MHGA slidedeck

Dr. Jen Dyer slides

What Isnt Working?...

Bolus adherence and glucose checks decreased over time
Needed reminders

Needed motivation Needed more support

EndoGoddess App Hypothesis:

Target engagement behavior: glucose checks Motivating, educating, triggering this target behavior will lead to improved medication adherence

BJ Foggs Health Behavior Model

Literacy (ability)
Make the mobile phone give information at the right time: Online content without searching Frequently used links How-to videos

Trigger
Make the mobile phone DO SOMETHING at the right time:

Send push notifications Add calendar events with alarms SMS CALL (Email)

Motivate
Make the patient WANT to take their medication: Utilize Game Mechanics Competition Social

What Isnt Working: Engagement

EndoGoddess App: Trigger

Subjects

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Results

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Nationwide Childrens Hospital, 7 physicians Academic year (6/1/08-5/31/09) 1,425 different patients with type 1 & type 2 diabetes 4,057 diabetes outpatient clinic visits Average of 200 diabetic patients per physician

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~175 inpatient admissions for DKA (involving ~70 different patients) ~80% related to nonadherence

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140 inpatient admissions for DKA related to nonadherence Average diabetes 3-5 day admission for DKA costs ~$10,000

Total costs of $1.4 million per year

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Reimbursement for texting overhead: - 3 cents per text - 7 texts per patient per week - 21 cents/patient/week - $42 per week per physician taking care of average 200 diabetic patients -~$11 per patient per year Reimbursement for physician time per week spent on texting: - 5% of clinical activity - 5% of salary - $10,000 per year - $200 per week - $1 per patient per week to physician taking care of average 200 diabetic patients for each texting encounter Total reimbursement (overhead + time): - ~$65 to physician per patient per year

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Potential savings: +$1.4 million per year

Reimbursement costs for 70 different patients: -$4,550 per year

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Nationwide Childrens Hospital, 2009

80% of hospitalizations due to insulin non-adherence

(140 total)

$10,000 each hospitalization $1.4 million total cost

Fifth Third Bank: Diabetes

21,000 employees
30 kids with type 1 diabetes 420 adults with diabetes on insulin

$450,000/year extra annual costs due to non-adherence

Adults with insulin-dependent diabetes (2% of total population) Kids with type 1 diabetes (0.15% of total population) 10% of those on insulin therapy will have hospitalization ($10000 each) due to non-adherence Sources: CDC, NIH, Fifth Third Annual Report

Competitive Analysis (US)

AgaMatrix iGlucose Glooko Telcare WellDoc EndoGoal

Data Management Device Connectivity Guidance

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Corporate Wellness

Adherence

Rewards

Definitions: How Apps Make Money

Subscription Model

Definitions: How Apps Make Money

In App Purchases

Definitions: How Apps Make Money

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