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Jennifer Shine Dyer M.D., M.P.H . Chief Medical Advisor eProximiti Duethealth.com Columbus, Ohio May 2011 'What Really Works': Diabetes and Mobile Health in Medical Practice
What Really Works?... ,[object Object],[object Object]
What Really Isn’t Working? ,[object Object],[object Object]
 
Intensive Basal Bolus Therapy Basal   Insulin Prandial Boluses Insulin 0hr 24hr BG mg/dl
Meal Bolus
Pump download, missed meal boluses
Solid Doctor-Patient Relationship ,[object Object],[object Object],[object Object]
Hypothesis ,[object Object]
Subjects
Methods ,[object Object],[object Object],[object Object],[object Object],[object Object]
Results
What Really Isn’t Working? ,[object Object],[object Object],[object Object],[object Object]
eproximiti.com duethealth.com
Phone, tablet, and iPod touch versions available for both platforms. Duet
Duet Pilot Data ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
What Really Isn’t Working?
BJ Fogg’s Health Behavior Model
Motivating & Rewarding Behavior
Motivating & Rewarding Behavior
Motivation from Support ,[object Object],[object Object],Positive reinforcement from friends & family.  Motivation + rewards. Using Peer & Family Reinforcement
Doctor-Patient Communication, Education, and Literacy Data Mgmt Weekly Texting Reminders Comprehensive Patient Tools
Hypothesis:   Teens that open app daily over 3 months will check glucoses more and improve meal bolus adherence Primary outcome variable:   ∆ hgba1c% change  over 3 months between control and intervention group Study Enrollment Control Group:  Standard of care routine office contacts Intervention Group:  Weekly personalized automated texts Routine Office Visit  (3 months) ,[object Object],[object Object],[object Object],[object Object],Real-time conversation monitoring for safety ,[object Object],50 patients 50 patients
 
What Really Works?... ,[object Object],[object Object],[object Object]
Jennifer Shine Dyer MD, MPH Chief Medical Advisor [email_address] [email_address] eproximiti.com duethealth.com © 2011 eProximiti, Inc.  All rights reserved
Dyer Health Care Social Media ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Blogging
Twitter
Facebook
LinkedIn
YouTube
Podcast
Health Literacy: Online Content
mHealth: app development ,[object Object],[object Object],[object Object]
The United States of Diabetes? Half the Country Could Have Diabetes or Prediabetes by 2020 Predicted cost of $3.35 trillion (10% of total healthcare spending)   The United States of Diabetes: Challenges and Opportunities in the Decade Ahead , UnitedHealth Group’s (NYSE: UNH) Center for Health Reform & Modernization, November 23, 2010: http://www.unitedhealthgroup.com/newsroom/news.aspx?id=36df663f-f24d-443f-9250-9dfdc97cedc5
 
External Internet Services: Facilitate initial programming, Facilitate operations of SMS texting delivery and storage
 
Nick Jonas Music Also loves Frappuccinos.
 
Hey Nick! I’ve added you to my address book! Cool. Thanks!  Keep rockin’ Dr. Dyer.
 
 
Dr. Dyer here. Hope the work on the new album is going well.  Can’t wait to hear a sample on your next visit!  February 10th
Hey Nick. How is it going with your boluses?  February 17th
Nick.  Hope the carb counting is going well.  I know u love Frappuccinos!  :)  February 24th
Keep on rocking the boluses, Nick!  See you in a few weeks.  March 3rd
Conversation Monitoring: Tweetdeck Interface
Hypothesis:   Teens that receive weekly personalized automated texts over 3 months will have a significant drop in hgba1c% Primary outcome variable:   ∆ hgba1c% change  over 3 months between control and intervention group Study Enrollment Control Group:  Standard of care routine office contacts Intervention Group:  Weekly personalized automated texts Routine Office Visit  (3 months) ,[object Object],[object Object],[object Object],[object Object],Weekly conversation monitoring on Dyer iphone for safety ,[object Object],50 patients 50 patients
Trigger ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Motivate ,[object Object],[object Object],[object Object],[object Object],[object Object]
 
Data Management ,[object Object],[object Object],[object Object]
Cost Benefit Analysis
[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object]
[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object]
In Conclusion… ,[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],http://www.time.com/time/photogallery/0,29307,1636836_1389493,00.html#ixzz15BlbmzVi
[object Object],http://www.time.com/time/photogallery/0,29307,1636836_1389499,00.html#ixzz15Bm7vMUI
[object Object],http://www.time.com/time/photogallery/0,29307,1636836_1389495,00.html#ixzz15BmJ5SQn
[object Object],http://www.time.com/time/photogallery/0,29307,1636836_1389496,00.html#ixzz15BmSawMk
1981: Portable Units ,[object Object],[object Object],[object Object],Source:  http://www.galaxyphones.co.uk/mobile_phones_history09.asp
[object Object],http://www.time.com/time/photogallery/0,29307,1636836_1389497,00.html#ixzz15BmcHsNI
1983: DynaTAC 8000X  ,[object Object],[object Object],[object Object],Source:  http://www.i4u.com/article421.html
[object Object],http://www.time.com/time/photogallery/0,29307,1636836_1389498,00.html#ixzz15BnJuNUs
1989: GSM Digital Phones ,[object Object],[object Object],Source:  http:// www.motorola.com
1993: Simon Smartphone ,[object Object],[object Object],[object Object],[object Object]
1996: Mobile Internet Connection ,[object Object],[object Object],[object Object]
2002: BlackBerry ,[object Object],[object Object]
Evolution of the Blackberry
[object Object],http://www.time.com/time/photogallery/0,29307,1636836_1389508,00.html#ixzz15BoNhxy4
[object Object],http://www.time.com/time/photogallery/0,29307,1636836_1389509,00.html#ixzz15BoeYHNS
[object Object],[object Object],http://www.thetechherald.com/article.php/200908/2972/Mitnick-Obama-s-BlackBerry-can-be-breached
http://www.time.com/time/photogallery/0,29307,1636836_1721987,00.html#ixzz15BoqFZg8 2008: The iPhone 3G Steve Jobs unveils the latest generation of his revolutionary product. The 3G is faster and less expensive than its predecessor with larger screen for video.

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Jennifer Shine Dyer M.D. discusses mobile health

Notas do Editor

  1. Reduced mindfulness, diabetes happens every meal and there isn’t a choice about it. It sucks.
  2. Frequent contact (intensive) as evidenced by DCCT trial and more physiologic basal bolus therapy.
  3. A lot of visits (good doc patient relationship) but they weren’t helping as noted by skipped bolues. I’m an academic and have removed some details of methods.
  4. One app with 20-30 specialty modules within it so duet becomes an educational software platform. Giving me an automated platform that I needed.
  5. Good patients record/engage, and bad patients don’t record/engage. Not checking glucoses.
  6. Motivation, Ability, Trigger….engagement theory
  7. In conclusion…
  8. If your not solving a problem, you’re irrelevant.
  9. At the current rate, it is projected that by 2020 that 40% of nation will be obese. One in five health dollars will be spent to address the consequences of obesity.
  10. Email – too passive
  11. The Fitbit accurately tracks your calories burned, steps taken, distance traveled and sleep quality. The Fitbit contains a 3D motion sensor like the one found in the Nintendo Wii. The Fitbit tracks your motion in three dimensions and converts this into useful information about your daily activities. You can wear the Fitbit on your waist, in your pocket or on undergarments. At night, you can wear the Fitbit clipped to the included wristband in order to track your sleep. Anytime you walk by the included wireless base station, data from your Fitbit is silently uploaded in the background to Fitbit.com. Integrates with Google Health, Facebook, Twitter
  12. 15-20% of total inpatient discharges ~1000 in the year
  13. Rate limiting factors: physician time and overhead. Incentives determine how time is spent. Average salary ~$200,000 per year (senior and junior faculty).