More Technology Patients Won't Use

David Kliff is the author of the "Diabetic Investor" and may be reached at

| Nov 1, 2007

This morning, a major meter manufacturer announced that its blood glucose meters will now operate on Microsoft's HealthVault. HealthVault is an online service that allows a patient to store and manage his health records without paying a fee.

These records can then be shared with the patient's physician or healthcare team.

As it stands today, nearly every glucose meter can download readings to software provided by the manufacturer. By using other programs, a patient can download not only his meter readings, but also his food intake, medications, exercise, and more. Presumably, the hope is that with all this information, the patient's healthcare team can assist the patient in better managing his diabetes.

To me, this announcement is just another example of how everyone is fascinated with technology and fails to understand the realities of life with diabetes. First and foremost, these programs make the assumption that patients are actually checking their glucose levels. That's a false assumption: Most patients rarely check their levels, and many don't check at all. Next, the programs add one more task to a patient's already demanding diabetes management. While downloading information from a meter is not a complex task, it does require effort. To my knowledge, no meter has automated this task.

Even if you have a motivated patient who is willing to regularly check his glucose levels and then download the results, that information by itself provides only a partial picture of what's going on. For the information to be truly useful, the patient must also record meal information, medications, exercise, and more. While this task is easier for an insulin pump patient, it's difficult to imagine a type 2 patient on oral medications recording all this information and then entering it all into his computer.

Suppose you have a really motivated patient who checks his levels regularly, downloads readings, keeps a diary of everything he does, and then enters all the information into the software, ready to be shared with his healthcare team - What then? Who will pay for the time it takes a physician to analyze the data and then make recommendations?

And what about patient privacy? Everyone has heard of stories of hackers breaking into systems and stealing credit card information. How does the patient know that this very personal information is not being shared?

Let's assume that a patient goes through all this work and his healthcare team provides recommendations that could lead to improved outcomes. Will the patients see any tangible benefits? Diabetes is not like a headache or a fever, where the patient feels better after treatment. Getting a patient under control takes time and effort. It is quite possible that even after all this intervention and advice, the patient may not see any tangible results for months.

Instead of adding to the patient's workload with all this fancy technology, why not provide patients with access to educational tools that they can use at their own pace? While there are several studies that demonstrate the value of educating patients, I have yet to see one proving that fancy technology leads to better outcomes. In spite of this fact, glucose monitoring companies continue to come out with these fancy systems that apply to a bare minority of patients.

The technological innovations that have actually increased sales are the ones that have made checking glucose levels easier. A perfect example of this is the Bayer meters, the Breeze and Contour, which do not require coding. This innovation had a true impact on patients and actually made their lives easier. Although that is not the sole reason Bayer is gaining market share, it is a contributing factor. Perhaps the other players in the marketplace will learn from Bayer and begin to make the patient's life easier instead of adding to their already demanding diabetes management regimens.

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Categories: Blood Glucose, Diabetes, Diabetes, Food, Insulin, Insulin Pumps, Meters, Professional Issues, Software, Type 1 Issues, Type 2 Issues

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Nov 1, 2007

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