Yesterday the major tech companies agreed to make it easier to share health related data. Per a story in today’s Wall Street Journal; “Major tech companies committed Monday to removing technological barriers that have hindered patient and provider access to healthcare data online.” Naturally this is being hailed as a major achievement, that this data sharing will result in better patient outcomes and lower overall costs.
This really isn’t that big of a deal for patients with diabetes as there are plethora of apps and toys that already share patient data. For years we’ve been writing about the emergence of interconnected diabetes management (IDM), which is just what was called disease management years ago just with fancy technology. Yes everyone just loves way cool whiz bang, all those fun toys in the toy chest.
As we noted this morning there is no question insulin using patients are benefiting from these technological advancements. Yet as we also noted the largest patient population, Type 2 patients who do not use insulin or a GLP-1 are being left behind. And it would be fair to state that not all insulin using patients are benefiting from all this way cool technology either. Whether people want to acknowledge it or not when it comes to diabetes management it’s a case of those who have and those who don’t.
Yes we have seen great strides in terms of improving patient access to the latest technology. However this does not mean every patient can afford all these fancy new toys. Just by way of example look at all the way cool whiz bang new insulin pumps. Let’s further assume that a patient has a traditional 80/20 plan with a reasonable deductible. A new pump can cost this patient upwards of a few thousand dollars with annual supply costs running near a thousand dollars annually.
While not as costly CGM sensors aren’t cheap either. Costs are coming down but have not yet reached price parity with conventional BGM.
Yet even if all this way cool whiz bang technology was cheap it won’t solve a structural problem with diabetes management that no one wants to address. Something we eluded to this morning as its pretty damn easy to provide the patient with the how to manage their diabetes but damn difficult making them want to manage their diabetes.
Data wont solve this problem. Toys won’t solve this problem. Healthcare reform wont solve this problem. Even better patient education wont solve this problem. What gets lost in this fascination with way cool whiz bang is when it comes to managing diabetes the patient MUST BE AN ACTIVE PARTICIPANT. Managing diabetes is not a passive endeavor.
This active participation extends beyond the simple act of swallowing a pill or series of pills. Yes it helps when the patient is compliant but compliance does not end there. Sadly diabetes is a destructive chronic disease which needs to be monitored to ensure the patient is following the correct therapy regimen. The patient could be 100% compliant but still be out of control. Yes technological and data sharing can help identify trends or therapy regimens which are not working but the patient still must make the changes recommended by their healthcare team.
Getting a patient compliant is an excellent first step but it is only one step in a very long and often times grueling journey. This is the aspect of diabetes management that goes unnoticed. Think of it this way any patient who has beaten cancer still must go through the stressful time of making sure the cancer does not return. Wether it’s blood tests or scans no cancer survivor feels secure until after these tests reveal the cancer has not returned.
There is no question data combined with analytics can be a plus for all patients with diabetes. We also have no doubt that some of the way cool whiz bang toys can help too, CGM in particular. However, until we solve the most complex problem of all – turning the patient from a passive to active participant- nothing much is going to change.