It’s not about hardware anymore

It’s not about hardware anymore

The wacky world of diabetes devices continues to undergo yet another transformation only this time it has nothing to do with lay-offs, consolidation, pricing pressure or lousy market dynamics in general. This time around the future of diabetes devices won’t be changed by new technology, or more accurately new hardware, rather this time around the future will shaped by companies who can develop and embrace “diabetes management systems.” The hardware or actually tools the patient uses everyday will play a role but they will not be the centerpiece of this new dynamic.

At the core of this new dynamic will be software and/or apps that will transform patient data into meaningful and understandable information that the patient can then use to better manage their diabetes; information which will be shared with the patient’s physician, caregiver, educator, pharmacy and insurer.

Driving this change is not the technology, which is available today; driving this change is better patient outcomes which ultimately produces lower overall patient costs. As we have stated previously the day is coming when physicians will be incentivized for helping patients achieve better outcomes. Even before this day arrives, employers and insurers are already moving in this direction; employers who are seeing their employee healthcare costs rise and insurers who are looking for workable solutions that increase their profits.

In theory patients who use these systems as intended will see improvements to their HbA1c will be more compliant with their therapy and avoid or at minimum delay many of the complications associated with poorly controlled diabetes. Theoretically these systems will also help devices companies lower their costs. For example, in the not so distant future a “smart” insulin pump will be able to detect and fix issues automatically therefore preventing a possible life-threating malfunction. This is not unlike what smartphones do today where apps automatically update without any or limited user interaction.

Although Diabetic Investor does not envision all human interaction being replaced the day is coming when patients will receive limited face to face contact and more digital or cellular interaction with their system provider. Here too companies will not just save money but will be better able to control the flow of information as well as have the ability to upsell their existing customer base.

It’s time to face some facts, although patients sometimes prefer to be speak with real human, in today’s interconnected world where nearly everyone carries a cellphone or has access to the internet, the human element is becoming less and less important. Just ask any patient who had to wait on hold for customer support listening to elevator music. Frankly it’s easier and faster for the patient to hope online and get what they need.

The key here isn’t whether or not these systems are valuable, they are. The key here is getting the patient engaged with their system and using it as it was intended to be used. The system could be the greatest system in the world but if the patient either does not use it or uses it improperly the system is basically worthless; as we noted a few weeks ago; garbage in equals garbage out.

Diabetic Investor has written much on how having diabetes is like having a second job, a 24x7x365 job with no days off; a job which to execute well requires hours of training. Think of all the tasks a patient with diabetes MUST do each and every day in addition to their real job.  Think of all the data this person MUST process each and every day, how many things they MUST remember to do each and every day and this goes well beyond just taking their meds. A patient living with diabetes is told to monitor their glucose levels regularly throughout the day. They are told to watch what they eat and when they eat. Insulin patients in particular, the primary target for these systems, have the additional tasks of understanding factors such as, insulin to carb factors, duration of insulin action, amount of insulin on board, etc.

But the task of managing their diabetes does not stop with these factors which they can control, an often ignored concept are all the factors which impact diabetes management which are NOT controlled by the patient. Factors such as stress levels, the weather and socially transmitted diseases such as the flu, which is for a patient with diabetes, can be a life threatening event.

Finally lost in this how diabetes impacts a patient’s mind. Besides worrying about all the normal things in life, paying the mortgage, keeping their job, dealing with family, etc.; a patient with diabetes is not just constantly reminded they have diabetes; they are constantly worried about their diabetes. Just ask any patient who waits for a glucose reading to appear on their monitor and wonders if they are in range. Or ask a patient who just can’t seem to get their levels under control and can’t figure out why as they were doing what they have been told to do.

The truth is most device companies have forgotten there is real human, a real human who has emotions, who will be using these systems. They falsely believe these people actually give a damn about managing their diabetes and that managing their diabetes is their number one priority each day. In the real world there is a minority of patients who are aggressively engaged with their diabetes and make managing their diabetes a priority no matter what. However, the vast majority of patients understand they have diabetes, understand they need to do something about it but wish that managing their diabetes wasn’t so damn complicated. That diabetes management fit into their life and didn’t make their already complex life even more complex.

This is the primary reason Diabetic Investor is somewhat skeptical as to whether or not these new diabetes management systems will actually be used. It’s not that the technology is bad, far from it, the technology is excellent. The issue is there is a real live person who must use this technology, a person who already is dealing with a host of non-diabetes related issues in their normal everyday lives. The vast majorities of whom who have no idea why they are doing what they are doing and only know that someone has told them to do it.

Hopefully the developers of these systems will incorporate some diabetes education into what they are developing as without an educated patient, these systems will surly fail. The simple fact is educated patients stand a far greater chance at better outcomes and there are hundreds of studies that prove this. While there are no guarantees technology combined with an educated patient is likely to produce the desired result, whereas technology without an educated patient is almost certain to produce nothing at all.

The real goal here should be not just to make these systems easy to use and patient friendly, the real goal here should be to provide the patient with how to and then motivate the patient so they will provide the want to. Technology can do many things but it’s no substitute for an educated, motivated patient who’s actively engaged with their diabetes management. Devices companies would be wise to remember this fact.