Type 2 diabetes is becoming a global pandemic. Around 450 million people worldwide are currently diagnosed with diabetes. That number is set to escalate to over 600 million in the next few years. Diabetes is growing beyond scale.
Recently, Welkin’s CEO, Chase Hansel, participated in a panel discussion with other healthcare startup founders to address this issue. The panel included Christine Lemke, Co-Founder & President, Evidation Health; Divya Bhat, Head of Product, Virta; Chase Hansel, CEO, Welkin; and Sean Duffy, CEO, Co-Founder, Omada Health. Here’s what we can learn from the health tech innovators who are addressing scalable health care.
Watch the panel here.
Why do these numbers keep growing?
Sean Duffy, CEO and Co-Founder of Omada Health, shared his thoughts on what he calls “global sickening.” According to Duffy, type 2 diabetes is a massively complex disease that won’t be solved with one simple solution.
While obesity is a key issue contributing to the growth of diabetes, each person with diabetes has a wide variety of factors predisposing them to this disease.
There are multiple dimensions that affect diabetes treatment, including clinical and behavioral treatments. Health care often focuses on these two aspects but sometimes fails to recognize one of the most important facets in diabetes treatment—time. Diagnosing diabetes before complications emerge or helping patients use a prediabetes diagnosis as a catalyst for behavior change will be the best medicine for the chronic disease crisis.
The challenges facing those who address diabetes
Health care has primarily measured outcomes by cost. For Evidation Health, of which Christine Lemke is the President, the focus on finances and payers seemed disproportionate to the needs of patients. So Evidation Health started focusing on and gathering data about diabetes and its progression.
By tracking everything from billing trends to disease progression, they saw firsthand the complexity of the diabetes crisis. That’s when they decided they needed to gather data on specific patients so they could customize patient care.
What they learned is that a single approach may not address the variety of patient needs. As a result, Christine shared how Evidation synthesizes “unique patient data [putting] it together with clinical data in order to get the best context for [patients].”
How to help patients find motivators
According to Divya Bhat, Head of Product at Virta, “reversing one’s diabetes is a very powerful motivator.” For instance, when patients who haven’t had feeling in their feet start to regain foot sensitivity, motivation naturally increases. As personalized treatment increases, more patients will have this type of powerful experience.
Digital therapeutics is enabling this personalization since we can now collect and store more data on individual patients. This enables clinical teams to vary treatments based on the particular needs of the patient.
Ultimately, Virta wants to compile enough data from motivational factors, comorbidities and patient responses to create a system that will work for a wide group of patients. That’s what Virta believes is the future of diabetes care.
How to offer workflow support for clinicians
To facilitate a better understanding of workflow tools, Welkin’s CEO Chase Hensel shared a bit about Welkin’s learning curve. Welkin started like many other digital coaching programs. With good psychology and growing engagement, we did start to see improvement in patient outcomes.
“However, it seemed like lots of companies kept building the same digital experience without really improving workflow,” Chase said. “This is when we realized that we were focusing on data care and tooling when what clinicians really needed was a platform that facilitated patient relationship management.”
Rather than build a disease management program, Welkin created a relationship management program where care teams can maintain strong ties with patients to improve wellness.
What’s happening in modern health care?
What’s happening in global health care isn’t just about diabetes; it’s a modern health care problem. The healthcare system’s tools of the past aren’t meeting the needs of the present.
Health care needs to consistently innovate to ensure providers have the right tools to keep up with patient needs. With updated workflow tools, providers can ensure better oversight and help engage patients to address behavioral health needs.
Where is the value in this type of business model?
Chronic disease affects millions of Americans. Over one-third of Americans have metabolic syndrome and approximately 133 million have at least one chronic disease. To care for these populations effectively, providers need scalable solutions.
Workflow as value
Talking about workflow would’ve seemed strange to those in the health care profession not so long ago. But today, health care organizations are realizing that clinical teams and especially primary care teams need the right tools so they can care for increasingly high volumes of patients.
Though this is a different model, there is significant value and market potential from a venture capital perspective. Software that enables better clinical pathways saves time and money, generating more value than the cost of the software.
Efficiency as value
Employing and managing a workforce is costly. For most health care organizations, the most expensive part of scaling is the patient-facing staff. By making staff more efficient, health organizations can save valuable time and money.
The difficulty is building workflow software that caters to diverse preferences. Every workforce has variations in workflow. So the challenge in this kind of software is to build an architecture that allows for customized and personal work systems.
What’s been changing for digital health startups?
As a whole, digital health companies still face challenges due to the conservative approach many health organizations take. While there has been more acceptance of digital health companies, many organizations are still very careful about who they do business with.
Often startups have to get to a certain point in maturity before they’ll be accepted as reasonable partnerships. But to get to maturity startups need clients. This can be an uphill battle. But in the midst of these challenges, there are a few positive mindset shifts that have happened over the last few years.
For one, startups, even those in early stages and no matter their funding round, have access to a stronger toolkit and partnerships than in the past that increase the likelihood that investors will invest in them. So although digital health startups enter a very competitive, conservative environment, there are more resources and assets available to them.
One way to help your startup gain traction is to perform clinical trials and develop user success stories from that research. In addition, peer review journals can add credibility to products and services. This credibility helps digital health startups gain trust with other health organizations.
What business models work for digital health startups?
Digital health startups can use a variety of business models to successfully address the chronic disease crisis and sell to health care organizations.
Virta and Omada Health represent a fees-at-risk model. Though this model is relatively new, clients love it. In this model, billing is based on outcomes. However, this model won’t work for all businesses because of the need for data fluidity.
Welkin operates with a SaaS business model, meaning there are monthly fees for care providers who use the software. To offset risk averseness, Welkin has to first put the product in people’s hands and then let them experience the value.
Another model that doesn’t get as much attention is a fully integrated direct to consumer model. Startups using this approach don’t need to work with the health system first. Instead, they focus their efforts at patients directly.
How digital solutions can help health care reach diverse populations
There’s a wealth of research backing up behavioral science and its implications for health care. However, without a framework to build upon, this information isn’t all that useable.
Digital health has the ability to make data useful by identifying patients who could benefit from certain interventions. For instance, tech advancements are making it more feasible to pinpoint the social determinants of health that are hindering patient lifestyle change.
Consider a patient who has limited access to healthy food sources. In the case of diabetes patients, this has major implications. They may struggle to lose weight or change diet habits simply because of limited access to healthy food.
In this instance, digital platforms can make it much easier to notice and address these barriers to change. Care teams can help patients work to address social determinants of health at home via telehealth, wearables or mobile apps. Along the way, they’ll be able to better understand the patient and help patients adjust accordingly.
This is just one way that digital health can help achieve scale. The implications of digital health solutions have the potential to make a big difference in patient outcomes and clinician workflow.
How are consumer mindsets changing health care?
Across all industries, consumer expectations are changing. Take banking, for instance. When was the last time you interacted with a bank that didn’t have a way to deposit checks from your phone? Consumers wanted easier ways to bank, and banks responded with mobile technology.
Health care and health insurance, on the other hand, hasn’t been as quick to adjust to consumer expectations. Yet the winning care plans and providers will be the ones who’ve recognized that the world is drastically different from twenty years ago. More and more, meeting consumer expectations will be the way to outpace other health organizations.
Measuring outcomes and engaging patient populations
As always, data is a prime way to prove outcomes. As data is stratified and experiments are run, consumer behavior can be compiled and respond to. With this type of research backing up engagement hypotheses, digital health can rapidly build platforms to meet the proven need.
The goal in digital health is to build a platform or tool or where the user feels like it was custom built for them. This doesn’t happen overnight, though. It comes from a series of microdecisions made over a long period of time. In this way, health tech is creating infinite personalization options for the consumer which makes scalable health care possible.
Changes that would improve health care
Each panelist shared how they dream of health care changing. Duffy shared that his desire would be to increase interoperability. This one change would ease so many complications within HIT and health care organizations.
For Hansel, Welkin’s goal is to infuse personalization into design so that health care can become more scalable.
Bhat sees several conflicts of interest in health care that prevent the adoption of life-changing therapeutics. She’d like to see health organizations with incentives and goals more clearly aligned.
Lemke’s top concern is regulated use of patient data. If patients are going to feel safe sharing their data, they need to be reassured that it won’t be used against them. That’s why she’d like to see health care develop measures to protect against data misuse