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

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

4. "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

5. #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…

6. © 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

7. © 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

8. © 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

9. © 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

10. © 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

11. © 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

12. 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

13. © 2013 Telcare, Inc.

14. © 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

15. © 2013 Telcare, Inc.
1
5
Smartphone
apps
to
enhance
engagement
Enables
carbohydrate,
medica?on,
exercise
data
input

16. © 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

17. © 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

18. © 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

19. © 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

20. © 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

21. © 2013 Telcare, Inc.
The
Most
Important
Result
What
do
our
Pa?ents
Say?

22. © 2013 Telcare, Inc.
The
Most
Important
Result
What
do
Pa?ents
Say?

23. © 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

24. #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

25. © 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

26. © 2013 Telcare, Inc.
#CONNECT2013
Telcare: it’s not a
sensor – it’s a solution