Devices & Diagnostics

A diabetes doctor’s wish list for mobile health

The daily testing and monitoring responsibilities for diabetes patients has made them, and their physicians, a prime target for mobile health products and services. But research suggests that even in this population of patients, use of mobile technologies is still reserved to a small group of early adopters. Dr. David Klonoff, an endocrinologist and clinical […]

The daily testing and monitoring responsibilities for diabetes patients has made them, and their physicians, a prime target for mobile health products and services. But research suggests that even in this population of patients, use of mobile technologies is still reserved to a small group of early adopters.

Dr. David Klonoff, an endocrinologist and clinical professor of medicine at University of California San Francisco, says doctors aren’t really prescribing these apps because they haven’t yet demonstrated the necessary value to patients, clinicians or payers.

In a talk today at the Body Sensor Networks conference in Cambridge, he said that in order for that to happen, a product has to not only be safe, but also make life easier for patients and clinicians.

For a clinician, the thought of having two dozen patients’ daily glucose numbers delivered to his computer is overwhelming and unhelpful. “I need something to sort it out,” he said. “And, don’t even show me the data unless one of these three outcomes occur:”

  • It saves the clinician time
  • Improves outcomes for the patient
  • Saves money for patient or provider

When physicians turn to the literature to look for that data, they find only a small amount of clinical data and even less economic data on mHealth. Payers, of course, want that cost savings data as well. “I’m being buffeted by patients who want something that’s safe and effective, by payers who are saying no way, and then the companies that are trying to make money,” he said.

But he thinks it’s just a matter of time until that kind of data becomes available, and mHealth finds a real place in diabetes management. “It’s a very nascent stage […] but it is starting to take hold,” he concluded.

If that happens, it would open the door for even more ways for physicians to keep an eye on diabetes patients remotely. Aside from continuous glucose, Klonoff said there are also other remote readings that would be useful to the clinicians. “My first choice would be insulin, because in a closed-loop artificial pancreas system, you want to know the glucose and it would be a great luxury to know the insulin level,” he said. “Other than that, lactate and keto acids would be of interest, and hydration.”