Telcare Blood Glucose Meter

Digital health management company Healthrageous is teaming with health insurer Highmark to test the latest iteration of its behavior modification program for type 2 diabetes.

Highmark is sponsoring a six-month trial that started in July at Acosta Sales and Marketing, a self-insured company in Jacksonville, Fla., for diabetes self-management using Healthrageous automated coaching technology tied to wireless glucometers. The plan is to follow newly updated recommendations from the American Diabetes Association and European Association for the Study of Diabetes that healthcare providers tailor diabetes care to each individual.

"We focus on the habits that contribute to obesity, and obesity and type 2 diabetes are closely linked," Healthrageous CEO Rick Lee tells MobiHealthNews.

Boston-based Healthrageous, a spinoff of Partners HealthCare's Center for Connected Health, is supplying selected Acosta employees with cellular-enabled blood-glucose monitors as part of the Healthrageous' existing relationship with Telcare. The vendor also draws data from wireless blood-pressure cuffs, weight scales and accelerometers.

This, according to Lee, is what differentiates Healthrageous from other technology companies in the realm of behavior modification and in disease management.

Healthrageous provides only the technology, since health plans already have plenty of what Lee calls "clinical assets" at their disposal, such as nurse case managers. Lee likes to think that his company fills the "chasm" between business-to-consumer and business-to-business approaches. Healthrageous collects, aggregates and analyzes data while following HIPAA privacy regulations. That, according to Lee, is something B2C companies often are not able to do.

"Unlike previous attempts [at disease management] throughout the years, this is a consumerized version, not a medicalized version," Lee says. In other words, the program coaches people on making lifestyle decisions, rather than providing medical advice such as reminders to take medications. "We feel like you really have to break down the medical jargon to get stickiness," Lee says.

And he believes that the system is "sticky" in that it keeps people engaged. Lee reports that 70 percent of patients managing hypertension with Healthrageous in an earlier trial stayed with it after three months. "You can have a greater impact by eating more healthfully, getting enough sleep, exercising regularly, quitting smoking, things like that," Lee explains.

One of the keys to holding user interest on the patient side and being effective from the payer perspective is the passive nature of wireless monitoring devices that continually collect and report data with little human effort necessary.

With this data, Healthrageous and its clients should be able to create personalized action plans for each participant, with specific, incentivized behavioral goals in mind. The Healthrageous platform also makes it easy for users to reorder blood-glucose test strips and other supplies, Lee says. On the back end, the system captures Healthcare Effectiveness Data and Information Set (HEDIS) measures for the payer to benchmark progress.

"It's those verifiable data points that inform the machine-learning engine," Lee says. For example, if someone's blood pressure is going up every day, the automated system starts asking the patient questions about sleep and exercise patterns until it identifies the likely culprit. "We're trying to learn by interacting with you on the one or two points that are exacerbating your condition," Lee explains.

After narrowing down the problem, the system will bring in social aspects, inviting family and friends to provide encouragement or facilitating competition between participants. This is another key differentiator, according to Lee.

Lee says that competition often plays better with male populations, while women tend to be more drawn by social aspects, though of course there are exceptions to these rules. "We are wholly committed to the idea that some things work for some people some of the time," Lee says., riffing on Abraham Lincoln's famous quip. "It's our job to figure out through these interactions what floats your boat," he adds.

"It becomes a virtuous cycle with a biofeedback loop."

The Highmark-Acosta pilot is scheduled to run through January. "Presumably, if we do well, we'll have an ongoing relationship with the health plan," Lee says.