Why we need two tracks

Why we need two tracks

According to a study by some Finnish researchers connected health combined patient coaching did not produce better overall patient outcomes. In this study the researchers randomized 500 patients, half with diabetes and half with high blood pressure, to either remote monitoring system with a health coach or usual care. In the former, they were given a toolkit with a connected blood pressure monitor, scale, activity tracker and glucose meter. Their health coaches contacted patients on a monthly basis to review data and offer feedback. Even with the assistance of a coach the researchers found no improvements in outcomes.

This study seems to confirm another study conducted by Scripps, which also noted that interconnected health did not produce better patient outcomes.

As we have noted consistently for interconnected diabetes management (IDM) to be truly impactful it must transform data into patient relevant, actionable information. That data by itself is meaningless even when that data is being reviewed and interrupted by a health coach.

Yet Diabetic Investor sees another reason why these two studies did not show improvements in patient outcomes.  Put simply it comes down to messaging, how the health coach delivers coaching to the patient. The fact is to date no one has applied advance analytics to patient behavioral data. No one has figured out which messages delivered to the patient are impactful.

This is in sharp contrast to how big data is impacting diabetes therapies. The efforts underway by Medtronic (NYSE: MDT) who’s partnered with Watson Health and Dexcom (NASDAQ: DXCM) who’s partnered with Google are beginning to produce better insulin dosing algorithms. Simply put these partnerships have yielded information which allows a patient to better manage their diabetes.  Medtronic recently announced that through their partnership with Watson patients can avoid hypoglycemic events.

What’s needed now is applying this analytical power to patient behavior data. To understand which messages not only reach the patient but which messages the patient responds too. Think of it this way a 54-year-old male insulin pump patient responds to different stimuli than a 30-year-old female insulin pump patient. While the older male may be more responsive to email messages or phone interventions the younger female may be more responsive to text messages delivered to her smartphone.

This is not just true of how the intervention is delivered but also the tone of the message. The fact is companies in the IDM space need to acknowledge the fact that the majority of patient’s want diabetes management to be part of their daily routine not to dominate their daily routine. It’s not that these people do not want or do not value the assistance of a coach, real or virtual, they just want their coach to communicate with them at their level. To understand that they are not living their lives FOR their diabetes rather they are living their lives WITH diabetes. That diabetes management is NOT the centerpiece of their lives but PART of their lives.

On the flip side IDM companies must also recognize that there will be a group of patients that no matter what they do these patients just won’t become engaged with their diabetes management. That it is not possible, not even feasible to try and help these patients.

What this really means is these companies must get to know the patient. To understand what they go through each and every day. To understand that these people aren’t dense and do care about managing their diabetes. However, given the demands of diabetes management, the fact that diabetes management is a 24 hour per day 365 days per year job with no days off, that patients sometimes get stressed out. That it’s ok if they want a diabetes day off. Yes, this is counter intuitive to everything these companies have come to understand. Yet, it is also VERY real world.

As it stands today the vast majority of companies in IDM are acting as if every patient wants to run a marathon and will endure the training necessary to run this race. When the reality is the vast majority of patients do not want to run a marathon and are perfectly content with a nice walk. This is why it’s imperative that these companies gain a better understanding of the patients they are trying to help.

We hate to be redundant but collecting data is the easy part, transforming this data to patient relevant, actionable data is where the rubber meets the road.