Example: Following Six Success Principles

In August 2010, the DiabetesManager became the first cell phone–based health technology cleared by FDA for distribution to healthcare providers and adults with Type-2 diabetes. The technology collects and analyzes real-time patient data, including blood glucose levels and other diabetes-related information, and provides patients with automated virtual coaching that promotes positive behavior change and gives providers clinical decision support. Here’s an example of a technology that illustrates each of the six principles for mobile health product success:

Integrated. The DiabetesManager is part of an initiative at AT&T to improve employee health while controlling costs. It will be offered to a select portion of the company’s 1.2 million workers. As such, it is integrated into the telecommunications company’s existing healthcare network and is accessible to providers.

Interoperable. The technology is being incorporated into the Allscripts electronic health records (EHR) system and is the first example of a mobile health solution that is interoperable with such a system. It enables practitioners to access the application through multiple channels, including on a single-sign-on basis through their patients’ EHRs, via cell phone or fax, or through the technology’s own Web portal.

Intelligent. In one clinical trial, doctors who used the Diabetes Manager were four times more likely to take action based on the data they received from it than nonparticipating providers.1 In such cases, intelligence becomes a value-multiplier that moves the needle on doctor-patient interaction and doctor prescribing behavior.

Socialized. The technology improves treatment and medication adherence while also providing virtual personal coaching, direct clinician support, and caregiver linkage. It also expands online access to health and wellness information.

Outcome Oriented. DiabetesManager focuses on achieving clearly identified and relevant metrics. In two successive randomized clinical trials, patients were able to show a statistically significant reduction in glycated hemoglobin (HbA1c or A1c), a primary measure of glucose control. The first trial results showed a 2.0% A1c reduction in just three months. The preliminary results of a larger, 12-month trial were presented at the American Association of Diabetes Educators annual meeting in 2010. The study showed that patients achieved a similarly significant drop of 1.9% in A1c.2 The clinical effect of any decrease is substantial, since each 1% drop in A1c represents a 37% decrease in the risk of microvascular complications and a 21% reduction in the risk of any Type-2 diabetes-related complications or death.3 The economic effect of these reductions is tremendous, given that the average medical costs among people with diabetes are more than twice as high as those without diabetes, according to the Centers for Disease Control.

Engaging. The factors that drive engagement are likely to differ across patients. Technology such as the DiabetesManager more effectively connects users by allowing patients to configure their settings, messaging, tonality, and modes of interaction. Along with a rich user experience and real-time and relevant content delivery, these combine to increase engagement and achieve effective results.

References

1. Quinn CC, et al, “Mobile Diabetes Management Randomized Controlled Trial: Change in Clinical and Behavioral Outcomes and Patient and Physician Satisfaction,” Diabetes Technology & Therapeutics, 10(3):160-168, 2008.

2. Quinn CC, et al, “Mobile diabetes Intervention study: Testing a personalized treatment/behavioral communication intervention for blood glucose control,” Contemporary Clinical Trials, 10(1016),2009.

3. Gray, A, et al, “Cost effectiveness of an intensive blood glucose control policy in patients with type 2 diabetes: economic analysis alongside randomised controlled trial (UKPDS 41)”, British Medical Journal, 320:1373-1378, 2000.

Anand K. Iyer, PhD is president and COO of WellDoc (Baltimore).

Return to the article, "Navigating Through the Mobile Healthcare Revolution," by Christopher Wasden.