What the future could look like

What the future could look like

Later this afternoon Facebook reports second quarter results and while the company would not seem like a diabetes company one day it just might be. Facebook has 1.6 Billion users and it’s still growing. Doing some simple back of the napkin math that means there are approximately 128 million users with diabetes, not exactly a small market.  A market that can be targeted and identified giving Facebook even greater leverage with advertisers.

Yet it is not the advertising dollars that we see as the ultimate potential for Facebook, rather the impact the site can have on patient outcomes. Facebook is one of the few portals that patients access not just everyday but multiple times per day. It is also one of the few portals that patients access via multiple platforms, laptop, mobile and tablet. Simply put Facebook is part of the patient’s daily life.

What’s the biggest obstacle standing between patients with diabetes and better outcomes? Therapy compliance.

What’s been proven as the most effective tool for improving therapy compliance? Patient education.

What is the largest group of patients who also happen to be the least engaged with their diabetes management? Non-insulin using patients with Type 2 diabetes.

Other than education what is lacking from this huge group of patients? Constant positive reinforcement.

Does Facebook have the tools to help these patients? Absolutely.

Can they monetize these tools beyond advertising rates? For sure.

Think of it this way as everyone who’s using Facebook uses it in different ways. In many respects Facebook uses are like patients with diabetes – one group using the platform daily posting multiple tines per day – another group that rarely posts at all only occasionally accessing the platform and the largest group who access the platform regularly posting from time to time.

It is this last group that mimics the majority of the diabetes population, patients who understand that diabetes is a serious disease, that it needs to be managed. Yet they don’t want diabetes management to run their lives, they want diabetes management made simple enough so it is just part of their life. These are the patients who want to live WITH and not FOR their diabetes. These are the patients who have lives and their diabetes management is not their top priority. These are the most difficult patients to reach and engage.

Over the years we have witnessed the failure of diabetes companies at reaching and engaging this huge group of patients. The biggest problem is these companies viewed the diabetes market through the eyes of what we call uber users, patients who are actively engaged with their diabetes and actualy given a damn what their A1C is. The majority of these patients not surprisingly use insulin to manage their diabetes. This is also the same group of patients who we like to call diabetes snobs patients who actually look down upon any patient who does not use insulin. This unfortunately also happens to be the most vocal group of patients.

As Momma Kliff used to say; “Just because you scream the loudest and get attention doesn’t mean that your right or represent the majority view.”

The harsh reality is these uber users cannot relate to the majority of patients. They cannot understand why they don’t measure their glucose regularly. Why they don’t take their medications as prescribed? Why they don’t give a damn what their A1C is? And most importantly they cannot phantom why managing their diabetes is not majorly important, why it is not the essence of their daily life.

In many respects Facebook is almost the perfect platform for helping patients who actually have real lives.  As anyone who is on Facebook knows they have ability to control what Facebook knows about them and what their friends can see and not see. Why then could Facebook not add in some additional fields that would allow the user to identify themselves as a person with diabetes. To opt into a program or group which is designed to help them manage their diabetes.

Just as users now receive posts reminding them of Facebook memories why not take that one step further and remind patients of things they need to do manage their diabetes. Or posts related to education. The best part of this type of interaction is that it’s the patient who is in control.  It is the patient who can choose to ignore these posts or investigate further. This is perhaps one of the most misunderstood aspects of patient engagement, giving a patient control.

From the moment a patient is diagnosed they are constantly being told what to do, often times without any detailed explanation of why they should be doing it. They are told to measure their glucose levels multiple times per day yet not educated as what these numbers mean or how to interrupt them. They are told to take their medications without being told what happens if they don’t take them. Many are told to lose weight. Worst of all they are told to do all these things but given little if any encouragement or incentive to do them.

Facebook has the potential to change all that. It can provide positive feedback, words of encouragement and most of all can elicit the help of others in doing so. Frankly this is already happening on Facebook as uber patients have already embraced the platform. The key here is expanding this peer reinforcement concept to the larger patient population. While uber patients actively seek information or join groups on Facebook, the majority of patients need some incentive or pushing.

It goes without saying that Facebook could easily construct their own version of interconnected diabetes management (IDM) and they just might do so.

The key as we see it with this huge group of patients who are semi-engaged with their diabetes management is constant touches that are not driven by a patient action. Think of all the way cool whiz bang cloud enabled glucose monitors, units which not only transmit data to the cloud but also transmit messages back to the patient. What’s the biggest issue here, to be effective the patient must do something, they must test so the data gets transmitted and analyzed.

While this could be part of the Facebook platform it does not need to be. The fact is patients are already actively engaged with Facebook all that Facebook needs to do is provide information and provide some encouragement. Most importantly of all they can do so in a guilt free environment that is controlled by the patient.

Designed properly this platform can do what these patients want more than anything, help them better manage their diabetes. It could make their diabetes management part of their lives without running their lives. It would treat them with respect providing a pathway to education which when accessed leads to knowledge and knowledge is the precursor for action.

One last item here that cannot be overstated, the platform does not have to overwhelm the patient. This is a huge problem today as when diagnosed so much is thrown at the patient they often times become overwhelmed and tune out. Proper diabetes management is not a sprint but a marathon. Yet far too often patients are being told to run this marathon without being given a training program or the time to train. They are basically told to wake up one day and run 26.3 miles. This is ludicrous but unfortunately very prevalent.

There is no question that social media has become a powerful platform, that Facebook is now engrained in our lives. There is also no question in our mind that should they decide to do so Facebook could have an enormous positive impact on the largest group of patients. That such a platform would be the ultimate win-win, Facebook makes more money and patients achieve better outcomes.

This may seem like pie in the sky thinking but then again who could have imagined the impact Facebook would have on our lives each and every day.  The simple fact is diabetes management and patient engagement must adapt to the world of social media.

No by our way of thinking it would be no surprise if Facebook joined their friends in Silicon Valley and jumped into the deep end of the diabetes pool. Yes, we live in interesting times.