Deconstructing WellDoc’s Research Data: Lessons and Opportunities for Mobile Health Startups
WellDoc, a company bringing mobile technology solutions to chronic disease management, is forging the path for mobile health startups through BlueStar, the first out of 40,000 healthcare apps to be approved by the FDA for type 2 diabetes management. Beyond diabetes, startups navigating mobile prescription therapy can learn from WellDoc’s beginnings and even weigh in on new questions. Dig past the top line readout of a 2 point drop in A1C (blood glucose) levels and uncover actionable data points to guide product and business development.
At Innovatively, we focus on existing research, a source of data many companies overlook when gathering business intelligence and one filled with hidden treasures as described by Google Ventures’ Michael Margolis. Let’s deconstruct WellDoc’s landmark clinical study published across 3 journal articles [1, 2, 3] and see what we find:
Designing a successful mobile health study: Lessons from WellDoc
Hit it with a bigger hammer
The study randomized patients across one control group and three with varying degrees of patient and physician intervention, with a 2 point drop in A1C levels reported being due to the highest intervention for patients and providers. Intermediate interventions had similar decreasing trends over 12 months but with mixed significance. Surprisingly, the results suggest that A1C levels improved when patients received coaching but not when patients received coaching and providers received patient logbooks without clinical decision support.
Be careful with statistics
More than half of all trials experience patient attrition, often leading to missing data. Some studies address this by recording patients who do not follow up as failing to meet the endpoint. Others, like this WellDoc study, estimate data. Regardless of the method used, proper planning, justification of the selected analysis method, and analysis are essential.
Measure more than A1Cs
WellDoc’s primary outcome measure was change in A1C levels, which have traditionally been used to get a snapshot of a patient’s diabetes management. However, a number of other measures can provide further insights. These include blood pressure, diabetes distress, and measures related to the utilization of healthcare services (cost, number of visits, etc.). Assessing physician and patient satisfaction with the WellDoc system can also provide insight into its feasibility in the real world. Many other details are available, but they are not published open access.
Opportunities in diabetes: What WellDoc’s data has not yet shown
Attention to patient experience
Patient engagement data remains scarce. This landmark study only cited that not all patients provided data at visits. A presentation at the recent American Diabetes Association meeting sheds some insight with 47% of patients using the latest version of BlueStar at least once a month. For an earlier version of BlueStar, patients were averaging 3.3 blood glucose readings per week by the end of the year-long study. The Mayo Clinic explains patients with type 2 diabetes may need to test their blood glucose levels multiple times a day. LifeScan’s current trial of its diabetes mobile app, OneTouch Reveal, is a promising example of transparency in assessing patient experience alongside clinical outcomes. Creating great experiences is not enough but cannot be ignored to activate and engage.
Not just apps and web sites
Only patients with Internet access or an email address were eligible, though phones with plans were also provided. Of the 16 patients that dropped out of an earlier pilot, nine could not afford cell phone payments. Since 1 out of 3 American adults do not own a smartphone, SMS-based and community-based solutions can reach a broader audience.
Beyond the privately insured
This study focused solely on privately insured patients. Only one WellDoc pilot has targeted Medicaid patients. However, since privately insured patients only account for 1 out every 3 dollars spent on diabetes, tailoring approaches to government-insured patients can tap into the $109B spent annually in direct medical costs.
Pilot studies of WellDoc showed promising trends in reduced hospitalizations and emergency room visits as well as lifestyle and medication changes. While the research suggests that extensive information was collected, the publications report limited data and results. Outside of the reduction in A1C levels, no other improvements from diabetes distress to blood pressure were reported. Looking beyond A1C levels to close gaps in self-care has the potential to create real impact.
How Innovatively is making research accessible
Today, navigating research is tedious but can provide actionable insights. Could you easily find all 8 journal articles that cover 4 clinical studies? How many places would you have to search and tools would you need? Imagine accessing everything on WellDoc with a click. Innovatively’s web platform is designed to make it easy for companies to leverage research data and get fast answers about their market, competitors and customers. Spend your time and money acting on, instead of researching, opportunities. Chat with us at firstname.lastname@example.org or submit a request today!
Innovatively’s technology collects, analyzes and connects data across publications, grants, patents, clinical trials and other creative data sources to provide actionable research intelligence. Our web platform makes sense of public research data to help companies know their market, competitors and customers faster, easier and better than ever before. Learn more at Innovatively.co.