Prof. Dr. med. habil. Peter Schwarz

Department for Prevention and Care

University Hospital „Carl Gustav Carus“ Dresden

Chairmen „Diabetes Prevention“ German Diabetes Association

Telemedicine and diabetes

management

1. Type 2 diabetes and its cardiovascular complications are becoming

more prevalent throughout the world.

2. The conditions and risk factors that precede type 2 diabetes have also

increased substantially. These risk factors are well-known: obesity,

central adiposity, physical inactivity and unhealthy diet.

3. At the time of diagnosis and the longer that diabetes exists, disease

complications are more likely – mostly CVD.

4. Prevention is the key: modifiable risk factors need to be addressed

through effective interventions

5. Prevention of type 2 diabetes is effective and needs management

TIME to ACT - alarming facts

16.03.2010

It includes 4 regional districts and 1 district capital – the city of Dresden.

Carus Consilium Sachsen (CCS) - geographic area

Aged population 2006

with prospective development 2020

- 7.0

35.9

47.3

- 10,0

-

10,0

20,0

30,0

40,0

50,0

60,0

Ratio of the elderly

Population 65+ years

of age compared to

18 to <65 years of age

jeweilige Bevölkerungsveränderung in %

Altenquotient

Altenquotient 2020

Quelle: Statistisches Landesamt Sachsen

Overall population

Aged population

Aged population 2020

Challenge The patient with diabetes

• Chronic disease with stigmatization

• Patients in all age groups with the nadir in middle age

• Quality of treatment depends on physician - patient interaction

• 45% of the patient have depressive symptoms

• Self Monitoring of blood glucose is the main step of diabetes treatment

• Documentation is integral part of self-management

• Compliance for documentation is the key in diabetes treatment

• Extremely costly diseases due to treatment and complications

Overview of the current way of Diabetes Management

Diabetes Management - GlucoTel one possible Answer

• Current system involves patient manually recording results in a log book or via manual down- and uploading procedures

• Reviews of this data with a caregiver is only done periodically (generally every 3 months)

• Patients are routinely poorly or non-compliant and results are not recorded accurately resulting in poor monitoring of disease and potential mis-diagnosis

• Any deficiencies in a patient’s treatment can only be spotted by the caregiver at long intervals

The Problems The Solution

GlucoTel has the potential to significantly reduceoverall healthcare costs for diabetes treatment

• Removes requirement for patient to manually record and transfer measured values

• Caregivers, granted access by the patient, can monitor values anytime online and deficiencies in treatment can be spotted in ‘real-time’

• Closes the gap between the patient and the caregiver offering better disease management for the patient and better quality of care for the caregiver

• Payers will have the option to monitor non-compliant patients and might consider potential solutions to this costly problem

Blood Glucose Meter

GlucoTel | Blood Glucose Monitoring and Diabetes Management System

• Real-time transmissions

• Bluetooth enabled meter

• Wireless transmission to

mobile phone

• Mobile phone automatically

transfers test result to

patient online log book

Diabetes Telemonitoring & Management System

Online Disease Management - www.bodytel.com

Internet platform that is accessible via normal internet browser and contains:

• Secure Patient Data CenterReal-time, CE Approved and FDA conform, HIPAA compliant, hosted by third-party with double redundancy

•Alert ManagerEnables caregivers to set up thresholds and alerts Web 2.0 Module (Instant Messaging, Email), Legacy Module (Text Message, Fax, etc.)

•Access Managerfor administrating access rights to caregivers

•Web ShopSubscription manager (automatic. supply with goods [e.g. test strips]) for all BT products and special 3rd party products

•OEM Interfacefor third party sensors

•eHealth InterfaceHL7 electronic, patient record e.g. into the Google healthcare record

• In the medium term, the BodyTel Center will seek to become a ‘one stop shop’ for patients with diabetes with numerous add-on options including:

– Ability to order diabetes focused books on cooking, disease management, lifestyle, etc.– Access to information on diabetes for newly diagnosed patients including online blogs, etc.– Ability to attract third-party diabetes relevant

advertising

Care Study to test the effect of Telemedicine

16.03.2010 11Prof. P. Schwarz,

1. Critical analysis of the telemedicine need

and the compliance situation of the patient

in real health care

2. Baseline analysis of the treatment status

and possible telemedicine adherence

3. Every 6 month standardized survey with

up to 4000 patients about the added

value of diabetes telemedicine (GlucoTel)

application and treatment effect

4. Identification of barrier to telemedicine in

real clinical care of diabetes patient

5. Development of an telemedicine medical

management for diabetes patients in real

health care

893 patients included

Advantage for patients and disease management

• GlucoTel changes and eases the live of diabetics

no written diary anymore; Glucose values immediately available to caretakers, etc.)

• Telemedicine can offer more convenient services to the patient

Patients receives service than stigmatization

• The patients do what they do and receive more quality service

• Telemedicine changes behavior do to perceived supervision

my doctors know my glucose value in the same moment

• Telemedicine helps reducing costs to the Social Security System

Pay per test and quality management

• Telemedicine (GlucoTel) is able as a tool to build customer satisfaction

• Telemedicine (GlucoTel) provides the missing link

National Health

insurance

(reimbursement)

National

Diabetes Plan

City planning

(reimbursement)

Tax incentive in

private sector

for screening

Community

based primary

prevention

programs

Environmental

programs for

exercise

Physician

education

Work side risk

reduction small

and big

business

Secondary

prevention

programs

Community

screening

programs

Intervention

manager

education

Targeted

intervention in

high risk groups

Quality

management

intervention

Guidelines for

diabetes

prevention EB

and practice

Health lifestyle

education at

school

Management

structures for

intervention

programs

Easy healthy

food choices in

daily life

Perrsonal

feedback about

progress

Easy to understand

intervention material

(minorities, social

groups)

State

Community

Intervention

structures

Personal

Necessary strategies for intervention for a new public-

health approach to diabetes prevention

MY benefit

from prevention

National Health

insurance

(reimbursement)

National

Diabetes Plan

City planning

(reimbursement)

Tax incentive in

private sector

for screening

Community

based primary

prevention

programs

Environmental

programs for

exercise

Physician

education

Work side risk

reduction small

and big

business

Secondary

prevention

programs

Community

screening

programs

Intervention

manager

education

Targeted

intervention in

high risk groups

Quality

management

intervention

Guidelines for

diabetes

prevention EB

and practice

Health lifestyle

education at

school

Management

structures for

intervention

programs

Easy healthy

food choices in

daily life

Perrsonal

feedback about

progress

Easy to understand

interventionmaterial

(minorities, social

groups)

State

Community

Intervention

structures

PersonalMY benefit

from prevention

Necessary strategies for intervention for a new public-

health approach to diabetes prevention

Development and Implementation of a European Guideline

and Training Standards for Diabetes Prevention

www.activeindiabetesprevention.com

Network

who are active in

diabetes prevention

Thank you for

your attention