A lot is happening this year vs. the past when it comes to technology and diabetes. Namely, the opportunity to task small sensors in the role of providing data as inputs to decision making for better control of blood sugar by people with diabetes… and many other health conditions as well. Decisions can also be made by computers. The trick isn’t just to use sensors or not to use them but how to fit them into our daily living unobtrusively and then making sure they are clearly effecting lifestyle and how we feel day to day.

Sensors & People is the name we’ve chosen for launching our new development program. It is also a new category on Challenge Diabetes so that it will be easy to find the posts that relate to the forthcoming products that we hope to create out of this R&D testbed.

I hope to post an update to our Remotely Monitored Artificial Pancreas (RMAP) project this week. This is just one project within our Sensors & People program. We don’t talk about RMAP much in the public space but it’s been in development here since we first published the concepts way back in 2003 as part of a proposal to the NIDDK. “You should call this OnStar for diabetes” as one parent of a child with type 1 diabetes once described it during a presentation in Sugarland, Texas way back in 2004. And as Sonia Cooper, President of Children With Diabetes Foundation, shared with me during a call discussing the first CGM devices, “CGM alarms for low blood sugar to a person who is unconscious kind of misses the point. Doesn’t it?”.

You would be amazed (or disgusted) at how much cool stuff is sitting idle in research labs around the world. I was even told recently that scientific research grants are being awarded based on evaluation of current business models. Huh? Call me naive but I thought science was pure and evidence forces the adoption of efficacious therapies (ie - leapfrog technology has no business model when it’s an idea)? That’s why we’re accelerating our efforts in this area now. Given the accelerated adoption of our GlucoMON-ADMS by health plans, health systems, providers and patients I think we’ve proven that we know how to get the job done. It’s time for the next generation of products incorporating Diabetech technology and ‘Sensors & People’ is a brand that you will be hearing about a lot more in the weeks and months to come.

I was thinking about all of the various research that we’ve supported over the years and also how we’ve talked about many different ways to use it. Sometimes I talk to people that get excited about physicians finally getting access to patient data in the field but I know that is a minority view. Sometimes the focus has been on status notifications to remote caregivers which is simply a near real-time copy of patient data sent to somebody who cares. In more recent times there has been a lot of discussion about social networks and keeping in touch with your online community but this is usually based on ‘data’ that you would type in yourself be that on a website or on your phone. In 2004 I wrote a paper titled “The Real-Time Virtual Loop” which described a roadmap of services once devices were connected into a virtual ecosystem for patient-centric health care.

What prompted me to start thinking about this was the lightning fast process of designing and implementing the first game of Mystery BGee which ended January 31st. As I said back in that paper, profound impact can be directed at patients as well as supporters once you have data in the centralized system. Because data collection is simple, frequent and reliable it’s a catalyst for what you might want to do with it. If it was hard to get at a game like Mystery BGee would be impossible or you would only get one winner - that one person who is willing to do whatever it takes to get their data from point A to point B.

The promise of connectivity is really more about implementing hunches at the speed of thought. After all, this is behavioral change we’re talking about so it’s more like pushing a wet noodle than ordering up a blood draw and a lab test. Our hunch was that we could reward a specific behavior:

- check blood sugar often and make sure we have your data (this part is easy because they are already doing it and it only takes a few seconds of their time anyway)

And that would result in two things:

- more people would perform the behavior
- people would receive positive reinforcement for the act of performing that behavior

In addition, because of the specific rules of the version we ran in the January edition of the game, people would know that in order to increase their odds of winning that they should check blood sugar more frequently than normal and they should use their GlucoMON daily. The GlucoMON usage frequency is an interesting one since most people only use it once a week for pattern management and education. The daily users are those people, usually kids at school, who need to use it for keeping mom apprised of the situation.

The other element to consider here is where the number crunching or feedback happens. For example, if you develop the world’s most sophisticated handheld device or turn a cell phone into a bg checker, you still might not get timely access to the data at the centralized management center where analysis across a community or population takes place.

Here’s the point of this post. While the example might be a diabetes game called Mystery BGee, the important thing this illustrates is that health care innovation can now go from a hunch to being live in a community of patients in less than an hour. Without a connected community already in place and easy to use technology at the patient’s fingertips, you can forget about these kinds of advances or micro tests. You also get to find out if your hunches are a hit or a flop within a few hours or days - adjust them and see what happens - repeat. Compare that to the typical clinical trial that takes months to plan, lots of money to finance and years before anyone ever gets to read about it.

So when we talk about connectivity in health care and all that goes with it, we need to make sure that the freedom to innovate is protected. We also need to make sure that the innovators have access to these platforms and communities and that’s why Diabetech has always had an open model - it’s available to anyone. So not just connectivity because we can, Connectivity because it will help us realize major advancements in self-care that have been promised for so long in the field of chronic disease management yet seldom delivered.

It was bound to happen. I knew it was only a matter of time and today was the day. I’m talking about sitting in a Starbucks prepared to pay my $9.95 ransom charge to hop on their access point so that I could do some email w file attachments no doubt in the midst of a several hundred mile trek through Texas. Almost the moment I turned on my laptop I was connected to (linksys) - Excellent (connection quality that is). Naturally intrigued, I searched for all available wireless network access points and sure enough the friendly t-mobile service was there and waiting.

So, I feel pretty confident in saying that the days of paying for broadband access are numbered. How much longer can Starbucks take the hit for charging due to some ancient contract they did w T-Mobile so many eons ago (in Internet years anyway)?

I could go on about how this impacts medical data and patient care… yada yada… but I think sharing my newfound ‘freedom of information access’ experience today of free Wi-Fi in a normally hostile environment is plenty all by itself!

And if my experience isn’t enough for you, link to the rest of the story to learn about Starbucks partnership w Apple and their iTunes service which, you guessed it, doesn’t require you to pay for access via T-Mobile.