It’s a new world

Since it’s Columbus Day which to us anyway celebrates the discovery of the new world it’s appropriate to examine the discovery of another new world, the post-COVID world. Yes we know COVID is still here but one day we will have a vaccine, likely several, and we will get back to whatever normal becomes. We did this after 9/11 and we’ll do it again after COVID. Just as we adapted to the changes made after 9/11 we shall adapt to the changes made due to COVID.

One area that continues to garner an outsized amount of attention is the role digital health will play. No one is quite sure when or IF we people will return to their offices. Several large companies Microsoft being the most recent has told employees they do not need to return and can work at home 100% of the time. Now the digital health players will say this is even more reason to use their services as remote monitoring is critical to better outcomes and as a result lower overall health care costs. But is it really?

Even before COVID remote patient monitoring was being used and the results while encouraging were somewhat of mixed bag. The simple fact is some people are receptive to remote monitoring while others aren’t. The problem comes in as the people most receptive to remote monitoring are the patients least likely to need it. These patients are already actively engaged with their diabetes management and tend to embrace any new toy or service that can help them. They are active, informed and willing to do all the heavy lifting needed to achieve better outcomes. Plus they do this because better outcomes ARE IMPORTANT TO THEM ON A PERSONAL LEVEL.

However the patients who really need help, patients who would truly benefit from remote monitoring and coaching are the least receptive to it. Worse for digital health companies this is by far the largest group of patients. They are patients either on oral therapies alone or orals plus insulin. Unlike their more engaged counterparts’ better outcomes ARE NOT IMPORTANT TO THEM ON A PERSONAL LEVEL. This isn’t to say they don’t care rather they just have other things that are more important. They don’t want to do all the heavy lifting as they don’t see a payoff.

In a post COVID world this will not change.

We are continually fascinated watching all the active in the digital health space as investors seem to have accepted the fact that digital health will become the standard. This could be true, but humans are still human and COVID or no COVID that isn’t going to change. Whether their health care is delivered in person or virtually each patient still has a decision to make. Do they take ownership of their diabetes and put in the work? Or do they as they were doing pre-COVID make a trade off prioritizing other areas of their lives? Do they decide to LIVE WITH AND NOT FOR THEIR DIABETES?

This is one reason we believe the companies who contract with digital health companies will become disillusioned over time. That they will be encouraged by early results as their employees are playing with their shinny new toy. But as time passes the allure of this shiny new toy fades and people return to the same behavior they practiced before. This is one reason all the digital health players consistently promote quick improvements in outcomes, quick reductions in health care costs. They surely know what we do that short-term results are no guarantee for sustained long term improvements. We have seen this over and over as it’s exactly what all the disease management companies did years ago.

The fact is COVID has been a boon for digital health. The herd has already accepted that digital health will become the future, that the future is now here. This by the way is exactly the same thing we heard when disease management was the shiny new toy. What disease management and now digital health has never understood is that behavior change is the most difficult hurdle to overcome when it comes to diabetes management, hence the reason they have come up with way cool terms for what in essence is behavior change.

Many things will change after COVID is gone but when it comes to diabetes management and the masses one thing won’t change. The masses will chose to LIVE WITH AND NOT FOR THEIR DIABETES.