Another “brilliant” Idea

Another “brilliant” Idea

According to an article that appeared in today’s Wall Street Journal; “Google Inc., moving to improve its online health-record service, is teaming with International Business Machines Corp. to allow patients to add data generated from home-health monitoring products, such as blood-pressure cuffs and glucose meters.

The companies said software developed by IBM, with consumers’ permission, can shift the data into a personal health record in Google Health, the search giant’s service for helping consumers manage and store their health information online. Other software lets the patient transfer the information from there to an electronic medical record kept by providers like health-care companies and primary-care physicians.”

The article goes on stating “Diabetes patients at home could check their blood sugar at the same time each day and upload the information. If the system detected a sharp change, it could alert a relative or a visiting nurse to check on the patient.”

Once again this attempt to marry fancy technology with improved patient care fails to recognize the realities of the market. Worse, this last statement about alerting a relative or visiting nurse shows a complete lack of understanding about diabetes. For example, let’s say a patient has such a device and actually checks their glucose levels at the same time each day. How does this system know that the patient hasn’t just eaten a big piece of chocolate cake? And let’s further assume this patient is taking oral medications to treat their diabetes just what is this relative or visiting nurse going to do about a sudden spike in the patient’s blood sugar?

On the flip side let’s say the reading is lower than normal, which could indicate a possible hypoglycemic event. How does this relative or visiting nurse react? How can they be sure that although the patient’s level is lower than normal that hypoglycemia is coming? Perhaps levels have begun to stabilize and administering glucose will then have the opposite effect and cause a hyperglycemic event.   

It’s laughable to think that any treatment decision would be made just because the patient happens to check this glucose level at the same time each day. In the real world we know that glucose levels are rarely consistent, even for the most well controlled patients. Spikes, both high and low are common. In the real world we also know that for the majority of patients who take oral medications there really isn’t much they can to bring down their levels during a hyperglycemic event. It’s not as if someone who’s taking metformin has insulin and syringes lying around on the odd chance they will need it for a hyperglycemic event.

Frankly Diabetic Investor is getting a little tired of all these efforts to use fancy technology to help patients with diabetes. Even if the patient measured their glucose at exactly the same time each day you cannot build a database using just one data point per day. As we have said many times several factors go into each glucose reading. As we have learned with continuous glucose monitoring, glucose trend information is much more valuable than point to point readings.

The reality is it’s much easier to develop all this fancy technology then deal with real problems facing patients with diabetes. Sure all this stuff is really cool but there is limited practical application in the real world. As we have pointed out on too many occasions even with all the advancements in glucose monitoring technology average testing frequency hasn’t increased. Smaller blood samples, alternate site “less painful” testing, faster test results and no-coding meters have done nothing to increase testing frequency. Still this hasn’t stopped companies from plowing millions of dollars into a technological solution to the diabetes epidemic.

The bottom line here is that just because a patient has better or more sophisticated tools that they will actually use them and achieve better outcomes. In the real world the majority of patients have no clue as to what all this data actually means or how to apply all this data to achieve better outcomes. As Anna C. Brackett wrote “Do not seek information of which you cannot make use.”