothing, if patients can’t get access.”
“I am grateful to have some of the best durable medical equipment coverage in the country. I have state benefits. I’m incredibly blessed. And yet, I still have a difficult time getting my supplies every 90 days. It shouldn’t be this hard. Access to these life-changing products for all must happen in order to make these innovations matter.”
Indeed, our Patient Voices Scholarship winners and many others in the room brought up access repeatedly; we are all keenly aware that more needs to be done on that front.
Another discussion point that came up repeatedly was the very real issue of women struggling to find comfortable spots to wear insulin pumps – in a bra or waistband, or being forced to wear some kind of halter if wearing a dress. As host and MC of the event, at one point I announced point-blank: “This is why we need more female product designers!”
The Closed Loop Showcase concluded with an amazing session by Dana Lewis, creator of OpenAPS, presenting the newest research she’s led on what’s happening with DIY closed loop systems in the real world.
Among other things, Dana emphasized that the algorithms used by DIY systems are simple, but can be personalized to the user – and how important this is. She described how for her personally, she has not needed to use a manual bolus dose for over 27 months despite managing being sick, jet lag, marathon training, an ankle fracture, and much more.
She also emphasized that new tools like the OpenAPS simulator can help answer questions like: how does the system respond to unannounced meals without a bolus? Their research found that OpenAPS simulator was surprisingly on point in handling actual vs. simulated unannounced meals!
Read the detailed report on this first-ever #DData Closed Loop Systems Showcase from our friends at diaTribe here.
A few other “firsts” of the two-day event included:
Unveiling of Ascensia Diabetes’ new Abound program – a new glucose meter plus mobile coaching program for people with type 2 diabetes. The program includes an Ascensia glucose meter, starter kit, unlimited test strips, and coaching focused on small, behavior modifications called “bursts.” The beautifully designed app was created with help from famous design firm IDEO. Abound is currently in a commercial pilot study that’s showing strong results, with a full launch expected in 2020.
Then, all the way from northern Finland, we got a look at how the DIY community is successfully helping to integrate the DIY Nightscout solution into EMRs and PHRs in that part of the world. Special thanks to Mikael Rinnetmaeki for making the long trip to present both this talk, and a demo of his Sensotrend platform (described below).
We were privileged to have an update from Alain Silk of FDA on the evolving regulatory pathway for new Closed Loop system technology.
And we heard about “where we are with diabetes device standards and interoperability in 2019” from Melanie Yeung of the Centre for Global eHealth Innovation in Toronto. Yeung herself is currently vice-chair of the Bluetooth Expert Working Group contributing to medtech specifications including CGM and insulin delivery profiles.
Also fascinating was a detailed look at new innovation in infusion set technology from Capillary Bio. Cannulas and infusion sets are of course key to making new automated delivery systems work — since all the tech is essentially worthless if the insulin is not getting into the patient properly! Mark Estes is a diabetes industry veteran who joined Capillary Bio in 2016 with a mission to help improve this “weak link in pump therapy” and it’s great to see the strides being made here.
We also got hot tech updates from DreaMed Diabetes, on its decision support technology that’s enabling doctors to provide better care, and , with a look under the hood of this company’s hugely successful AI-enabled platform.
Note that Livongo’s presenter, Chief Data Scientist Anmol Madan, just recently accepted the UCSF Digital Health Award for Best Application of AI with this platform.
Matching people with diabetes to devices? There’s an app for that! Actually, it’s an online information hub called DiabetesWise, newly developed by Dr. Korey Hood and team at Stanford Diabetes Research Center. Korey, along with healthcare designer and T1D advocate Sara Krugman, and Stanford School of Medicine Project Designer Sierra Nelmes, walked our whole group through a fascinating interactive ethical discussion around this platform.
Everyone was asked to stand, and move to the left or right of the event hall depending on the degree to which they agreed or disagreed with some key questions, like whether or not DiabetesWise should solicit industry sponsorship. This is tricky, given that the platform is supposed to a resource for unbiased, patient-generated feedback on various products — but it could also benefit from a stream of updated information and support from industry. A great discussion ensued!
We were also thrilled to host four additional hot new #DData demos! Have a look at the presentations (and our coverage) by clicking on the links here:
- UnderMyFork – a cool new food app that combines data from CGM sensors with meal photos to help users understand their personal BG patterns and learn how different meals impact D-control.
- Cam Med’s Evopump – flexible, bandage-like pump unlike any we’ve seen to date. See our full profile of Evopump here.
- Pacific Diabetes Technology – single-port CGM/insulin catheter. See our full PDT profile here.
- Sensotrend – a platform that combines data from various sources — BG meters, pumps, CGM, nutrition diaries, pedometers, sports trackers, etc. into single visual dashboard.
Our learning-focused Innovation Summit day was built around the theme of the growing importance of patient experience.
The idea being that after it being a buzzword for years, experts are finally taking a deeper, methodological approach to understanding the key components of patient experience. We wanted to explore and celebrate that.
In fact, we kicked off the day with new research from Heather Walker, a T1D patient and advocate herself, who is Social Scientist at University of Utah Health. She just completed her dissertation project on diabetes self-identity, and the broad social and political undercurrents of online discourse around diabetes.
From this comprehensive study she did, we asked her to share 5 Major Insights her team gained on patient’s self-perception – why do what they do on social media? This turned out to be our top-rated session!
Next up was “The Rise of Patient Voices” session – “a powerhouse panel” featuring FDA’s Michelle Tarver, Novo Nordisk’s Jonas Thinggaard, and UCSF’s Susan Pappas discussing how they integrate patient voices into their initiatives – what resources they’re investing and what outcomes they’re seeing.
See opening remarks from each of the panelists here:
We also explored how on how independent clinics are changing the landscape of diabetes care, in a session titled “New Clinics for a New Age.” This was kicked off and led by Harvard Healthcare Scholar Dr. Ateev Mehrotra. In his provocative opening talk, he challenged many broadly held assumptions about healthcare, for example that telemedicine is primarily for those in rural areas, poor, and underrepresented minorities.
He then led a panel including three key virtual / specialty clinics. Check out the presentations here:
Participants also took part in three 1.5-hours hands-on workshops, where they got to collaborate creatively on hot topics around patient experience.
I was thrilled to announce that our first workshop was led by one of the country’s leading payer (health insurance) organizations, that has actually ‘gotten religion’ on the importance of creating a better customer experience for patients!
The Payer Imperative: Reinventing the Customer Experience
- Led by Kent Lawson, Executive Director Brand & Customer Experience, and Garrett Smith, Director of CX Strategy & Design, Blue Cross Blue Shield.
They broke their group into subgroups, who each explored the real-world insurance struggles of one of our Patient Winners, and then were guided through a brainstorm of how to solve the problem(s).
Participants came up with many creative ways that payers can improve the call center experience, so patients can eliminate the time and hassle. One of the recurring themes was bringing on “Insurance Navigators” who could help people with chronic conditions work more efficiently with the health insurance organization they depend on. (Amen to that!)
New Frontiers in Capturing & Processing Patient Insights
- Led by Barry Kurland, COO, Cecelia Health, and Teresa McArthur, VP Clinical Services, Cecelia Health.
In our 2nd Workshop, participants learned about a new methodology for actually capturing patient’s self-reported challenges, frustrations and wins, and turning those into building blocks for helping them achieve better outcomes.
So necessary, and a very cool stuff!
The group listened to recorded calls between patients and diabetes educator-coaches, and then were guided through using this new methodology to record and explore the specific insights they heard.
Click here to see the Cecelia Health survey results coming out of that Workshop.
Design Principles for a Patient-Centered Future
- Led by two graduate students from the Stanford MedX “Everyone Included” Team: Designers Urvi Gupta and Stella Tu.
And then from the Stanford University Medicine X team, we learned about a new set of well-researched and vetted design principles that can be put into practice to make “patient centeredness” a reality.
Participants learned about the “Everyone Included” approach and then had a chance to partner with an individual from a different stakeholder group (patient, clinician, industry, designer, regulatory) to brainstorm how to apply some of these principles in their own work or community.
When asked, ‘What did you like best about the program?’ in our In our evaluation survey, we heard:
“Bringing people together from different backgrounds so that those in industry, research, healthcare better understand patients’ points of view.”
“The right mix of industry, tech and patient perspective! Thank you for bringing together a dynamic symposium!”
“The ideas generated in the breakout sessions were very impressive — especially the Blue Cross/Blue Shield session. Attendees took the patient seriously and utilized their experience to pitch innovations, many of which could be tremendously helpful to patients if put into practice.”
“The New Clinics for a New Age session was one of my favorites. It is important for clinicians, patients, and industry to think about how diabetes care can be delivered more effectively to populations outside of the traditional system.”
2019 Patient Voices winner Hannah Carey says: “It was an incredible experience for me- how amazing to be in the same room with so many great thinkers, innovators, and people who share my vision for a more manageable disease and better support for PWD. I learned so much, and hope I was able to give back a little, too. I made wonderful connections and just felt so inspired and energized by that environment. Thank you for allowing me this opportunity!”
And from the industry side, Steph Habif of Tandem Diabetes Care noted:
“It’s a phenomenal group of people you gather… and I look forward to attending future gatherings!”
A huge thank you to our 2019 sponsors, and we so look forward to more great DiabetesMine Innovation meetings in the coming year!
Amy Tenderich is the Founder & Editor of DiabetesMine, a news and advocacy resource she started after her own diagnosis with type 1 diabetes in 2003. She’s become a nationally known patient advocate, public speaker, researcher and consultant, who runs a series of influential DiabetesMine Innovation forums. When not working, she enjoys spending time with her three daughters, and hiking the great outdoors in the San Francisco Bay Area.