Health 2.0 Europe - Voluntis Deep Dive

Introducing diabeo

Mobile & web diabetes telecare system

Health 2.0 conference – Paris, April 2010

Lydie CANIPEL, CERITD

Géraud RABEONY, VOLUNTIS

Type 1 diabetes management – insulin therapy

Quantités de
Amount of
glucides
carbohydrates Insuline rapide
Rapid-acting insulin

Insuline lente
Long-acting insulin

8h 12 h 20 h 24 h

© 2010 VOLUNTIS & CERITD. All Rights Reserved. The Voluntis and medpassport names and logos are registered trademarks of VOLUNTIS S.A. 2

A day in a life of a diabetic …

A typical day

A health care professional who must, in 20 min
every 6 months, analyze 180 such days

Glucose readings
at least 4/day

Calculate Identify servings
insulin doses

How to improve this follow-up?
Adaptation / Is the electronic logbook the answer?
Physical activity


A day in a life of a diabetic … with diabeo

A typical day with
DIABEO

Glucose readings
at least 4/day
Physical activity

Servings identification

Medical Insulin dose adjustment
prescription


Scientific validation of diabeo using Evidence-based medicine
2005: « PDAphone1 » : Feasibility study (CERITD, 10 patients, 3 months)
Mono-
center
2006: « PDAphone2 » Validation study (CERITD, 30 patients, 4 months)

2007-2009: « TELEDIAB1 » : Multi-center study (RCT in 20 French
hospitals, 180 patients) to evaluate the clinical and economic impact of
the system on T1DM management
Multi-
2008-2011: « TELEDIAB2 » Multi-center study (RCT in 20+ hospitals &
center
PCP practices, 180 patients) to evaluate the clinical and economic
impact of the system on T2DM management

2010-2013: « MEOS » Electronic Medical Records online, managed by
the diabetologist and the patient

2011-2013: « TELESAGE1 » large-scale cohort study
The TELEDIAB1 and TELEDIAB2 studies have been conducted in partnership with Orange Healthcare and the pharmaceutical industry


TELEDIAB1 study results

Improved glycemic control with Diabeo…
Without
Improved glycemic control increasing
without increasing healthcare Modification of HbA1c at Month 6 hypoglycemic
professionals’ clinical time by patient group events

-0,9 pt HbA1c

More
response in
the DIABEO
group

3/4 of patients
want to keep
using Diabeo

Usual care DIABEO + usual care DIABEO +
teleconsultations

-10% of HbA1c= -10% of HbA1c=
- 25 % of risk of -39 % of risk of
microalbuminuria retinopathy
development development


Introducing diabeo

Innovative mobile & web diabetes management solution
based on the software platform

Developed through a scientific collaboration between
Voluntis and CERITD (diabetes research institute led by
Dr Guillaume CHARPENTIER)

Supported by the telemedicine working
group of SFD (French Diabetology Society)

Endorsed by AFD (French Diabetics’ Association)

Winner of the 2007 Innovation Trophies (Orange Business
Services, Syntec Informatique)


Overview of the diabeo system
Researchers

Database export

Patient App
Diabetes telecare system HCP
Patient Powered by Portals HCPs
(T1 / T2) (PCP / Endo / CDE)
Patient Portal


Patient-HCP interactions enabled by diabeo

Diabetes telecare system
Patient
Powered by
With a smartphone
Healthcare professional
WIth access to the Internet

Phone-based teleconsultations


Patient mobile interface


Patient mobile interface

My Stats


Data synchronization with the Medpassport web server


Patient logbook (weekly view)


Goal setting

Goals

Pre-meal targets

Minimum goal

Maximum goal

Post-meal targets

Maximum goal

Bedtime targets

Minimum goal

Maximum goal

Update


Treatment profile


Adjustment of insulin dose parameters (T1DM)


Summary of diabeo’s benefits

For patients

• Assistance in the insulin dosage process, higher dietary freedom, modern vs. paper logbook
• Reinforced link with the health care team

For healthcare professionals

• Tool to reinforce the treatment and achieve better glycemic control among patients
• Productivity gains in the clinical care process (e.g. instant access to patient data) and
efficient system for teleconsultations

For payers

• Short-term savings due to avoided transportation and absenteeism costs
• Mid-term savings due to avoided hospitalizations thanks to the prevention of complications

For researchers

• Highly-valuable real-life database which will serve to optimize treatment recommendations


Current status and near-term perspectives

BETA test ongoing for T1 patients since H1 2009

Preparing the commercial launch for T1 patients

Completing the scientific evaluation of diabeo for T2 patients

Launching TELESAGE1 (large-scale cohort study)

Internationalizing diabeo (primary focus on Europe & USA)

Filing for reimbursement by health care payers

… Stay informed by contacting us at www.diabeo.com !


Thanks for your attention!

To contact us:

Géraud RABEONY Lydie CANIPEL
Sr Sales Managing Director
geraud.rabeony@voluntis.com direction@ceritd.com
www.voluntis.com

www.diabeo.com


diabeo usage data
120,00%
% of daily data entered by patients (glucose levels, carb counts, insulin doses) (n = 30)

100,00%

80,00%

60,00%

40,00%

20,00%

0,00%
1 3 5 7 9 11 13 15 17 19 21 23 25 27 29

Average filling rate = 96.9%, 22 out of 30 have a rate > 99,1%
No noticeable decrease of usage of the system over the 4 months of the study Source: Voluntis


Blood sugar control with diabeo

Mean glycaemic profile during the 1st month of study in the population

(n=35)
14.0

12.0
Blood glucose value (mmol/l)

10.0

8.0

6.0

4.0

2.0 Breakfast Lunch Dinner

0.0
FBG PP BG FBG PP BG FBG PP BG Nocturnal BG

(n=1072) (n=623) (n=992) (n=666) (n=1028) (n=642) (n=370)

Source: CERITD


Dietary freedom with diabeo

Source: CERITD

Patients ate the same mean amount of carbohydrates at lunch and dinner in half of the cases. The rest of the time, they modified the
number of 20g carbohydrate portions of their meal from 1 to 4 portions and even more.


Patient satisfaction with diabeo
« Regarding the general interest of the program, have you been… »
a - Très satisfait
4% 88%
8% patients
b - Assez satisfait

c - Peu satisfait
29%
59%
d - Pas du tout satisfait.

(vide)

« In routine, how long would you use the system ? »
a - Pour quelques mois seulement
6% 4% (apprentissage de l’IF par ex.)

b -Pour une durée indéterminée
(remplacement intégral du carnet
papier)
90%
(vide)

Source: enquête patients intermédiaire dans le cadre de l’étude TELEDIAB1 (N=49, données recueillies en novembre 2008)


Patients’ willingness to pay out-of-pocket for diabeo

« If this service was proposed for a fee, would you accept to suscribe to it? »

12% % patients répondant

Oui
29% Non
59% (vide)

50%
« In addition to the mobile phone and the 45% Between 10 and 15 €
GPRS data connections, we estimated the 40%
per month (78%)
cost of the service at around 15 € per 35%
month. 30%

What monthly fee would you be 25%
Sé
ready to pay for the services which 20%
15%
would include the use of the mobile
10%
software and its potential upgrades, the
5%
management of the web site and the 0%
periodic medical follow-up? » 0 10 15 20 25 30 (vide)
Euros

Source: enquête patients intermédiaire dans le cadre de l’étude TELEDIAB1 (N=49, données recueillies en novembre 2008)


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