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![Executive Summary | DT2 app’ focuses on diabetes in the UK. The benefits of this smartphone app’ are in the areas of diabetes prevention, management and ultimately improving healthcare delivery . Diabetes was chosen for the 2 reasons: First, it is expected to be the 6 th disease leading to death in 20 years [WHO, 2011] - 80% of which in emerging countries. Second, the current smartphone applications for diabetes are not complete . Finally, the UK was chosen to ease the process of implementation of DT2. The challenges for the current health and diabetes application: 1) “The CHIC survey stems from a March 2011 consumer survey showing that 26% of apps are downloaded and used only once. Of the people who confirm using their apps, 74% drop out by the 10th use. The same survey, however, also shows that 26% of smartphone applications retain consumer loyalty and are used repeatedly” . The solutions brought in the current app are the following: i) reward via free text ii) reward via healthy restaurant voucher iii) social reward (via meetings with other user) iv) nice interface of the application taken into account all the behavioural and metabolic risk factors in the same app with all the present and future ways of monitoring. Current diabetes applications are either missing the awareness platform or number of key quantifications. 2) Individual need are different from each other. Some want to know more about disease Other want to control and quantify the level of health. Consequently, DT2 has 2 interfaces: behavioural and metabolic risk factors . 3) Two pilot study needs to be carried out to test the attractiveness of the concept. i) At Imperial College (IC) The feasibility of this app’ will be tested at a very small scale in the vicinity of IC because it will be easy to implement a spirit of appartenance at that scale. The cost will be literally minimal, as the iphone app developer is free and a programme may be easily lauched to create an interface in the computer department. ii) In Chelsea and Westminster hospital, professional developers are needed (40 000 £ in the UK, possible outsourcing in India) The main cost will be linked with the rewards contract with strategic alliances](https://image.slidesharecdn.com/ncdchallengeic2011-111220045024-phpapp01/75/Ncd-challenge-ic_2011-2-2048.jpg)
![Why Diabetes disease? | - More than 346 million people worldwide have diabetes. - Total deaths from diabetes are projected to rise by more than 50% in the next 10 years Why Diabetes type 2? Type 2 accounts for around 90% of all diabetes worldwide . Cardiovascular disease is responsible for between 50% and 80% of deaths in people with diabetes. Why in the UK? The number of smartphone users in the UK is high. Current NHS revolution/evolution. [5% prevalence in the UK] Why Diabetes disease Type 2 in the UK? [WHO, 2011] [WHO, 2011] [Global mobile statistics, 2011] TYPE 1: 10 % TYPE 2: 90%](https://image.slidesharecdn.com/ncdchallengeic2011-111220045024-phpapp01/75/Ncd-challenge-ic_2011-3-2048.jpg)
![Why an App? | [PwC, 2011] “Pharma 2020: Supplying the future” [Gainsbury, S, FT, 2011], “Government urged to rethink cost-cutting plans” For government For patients Why an App’ For Pharma Company](https://image.slidesharecdn.com/ncdchallengeic2011-111220045024-phpapp01/75/Ncd-challenge-ic_2011-5-2048.jpg)
![Why an App’ for future user? | Apps are the way forward Awareness Disease Management Health info **SMS are not encrypted Huge expected grow in use of smartphone [McLean, 2011] [McLean, 2011]](https://image.slidesharecdn.com/ncdchallengeic2011-111220045024-phpapp01/75/Ncd-challenge-ic_2011-6-2048.jpg)
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Ncd challenge ic_2011
- 1. 9 th December 2011 | IPhone application for Diabetes Type 2 (DT2) in the UK Imperial College London Ankita Shroff Lise Retat Malvika Seth Manvitha Chennuru Rahul Garhwal DT2’ APP’
- 2. Executive Summary | DT2 app’ focuses on diabetes in the UK. The benefits of this smartphone app’ are in the areas of diabetes prevention, management and ultimately improving healthcare delivery . Diabetes was chosen for the 2 reasons: First, it is expected to be the 6 th disease leading to death in 20 years [WHO, 2011] - 80% of which in emerging countries. Second, the current smartphone applications for diabetes are not complete . Finally, the UK was chosen to ease the process of implementation of DT2. The challenges for the current health and diabetes application: 1) “The CHIC survey stems from a March 2011 consumer survey showing that 26% of apps are downloaded and used only once. Of the people who confirm using their apps, 74% drop out by the 10th use. The same survey, however, also shows that 26% of smartphone applications retain consumer loyalty and are used repeatedly” . The solutions brought in the current app are the following: i) reward via free text ii) reward via healthy restaurant voucher iii) social reward (via meetings with other user) iv) nice interface of the application taken into account all the behavioural and metabolic risk factors in the same app with all the present and future ways of monitoring. Current diabetes applications are either missing the awareness platform or number of key quantifications. 2) Individual need are different from each other. Some want to know more about disease Other want to control and quantify the level of health. Consequently, DT2 has 2 interfaces: behavioural and metabolic risk factors . 3) Two pilot study needs to be carried out to test the attractiveness of the concept. i) At Imperial College (IC) The feasibility of this app’ will be tested at a very small scale in the vicinity of IC because it will be easy to implement a spirit of appartenance at that scale. The cost will be literally minimal, as the iphone app developer is free and a programme may be easily lauched to create an interface in the computer department. ii) In Chelsea and Westminster hospital, professional developers are needed (40 000 £ in the UK, possible outsourcing in India) The main cost will be linked with the rewards contract with strategic alliances
- 3. Why Diabetes disease? | - More than 346 million people worldwide have diabetes. - Total deaths from diabetes are projected to rise by more than 50% in the next 10 years Why Diabetes type 2? Type 2 accounts for around 90% of all diabetes worldwide . Cardiovascular disease is responsible for between 50% and 80% of deaths in people with diabetes. Why in the UK? The number of smartphone users in the UK is high. Current NHS revolution/evolution. [5% prevalence in the UK] Why Diabetes disease Type 2 in the UK? [WHO, 2011] [WHO, 2011] [Global mobile statistics, 2011] TYPE 1: 10 % TYPE 2: 90%
- 4. Risk factors ofdiabetes Type 2 Metabolic Risk Factors Other Risk Factors | Behavioural risk factors Tobacco use Harmful use of alcohol Unhealthy diet Physical Inactivity Raised blood sugar Raised blood pressure Raised blood lipids Overweight and obesity Poverty and low education status Advancing age Gender Genetic indisposition Psychological factors
- 5. Why an App? | [PwC, 2011] “Pharma 2020: Supplying the future” [Gainsbury, S, FT, 2011], “Government urged to rethink cost-cutting plans” For government For patients Why an App’ For Pharma Company
- 6. Why an App’for future user? | Apps are the way forward Awareness Disease Management Health info **SMS are not encrypted Huge expected grow in use of smartphone [McLean, 2011] [McLean, 2011]
- 7. Key Problems linkedto any current Health Application? | (1) Although penetration of smartphone use is increasing health apps have to have sustaining value to patients and be easy to use. This means that more pounds are needed to ensure the apps stay up to date and are available for the variety of smartphone platforms. (2) Do not lump all disease states with this data. People respond differently to different types of health conditions; some are open to getting tips and helping them manage their health condition while for others a reminder is not welcome because it reminds them they have a health problem. (3) Marketers need to test applications with patients/target audience before releasing them to the public. This means usability studies with patients. (4) Application healthcare marketing is a long term commitment thus you need to choose a vendor who can form a strategic alliance with your company and help you develop and update your apps for the long term.
- 8. What are thecurrent app’ for diabetes? Diabetes _ Control In 2006, the daily SMBG (self-monitoring of blood glucose) rate was 63.4% among all adults with diabetes and 86.7% among those treated with insulin. Collaborations to ensure adequate health insurance coverage, diabetes education and counseling to encourage more intensive medical care and self-management practices, and continued surveillance measures to track changes in SMBG rates are needed to improve and monitor SMBG trends. However there is a fine line between informing and being intrusive. | Easy Diabetes Log For Life Diabetes Log Type2 Friendly Diabetes Diary Blood Glucose (Sugar) Tracker Gluco Sentinel Diabetic Meal Planner Lite Carbohydrate Intake Blood Glucose Level Bolus Insulin Dose Basal Insulin Dose Weight Healthy Restaurant Exercice Food Intake Medications
- 9. Solutions | | DT2 in the UK!!! Link via facebook to (3 rd most downoaded app) Not fully implemented yet Not fully implemented yet Not fully implemented yet in diabetes apps Not implemented yet in a diabetes app ’ Games required to attract UK Required to attract UK- but small feasibility King of mobile communication King of mobile communication Not fully implemented yet in current diabetes apps Not implemented yet in a diabetes app ’ Easy Diabetes Log For Life Diabetes Log Type2 Friendly Diabetes Diary Blood Glucose (Sugar) Tracker Gluco Sentinel Diabetic Meal Planner Lite Carbohydrate Intake Carbohydrate Correction Blood Glucose Level Bolus Insulin Dose Basal Insulin Dose Ketones Weight Cigarettes Healthy Restaurant Fitness centres User interface Medical news for diabetes Exercice Quizzes Celebrity SMS for remembering the insulin SMS when glucose level too low Food Intake Medications Social Platform
- 10. Risk factors takeninto account in DT2’app Metabolic Risk Factors Other Risk Factors | Behavioural risk factors Tobacco use Harmful use of alcohol Unhealthy diet Physical Inactivity Raised blood sugar Raised blood pressure Raised blood lipids Overweight and obesity Behavioural Risk Factors Metabolic Factors
- 11. | Tobacco use Harmful use of alcohol Unhealthy diet Physical Inactivity Disease Awareness Behavioural Risk Factors Metabolic Factors
- 12. | Cheryl Fergison – Diabetes UK supporter Pubmed abstracts Science abstracts Forum Blogs Pubmed Science Forum Blogs Reward with free SMS Disease Awareness Celebrity giving feedbacks Medical news/articles sent about diabetes treatments Daily quizzes Medical news about behavioural factors related to Diabetes Disease Awareness
- 13. | Tobacco use Harmful use of alcohol Unhealthy diet Physical Inactivity Disease Awareness Behavioural Risk Factors Metabolic Factors Health Monitoring Find fitness related centres
- 14. IMPERIAL COLLEGE LONDONEthos . Facilities of the place 1pm, Rock-climbing 6pm: Acqua-gym 2pm: Tai-Chi Imperial College Dental and Health Centres : Healthy Restaurant: I have side effect with my Insuline drug. Does anyone has this? Let’s meet! Anyone up for a run ? | Find fitness related centres Find Health related centres Register Register Register Take an appointment Today Tomorrow This week-end Take an appointment Rating from Diab’app Rating Like Rating Like Rating from Diab’app Find fitness related centres Find Health related centres Fitness and Health Centres iCal iCal iCal
- 15. Weekly / Monthlystrategies Enter date and weight Food intake (1000 products) See your weight over time Reward Weekly / Monthly strategies Enter date and number of cigarettes or the date since last cigarette/ Award See your money saved over time and what it is the equivalent to (ipad,..) Monitoring of the miles distance walked/ ran Monitoring of the time spend on exercising | Health Monitoring Non -smoking Area Weight Area Exercice Area Health Monitoring
- 16. | Tobacco use Harmful use of alcohol Unhealthy diet Physical Inactivity Disease Awareness Behavioural Risk Factors Metabolic Factors Health Monitoring Find fitness related centres Find healthy restaurants
- 17. | Raised blood sugar Raised blood pressure Raised blood lipids Overweight and obesity Behavioural Risk Factors Metabolic Factors Find Health related centres Medication History Bookmarks and Appoint-ments
- 18. A log bookthat shows: Carbohydrate intake Carbohydrate correction, Displayed blood glucose level Bolus insulin dose Correction dose Basal insulin dose Ketones | Medication History Prescriptions List of branded and generics drugs taken Contact GPs/ Pharmacist SMS and alarms to remind to take insulin as well as when the glucose level is too low
- 19. | Future Platform US imaging probe i-steotoscope Remote sensor for glucose monitoring New remote ways of cigarette/ drugs intake
- 20. Why the solutionis innovative? | Diabetes _ Control | Easy Diabetes Log For Life Diabetes Log Type2 Friendly Diabetes Diary Blood Glucose (Sugar) Tracker Gluco Sentinel Diabetic Meal Planner Lite Carbohydrate Intake Carbohydrate Correction Blood Glucose Level Bolus Insulin Dose Basal Insulin Dose Ketones Weight Cigarettes Healthy Restaurant Fitness centres User interface Medical news for diabetes Exercice Quizzes Celebrity SMS for remembering the insulin SMS when glucose level too low Food Intake Medications Social Platform
- 21. Benefits and impactfrom the solution Our solution provides easy and small Steps towards Big Rewards. Improved quality of life (experienced by the patient), Long term cost savings from avoided complications and reduced health care service use (experienced by the plan, its providers, and potentially employers) Workplace productivity gains (experienced by patients and their employers). Saves Patients Time and Money, yet Providing Better Diabetes Care Lifestyle change tool so people who are at risk can put them to use in their every day lives and have a healthier life Improve care processes, delay diabetes complications, and save health care million of dollars thanks to the solution Helps individuals to be fit and avoid future complications |
- 22. Challenges and constraints | | (1) Privacy and data security ==> solutions: encryption and Imperial College research projects (2) Small screens.==> solution: high resolution (3) Funding and incentives ==> IBM/Novartis
- 23. 9 th December 2011 | IPhone application for Diabetes Type 2 (DT2) in the UK or How the solution may be deployed DT2’ APP’ | IMPERIAL COLLEGE PILOT STUDY (free/ 6 months) Waiting for commercialisation CHELSEA AND WESTMINSTER HOSPITAL (free/ 9 months) SUPPORT FROM IBM/NOVARTIS (40000£ for finishing developing/marketing/ specialist for choosing relevant articles) DT2 APP Awareness platform Future platform Full platform Patient platform
- 24. Short term implementation | 40000 £) Westminster
- 25. How the Appworks ? | Challenges tackled 9 Submenus Medical History Health Monitoring Find fitness related centres Disease Awareness Find Health related centres Find nearest use/patient/family related centres Medication History Bookmarks and Appoint-ments Hardware Platform
- 26. | Acknowledgments: Dominic King, Andreas Pamboris, Tayllit Aherdan, Alexis Biller, Navneet K Mahal, Chaturika Jayadewa
Editor's Notes
- #23 Current privacy and security standards for mobile technology are not sufficiently robust :Furthermore, existing health privacy and security laws, such as the requirements under the Health Insurance Portability and Accountability Act (HIPAA), may not adequately address data collected, stored, and shared by mobile apps Since the eligibility process requires the downloading of large amounts of data, use of these services could be cost-prohibitive for some applicants, depending on their data plan. Working with developers and telecommunication service providers to minimize such cost barriers will help to maximize the impact of these tools. The screen on many mobile devices is small. In developing Websites and Internet portals for health benefits, federal and state agencies and their contractors should consider developing versions that are optimized for smaller, lower resolution screens. For instance, the new federal Web portal (http://healthcare.gov) is not optimized for small screens, though it is intended to be a key consumer resource about health insurance opportunities going forward. To make this technology most useful for low-income individuals and families, steps to ensure that consumers bear little to no cost when using the full range of available mobile technology tools in the eligibility process will be important. Public-private funding partnerships among insurance programs, financial institutions, and the mobile industry could help mitigate some of the costs for the consumer. Consumer input . Consistent with ACA’s goal of delivering a superior customer experience, consumer input will be valuable as devices and new applications are created and adapted for use in enrollment, renewal and other health coverage-related functions. Consumer-friendly tools that take into account health literacy and cultural competency considerations and the needs of people with disabilities can help increase the coverage impact of this technology. Pre-implementation testing will be important to make sure that these tools are usable and work for the underserved populations that stand to benefit most.