Just in case anyone needs to be reminded

Just in case anyone needs to be reminded

There are certain rarities when it comes to JPM, one of which is any company having an overflow audience on a Wednesday. Typically, Monday and Tuesday are the busiest days here while Wednesday and Thursday being more relaxed. Today IBM Watson Health was one of those rare Wednesday presentations with an overflow audience. Now we could explain away this level of interest as this is after all IBM, but that would be too simple.

The fact, yes, those pesky facts again, is that data analytics and health care go together like peanut butter and jelly. The investment community has already awakened to this as they see the powerful potential of applying data analytics with disease management. Even better they understand the immense power of predictive analytics preventing a small problem from becoming a big one.

Hence the reason Medtronic (NYSE: MDT) partnered with IBM Watson Health and Dexcom (NASDAQ: DXCM) partnered with Google. It should be obvious why. Besides developing better and more sophisticated algorithms, these companies see the potential of the big kahuna – using predictive analytics to prevent a severe hypoglycemic event for example. Yes, the application for a true artificial pancreas is obvious as well but this goes well beyond that.

While everyone is fixated on insulin using patients this to us is just the tip of the iceberg. The much broader and more profitable application is for non-intensively managed patients. Think of what it would mean if we knew whether a particular drug combination works for a patient BEFORE putting that patient on their therapy regimen. Imagine the value in knowing BEFORE hand whether or not if a patient will be adherent to their therapy regimen. With the data, this is possible.

Now before everyone gets too excited let’s look at the flip side of this before any of this is possible we need to get not just the damn data but the right data.  It is not enough to know glucose levels we also need to know when, how much and IF the patient is taking their meds. It would also be great to know what the patient is doing and would be even better if we knew what they were eating. CGM’s solve the glucose problem, interconnected insulin pumps and pens solve the insulin dosing problem and there are a host of devices that track activity. The missing link is food intake. Another missing link is oral medications.

Even with the missing links the chain can still be built for non-intensively managed patients. Listen it doesn’t take a rocket scientist to figure out there is problem provided they have enough data to analyze. Think of it this way with the new Band-Aid sensor from Dexcom/Google a physician could figure out whether a non-intensively managed patient is taking their meds or not. Listen there are only so many reasons a patient is not achieving better control. Glucose data combined with data analytics helps narrow down the possibilities.

Let’s be honest here patients are not always honest with their physician. They will tell their physician they are taking their meds when they aren’t. They will say they are eating properly when they aren’t. Armed with data the physician can have a more thoughtful dialogue with the patient. Hopefully a dialogue that’s not condescending rather more consultative. Kind of like this; “Hey Mr. Patient I know you are telling me you are taking your meds but I see here that your levels aren’t improving. What this tells me is as few things, either the meds we have you on aren’t working and we need to make some changes or perhaps you’ve been missing some doses.”

This is why data can be so empowering as it creates a more constructive dialogue between the patient and their physician. Even better this dialogue does not have to be face to face it can easily and quite frankly should be done electronically. Armed with data the physician can do what talked about earlier today explain WHY they should be doing what they are being told to do.  As we noted earlier today patients want to understand why before they take any action. Data analytics makes this possible.

Let’s dumb this down even further, HbA1c is not just the gold standard for measuring control it is also an actionable number. A number used to create the type of dialogue we are talking about. Yet the major drawbacks to A1c are it can only be done every 90 days and it does not measure glycemic variability. Slap on the Band-Aid sensor problem solved not only can the physician estimate future A1c with average mean glucose they will also know if the patient is keeping their levels in range. This one device has the potential to become an action point device.

This is why we are so high on what Dexcom is doing.  This why the Band-Aid sensor has the potential to deeply penetrate the huge market of non-intensively managed patients. As we have said all along intensively managed patients are the low hanging fruit for CGM, the real money, huge money is with non-intensively managed patients. This is also why conventional BGM is going to die a slow and very painful death. Like the Intarcia micropump the Band-Aid sensor is an elegant yet dumb solution it is way cool slap it on turn it on forget about it technology.

This is technology that truly empowers a patient, it is technology which does not require a patient to think. It does not add to their burden it makes their lives easier. Most importantly it will provide the WHY. From day one we have also said we can provide patients with the how too what we can’t provide is the want too. The want too the motivation will only come when the patient understands WHY. The Band-Aid sensor by itself won’t do this but it will be a huge step forward in making it possible.