1
Jennifer Shine Dyer M.D., M.P.HJennifer Shine Dyer M.D., M.P.H..Chief Medical AdvisorChief Medical Advisor
DuetHealth.com by eProximitiDuetHealth.com by eProximitiColumbus, OhioColumbus, Ohio
December 2011December 2011
Doctor-Patient Use Cases: Mobile Health and Diabetes
• Pediatric Endocrinologist
• Health Behavioralist (MPH)
• Problem-solving technology entrepreneur
• Social media enthusiast (@EndoGoddess)
Bolus Reminder App, 2010Bolus Reminder App, 2010• When: Fall 2010 (never
released in App Store)
• Who: Dyer teen patients with diabetes on insulin
• Why: Automate personalized weekly SMS texting protocol
• How: Master phone has app, patient phones SMS texting only
EndoGoddess App, 2011EndoGoddess App, 2011• When: September 2011, Apple
App Store
• Who: any patients with diabetes on insulin (teens, young adults)
• Why: motivate, educate, trigger behavior of checking glucoses 4X /day
• How: self-entry glucose journal, iTunes rewards, diabetes online community motivating quotes
Meal BolusMeal Bolus
Pump download, missed meal bolusesPump download, missed meal boluses
HypothesisHypothesis
• Weekly personalized and interactive engagement via texting with the physician will improve meal bolus mindfulness and reduce hgba1c % within 3 months (at next clinic visit) in teens with type 1 diabetes.
MethodsMethodsWeekly Texting Protocol (Thursdays at 5pm)Weekly Texting Protocol (Thursdays at 5pm)• Initial greeting message• Customized question unique to each patient’s
interests (how is your lacrosse team playing?, how did your finals go?, how is marching band?, did you have fun 4-wheeling last week?)
• Questions specific to diabetes adherence: glucose testing, meal boluses, frequency of high glucoses, frequency of low glucoses
• Conclusion message stating continuation of text messaging at regularly scheduled time
SubjectsSubjects
ResultsResults
External Internet Services: Facilitate initial programming, Facilitate operations ofExternal Internet Services: Facilitate initial programming, Facilitate operations ofSMS texting delivery and storageSMS texting delivery and storage
Nick
Jonas
Music
Also loves Frappuccinos.
Hey Nick! I’ve added you to my address book!
Cool. Thanks! Keep rockin’ Dr. Dyer.
Nick. Hope the carb counting is going well. I know u love Frappuccinos! :) February 24th
Keep on rocking the boluses, Nick! See you in a few weeks. March 3rd
What IsnWhat Isn’’t Working?...t Working?...
• Bolus adherence and glucose checks decreased over time
• Needed motivation
• Needed reminders
• Needed more support
What Isn’t Working: EngagementWhat Isn’t Working: Engagement
eproximiti.com duethealth.com
23
EndoGoddess App EndoGoddess App Hypothesis:Hypothesis:
• Target engagement behavior: glucose checks
• Motivating, educating, triggering this target behavior will lead to improved medication adherence
BJ Fogg’s Health Behavior BJ Fogg’s Health Behavior ModelModel
Literacy (ability)Literacy (ability)
Make the mobile phone give information at the right time:
• Online content without searching
• Frequently used links
• How-to videos
TriggerTrigger
Make the mobile phone DO SOMETHING at the right time:
• Send push notifications
• Add calendar events with alarms
• SMS
• CALL
• (Email)
MotivateMotivate
Make the patient WANT to take their medication:
• Utilize Game Mechanics
• Competition
• Social
SXSW InteractiveSXSW Interactive
Coding at EproximitiCoding at Eproximiti
Download from App StoreDownload from App Store
EndoGoddess App: JournalEndoGoddess App: Journal
EndoGoddess App: Motivation EndoGoddess App: Motivation
• iTunes rewards points
• Friends/family sponsorship
• Social: daily motivational quotes submission
Motivation from Support•iTunes account deposits
•Social Network supportPositive reinforcement from friends & family: Motivation + rewards
Social Business Model: Social Business Model: Using Peer & Family ReinforcementUsing Peer & Family Reinforcement
EndoGoddess App: TriggerEndoGoddess App: Trigger
EndoGoddess App: LiteracyEndoGoddess App: Literacy
Online Communities: DSMA Online Communities: DSMA
Social Networks: DiabetesSocial Networks: Diabetes
EndoGoddess App: Droid version in process…
How many diabetes apps are there?
«diabetes» OR «glucose» search oniTunes Norwegian Market
T Chomutare, et al. JMIR, 2011. http://www.jmir.org/2011/3/e65/
ResultsFeature Prevalence (%)
19/49 Apps Free
Mean Price = $4.00
Modal Price = $3.00
T Chomutare, et al. JMIR, 2011. http://www.jmir.org/2011/3/e65/
EndoGoddess App Future?EndoGoddess App Future?• EndoGoddess app RCT
• EndoGoddess Kids App with dog/cat motivation
• ?Partnership with medical device (glucometer)
• ?Partnership with pharma for test strips
• ?EMR partnership and integration
• ?Advertisements
endogoddess.blogspot.com/endogoddess.blogspot.com/
Top Related