Apples and Oranges

Apples and Oranges

While it may seem like it at times Apple isn’t the only smartphone which seeks to be a healthcare tool. Per a post on MobileHealthNews;

“Samsung Galaxy smartphones will be serving as the controlling device for Billerica, Massachusetts-based Insulet Corporation’s tubeless insulin pump devices, the two companies announced today.”

This will be Insulet’s first step towards one day eliminating the PDM which now controls the OmniPod and having the OmniPod controlled from a patient’s smartphone. This move will not just be patient friendly but as we noted the other day a huge savings for Insulet. It also should enable OmniPod users to integrate their CGM product into the system.

Based on public statements made by Insulet they seem to prefer an open platform allowing access to Dexcom or Libre systems. This while maintaining their relationship with Dexcom for the coming closed loop system. Given that the FreeStyle meter from Abbott is already integrated into the PDM, this move keeps everyone happy.

Another benefit of this move towards smartphone control is it could allow the user to select which insulin dosing algorithm they use. Although we believe the TypeZero algorithm is the gold standard they aren’t the only algorithm available. The moves being made by Insulet could be the first steps towards another goal which is shared by the FDA, allowing patients to mix and match their product preferences.

While we have noted some of the risks with this approach the open platform movement isn’t going to go away.

The fact is we are quickly moving towards the era where the patients smartphone becomes the hub of their healthcare. Smartphones can collect data from all sorts of devices, through text messaging or FaceTime patient coaching is a snap and device companies benefit as they do not have build and supply separate devices which control their toy.

Since Apple, Google and now Samsung have made the deep dive into diabetes we have maintained this is battle over platforms. Apple, Google, Samsung and Amazon see health and chronic diseases such as diabetes as ways to expand their platforms, create more customers and sell ancillary products/apps/services.

Besides having gobs of money all the tech giants have another plus, massive scale and in Amazon’s case outstanding logistics. Just by way of example think of all the Apple users who think nothing of spending $1 per month to buy additional cloud storage, then multiple that $12 per year by millions of Apple users and you can see why there are lots of happy faces in the Valley. Should they decided to Apple, Google, Amazon or Samsung could offer similar low cost apps to help the patient more effectively manage their diabetes.

This is another reason by the way we don’t see much future for companies like OneDrop or Livongo as we have said from the start they are easily replaced. See none of the tech companies want to be directly in the diabetes toy business, they will leave that to the professionals like Dexcom, Insulet, etc. They would much rather have platforms which work with all these toys and then using their massive scale sell these patients other products and/or services.

Not like we need more reasons to dump on Medtronic but their insistence to have a non-cloud enabled closed platform could well come back and haunt them. The reality is this closed platform with vertical integration was perfect when patients didn’t have smartphones, tablets, etc. The Medtronic model was nearly perfect as they made money not from getting someone on their system, that was small potatoes. The real money came from the continual sale of pump supplies, items made for pennies and sold for dollars. This model seemed to be getting better when sensor augmented pumps took over as with their closed platform sensor revenue was now added to the mix.

In an open platform environment it would be possible for a patient to select a Medtronic insulin pump and a Dexcom sensor with the system being controlled by the patients smartphone. As we have noted many times the insulin pump is the least important link in the chain, basically a commodity. Given that Tandem and Insulet are moving quickly towards cloud enabled systems they have a strategic advantage over Medtronic who still has yet to offer a system with cloud capabilities. As we have said before Medtronic has a huge problem on their hands for to offer cloud capabilities requires new hardware.

The reality is the insulin pump and by extension the Tyler markets are moving rapidly towards smartphone control and/or assistance. Which makes perfect sense as just look around and what do you see but people talking, texting, taking selfies or ordering Ubers on their smartphones. The smartphone is already the hub of peoples lives and it’s only logical that it will become their healthcare hub as well.

The more we see the more we hear the faster this moves the more it looks as those the dominoes are aligning and when they first one gets knocked over it will be closed platform systems that get hurt the most. Everyone in the diabetes pool better be paying attention here and not just the toy makers. The question is no longer if all this technology will change our wacky world rather just how dramatically it will.