Shockingly, most diabetes patients never have the opportunity to speak with a provider or doctor about their disease. If they do, such encounters are usually for one or two brief sessions, to learn how to take their medication or modify their diet. Furthermore, when surveyed, what diabetic patients understand about their disease from glucose levels (known as the A1-C score) to identifying good foods from bad ones, is quite limited. Diabetes patients are also a unique group in that their disease presents an overwhelming reality, one that most diabetes patients donâ€™t really want to face. Many of these patients are not proactively engaging in self-management regimens. In fact, many will drop their prescribed treatment within the first six months of diagnosis. This paradigm overwhelms providers â€” from nurse practitioners to doctors to hospitals â€” and impacts insurance companies with increasingly costly financial liability.
â€śSelf-managementâ€ť is the term used in the healthcare industry to describe how patients manage conditions like diabetes. While ample information and education is available for diabetics to learn about self-care, less than 2% of eligible patients currently take advantage of this body of knowledge although 58% have attended some form of DSME â€” Diabetes self-management education. Medicare Part B (Medical Insurance) covers outpatient diabetes self-management training (DSMT) to teach patients to cope with and manage diabetes. It includes tips for eating healthy, being active, monitoring blood sugar, taking drugs, and reducing long-term risks from the disease.
Insurance companies are well aware of these statistics: only 18% of all insured people with diabetes account for 40% of the total costs per year, according to the American Diabetes Association. Clearly, encouraging appropriate self-management of this disease has social and economic benefits.
David Weingard, CEO of Fit4D, was diagnosed with type-1 diabetes at the age of 36, after feeling tired and sluggish. He was preparing to run a marathon, but between feeling tired and losing weight for no apparent reason, David went to see his doctor, only to learn that he was a type-1 diabetic. He was handed some brochures and walked away, alternating between disbelief and denial. Months later, with no real improvement in his symptoms, he met Cecelia, a Certified Diabetes Educator (CDE). A CDE is a licensed healthcare professional who has comprehensive knowledge and experience in diabetes prevention, treatment and management. It was the one-on-one care that Cecelia provided David, including weekly phone calls, text messages and in-person meetings, that began to make a difference in Davidâ€™s life as a diabetic.
David noted a problematic gap in diabetes care: lots of information and strategies were â€śout thereâ€ť, but most programs lacked a very significant component â€” that of a consistent human relationship. Without a guide helping them, it was very difficult for diabetic patients to create the real behavioral changes needed to manage a difficult disease.
David gave notice at Microsoft, where he had worked for many years, and started Fit4D, a diabetes coaching service that directly connects certified diabetes educators like Ceclia to patients. Fit4D offers personalized, one-on-one care to help empower patients to self-manage their disease. While this type of care is beginning to be offered by competitive diabetes startups, none have positioned the human relationship as the primary driver for a health technology company. Fit4D offers that crucial human connection as an essential part of its business model.
A recent article in Harvard Business Review titled â€śPutting Humans at the Center of Health Care Innovationâ€ť identifies human-centered care designs as an emerging trend in health tech companies. The article notes: â€śAn alternative emerging at healthcare institutions worldwide is human-centered design and co-creation, a set of approaches that can accelerate and humanize healthcare innovation. This model isnâ€™t just about getting greater patient feedback during the innovation process. Patients are co-designers, co-developers, and increasingly more responsible for their own and collective health outcomes.â€ť These concepts about the interaction of caregivers, advisors, educators and patients is at the very center of Fit4D. Their goal is helping patients managing their outcomes through the human relationship, scaled with technology.
Fit4Dâ€™s CDEs support their patients by coaching them through personal barriers and setbacks to adherence and health, using phone, email or text. Each participant receives coaching and a customized education program specific to their health and needs. Through multichannel interactions, the CDE focuses on helping each participant overcome various challenges to managing their diabetes. Sessions are designed to fit an individualâ€™s schedule, preferred methods of communication (e.g., text, email, or phone), and language with Spanish, English and Chinese dialects currently available.
Fit4D enrollment leads to lowered blood sugar levels among its clients, and delivers significant cost-savings and ROI. The company has earned a Platinum Overall Impact Business Model â€” the highest rating available from GIIRS, the Global Impact Investing Rating System. Fit4D is in the business of improving the health of diabetic patients throughout the United States through the â€śhuman touchâ€ť their model embodies. Their success is worth noting for new healthcare startups looking to find high-tech solutions to todayâ€™s biggest health issues. Sometimes, the best way to make a difference is to put people back into the equation.