Our lives have transformed so dramatically when it comes to utilizing technology to communicate. We have our hand-held devices, our iPads and tablets as well as our Facebook pages. But, what is most exciting is that we are finally seeing the wireless generation being applied to help advance the care of chronic diseases and conditions.
For example, diabetes places a huge burden and tax on people's health, quality of life and on our economy. In fact, the statistics are daunting; there are 25 million people in the United States currently suffering from diabetes. The American Diabetes Association has calculated that the disease's total annual cost to society to be around $218 billion. This translates into approximately $9,000 per diabetic per year. It's a staggering number for such a terrible and debilitating disease -- the full societal, emotional, and health care costs of which we will never fully appreciate.
Diabetes still has a long way to go here in the U.S. However; there are ways to manage the disease. Health care providers and medical companies are quickly learning how to leverage emerging communication and electronic technologies to make diabetes management more efficient, reducing hospitalizations and ultimately decreasing the cost of the disease to individuals and on society.
What's more, the health care market is seeing a large influx of companies who are putting technology to use in a growing field of healthcare communications and health-record management; at a basic level, this means using technology to manage health records and share information with a patient's physician or other approved health care providers and caregivers -- including family members.
But, for treating diabetes patients in particular, the use of technology has been slow. This is quite ironic since the ever-changing condition of diabetes, by its very nature, could benefit from up-to-the minute capabilities that technology brings. Why? I have wondered this myself and I believe the answer lies in the age old tradition of sticking with the status quo. Diabetes care was slow to change. It seemed to work -- for the pharmaceutical companies -- and the patients weren't demanding new and more efficient ways to treat the disease.
But, now we are finally on our way to technological applications being used across the board in caring and monitoring diabetics. In fact, just in the past few years, there finally has been marvelous progress in diabetes care. This isn't just with insulin pumps and home blood glucose monitoring systems. The technologies available now and those at the cusp of development are really encouraging and exciting.
For example, there are new computer programs that support the analysis of home blood glucose data. Insulin pens are finally the norm and diabetes sufferers are using not just more convenient and expedient methods of insulin administration - they are now using more accurate methods because of technologies that provide improved measurement and monitoring. The idea of subcutaneous glucose sensors were a dream only a decade ago and now they're an everyday part of diabetes care.
Today's children with diabetes also have the opportunity for better blood glucose control than any generation before. A research study reported in Pediatric Diabetes showed that, compared to multiple daily insulin shots, children on insulin pump therapy for 12 months significantly and consistently lowered their A1C levels. In fact, insulin pump therapy has been shown to significantly decrease severe hypoglycemia in youth. Recent studies showed that adolescents and young children on insulin pump therapy had over 50 percent fewer episodes.
Many diabetes-related health problems -- such as eye, kidney and heart disease -- are the result of high levels of blood glucose affecting organs over time. So doctors are encouraged that today's young diabetes patients can achieve consistent, lower blood sugar levels from an early age that can continue for a lifetime. For example, Roche makes the ACCU-CHEK® Spirit insulin pump system. These pumps are milestones above the traditional method of treating fluctuating glucose levels. These pumps can deliver 480 basal doses of insulin each day. But here's where technology comes in: A Palm device and the ACCU-CHEK Pocket Compass software with a bolus calculator determines a patient's bolus doses and even creates pie charts and other graphs to track a patient's progress. This software application can be loaded onto smartphones.
Of course, there's also the smaller companies such as start-up Telcare, a Bethesda-based company that has developed blood glucose monitoring technology that combines a glucose meter with wireless connectivity to Telcare's "cloud" server. The electronic device keeps an open two-way communication between a patients and caregivers -- those that are loved ones and those that are professionals such as the nurses and doctors. Telcare monitor users can access all of their glucose data, as well as offering additional electronic logbook capabilities such as manual recording, nutrition recording, weight management, exercise regimens, medication amounts, and blood pressure statistics.
Most impressive is that Telcare provides a cross-platform social community where people with diabetes and healthcare professionals can interact, share stories, discuss the diabetes technology that they use, and learn from one another.
Another company is PositiveID Corp. a growth-stage micro-cap known for their digital personal health records technology. The company debuted their new iglucose technology at the Cellular Technology Industry Association (CTIA) annual conference in Orlanda, Florida last week. It is a wireless communication device for the automatic transmission of blood glucose readings from market leading, data-capable glucometers to the iglucose database.
PositiveID's iglucose technology is making great strides in the advancement of diabetes management and control by allowing patients to wirelessly track blood glucose levels. It connects to the patient's existing glucometer and, using M2M (machine-to-machine) technology provided by PSID's partnership with AT&T, collects, records and transmits a patient's blood glucose data to the iglucose database.
From there, it can be shared automatically via text message, email or fax with family members and health care professionals in real-time. In doing so, iglucose helps eliminate the burden of keeping journals and empowering individuals with diabetes to be more engaged in the self-management of their condition.
There's more to come and in labs across this country, the advantages of the wireless world are finally being brought to use beyond socializing -- they're a means of communicating critical information about our health and the status of those conditions that can be mortally devastating and an expensive burden on our society. Nothing replaces weight loss and proper diet -- but, in the meantime, communications technology can be used as a means to inform, monitor and support patients.
Follow Hilary Kramer on Twitter: www.twitter.com/@HilaryKramer
Ron Gutman: How Technology Has Changed The Way We Access Health
Technology Can Improve Health Care - NYTimes.com
It's all quite amazing, even more so because it's an advance that actually has nothing to do with a greater understanding of the disorder itself, just a better integration of technologies.
Some of these technologies are true innovations, some are just toys. Most of my own pump patients come in with reams of data, when often I can deduce a pattern with a fraction of the numbers. Perhaps more money should be spent on preventing DM2. If the Type 1s (especially children) like the digital readouts/wireless connectivity/databases etc., wonderful. But I wonder who will interpret all the data, with less and less MDs going into Endocrinology. We really need more diabetes educators, NPs etc. to help is out. Please come into the field. We'd love (and need) to have you.
Regarding the "pump and dump" concept below, I find myself reluctantly agreeing with the CEO. We could spend 24hours/day interpreting this data with absolutely no reimbursement. We need to help everyone, not just those with fancy machines.
Might I suggest that the barriers include lack of reimbursement for physicians to look at this data sent by patients, poorly designed feedback that fails to help patients understand what to do, aggressive insulin pump company sales tactics that result in what we in the industry call the "Pump and Dump" that leaves patients hooked up to an incredibly powerful device but without sufficient training, education and support.
At the end of the day, all of the technology we throw at patients doesn't replace the power of a well educated and motivated patient supported by a highly skilled behavioral and diabetes savvy team. Because of these tools we can also be more efficient than trying to transform traditional care providers (doctors and nurses). This dream has been a reality for Texans since 2002.