Enara CEO Dr. Rami Bailony in response to new research questioning diabetes solutions.

Digital Health

Digital Diabetes Management in the Hot Seat

Digital diabetes management tools found themselves in the hot seat after a blistering study from the Peterson Health Technology Institute suggested that several leading solutions don’t provide significant clinical benefit, especially relative to their cost.

That conclusion naturally had many digital health advocates sharpening their pitchforks, but first let’s start by unpacking PHTI’s research and findings.

The analysis had two main endpoints: clinical effectiveness and economic impact. PHTI reviewed 1,100+ articles, including 120 submitted by the companies being evaluated, then offered ratings across three categories – remote patient monitoring, behavior / lifestyle modification, and nutritional ketosis. This chart summarizes the results beautifully.

• On the clinical side, PHTI found that these tools deliver small reductions in HbA1c (0.23 to 0.60 percentage points) compared to usual care, as well as limited long term durability of the improvements.

• On the economic side, PHTI concluded that each of the three product categories led to a net increase in spending, with total reimbursement and program investment exceeding any cost reduction from avoided care (the ketosis category carried an asterisk for its potential to cut costs over the long term).

Those findings led to plenty of blowback, including an excellent rebuttal from the Digital Therapeutics Alliance and a flurry of press releases from the companies in the report.

The DTx Alliance’s rebuttal centered around three primary issues:

• The limited selection of solutions overlooks a large portion of the diabetes tools on the market, and that it’s misleading to give generalized conclusions based on a small sample when many products can demonstrably improve clinical and economic outcomes.

• The report’s reliance on predictive models rather than actual cost studies overlooks real-world evidence, particularly concerning products like Dario, which has independent studies demonstrating reductions in both costs and hospitalizations.

• It might have made sense for PHTI to list any of the nation’s 9,000 endocrinologists (diabetes experts) as authors or advisors. It’s tough to beat their pointed suggestion: “Had there been expertise in this evaluation, they may have considered the broader scope of diabetes management like reductions in hypo- and hyperglycemic events, in addition to the reduction of A1C levels.”

The Takeaway

Embracing debate is essential if the industry wants to improve, and even if there was room for improvement in PHTI’s methodology, it definitely succeeded in its goal of refocusing attention on the clinical and economic impact of digital innovations.

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Lift MA Plan Performance by Impacting SDoH

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The Wire

• Change Makes Progress on Reboot: Change Healthcare is reportedly starting to work through its $14 billion+ medical claims backlog as it restores key software services knocked offline during last month’s cyberattack. Reuters also revealed that UnitedHealth Group has advanced a whopping $2.5 billion to providers, up from just $2 billion one week ago. This timeline from UHG shows when various products can expect to be restored, and it looks like we’re still a few weeks away from the finish line.

• GenAI Scandal Rocks Publishers: The academic publishing world is once again in the spotlight after new evidence surfaced that researchers are using generative AI models like ChatGPT to write papers. In multiple posts on Twitter/X, observers are sharing papers published in mainstream journals containing chatbot prompts that weren’t removed by authors despite making it through the peer-review process. Really makes you question peer-review when the chatbot prompt gets published as the first line of the introduction… 

• Tufts + Curai: Text-first virtual clinic Curai Health is partnering with Tufts Medicine to expand access to virtual care in Massachusetts and New Hampshire. Curai’s primary care team will be embedded within the MyTuftsMed patient portal app, allowing users to chat with a licensed clinician around the clock while getting seamlessly referred to Tuft physicians if any in-person care is needed after the virtual visit.

• Physician Market Overview: Michael Stratton at Health Data Atlas penned a fantastic overview of the physician market, diving into the size and affiliation of different practices while detailing the trends behind each of the numbers. If you’re marketing to providers and want a succinct look at the entire landscape, this is exactly what you’ve been searching for.

• Polychronic Patients Lean On Telehealth: In this study of 5,437 US adults with healthcare visits in 2022, many patients continued opting for telehealth even after in-person visits were available, regardless of education level, race, or income. While that alone speaks to the value of virtual care, the study also reinforced that it’s especially valuable to polychronic patients, with telemedicine use reported by over 50% of those with multiple chronic conditions (vs. 33% with no chronic conditions).

• Anima Series A: Care enablement startup Anima closed $12M in Series A funding to bring “Salesforce-like” capabilities to more clinics. Sprung out of Y Combinator in 2021, Anima’s software lets staff process and file healthcare documents in a “real-time multiplayer dashboard” that sounds a lot like Slack, while also eliminating the need for manual data entry by autonomously translating any handwritten files to digital summaries.

• Maternal Health Inequities: A Deloitte report based on a survey of 2,000 people who were pregnant in the last two years found that digital tools are a lifeline for many expectant mothers, although there’s still work to be done to ensure equitable outcomes. About 77% of respondents used digital tools to help with areas like mental health, appointment scheduling, and ovulation tracking, but Black respondents were over twice as likely as White respondents to say that these tools need to be more culturally informed (30% vs. 13%).

• Tennr Raises $18M: Document automation vendor Tennr raised $18M in a Series A round led by a16z, giving it extra ammunition in its war against the fax machine. Tennr sits on top of its clients’ existing EHRs to read and analyze incoming e-faxes before automatically entering any necessary follow-up items such as missing info requests or appointment scheduling.

• Prisma Links With Bamboo: South Carolina’s largest healthcare organization Prisma Health is implementing three solutions from Bamboo Health – as well as its inVio network of 5,500 physicians – to provide a more seamless transition for patients moving between care settings. The trio of Bamboo solutions include Pings (patient care alerts during transitions), Discharge Summaries (facilitates communication across different settings), and Spotlights (user-friendly analytics for key performance indicators).

• Healthcare Companies Ramp Up Benefits: Healthcare companies are continuing to ramp up their benefits to attract talent, bucking the trend seen in most other industries. A report from staffing site Adzuna found that tuition reimbursement and expanded parental leave were the most common benefits offered in healthcare jobs posted in February, with over 27k new listings including enhanced parental leave. Fertility benefits, onsite daycare, and adoption support were all flagged as less common benefits that can set healthcare employers apart.

• Masimo Spins Off Consumer Business: Masimo is getting ready to spin off its consumer business of personal health and audio products as it looks to establish a singular focus on its healthcare portfolio. Masimo said it expects the move to improve the bottom line of its core pulse oximetry, telehealth, and RPM solutions. The consumer spin off comes two years after Masimo acquired audio brand Sound United in a $1B transaction, and will also include products like the Freedom smartwatch and Stork baby monitor.

Patient-Centered Design for Diabetes Care

Glooko’s recently overhauled Mobile App makes it easier than ever for diabetes patients to organize, log, visualize, and share their data. Head over to this conversation with Glooko’s product and design team for a behind-the-scenes look at how patient-centered design is improving diabetes outcomes.

Unlock Revenue Potential in Payor Enrollment

Tune into Medallion’s Webinar on April 4 to delve into the intricacies of managing providers’ CAQH profiles during payor enrollment and learn the best practices to prevent any lapses. They’ll be walking through the end-to-end process, as well as the solutions that can help elevate your credentialing workflow.

Meet Nabla at Becker’s Annual Meeting

Nabla is heading to Becker’s Annual Meeting on April 8-11 in Chicago! Swing by Booth #515 to meet the team, watch Nabla Copilot in action, and discuss clinical leadership in changing times.