DIABETES MANAGEMENT FOR ALL PEOPLE WITH DIABETES

As part of our series of Case Studies for The HETT Show (www.hettshow.co.Uk) – we look at the rise of the Nipro Diagnostics company in Diabetes healthcare and ask, – from a standing start (with the new 4SURE portfolio), in just a few years, has their time come to be a major UK player?

For many people like you and I, the realisation that many people with diabetes do not have their condition out of choice, is a hard one to accept.  And yet its management requires a complex understanding.  

Let’s try and set the scene. In the last 10 years, the cost of treating Diabetes in the UK, has almost doubled. Looking at it another way – some 13% of all the NHS spending, is diabetes related. It is the largest slice of spending in the NHS cake.  And for type 2 diabetes there is no shortage of blame. Everything from the UK government’s lack of practical steps – through to you and I for eating the wrong food and an ever increasing sedentary lifestyle . 

Or maybe, there is no blame? Maybe, despite the fact that 10 years is a long time, and long enough to change both personal and NHS day-to-day processes, is it only now that we need to take a deeper look?

Is it therefore time? Time to reassess, and look again at what do we really need, now, to bring the diabetes epidemic under control and into the 21st century with technological advancements?

10 years ago, and with a Nipro global headcount of some 29,000 people – the NiproDIAGNOSTICS company was not a known player in the UK. Two years ago, they set out to furtherfocus their attention to help people living with Type 1 diabetes, by launching the 4SURE range of glucose meters and partnered with the revolutionary Diabetes:M App. With the aim of being the single one stop shop for every person requiring blood glucose monitoring, Nipro set about bringing into a needy market, a combined process that was affordable for the NHS, and easy to understand for you and I.

Tom Atkinson, Country Manager of Nipro Diagnostics UK, looks corporate cool – with a fashionable soft northern accent, dressed in an open white shirt, he leans into his screen and talks fluidly about his Insulin Pharma background, and the wish to be part of a complete solution. 

“What we understood from day one, was that we have to work the same way as our patients. They don’t want a meter that the NHS cannot afford; they want one with Bluetooth connectivity.And they want an App, which has got to be their Dashboard – everybody wants an App. Our big plus is that access to our new innovative technology, is obviously free, along with the Starter Pack from their diabetes clinic – which includes their initial consumables.”

We talk about the pandemic. It is an irony that, at a time when the NHS and health service provision has been desperate for so many – the essential acceptance overnight of remote diagnostics and monitoring by NHS nurses, has been a game changer for the better, for Nipro. 

“Clearly, we had not forecast a pandemic”, continues Tom, “but it was obvious that it was only a matter of time before common acceptance and a desire for remote diabetes monitoring. What has helped, is that our meters have an accuracy rate of 99.3%, and we are the fastest growing provider of diabetes solutions”.

The corporate ethos of a sales pitch is creeping into the discussion, and I don’t have a problem with that. What is equally evident is the pride of helping the ordinary person with diabetes, just being available, at the end of a phone line if a patient needs help or advice.  But that does not address the basic issue of human behavior. A diabetes meter can only be reactive to a patient’s condition.

Not necessarily. By giving the patient an affordable, information-driven, platform to manage their condition, patients themselves can change their lifestyles armed with the facts and see the benefits of their condition improving by relating to their life choices.

Tom interrupts; “yes, this is true – we are “part” of the solution – but for the patient, we are the major part – as it’s our technology they are using every day and we are the link between them and their own clinic or doctor, as we are providing the vital remote monitoring bridge to keep a patient in touch with their HCP so they can monitor their glucose levels remotely in real time and change their medication and other variables, there and then, if needs be”.

The focus of the discussion goes back to that of patient-provider relationship. “We don’t want diabetes to be the affliction for everyone – but we do want to provide the all-embracing solution for those that need it”. Tom looks at his watch. We have been engaged in academic discussion for nearly an hour, and it is Friday afternoon, end of July. He is taking his family on holiday. 

I closed my screen and take a moment of reflection. Innovation is not necessarily about technology. The patient also has a role to play. The Innovation at Nipro is the approach, taking the fear-factor, the newness, and combining it to tech that simply delivers, and communicating that to the person in the street.

CARE ON OUR OWN TERMS.

We look at how patients are becoming consumers and are driving the growth of virtual technology in healthcare.

One of the most relevant discussions for the future of UK healthcare, was not taken in any formal setting. My colleague was not visible on my Skype screen, and I was some 500 miles distant, sitting on my sofa, drinking tea.

It is an irony that is not lost on either of us. At a time when the key assumption of the benefit of the HIMSS  2018 Conference, is face to face interaction, my counterpart Kaveh Safavi of Accenture is eloquently discussing the essential benefits of his Presentation on virtual healthcare, that he made just a few hours earlier sitting in Barcelona; and I am nowhere to be found.

“Virtual healthcare” has taken over as the buzzword from the more difficult term “A.I”, which nobody could understand. And it is not before time. If the WHO is saying that by the year 2030, we will have a shortage of some 15 million healthcare professionals – the one thing we don’t need is to carry on putting in place more and more clinics, with longer and longer waiting times, for an ever increasing number of patients, with nursing staff that we do not have. Better option is first enabling our existing resources to work optimally.

We have reached a critical moment where the population (that’s you and I) – are increasingly comfortable using our smartphones, our Apple Watches, our connected meters, etc – to deliver our our health data to responsible health people who can manage this. But our health service providers are standing still in their acceptance that things have to change. And so, if this remote interaction works – and the technology exists to bring health data remotely into the distant screens – why is the rate of traction in Europe and certainly the UK – so slow?

The answer is many and varied, and it comes from not communicating the benefits – and also a myopic fear on the part of our providers, of losing their jobs or reducing their salaries. From experience of automation in the commercial sector, neither of those latter scenarios actually would take place.

So far, virtual healthcare has been limited in its explanation, to automatically registering a patient appointment – to go to a clinic, let’s say. But this misses the point. The real benefit is far deeper than that. If we associate virtual healthcare with long standing conditions, let’s say Diabetes for example – (where remote tech is now starting to get traction) – patients and providers will get the immediate benefit of more rapid diagnosis, more motivated and engaged patients, far less cost per patient in monitoring. And they need never visit a clinic at all. In some clinics, holograms have taken over from even seeing a real person.

In short – virtual healthcare is convenient. It also increases the “quality” of the service provided; Because sure if things are wrong and your data is untoward – only then do you go to your clinic, and your Nurse will have far more time to see you, and your discussion will already be personalised and entirely based on the health data you have already sent, in real time, through the very technology you are already wearing on your wrist. You will not be rushed out of the door.

I take a pause in my dialogue with Kaveh and glance at my Apple Health app on my watch – my heart is beating a bit quicker, apparently. I think I’ll take another cup of tea.

How to Manage Diabetes.

We look at the plethora of Diabetes “solutions” and focus on our best of breed.

The apparent growth in the market, so to say, of people suffering from Diabetes – has not been unnoticed by software and clinical solutions vendors – and yet it seems such a surprise, nonetheless. It is redolent of overnight pop-star successes, who have been quietly carving their career for the past decade, but without public recognition. Until now.

The question tho – is that, from among the vendors of solutions that are now visible – which ones will fly and which are merely good eggs?

The answer is not about clinical excellence. You can safely say that all diabetes solutions have their merits. The answer is about understanding their market, and having the gotomarket strategy and planning, to execute that strategy.

This is the forte of the RIMIDI company, whose CEO, Lucie Idea, talked to me a few evenings ago.

The RIMIDI solutions sits in the hospital itself, but can be accessed online.

Let’s start with the key points – there are two. RIMIDI is a clinical solution borne out of accidental observation. Lucie is a Doctor in her own right, but with a background in VC Finance. Having spotted the opportunity, it was a logical next step to create an App that focuses on the essential problem – how to get patients to monitor their own situation in an easy to do, way; and how to access and then use that info, in ways that can make a clinical difference – and therefore, a commercial difference for the hospital concerned. RIMIDI crosses the bridge from being a “clinical” data transfer solution – to one that empowers the Community. There is a strong and unique focus on “wellness”, joining up of the dots, for the clinician to see the Big Community Picture.

But more than that – RIMIDI focusses commercially on strategic alliances with the big EHR vendors (they have a white label agreement with Cerner) – as their means of getting bandwidth. This is astute – but also worrying. Whilst it avoids the need for the sales process – it also loses control. in many ways this recognition explains the presence at HIMSS. The Cerner collaboration gives implicit credibility in front of the myriad of individual hospitals that will pass by.

Ultimately RIMIDI success will come down to Lucie’s view as a pragmatist; her final words put it well” “RIMIDI is about saving time. Any solution can get information together. At RIMIDI, we make it possible to save time doing what every clinician needs to do, and what every Community needs to deliver.”.

The question will be, with Lucie’s VC background – will there be a buy-out in the next year or two? Or will RMIDI as a brand become a market leader, and saw a range of similar Apps? We hope it will be the latter.