Why bother with the facts?

The way things are going at Livongo we’re shocked they haven’t announced they have developed a new program to battle the coronavirus. It was bad enough that yesterday company founder Glen Tullman appeared on CNBC shamelessly implying that somehow the Livongo platform is helping patients with diabetes battle the virus, when in fact nothing could be further from the truth. Nope the company is doubling down today with a statement made by Vice President, Government Affairs Leslie Krigstein.

According to a post on the company’s blog Ms. Krigstein states;

“But while this stimulus is a great step, we need to do more to support the present and future health needs of our most vulnerable populations.”

She concludes her post stating;

“The COVID-19 pandemic presents us with a historic opportunity to reevaluate our health system, and its ability to address the urgent and unique demands of our nation’s most vulnerable citizens. This is clearly an opportunity for telehealth to step up and show how it can help, and the stimulus plan is pivotal in clearing the way for it to do so. But remote monitoring and management are essential components of the comprehensive solution as we look to scale virtual care and provide solutions for people to manage their health outside the physical bounds of our healthcare system. Through thoughtful implementation and a strong clinically backed approach, remote monitoring creates a great experience that makes it easier for people to stay healthy throughout all stages of their care journey. When we look back on this time, we’ll either view the current stimulus as a well-intended, but incomplete fix, or a decisive turning point toward an entirely new standard of care.”

Now we hate to burst anyone’s bubble here but let’s examine some very real and very pesky facts;

1. There is absolutely no correlation between poorly controlled diabetes and an increased risk of developing the coronavirus. Nor is there any evidence to suggest that patients under good control have a lower risk of getting the coronavirus.

2. It’s a fallacy to believe that increased use of telemedicine or remote monitoring decreases the risk of getting the coronavirus.

3. Social distancing combined with common sense things like washing hands regularly are the most effective methods for preventing a patient from getting the virus.

4. To the best of our knowledge data analytics do not indicate that a patient might have the virus. Or put another way all the glucose readings in the world are not correlated to whether or not the patient might have the virus.

5. Even if the patient has the virus there isn’t much Livongo can do to help them. There are no drugs these patients can take nor are there any steps other than self-isolation that protect the patient.

Yesterday we noted that perhaps at long last digital health which includes remote monitoring and virtual physician visit could at long last go from being something we talk about to something that actually works. However it should also be noted for patients with diabetes these tools have been widely available for years. For years all the toys in the toy chest have been talking to each other while sharing patient data via the cloud. Thanks to this connectivity patients can easily share their data with their physician.

There are also a plethora of free apps which take all this data apply data analytics to it and provide recommendations to patients. Simply put the patient has plenty of options if they want to take advantage of them.

Yet even with all this way cool whiz bang technology one indisputable fact remains – the majority of patients are NOT achieving better outcomes. Which makes us wonder how increased usage of remote monitoring or virtual office visits will change that fact. Again we hate to burst anyone’s bubble here but what leads anyone to think that virtual physician visits will be more effective than in person visits.

The fact is in the real-world patients forget about 90% of what they are told, why would this change just because they were told this virtually. The fact is in the real-world patients are not adherent with their therapy regimen, has this changed with remote monitoring? The fact is in the real-world good diabetes management is not that complex, as we say consistently providing the patient with the how to manage their diabetes is the easy part. The hard part is getting the patient to want to manage their diabetes, how will remote monitoring or telemedicine change this is?

What Livongo and every other patient coaching platform boils down to is behavior change and yes, it’s that simple. Yet even with all the fancy data analytics, remote monitoring and telemedicine the majority of patients either don’t want to change their behavior or cannot sustain them. We hate to be Captain Obvious here but why do so many people who have worked so hard at losing weight gain it all back?

The harsh reality here is that there is nothing Livongo can do to help patients avoid the coronavirus. Sure they can remind them to practice social distancing, it can remind them to wash their hands but beyond these already well-known steps what can they add? Increased glucose monitoring doesn’t help, eating better doesn’t help. But hey why let these well-established facts get in the way of shameless promotion.

Now to be fair Livongo is not the only company attempting to turn this crisis into a higher stock price. Unfortunately Livongo is just one of many. Are we surprised by this? Nope. However we would remise in our responsibility if we did not bring to light the many holes in what Livongo is claiming. This is a company that loves to play very fast and very loose with the facts. They continue to make outrageous unfounded claims backed up not by science but fuzzy math.

Livongo is playing a very dangerous game betting that this house of cards does not come tumbling down before they can sell the company. They will do or say almost anything to promote the myth that they have developed something unique, when in fact all they have done is taken an old idea that didn’t work the first time around, wrapped it in new technology and telling everyone how great it is. They are using revenue recognition methods that at best are convoluted and at worst borderline illegal.

As Momma Kliff used to say it’s during times of crisis that people reveal their true colors. Thankfully the coronavirus crisis has brought out many examples of people showing their better selves. We have seen some incredible acts of kindness combined with a new appreciation for who the real heroes are. Just as we came together after 9/11 once again the American people are joining forces, putting aside past differences and coming together.

However there are always those who seek to take advantage of a crisis, to enrich themselves rather than help others. During this crisis Livongo is showing their true colors and they aren’t pretty at all.