More Technology Patients Won’t Use

This morning, a major meter manufacturer announced that its blood glucose meterswill now operate on Microsoft's HealthVault. HealthVault is an online servicethat allows a patient to store and manage his health records without paying afee.

These records can then be shared with the patient's physician or healthcareteam.

As it stands today, nearly every glucose meter can download readings to softwareprovided by the manufacturer. By using other programs, a patient can downloadnot only his meter readings, but also his food intake, medications, exercise,and more. Presumably, the hope is that with all this information, the patient'shealthcare team can assist the patient in better managing his diabetes.

To me, this announcement is just another example of how everyone is fascinatedwith technology and fails to understand the realities of life with diabetes.First and foremost, these programs make the assumption that patients areactually checking their glucose levels. That's a false assumption: Most patientsrarely check their levels, and many don't check at all. Next, the programs addone more task to a patient's already demanding diabetes management. Whiledownloading information from a meter is not a complex task, it does requireeffort. To my knowledge, no meter has automated this task.

Even if you have a motivated patient who is willing to regularly check hisglucose levels and then download the results, that information by itselfprovides only a partial picture of what's going on. For the information to betruly useful, the patient must also record meal information, medications,exercise, and more. While this task is easier for an insulin pump patient, it'sdifficult to imagine a type 2 patient on oral medications recording all thisinformation and then entering it all into his computer.

Suppose you have a really motivated patient who checks his levels regularly,downloads readings, keeps a diary of everything he does, and then enters all theinformation into the software, ready to be shared with his healthcare team – Whatthen? Who will pay for the time it takes a physician to analyze the data andthen make recommendations?

And what about patient privacy? Everyone has heard of stories of hackersbreaking into systems and stealing credit card information. How does the patientknow that this very personal information is not being shared?

Let's assume that a patient goes through all this work and his healthcare teamprovides recommendations that could lead to improved outcomes. Will the patientssee any tangible benefits? Diabetes is not like a headache or a fever, where thepatient feels better after treatment. Getting a patient under control takes timeand effort. It is quite possible that even after all this intervention andadvice, the patient may not see any tangible results for months.

Instead of adding to the patient's workload with all this fancy technology, whynot provide patients with access to educational tools that they can use at theirown pace? While there are several studies that demonstrate the value ofeducating patients, I have yet to see one proving that fancy technology leads tobetter outcomes. In spite of this fact, glucose monitoring companies continue tocome out with these fancy systems that apply to a bare minority of patients.

The technological innovations that have actually increased sales are the onesthat have made checking glucose levels easier. A perfect example of this is theBayer meters, the Breeze and Contour, which do not require coding. Thisinnovation had a true impact on patients and actually made their lives easier.Although that is not the sole reason Bayer is gaining market share, it is acontributing factor. Perhaps the other players in the marketplace will learnfrom Bayer and begin to make the patient's life easier instead of adding totheir already demanding diabetes management regimens.

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