Most mobile apps and wireless devices for diabetes patients have historically offered basic logging or tracking capabilities along with general health and lifestyle information. Newer “smart” apps and advanced Bluetooth-enabled diabetes devices are designed to appeal to a broader audience by providing more personalized functions and disease management support.
During Saturday afternoon’s symposium Online and Mobile Support—Wading through the Noise, three technology experts will discuss the potential benefits and concerns of these evolving technologies. The two-hour symposium will begin at 4:00 p.m. in room W304A-D.
Adam Brown, BS, will open the symposium with a look at trends in diabetes mobile apps, including some apps still in development. Brown, who was diagnosed with type 1 diabetes in 2001, is a Senior Editor at diaTribe.org and Head of Diabetes Technology & Digital Health at Close Concerns, a health care information firm exclusively focused on diabetes and obesity. He is also author of the book Bright Spots & Landmines: The Diabetes Guide I Wish Someone Had Handed Me.
“Although there are a lot of diabetes apps available where you can log all your data manually, these apps are difficult to use over a long period of time—manual logging is exhausting. For apps to truly see traction and drive outcomes, they must reduce burden and make life easier,” Brown said. “For example, we’ve been talking about Bluetooth-connected glucose meters for years now, but when you actually look at the data, less than 10 percent of people actually have a meter with Bluetooth in it—let alone using the app.”
Brown thinks technology adoption will rise as new generations of apps and connected devices bring more advanced capabilities and more personalized support to diabetes patients.
“We’re finally seeing apps that actually replace medical devices,” he said. “There are several continuous glucose monitoring apps available now that eliminate the need to carry a receiver around to view your real-time glucose values.”
Brown said that some apps currently being developed will function as a “personal diabetes assistant,” able to analyze data and provide personalized pattern recognition and insulin-dosing decision support.
“It’s exciting to see a whole new generation of apps that will sort through diabetes data and find hidden patterns that you wouldn’t recogize had you been looking at the data yourself,” he said. “These are the kinds of capabilities that are going to make life easier by providing decision support at key moments in time.”
David Fedele, PhD, Assistant Professor in the Department of Clinical and Health Psychology at the University of Florida, will also discuss the potential for mobile apps to function as disease self-management tools and he will also examine the challenge of getting people to use them.
“There’s a lot of interest in the health care community about how we can all work together to maximize this opportunity to develop apps or use technology to track behavior, promote medication adherence, and provide nutrition and lifestyle guidance to help improve health outcomes in patients with diabetes,” he said.
Personalization is the key, Dr. Fedele continued. Technology has evolved toward adaptive and more automatized apps that use personalized algorithms to provide feedback.
“The feedback we get from families in our own studies and reading through the literature is that the more personalized, meaningful, and valuable you can make it for a patient or a user, the more likely they are to use that piece of technology in the future,” Dr. Fedele said. “Apps that can give people recommendations, reminders, and guidance in terms of disease management that is specific to them are inherently complex and require quite a lot of work on the back end, but it’s an emerging area with a lot of opportunity moving forward.”
As the technology evolves and adoption becomes more widespread, privacy and security issues become a greater concern, according to David C. Klonoff, MD, FACP, FRCP (Edin), Medical Director of the Diabetes Research Institute at Mills-Peninsula Medical Center, Clinical Professor of Medicine at the University of California, San Francisco, Editor-in-Chief of the Journal of Diabetes Science and Technology, and President of the Diabetes Technology Society.
“Just like so many of the apps and devices we use today, these diabetes tools are part of the Internet of Things—they send information out to readers and various hubs and they also sometimes receive information, such as commands from a controller or smartphone,” Dr. Klonoff explained. “If a diabetes device, such as a continuous glucose monitor or an insulin pump, does not provide privacy and security, a number of problems can occur. From the privacy standpoint, it’s a transfer of protected personal health information, which could have legal implications.”
Dr. Klonoff said that patients and providers must demand that products meet certain privacy and security standards.
“It’s very hard to get information from the app developers or from the hardware manufacturers about the level of security and privacy they offer,” he said. “I’m working with a large team that includes representatives from government, organizations such as the ADA, the medical device industry, the mobile phone industry, and academia to set performance requirements and assurance requirements for security to ensure that these mobile apps and internet-connected devices are safe and secure for patients.”