Memorandum

Atrius Health, large Boston ACO, to fully roll out Glooko in endocrine clinic after positive pilot in gestational diabetes; includes EHR integration – October 24, 2016

Executive Highlights

  • Atrius Health, a large Boston accountable care organization (ACO) will begin offering the Glooko platform in its endocrine clinic following a successful pilot in gestational diabetes (n=140). Atrius has managed >27,000 people with diabetes over the past 1.5 years, which makes this a pretty big deal for Glooko. The implementation will include EHR integration, a major clinical gap in diabetes data management to date.
  • Notably, Atrius earns 75% of its revenue through risk-based contracts, a vote of confidence that Glooko’s data management platform offers a cost-effective benefit in clinical practice (e.g., its Population Tracker can help prioritize care and remotely identify those in trouble). Atrius considered cellular-enabled meters, but found the cost too high. Patients will have to opt-in to using the Glooko platform.
  • Separately, Glooko and Diasend have begun co-branding following the merger announcement last month.

Glooko announced on Friday that Atrius Health, a large, Boston-based ACO (Accountable Care Organization) has opted to fully implement Glooko’s data management platform in its endocrine clinic, including EHR integration. Atrius brings notable scale, having provided care for >27,000 people with diabetes over the past 18 months (675,000 adults/pediatrics overall). The ACO also earns 75% of its revenue through risk-based contracts, meaning it clearly sees financial and outcomes value in using Glooko’s platform. This is exciting!

Dr. Mike Lee, Senior Medical Director of Clinical informatics at Atrius Health, pointed out in a webinar this morning (watch it here) that if Glooko reduces the number of hospitalizations OR the number of clinic visits by 20%, then the ACO saves money – this is actually a higher bar than we would have guessed (given all the wasted time on data downloading) and we wonder if the pilot data showed reduced clinic visits and hospitalizations. Glooko’s Population Tracker should theoretically improve efficiency, as it allows providers to monitor patients remotely, look at their diabetes data, and give more targeted care (“Jane is doing great”; “John seems to be in trouble”). Will population tracking become the norm in diabetes care, particularly as Bluetooth-enabled meters and mobile CGM become more widely used (auto-upload), and as incentives align to provide remote care? Gosh this would be great.

Atrius began piloting Glooko approximately two years ago, enrolling ~140 patients with gestational diabetes to use the data management platform to upload their diabetes data (smartphone app, MeterSync cable, web platform, provider kiosk). On average, the group doubled their fingerstick frequency over the first 20 weeks. No other “hard” outcomes data were shared, but surveys (see below) suggested strong satisfaction with the Glooko experience.

Interestingly, Atrius considered issuing cellular-enabled meters to all of its patients instead of partnering with Glooko, but found the financial investment too high and the likelihood that patients would want to switch from their current devices low. Glooko made a point of calling this out, presumably to counter the value proposition of products like Livongo’s BGM. We think many solutions will be needed to tackle the combined diabetes data, clinical efficiency, and decision support challenges in the field. Atrius is not requiring patients to switch to the Glooko platform, though we have to imagine most would appreciate more continuous care with less potential need for in-clinic visits. It sounded like patients themselves will be charged for the MeterSync cable, but we’re confirming with the company.

  • It is great to see Glooko and Diasend co-branding, just a month following the merger announcement at EASD. Glooko’s website displays the first understated banner below, while diasend’s website very prominently shows the second (much larger) banner flanked by balloons. The two companies announced the merger last month and plan to combine their respective products into a single offering over the next year. We hope they can move faster as a combined entity, particularly to bring more robust decision support to market quickly.

  • More details on the Atrius survey of patient/provider experience with Glooko: 100% of patients felt syncing their readings from their meter was extremely easy or very easy, 90% felt sharing their blood glucose readings with their care team was extremely easy or very easy, 100% felt their care team was able to easily follow their diabetes during their pregnancy and 100% felt this monitoring improved their experience at Atrius Health. Of the providers who used Glooko at Atrius, 86% felt using Glooko was easier compared to their previous method of monitoring patients with diabetes, and 75% felt Glooko made it easier to have a more positive relationship with their patients.
    • It’s interesting to see that Atrius tested Glooko in pregnant women with diabetes, many of whom likely have higher motivation to engage with diabetes data than other patients (though certainly not all). We wonder if this was a generalizable population to extrapolate the benefits of Glooko’s system – will the same outcomes transfer to older and younger patients? This is also a costly population, as most of these patients are very high-risk.

-- by Brian Levine, Adam Brown, and Kelly Close