Here is the presentation of the DT2 app' for the NCD challenge (IBM/Novartis). Many Thanks, IC_Team

1. 9 th December 2011 | IPhone application for Diabetes Type 2 (DT2) in the UK Imperial College London Ankita Shroff Lise Retat Malvika Seth Manvitha Chennuru Rahul Garhwal DT2’ APP’

2. Executive Summary | DT2 app’ focuses on diabetes in the UK. The benefits of this smartphone app’ are in the areas of diabetes prevention, management and ultimately improving healthcare delivery . Diabetes was chosen for the 2 reasons: First, it is expected to be the 6 th disease leading to death in 20 years [WHO, 2011] - 80% of which in emerging countries. Second, the current smartphone applications for diabetes are not complete . Finally, the UK was chosen to ease the process of implementation of DT2. The challenges for the current health and diabetes application: 1) “The CHIC survey stems from a March 2011 consumer survey showing that 26% of apps are downloaded and used only once. Of the people who confirm using their apps, 74% drop out by the 10th use. The same survey, however, also shows that 26% of smartphone applications retain consumer loyalty and are used repeatedly” . The solutions brought in the current app are the following: i) reward via free text ii) reward via healthy restaurant voucher iii) social reward (via meetings with other user) iv) nice interface of the application taken into account all the behavioural and metabolic risk factors in the same app with all the present and future ways of monitoring. Current diabetes applications are either missing the awareness platform or number of key quantifications. 2) Individual need are different from each other. Some want to know more about disease Other want to control and quantify the level of health. Consequently, DT2 has 2 interfaces: behavioural and metabolic risk factors . 3) Two pilot study needs to be carried out to test the attractiveness of the concept. i) At Imperial College (IC) The feasibility of this app’ will be tested at a very small scale in the vicinity of IC because it will be easy to implement a spirit of appartenance at that scale. The cost will be literally minimal, as the iphone app developer is free and a programme may be easily lauched to create an interface in the computer department. ii) In Chelsea and Westminster hospital, professional developers are needed (40 000 £ in the UK, possible outsourcing in India) The main cost will be linked with the rewards  contract with strategic alliances

4. Risk factors of diabetes Type 2 Metabolic Risk Factors Other Risk Factors | Behavioural risk factors Tobacco use Harmful use of alcohol Unhealthy diet Physical Inactivity Raised blood sugar Raised blood pressure Raised blood lipids Overweight and obesity Poverty and low education status Advancing age Gender Genetic indisposition Psychological factors

5. Why an App? | [PwC, 2011] “Pharma 2020: Supplying the future” [Gainsbury, S, FT, 2011], “Government urged to rethink cost-cutting plans” For government For patients Why an App’ For Pharma Company

6. Why an App’ for future user? | Apps are the way forward Awareness Disease Management Health info **SMS are not encrypted Huge expected grow in use of smartphone [McLean, 2011] [McLean, 2011]

7. Key Problems linked to any current Health Application? | (1) Although penetration of smartphone use is increasing health apps have to have sustaining value to patients and be easy to use. This means that more pounds are needed to ensure the apps stay up to date and are available for the variety of smartphone platforms. (2) Do not lump all disease states with this data. People respond differently to different types of health conditions; some are open to getting tips and helping them manage their health condition while for others a reminder is not welcome because it reminds them they have a health problem. (3) Marketers need to test applications with patients/target audience before releasing them to the public. This means usability studies with patients. (4) Application healthcare marketing is a long term commitment thus you need to choose a vendor who can form a strategic alliance with your company and help you develop and update your apps for the long term.

8. What are the current app’ for diabetes? Diabetes _ Control In 2006, the daily SMBG (self-monitoring of blood glucose) rate was 63.4% among all adults with diabetes and 86.7% among those treated with insulin. Collaborations to ensure adequate health insurance coverage, diabetes education and counseling to encourage more intensive medical care and self-management practices, and continued surveillance measures to track changes in SMBG rates are needed to improve and monitor SMBG trends. However there is a fine line between informing and being intrusive. | Easy Diabetes Log For Life Diabetes Log Type2 Friendly Diabetes Diary Blood Glucose (Sugar) Tracker Gluco Sentinel Diabetic Meal Planner Lite Carbohydrate Intake Blood Glucose Level Bolus Insulin Dose Basal Insulin Dose Weight Healthy Restaurant Exercice Food Intake Medications

9. Solutions | | DT2 in the UK!!! Link via facebook to (3 rd most downoaded app) Not fully implemented yet Not fully implemented yet Not fully implemented yet in diabetes apps Not implemented yet in a diabetes app ’ Games required to attract UK Required to attract UK- but small feasibility King of mobile communication King of mobile communication Not fully implemented yet in current diabetes apps Not implemented yet in a diabetes app ’ Easy Diabetes Log For Life Diabetes Log Type2 Friendly Diabetes Diary Blood Glucose (Sugar) Tracker Gluco Sentinel Diabetic Meal Planner Lite Carbohydrate Intake Carbohydrate Correction Blood Glucose Level Bolus Insulin Dose Basal Insulin Dose Ketones Weight Cigarettes Healthy Restaurant Fitness centres User interface Medical news for diabetes Exercice Quizzes Celebrity SMS for remembering the insulin SMS when glucose level too low Food Intake Medications Social Platform

10. Risk factors taken into account in DT2’app Metabolic Risk Factors Other Risk Factors | Behavioural risk factors Tobacco use Harmful use of alcohol Unhealthy diet Physical Inactivity Raised blood sugar Raised blood pressure Raised blood lipids Overweight and obesity Behavioural Risk Factors Metabolic Factors

11. | Tobacco use Harmful use of alcohol Unhealthy diet Physical Inactivity Disease Awareness Behavioural Risk Factors Metabolic Factors

12. | Cheryl Fergison – Diabetes UK supporter Pubmed abstracts Science abstracts Forum Blogs Pubmed Science Forum Blogs Reward with free SMS Disease Awareness Celebrity giving feedbacks Medical news/articles sent about diabetes treatments Daily quizzes Medical news about behavioural factors related to Diabetes Disease Awareness

13. | Tobacco use Harmful use of alcohol Unhealthy diet Physical Inactivity Disease Awareness Behavioural Risk Factors Metabolic Factors Health Monitoring Find fitness related centres

14. IMPERIAL COLLEGE LONDON Ethos . Facilities of the place 1pm, Rock-climbing 6pm: Acqua-gym 2pm: Tai-Chi Imperial College Dental and Health Centres : Healthy Restaurant: I have side effect with my Insuline drug. Does anyone has this? Let’s meet! Anyone up for a run ? | Find fitness related centres Find Health related centres Register Register Register Take an appointment Today Tomorrow This week-end Take an appointment Rating from Diab’app Rating Like Rating Like Rating from Diab’app Find fitness related centres Find Health related centres Fitness and Health Centres iCal iCal iCal

16. | Tobacco use Harmful use of alcohol Unhealthy diet Physical Inactivity Disease Awareness Behavioural Risk Factors Metabolic Factors Health Monitoring Find fitness related centres Find healthy restaurants

17. | Raised blood sugar Raised blood pressure Raised blood lipids Overweight and obesity Behavioural Risk Factors Metabolic Factors Find Health related centres Medication History Bookmarks and Appoint-ments

19. | Future Platform US imaging probe i-steotoscope Remote sensor for glucose monitoring New remote ways of cigarette/ drugs intake

20. Why the solution is innovative? | Diabetes _ Control | Easy Diabetes Log For Life Diabetes Log Type2 Friendly Diabetes Diary Blood Glucose (Sugar) Tracker Gluco Sentinel Diabetic Meal Planner Lite Carbohydrate Intake Carbohydrate Correction Blood Glucose Level Bolus Insulin Dose Basal Insulin Dose Ketones Weight Cigarettes Healthy Restaurant Fitness centres User interface Medical news for diabetes Exercice Quizzes Celebrity SMS for remembering the insulin SMS when glucose level too low Food Intake Medications Social Platform

22. Challenges and constraints | | (1) Privacy and data security ==> solutions: encryption and Imperial College research projects (2) Small screens.==> solution: high resolution (3) Funding and incentives ==> IBM/Novartis

23. 9 th December 2011 | IPhone application for Diabetes Type 2 (DT2) in the UK or How the solution may be deployed DT2’ APP’ | IMPERIAL COLLEGE PILOT STUDY (free/ 6 months) Waiting for commercialisation CHELSEA AND WESTMINSTER HOSPITAL (free/ 9 months) SUPPORT FROM IBM/NOVARTIS (40000£ for finishing developing/marketing/ specialist for choosing relevant articles) DT2 APP Awareness platform Future platform Full platform Patient platform

24. Short term implementation | 40000 £) Westminster

26. | Acknowledgments: Dominic King, Andreas Pamboris, Tayllit Aherdan, Alexis Biller, Navneet K Mahal, Chaturika Jayadewa