Telcare's mobile diabetes management offerings

By Padma Naggapan

Three diabetes device companies, Glooko, AgaMatrix, and Telcare discussed their wares and approaches to the wireless-enabled diabetes management market during at panel at last week's WLSA Convergence event in San Diego.

Glooko is a Silicon Valley startup that enables diabetes patients to collect and view their glucose meter readings in a logbook on their smartphones or other devices like the iPod. The company's MeterSync Cable saves time and eliminates errors that may occur from manually entering the readings and is compatible with many glucose meters in the market. Glooko's Anita Mathew, vice president of business development, participated on the panel.

AgaMatrix offers a glucose meter that plugs right into the iPhone, which has received 510(k) clearance from the FDA and is marketed under the iBGStar brand name by Sanofi Aventis. Co-founder and CTO Sridhar Iyengar said the company went with the iPhone technology because of its popularity and the ease of its user interface.

Telcare offers a wireless device that can test and upload the glucose meter reading to an FDA and HIPAA-cleared cloud server without needing to use a smartphone or other device to transmit the data. Telcare's cloud server provides portal access to patients, physicians, and family members, while also relaying immediate coaching and feedback to the patient's glucose meter. The device is FDA approved and has insurance coverage for the meter and test strips. Javitt displayed a side-by-side comparison with Glooko and AgaMatrix and played up Telcare's approach to diabetes.

Javitt noted that while all three of the companies' approaches enable the user to sync data with a computer, Telcare's goes beyond creating connectivity to create actionable data that links patients, caregivers, and family members and guides them in what to do next to manage their diabetes. Telcare also has offered up a smartphone app that links to its cloud server that is free to download for anyone who wishes to download it.

"Our approach was to build a one-handed, universal solution where as everyone else in the world has a multi-handed non-universal method. Only 15 percent of diabetes patients have iPhones. With the Telcare device, you can get a complete feedback loop, that doesn't require you to own an iPhone or a separate glucose meter," Javitt said.

Panel moderator Stan Kachnowski asked Iyengar to respond to Javitt's claim, and he came back with a pithy response.

"We're in the Apple store."

Javitt said Telcare may get into an Apple store or a Best Buy some day, but right now it's talking to insurance companies which tell him that they want a comprehensive, easy to reimburse device and don't want to bother about which cell phones patients use.

"Our goal is simple -- to use wireless connectivity in a manner that enables people to better manage their disease and prevent complications. Unless we start connecting diabetes patients with caregivers, diabetes is going to eat the healthcare budget in the U.S soon," Javitt said.

Iyengar said that when his company broke up its demo groups according to socio-economic strata, it admittedly found that many people did not have iPhones, but to its surprise, a greater number from the lower economic group owned iPhones where as people from higher economic groups with multiple devices did not necessarily own the device.

"But providing finger tip access to all that data was of uniform value across groups," Iyengar said.

Glooko's Mathew echoed the thought, that providing easy access to the data in a way that could be trusted was important for the physicians and patients have gotten back to the company with the same thought, so it's looking to create a business standard in the space.

"We're looking at the marketplace to see what's the simplest thing we can do to allow patients to manage their own disease," Mathew said.

When it came to specific solutions that work well, she said users love the fact that Glooko enables syncing of all the data.

AgaMatrix found that users liked that its app uses a different color to highlight each reading, depending on whether it was taken in the morning, afternoon or evening, which enabled them to differentiate their readings according to the time of day.

Javitt distinguished what he believed to be the key advantages of Telcare's solution.

"Syncing is a great idea. What really helps people give up their legacy technology and do something new, is for a mom who has a diabetic child and calls the school nurse three times a day to ask for her child's reading, to suddenly be able to see that result on her phone, or look it up online."

Moderator Kachnowski pointed out that all three are companies that are pushing the envelope in this niche market. He asked them about institutional barriers they faced in advancing their solutions.

Iyengar said there was skepticism when it began several years ago, since the iPhone was still new, but it forged ahead with its choice. "We decided to overcome this by taking a gamble and felt that by the time we got there, the world would have caught up."

Javitt said Telcare faced enormous barriers, especially with the cost of the device and people were skeptical about a nearly $100 value for a glucose device. "Back then, most of the VCs looked at us with pity, but Qualcomm believed in us. Today, Telcare's technology has been adopted by insurers in six states."

Mathew said people will not invest unless they see the value of the data and what it means to them, so making it available at low cost is key.

As for the future, Javitt expects we will soon be seeing glucose devices that monitor levels constantly as opposed to a couple times a day. By the same token, we will also see continuous insulin delivery devices. "When you add to this a person who electronically monitors the situation, you're adding brains to the device in a transformative way."

Iyengar is looking at expanding to other devices aside from the iPhone, which represents a growth opportunity. "As we evolve, we'll leverage what phones themselves can do, so we can do more with them."

Mathew thinks having a feedback loop is key to the future. Increasing compliance to the testing regimen prescribed by the doctor will also depend on this connectivity and two-way interaction, which will help people better understand the value of the test.