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In the past, healthcare providers have pointed out the difficulties in managing diabetes effectively because of the barriers in collecting those measurements. Now, with mobile health tools at their disposal, they're seeing those barriers disappear.
The latest evidence comes in a study commissioned last year by WellDoc, a Baltimore-based behavioral science and technology company. Published last fall in Diabetes Care and highlighted earlier this month during the American Diabetes Association's 72nd Scientific Session in Philadelphia, the study's findings indicate that mHealth tools – used by both the patient and the clinician – can positively affect a diabetic patient's health.
"It's the first demonstration that mobile health can deliver clinical decision support," said Suzanne Clough, WellDoc's founder and a former endocrinologist. By developing a mobile platform that uses the physician's tools as well as patient data, she said, "we finally have a marriage of the person and the patient."
Delivered by Charlene C. Quinn, RN, PhD, of the University of Maryland School of Medicine, who was the lead investigator, "Mobile Diabetes Intervention for Glycemic Control: Impact on Physician Describing Behavior" assessed the impact of a physician's medical management plan for a patient with type 2 diabetes when the patient used WellDoc's Mobile Diabetes Intervention System (MDIS) and the physician used associated clinical decision support tools.
According to the study, patients using mobile devices to report their blood-glucose levels to physicians saw their A1c reduced by 1.5 percent on average – and if physicians used clinical decision support in conjunction with those readings, the patient's A1c level dropped an additional 30 percent on average, for a total of 1.9 percent. This was compared to a control group that, under usual care, saw a 0.7 percent average reduction in A1c levels.
"Our research shows that this mobile diabetes study intervention impacted how physicians manage medications for their diabetes patients," Quinn reported at the ADA conference. "The WellDoc intervention provided a patient-centric care solution that impacted mediation therapy management at the provider level, while simultaneously supporting other key aspects of diabetes self-management, such as glucose testing, diet and exercise."
Simply put, diabetic patients who use mobile devices regularly are more apt to manage their healthcare, while physicians receiving data through mobile devices on a daily basis are able to intervene more quickly and develop a more appropriate care plan.
Clough said the study proves that objective, population-based data represents only the first step in a care management plan, and that physicians should be able to develop individual care plans based on subjective data – information reported by patients, using mobile devices, in between the blood-glucose readings.
"It's less about numbers and more about personal data," she said. "Population data is a place to start, a place to jump off, but we can't complete the picture unless we can get what someone experiences in their day-to-day life."
With this study in hand, WellDoc is now getting ready to launch a physician-prescribed mobile health app for people with type 2 diabetes.
In a recent interview with MedCity News, Chris Bergstrom, the company's chief strategy and commercial officer, said WellDoc would launch the Mobile Diabetes Intervention System during the first half of 2013. He said the tool, which would be activated by the prescriber, would transmit messages to the patient based on his or her blood glucose value – allowing the doctor to adjust a patient's diabetes management plan on the go while giving the patient real-time feedback on lifestyle decisions that affect his or her health.
According to the new article, Bergstrom said the tool will improve the quality of patient-doctor interactions by giving the doctor more information, collected from mobile devices, to fine-tune a care plan, while giving the patient more opportunities to manage their lifestyle.
WellDoc isn't the only developer of products for diabetes management to wade into the wireless space. A panel discussion at the recent Wireless-Life Sciences Alliance's 7th Annual Wireless Health Convergence Summit in San Diego brought together three such companies: Telcare, Glooko and AgaMetrix. All are developing tools designed to allow physicians and their patients to gather and report data through mobile devices such as smartphones.
Sridhar G. Iyengar, PhD, founder and chief technology officer for AgaMetrix, said the key to effective diabetes management lies in making the tools simple and invisible. And Anita Matthew, co-founder of Glooko, pointed out that devices that can transmit data back to the caregiver can only improve the level of communication and trust between patient and doctor.
"It's not about the connectivity - it's about the two-way connection to the caregiver," said Jonathan Javitt, MD, whose company (Telcare) is developing a cellular-enabled blood glucose monitor that automatically transmits blood glucose readings from the patient to the doctor. He said diabetes management platform of the future will enable constant connectivity to monitors and devices that administer insulin.
'It will become the brains of a whole new way of treating diabetes," he said.
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