Managing Diabetes with Intelligent Lifestyle Apps

Author: Dhrub Bandhopadhya

Designation:

Head, Digital Marketing & Transformation Practices

LIVE LIFE

Smarter | Healthier | Happier

Diabetes – The Silent Killer – medically termed as ‘Diabetes Mellitus’ – a chronic disease caused by an abnormality in blood sugar levels, shooting higher than normal limits. Diabetes patients are diagnosed in two classes, primarily either they are Type 1 – those where the ability to produce insulin is not enough and the other Type 2 – where the body stops responding to effects of insulin. While my motive is not to speak about what is diabetes, it is essential that we understand the seriousness and criticality of this disease that makes it incurable.

I was recently checking some of the infographics that show up on Pinterest and I was astounded to see the numbers exponentially rising over the years. On a global view, we are looking at 1 diabetic patient of every 12 people we meet and that comes with a caveat where 1 in 2 does not even know they have diabetes. In the global scale, the World Health Organization in their recent global report on diabetes estimated around 422 million adults are diabetic and that leaves aside more than 45% stand undiagnosed. Lives lost due to diabetes is 1 in every 7 seconds. International Diabetes Foundation shows data that says in 2015 there were 415 Million Adults diagnosed with either type 1 or type 2 diabetes and trends show that this data is going to shoot up to 650 + million by 2040.

We all know it’s incurable and it is on the rise like an epidemic. The need of the hour is more about addressing the patients and suffering from diabetes and check the options that can systematically control diabetes by just managing the disease by Self Care through:

Proper Diabetes Education
Exercise Regularly
Eat Healthy
Manage Stress
Check Sugar Levels
Track and Monitor Body vitals
Take Medicine regularly

and few more activities that help you live a life worth living even with diabetes. While, doctors suggest with the best of intentions to help patients, practicing the advice is a whole new game – when it comes to – sticking to the plan, strictly. For a patient, in their busy lives, it is next to impossible to keep an eye on all of these critical aspects.

There are a wide range of medical smart devices and products that help in tracking body vitals, monitor blood glucose even checks stress levels and a lot more aspects pertaining to patient Self Care. There are numerous apps flooding the app stores with smart wearable devices integration that work well. However, evaluating from a diabetes patient’s perspective these apps do not focus on the patient’s lifestyle, while they are certainly purposed to health and fitness.

Our innovation team identified this missing piece and started working on an idea that was more patient centric, where technology was used as a tool to facilitate patients to manage their life with diabetes more efficiently and effectively. We have successfully demonstrated this idea to pharma giants, who are relentlessly working towards simplifying patient lives with Diabetes. The idea was conceived very much opposed to other apps which had a product centricity in its functional orientation. Our primary objective was to make an app that would revolve around a patient’s life specific needs addressing the top 7 aspects (as mentioned above) automating connected care. Depending on these aspects we selected smart technologies that would facilitate optimum care to patients and shall prove to be a life saver in the long run.

For us to be more authentic and accurate in our approach, we created a Virtual Patient Profile (VPP) as a prescribed user of this app – even put a name to it and build a patient life around, so we could imagine the possible needs. We made a list of questions that the app could answer. Here is a sample:

How do I monitor my blood glucose?

How often should I check my Blood Glucose?

Which monitoring device is good for me?

How often do I need to take insulin?

How am I doing now?

What diet do I take to keep my sugar in control?

How do I control my Diet on a regular basis?

What all things do I need to take care of in my diet?

What kind of exercises should I do to keep my blood glucose levels controlled?

How often to do that exercise?

When and how often do I need to consult a doctor?

Where can I get the right information about Diabetes?

How are others managing life with diabetes?

and much more…

We started drafting out the app functional features that would give the best experience of digital healthcare, answering these questions.

We had conceived this app to be governed and owned probably by a Pharma or a medical devices company working focused in the diabetes space that would be able to use this app to connect with its intended patients providing reliable care. Keeping that creation in mind, we have made the patient profile to be more open. However, the app would certainly have options of creating a Patient Profile including Social Login Feature. Since the idea is to provide a 360O care to the patient inclusive of physician consulting and pharmacy integration the profile would have an option of My Wallet as a feature with option to add Credit Card and sync with bank accounts. This would further have sections pertaining to medicinal purchases with order/pre-order functionality.  This app would work two ways from the same login interface, where a physician can be registered by the pharma company, may be also referred by a patient as their preferred physician under a well-conceived patient connect program or the physician can also volunteer as a consultant physician. The idea is to create a physician connect also so that the pharma company can have more and more physician connect for patients to find the best physician. It goes without saying that the very purpose of having the physician connect is to securely automate and regulate the consulting and prescription cycle, automating the point of care and evolving it to on-demand care consulting for patients suffering from diabetes. Taking one step forward the app would also allow patients perform an online purchase with a possibility to avail benefits like discounts and free home delivery etc. The integration of the pharmacy would consider a buying process which includes purchase under an authentication process with e-prescription and also integration with Co-Pay APIs.

Smart Device Integration

While there are a number of smart devices available there would be possible variance in compliance considering Class 2 and Class 3 devices from a regulatory point of view. None the less the admin module would be able to integrate, configure and manage smart devices through the app for tracking and monitoring of:

Blood Glucose for HBA1C and also for ambulatory glucose profiling through smart BT/BLE/NFC based CGM devices.

Body Vitals such as Body Temperature, Heart Rate, Pulse, Blood Pressure, Breath Rate, Stress and much more.

Activities through activity sensing devices for walking, running/ jogging, climbing etc.

The key function of the app would be the smart tracker – a pivoting feature sourced through an integration of a wide range of smart device integration, typically have four aspects to cover tracking:

Blood glucose with both Manual and Medical Device.

Track and Manage Diet Intake (in Calories) through manual feed and data updates.

Tracks daily activities using activity sensing devices.

Tracks Body vitals using wearables, smart sensing and Medical Devices.

It is termed as a smart tracker because it would automatically pair with BLE / BT based smart medical devices and wearables and collect the vitals and record under a prescribed time schedule. The patient would work hassle-free and perform a normal routine unless their intervention is needed such as using a CGM / BGM device where additional preparations are needed to be done to track the sugar levels. In adverse cases, the alert notifications sounds would prompt the users to make sure the devices are ready to be paired etc.

Smart Health Analytics

The Smart Health Analytics is an interactive dashboard, comprising of data-driven purpose visualization of health records for a definite time period. For a selected duration, this would typically include, the variance in HBA1C or the entire ambulatory glucose profile – showing the hyper or hypoglycemic conditions against a timeline, variance in body vitals, calories intake Vs calories burnt, water intake, activity Scores like steps walked, running in miles, bicycling in miles etc. diet plan deviance, alerts missed & unread notifications

Insulin dosage frequency and quantity, monitoring and tracking efficiency and a lot more customer analytics that a patient can define based on their needs. The possibility is also there to provide an interface to the physicians where they can also create custom dashboards and visualizations per patient for better observation and diagnosis, resulting in effective treatment.

While tracking is a pivotal aspect to be considered, it calls for an intelligent scheduler that would allow the patient or the physician to also prescribe to manage schedules with blood glucose monitoring, insulin dosage, medicine intake, water consumption, diet plan for 4 phases of the day (breakfast, lunch, snacks, dinner), activity planner and more. The objective here is to automate the process of life management so that the system itself defines and identifies the actions to be taken per timeline or indicate the patient to take the actions through reminders and alerts.

Learning Center and Emergency Helpline

The learning center is an interactive experience of a patient that would be primarily sourced through a Smart Search function. The Smart search would include typing and voice-enabled search feature as well and can be configured for Conversational Bot Mode (CBM) as well, which would typically make the patient hands-free for experiencing content designed for enhancing the patient’s knowledge on diabetes. There would be a wide range of content including, videos, 3D and 2D animations, presentations, PDF documents and HTML content which would all be searchable through keywords. The smart search would come with intelligent machine learning algorithms that would understand the patients need and would support through recommending keywords that would get them relevant content. There would be advanced searching and sorting features to filter content from a large result base. Content preview and other similar features would not be available on the app – however, we are working on a Patient Connect Platform that can possibly include many of these features in a cloud web environment.

The app would also have an intelligent emergency helpline service that would work in direct sync with the smart tracker and would respond to alert levels defined majorly by the physician or the patient itself, under prescribed guidelines of a physician.

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