If you search for “diabetes technology” on the web, you'll find a lot of information about gizmos that make daily life easier for people with type 1 diabetes -- i.e. insulin pumps, Artificial Pancreas tech, and the Apple Watch beaming data from continuous glucose monitors.
But not much attention is paid to equally exciting technology that is tackling a daunting public health challenge: too many economically disadvantaged people with diabetes (PWDs) -- especially those of color -- aren’t being screened or effectively treated for a host of health problems. That’s a key reason why racial and ethnic minority populations, which are disproportionately low-income, have a higher risk of diabetes complications.
So it’s good news that the American Diabetes Association (ADA) recently acknowledged companies that are addressing those health disparities. In its second-annual “Diabetes Innovation Venture Challenge” last year, the ADA sought to "identify emerging, innovative solutions for improved diabetes prevention and management." This challenge has historically offered a grand prize of $10,000 and "favorable introductions" to ADA sponsors and partners who can help accelerate commercialization of the winning ideas.
Of the six finalists announced in Fall 2017, four were tech-startups focusing on complications and/or disease management in underserved populations. Here's a look at three companies we thought were especially compelling.
EyeLogic: Retinopathy Screening, via Smartphone
This year's grand prize winner was California startup EyeLogic, which is developing an app for instant, smartphone-based detection of eye disease. It offers results within seconds, using a low-cost iPhone ophthalmoscope attachment with 97% accurate artificial intelligence.
Using smartphone technology to simplify and reduce the cost of screening for retinopathy is hugely important, because only about 30% of PWDs get the recommended annual screening for that eye complication; and those with low incomes are much less likely to be screened than others.
One of the founders behind EyeLogic is actually a teen from Saratoga, CA, named Rishab Gargeya, who developed the idea while in high school (!). The San Jose Mercury News reported that he previously won a $50,000 Davidson Fellows Scholarship for this creation, and he'll be using the money for his education in computer science at Stanford University.
"The teen’s work circumvents the need for a clinician by creating an automated smartphone-based application that can detect any symptomatic pathology in the retina from a retinal scan. This allows users to accurately monitor their own vision and seek out medical attention accordingly," the newspaper states.
Along with Gargeya, the other two founders are eye specialists Dr. Theodore Leng and Dr. Ankur Gupta.
This isn't a completely novel concept, as others have looked at using smartphones for eye health exams and screening, from the "iExaminer" to "D-Eye" and the "CellScope Retina" device. EyeLogic seems to be different because it's extremely affordable and accessible, with the potential to reach underserved populations that lack access to screening for retinopathy.
Let’s hope this will be a huge benefit for PWDs who too often fall through the cracks on eye health!
NowPow: Customized Health Referrals
Chicago-based NowPow was recognized for its work using a digital platform to help people in urban populations find specialists for a wide range of health problems -- including diabetes complications -- and other important resources, such as healthy food pantries, exercise and yoga programs, mold abatement, pest control services and more.
Launched in 2015 and now working with 25 health systems in Chicago and five other cities, NowPow creates detailed inventories of available, local community resources. That information is integrated into 43 so-called “condition algorithms,” which identify what patients with specific health conditions might need when they come home from a doctor’s office or hospital.
The NowPow system creates a so-called “HeatheRx” for each patient, listing resources near their homes that are a good match based on their age, gender, preferred language, and other factors. When patients receive the information, they can either reach out on their own immediately, or opt to receive different nudges and reminders to encourage them to take advantage of available resources.
All of this helped a 49-year-old African-American man who received care from Friend Family Health Center on Chicago’s South Side. His medical history, according to a “care coordinator” from the Center, included “uncontrolled” type 1 diabetes, hypertension, arthritis, an operation to remove a rectal tumor, anxiety and complaints of hip and foot pain from diabetes.
After NowPow helped him find a podiatrist, food pantry, and fitness class near his home, he “reported the resources were really useful, especially the healthy offerings at the food pantry.”
NowPow’s approach and many of its algorithms were developed by the company founder, Dr. Stacy Lindau of the University of Chicago. When it comes to those “on the wrong side of health disparities," she told me, “some of the most critical sectors required to meet people’s needs remain in the pencil-and-paper economy. Human and social services remain off the grid, and we need solutions that bring us into the 21st century.”
Couldn’t agree more.
Kaizen Health: Web-Based Medical Transport
Of course, not everyone can find healthcare providers close to home. What if someone needs medical help but can’t get it because they don’t have access to transportation?
That's a question that competition finalist Kaizen Health is addressing. They've developed a web-based platform to coordinate a diverse fleet of vehicles as medical transportation for people in need. Borrowing a page from Uber and Lyft, they provide an information hub that links patients, health care providers, insurers, and transportation companies.
The startup's founder and CEO, Mindi Knebel, tells the story of “Greg,” a 64-year-old jobless person with diabetes in Chicago who has no access to a car and lives far from a train line. As a result, he often didn’t show up for medical check-ups. It was the main reason why his neuropathy wasn’t diagnosed in time and two of his toes had to be amputated.
That’s inexcusable. So is the fact that about 3.6 million Americans either delay or don’t go to medical appointments because they can’t get a ride, Knebel says.
Kaizen Health wants to change that. Its customers are health systems that usually pay the initial cost of the rides. While there are other medical transportation brokers out there, Kaizen says they mostly rely on a process that is “riddled with pencils and paper and fax machines, and it takes two days to get a ride.” It takes people using Kaizen’s system about two hours.
They provided their first rides in December 2016, now have contracts with 10 health systems in the Chicago area and are planning to expand to New York City and Florida soon.
Time to Close Healthcare Gaps
Clearly, PWDs aren’t the only the beneficiaries of these innovations. But technology that brings better prevention and treatment services to underserved populations is especially important to those with diabetes.
As the ADA puts it, “some communities are affected more severely (disparately impacted) by diabetes but do not receive a commensurate share of diabetes research, treatment and education.”
The ADA deserves credit for giving visibility to companies that are setting their sites on helping these communities.