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9th December 2011

IPhone application for Diabetes Type 2 (DT2) in the UK

Imperial College LondonAnkita ShroffLise RetatMalvika SethManvitha Chennuru Rahul Garhwal

DT2’ APP’

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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 6th 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

Executive Summary

Why Diabetes disease?

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- - 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.

TYPE 1:

10 %

TYPE 2:90%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]

Behavioural

risk factors

Metabolic 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

Other Risk Factors

Risk factors of diabetes Type 2

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Why an App?

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For government

For patients

Why an

App’

For Pharma

Company [PwC, 2011] “Pharma 2020: Supplying the future”

[Gainsbury, S, FT, 2011], “Government urged to rethink cost-cutting plans”

Why an App’ for future user?

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Apps are the way forwardAwareness

Disease Management

Health info

**SMS are not encrypted

Huge expected grow in use of smartphone

[McLean, 2011] [McLean, 2011]

(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.

Key Problems linked to any current Health Application?

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What are the current app’ for diabetes?

Easy Diabetes

Log For Life

Diabetes Log

Diabetes

_

Control

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

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.

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Solutions

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Easy Diabetes

Log For Life

Diabetes Log

DT2 in the UK!!!

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

Link via facebook to (3rd 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’

Behavioural

risk factors

Metabolic Risk Factors

Tobacco use

Harmful use of alcohol Unhealthy

diet

Physical Inactivity

Raised blood sugar

Raised blood

pressure

Raised blood lipids

Overweight and obesity

Other Risk Factors

Risk factors taken into account in DT2’app

Behavioural Risk Factors Metabolic Factors

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Tobacco use

Harmful use of alcohol

Unhealthy diet

Physical Inactivity

Disease

Awareness

Behavioural Risk Factors Metabolic Factors

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Disease

Awareness

Celebrity giving

feedbacks Medical news/articles

sent about diabetes

treatments

Daily quizzes

Medical news about behavioural

factors related to Diabetes

Cheryl Fergison – Diabetes UK supporter

Pubmed abstracts

Science abstracts

Forum

Blogs

Pubmed

Science

Forum

Blogs

Reward with free SMS

Disease Awareness

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Tobacco use

Harmful use of alcohol

Unhealthy diet

Physical Inactivity

Disease

Awareness

Behavioural Risk Factors Metabolic Factors

Health Monitoring

Find fitness related centres

Find fitness related centres

Find Health related centres

IMPERIAL COLLEGE LONDON

Ethos. Facilities of the place

1pm, Rock-climbing

6pm: Acqua-gym

2pm: Tai-Chi

Imperial College Dental and Health Centres:

Register

Register

Register

Take an appointment

Today Tomorrow This week-end

Healthy Restaurant:

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

I have side effect with my Insuline drug. Does anyone has this? Let’s meet!

Anyone up for a run ?

iCal

iCal

iCal

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Health Monitoring

Non -smoking

Area

Weight Area

Exercice Area

Health Monitoring

• Weekly / Monthly strategies

• 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

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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

Raised blood sugar

Raised blood

pressure

Raised blood lipids

Overweight and obesity

Behavioural Risk FactorsMetabolic Factors

Find Health related centres

Medication History Bookmarks

and Appoint-ments

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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

A log book that shows:

-Carbohydrate intake

-Carbohydrate correction,

-Displayed blood glucose level

-Bolus insulin dose

-Correction dose

-Basal insulin dose

-Ketones

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Future Platform

US imaging probe

i-steotoscope

Remote sensor for glucose

monitoring

New remote ways of

cigarette/ drugs intake

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Why the solution is innovative?

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Easy Diabetes

Log For Life

Diabetes Log

Diabetes

_

Control

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

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Benefits and impact from 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

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Challenges and constraints

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(1) Privacy and data security ==> solutions: encryption and Imperial College research projects

(2) Small screens.==> solution: high resolution

(3) Funding and incentives ==> IBM/Novartis

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9th December 2011

IPhone application for Diabetes Type 2 (DT2) in the UK or How the solution may be deployed

DT2’ APP’

DT2

APP

Awareness platform

Future platform

Full platform

Patient platform

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)

Short term implementation

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40000 £)

Westminster

How the App works ?

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Medical History

Health Monitoring

Find fitness related centres

Disease

Awareness

Challenges tackled

Find Health related centres

Find nearest use/patient/family related

centres

Medication History Bookmarks

and Appoint-ments

Hardware Platform

1) 9 Submenus

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Acknowledgments:Dominic King, Andreas Pamboris,Tayllit Aherdan, Alexis Biller, Navneet K Mahal, Chaturika Jayadewa