We’re not silly enough to think that people will use something like this every day. However, we do know from experience that people in our programs like using this kind of tool during one of our Step Ups that last only a few days.

We also know that it has to be incredibly simple and the person using it has to get valuable feedback as a reward from using it. I think that’s what makes Zip It! different than other approaches. Since it’s part of our technology enhanced diabetes education and management programs, covered by a growing number of health plans including BlueCross BlueShield of Texas, we know when it gets used, how it gets used and we track the impact of using it.

So advanced, it’s simple.

Along with one of our solution partners, we’re announcing some big news this week at the bi-annual wireless trade show specific to people with diabetes: Your new technology innovations that ride on the cellular airwaves are now part of a covered diabetes education program!!! That is if you live in Texas and you have BlueCross BlueShield. There are also several health plans outside of Texas, too.

While the people with cool health related wireless technology at that show will spend a lot of money and a lot of time talking about how cool their stuff is, I am humbled at being the only that gets to tell them that after 8 years I have a way to actually get paid to put this cool stuff in the hands of patients. And not just that we get paid for our programs but that the payers hold our feet to the fire to show them outcomes like lower A1c and active participation. I actually have success metrics that I need to attain in order to continue working with patients and getting paid for that privelege.

It’s been my experience that success comes when all of the party’s interests are aligned. One common goal. That is certainly the case here and we look forward to working with these patients, capturing the outcomes data and reporting back to the payers who have agreed to cover our programs.

Forgive me if I come across as crowing over the next few weeks but it’s been a long hard row to hoe. Thanks to our randomized, controlled clinical trial data, patients finally have access to the good stuff and that happens to include wireless network airtime. For anyone with an idea that’s even half baked or looking for a way to move forward, we have that covered too via our R&D program incorporating the technology platform, wireless airtime, SIM cards, cell phone, smart phones, custom development and specific Regulatory compliance elements that are necessary before you put new stuff in the hands of real patients. More on this wireless health accelerator and how we provide streamlined and cost effective access to the market in a future post.

To sum the importance of this post in one thought - people with diabetes can now get what they need between doctor visits at no additional cost. How cool is that? and it just keeps getting better.

This is a topic I’ve been thinking about for a while but haven’t come up with the right angle or the interesting thoughts beyond the obvious until now I suppose. However, you the reader can be the judge of that.

Now it’s about the Medingo pump - a so-called ‘upgrade’ to the ‘revolutionary’ Omnipod by Insulet. Revolutionary in that it eliminates the tube (while simultaneously introducing several of its own technical issues and glitches). Does it make life with diabetes easier vs a pump with tubing or does it give the user better control over their blood sugars? Not so much. At least it’s not clear to me that the pump or any device for that matter can do that by itself. What if there was an all in one blood glucose meter that doubled as a cell phone with two way text messaging (they want you to say ooh here)… So what? There are already several of these by the way, including a few different versions created by Diabetech’s engineering team. My engineers would agree that these devices by themselves are a big so what. NONE of them have data to show that they are any better at helping a person to control their diabetes nor do they make life easier for the patient. What about the new iPhone diabetes mania? Again, just a tool… so what. CGM is here. Why such a mixed review by the people who are lucky enough to have this available as a covered benefit by their insurance? What about Health2.0? Again, a collection of discreet tools that ask you to spend more time figuring out how to use it by yourself as a one-off. Where’s the focus on solutions or integrating this tool with that tool… a real recipe for success? That group told me they’re not interested in that yet but maybe some day in the future. Huh?

We’re back to the question of how does all of this technology get used by the patient which determines the result.

I’ve been in this field for 8 years now and I still don’t know of any regimented program for how one would use an insulin pump to get specific outcomes. The analogy would be Dr. Bernstein’s low carb/ no carb diet as a prescriptive guide to do this behavior and get this outcome (a non-diabetic A1c below 6 aka the Under 6 Club). Perhaps this is because of the complexity of matching insulin to carbs and the myriad choices made every hour or two by the patient that makes this unrealistic to have a militaristic prescriptive for living with a pump. But why not attempt something like a diabetes boot camp for controlling blood sugar with the emphasis on the regimen and choices vs. ‘See all these new features’ and use them however you like or don’t or skip boluses or whatever. Rightly or wrongly we’ve come up with a term describing scenarios of patients and their random approaches to how they manage as The Free-Range Patient. We chuckle about this but isn’t this really at the root of why it’s so difficult for a provider to ‘manage’ their patients? The fact is that the only person who manages the patient is the patient himself. Providers should stop using ‘managing patients’ since it is entirely incorrect and perhaps gets in the way of the proper perspective which is more of a coach. Mentor isn’t even appropriate unless of course that level of relationship has truly been established which most often times it has not since that is a rare relationship indeed.

Now here’s something that doesn’t require a new device, which can save lives and give you back more sleepful nights while also helping you to improve blood sugar control. This little trick was implemented under the close supervision of our own Stephen Ponder (pediatric endocrinologist) and a team of medical staff ‘hovering’ over their kids. This revolutionary new technique is being written up by Dr. Ponder as we speak and hopefully we can grab an excerpt of it for publication on this blog soon. This new tool is called… wait for it… extended bolus. The trick is in how this tool is applied however. Very cool and worked wonders at diabetes camp this summer. That’s about all I can say so as not to steal his thunder but stay tuned for this awesome new technique that is sure to give many a real boost to their blood sugar control.

So when the bus comes by again to pick everyone up so that they can ooh and ahh about the next magical device for people with diabetes, you won’t see me getting on. What I will do is give it the sideways look and see if it helps to solve a certain problem or remove a barrier to improved self-care as part of a prescriptive program addressing a very specific lifestyle-demographic. More simply, is it truly useful or not by itself and if not, can we make it useful as part of a prescriptive system/program?