Perception vs Reality

First some possible good news as Medtronic has agreed to an interview Friday morning, so stay tuned. As we promised we will publish what’s discussed. Along these same lines we have been doing some additional research into the insulin pump world looking specifically at how patients view their systems. Surfing through various social media sites its pretty obvious that none of the insulin pump companies are listening to patients very well. There is a huge gap between what patients expect and what these companies can deliver.

The short explanation is patients believe their device should never fail, that customer service should respond within seconds and supplies which now include sensors are too damn expensive. They love their devices when they work and hate them with real live hate when they don’t. Keep in mind that insulin pump patients and their families are the most vocal and are in no way shy about expressing their opinions. (Sounds like someone we know, but lets not digress well not yet anyway.)

Insulin pump companies on the other hand are in business to make money which from their perspective would be a lot easier if it wasn’t for those pesky demanding patients. They are afraid to tell the truth which is medical devices fail and/or malfunction. Customer service is costing them a fortune and unfortunately not a priority to fix as the fix costs even more money. And yep supplies do cost a lot of money and they are thrilled with this as they make most of their money from the sale of supplies.

Now this disconnect between the people who use the product and the people who make and support them is nothing new. The difference today is we have social media which allows patients to vent their frustrations. Yet there is a lesson to be learned here for all the insulin pump wannabes that is to say if they are willing to learn.

We are about to enter a new era for insulin pumping. An era where insulin pump therapy while not easy will be much easier than it is today. Thanks to CGM and insulin dosing algorithms the day is coming when using a pump becomes fairly simple. Training will no longer take hours or days and will center mostly around the structural issues related to insulin pump therapy, i.e. how to insert the infusion set, fill the reservoir, insert the sensor, etc.

Thanks to CGM and insulin dosing algorithms things that pumpers used to learn, i.e. time to action, duration of action, insulin to carbs ratios and carb counting will be a thing of the past. The heavy lifting that used to be done by the patient will soon be done by the system. While we wouldn’t go as far and state that a severe hypoglycemic event will be a thing of the past these events will happen with less frequency.

Another hidden benefit of this new world is connectivity should improve customer service too. See when a pump communicates with the cloud its not just sending patient related information but system information too. In the future pump companies can be proactive rather reactive. Depending on the system it possible that should an issue be detected a fix can be sent via the cloud just as we update the apps on our smartphones. In other cases a replacement pump can be sent BEFORE the current pump fails.

In this new era customer service costs should decrease for the same reason. With the system doing all the heavy lifting the patient shouldn’t have to contact customer service much.

All of these benefits assumes the system works as designed, that there aren’t inaccurate sensors or faulty “reservoirs”. This is why the issues we have identified with Medtronic are so damn important. We will say it again when the damn thing works its great when it doesn’t its not just frustrating it can kill the patient. This is why these closed loops systems should be held to the highest standard. While we appreciate the FDA’s new approach to approving these systems we do believe changes need to be made in how they monitor their performance.

The reality here is the responsibility lies with the insulin pump companies to ensure they produce systems that work as designed. Let’s be honest here the majority of insulin pump patients could care less about the business side of diabetes. Nor should they. To them this device isn’t a toy it’s a life sustaining device. They should not have to wait hours on hold when they call customer service. They should not have to worry that their sensor is delivering inaccurate readings.

What patients deserve most of all is that companies don’t ignore issues. That they take this responsibility seriously and never put one life ahead of making a buck. We have no problem whatsoever with these companies making boatloads of money. Our issue comes when they blatantly ignore what are very obvious problems that need to be fixed.

So to Medtronic we say this, make all the money you can but it’s time to man up, patients aren’t just demanding this they deserve it.