Qualcomm Life Connect 2013 - Jonathan Javitt, M.D., M.P.H.


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Telcare, Inc. Founder, CEO, and Vice Chairman Jonathan Javitt, M.D., M.P.H on transforming the care of diabetes through wireless technology.

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Qualcomm Life Connect 2013 - Jonathan Javitt, M.D., M.P.H.

  1. 1. #CONNECT2013 Connecting for Good Loews Coronado Bay Resort, San Diego, California Jonathan Javitt, M.D., M.P.H. Founder, CEO, Vice Chairman, Telcare, Inc. Transforming  the  care  of   Diabetes  through  wireless   technology  
  2. 2. "We  will  make  wider  use  of   electronic  records  and  other   health  informa5on  technology   to  help  control  costs  and   reduce  dangerous  medical   errors."                                                                                                          -­‐-­‐  President   George  W.  Bush,  Na?onal  Address   January  31,  2006  
  3. 3. #CONNECT2013 Transforming care for people with Diabetes, those who care for them and those who care about them Unless you connect the patient to the system, nothing happens. It’s not the tool itself, it’s what you do with it…
  4. 4. © 2013 Telcare, Inc. People with Diabetes 6 Spend less than 1 hour/year with their doctor They  leave  the     encounter  confused,   perturbed,  and   frightened     They  remember  liIle   of  what  was  said     They  feel  alone  and   abandoned  
  5. 5. © 2013 Telcare, Inc. Then they spend 7 8759 hours per year attempting to be their doctor The  array  of  tasks  is  enough      to  baffle  and  demoralize  the      brightest,  most  commiIed      pa?ent     The  result  is  frustra?on,      fu?lity,  inconsistent  adherence,      and  oNen  failure  to  treat  at  all  
  6. 6. © 2013 Telcare, Inc. Blood sugar control prevents complications and cost of Diabetes 0   5   10   15   20   25   30   35   80+   60  -­‐  79   40  -­‐  59     20  -­‐  39   <20   Annual  Risk  of  Hospitaliza1on   Worse  Adherence   Risk  of  Hospitaliza1on   8 $0   $1,000   $2,000   $3,000   $4,000   $5,000   $6,000   $7,000   $8,000   $9,000   $10,000   80+   60  -­‐  79   40  -­‐  59     20  -­‐  39   <20  Dollars   Worse  Adherence   Diabetes  Expense  per  Person   Sokol  S:    Impact  of  Medica?on  Adherence  on  Hospitaliza?on   Risk  and  Healthcare  Cost.  Medical  Care  2005  
  7. 7. © 2013 Telcare, Inc.     §  About  3x  the  cost  of  other  members  in  the  popula?on   §  Beyond  direct  spend  lies  the  burden  of  …  absenteeism,  increased  workers  comp  risk,  decreased   produc?vity,  and  replacement.  (ADA  es?mate  $3000/year)       Non-­‐diabe?c   Popula?on   Diabe?c  Popula?on   Diabetes  affects  10%  of  popula?on,   but  incurs  30%  of  costs   Popula'on   Healthcare  Costs  
  8. 8. © 2013 Telcare, Inc. ~15%   R   I   S   K     $   High   Low   Tradi?onal  Disease  Management  Has  Failed   “High  risk”  pa?ents  (stra?fied  based  on   past  claims  costs)  are  the  focus  of  exis1ng   care  management  efforts.       Iden?fying  and  addressing   last  year’s  high  cost   pa?ents  misses  the   majority  of  those  who  will   be    next  year’s  high  cost     pa?ents  
  9. 9. © 2013 Telcare, Inc. ü  Monitor  100%  of  the  popula?on   for:   §  Adherence   §  Extreme  Highs   §  Extreme  Lows   §  Sustained  Highs  or  Lows   §  PaIerns   ü  Iden?fy  high-­‐risk,  poten?ally  high-­‐ cost  episodes   ü  Intervene  with  data  that  enables   meaningful  and  contextual   coaching.   ü  Prevent  complica?ons,  cost,  and   hospitaliza?on   The  Future:  Popula?on  Monitoring  &  Management  
  10. 10. People with Diabetes Need to care for their disease wherever, whenever … Unless  we  issue  every  pa?ent  a      24/7  physician,  mobile  health      is  the  only  solu?on  
  11. 11. © 2013 Telcare, Inc.
  12. 12. © 2013 Telcare, Inc. Building  a  Network  of  Care   around  the  pa?ent   •  Family  members,  diabetes  educators,  the   school  nurse,  and  most  importantly,  peers.     •  Diabetes  is  about  what  you  eat,  how  you   exercise,  and  what  medicines  you  take.     •  People  with  Diabetes  universally  express  a   profound  sense  of  isola?on.   •  Telcare  connects  people  with  diabetes  to   their  social  network  through  the    cloud   using  the  tool  they  use  the  most  –  their   glucose  meter  
  13. 13. © 2013 Telcare, Inc. 1 5 Smartphone  apps  to  enhance  engagement   Enables  carbohydrate,   medica?on,  exercise   data  input    
  14. 14. © 2013 Telcare, Inc. Partnering for Increased engagement, Social Networking and Gaming Bodymedia and Withings for fitness Calorie King for Carbohydrate and nutrition tracking EA Games and incentives for kids Rewards and Incentives
  15. 15. © 2013 Telcare, Inc. Empowering the Caregiver 1 7 Presenting the big picture to identify patients in need of support And the actionable information needed to drive meaningful improvement
  16. 16. © 2013 Telcare, Inc. For  Employed  Popula?ons:   A  care  management  layer  is  cri1cal   •  May  be  a  Telcare  partner,  Managed  Care   Organiza?on,  or  healthcare  provider     •  Automated  messaging  maintains  the  daily   touch     •  Automated  messaging  must  be   supplemented  by  human  touch  and   rela?onship  for  maximum  efficacy   •  Rewards  and  incen?ves  make  a  difference  
  17. 17. © 2013 Telcare, Inc. 0%   10%   20%   30%   40%   50%   60%   70%   80%   Before   Telcare   Direct   Purchase   HMO   Physician   Office   Endo  +  CDE   CRO   Tradi?onal   Insurance   Site  of  Care   %  Adherence  with  Telcare  BGM   Results:  Unprecedented  Adherence   For  the  pa1ent:  improved  tes1ng   adherence  means  bePer  glucose  control   For  the  caregiver:  demonstrated   adherence  means  higher  reimbursement  
  18. 18. © 2013 Telcare, Inc. •  Meaningful  result  seen  in  all   treated  pa?ents   •  11%  rela?ve  difference  in  A1c  in   those  who  engaged  >1x  per   week   Results:  Meaningful  Clinical  Improvement   For  the  pa1ent:  10%  reduc1on  in  A1c      means  37%  less  hospitaliza1on,  stroke,        heart  aPack,  amputa1on,  vision  loss   For  the  caregiver:  demonstrated  clinical        results  drive  reimbursement  under      accountable  care  
  19. 19. © 2013 Telcare, Inc. The  Most  Important  Result   What  do  our  Pa?ents  Say?  
  20. 20. © 2013 Telcare, Inc. The  Most  Important  Result   What  do  Pa?ents  Say?  
  21. 21. © 2013 Telcare, Inc. Results  for  Employers   ADA  data  show  that  non-­‐healthcare  costs  of  diabetes  are  at  least  as    high  as  the  direct  healthcare  costs   Days  away  from  work   Decreased  produc?vity  on  the  job   Accidents  and  comp  claims   Worker  replacement  
  22. 22. #CONNECT2013 What  have  we  learned?   mHealth  is  a  medium  that  is  no  more  useful  without  content      than  radio,  television,  or  cellphones   Now  that  we  have  the  medium          it’s  1me  to  focus  on  paths                to  engagement  
  23. 23. © 2013 Telcare, Inc. Telcare’s Future: A comprehensive Diabetes Solution 25   Withings and Bodymedia Integration to the meter Bluetooth Insulin Pump Monitored Pancreas Intelligent Insulin Pen Bluetooth CGM TBN V 2.0 Total Diabetes Management
  24. 24. © 2013 Telcare, Inc. #CONNECT2013 Telcare: it’s not a sensor – it’s a solution