Memorandum

Glooko expands integrations with Roche, LifeScan, and Abbott; launches Office Kiosk for in-clinic data uploading – September 29, 2015

Executive Highlights

  • Glooko has expanded the compatibility of its data management platform to include Roche’s Accu-Chek Connect Bluetooth BGM; Abbott's Freestyle Libre, Optium Neo, and Precision Neo; and LifeScan's OneTouch Verio, Verio IQ, and Verio Sync.
  • In separate news, Glooko announced the launch of an Office Kiosk for in-clinic diabetes care. The Kiosk – previously only available to health systems – provides clinics with an improved device downloading solution for $300 per month.
  • How will diabetes data management companies work together? When will better analytics come? What impact will Google and IBM Watson have on this field?

Glooko has announced expanded partnerships with Roche, Abbott, and LifeScan to broaden the compatibility of its diabetes data management platform. The update will enable data upload from Roche’s Accu-Chek Connect; Abbott's Freestyle Libre, Optium Neo, and Precision Neo; and LifeScan's OneTouch Verio, Verio IQ, and Verio Sync. The integration with Roche’s Accu-Chek Connect rolled out last week, while general availability with the new Abbott and LifeScan devices will “come soon.”

It is encouraging to see Glooko supporting two Bluetooth-connected meters: Roche’s Connect (launched in August) and LifeScan’s Verio Sync (launched in January 2014). The upside here is no cables or adaptors – data will go right from the meters to the Glooko platform.

This integration also means FreeStyle Libre data will now upload to Abbott’s own software, diasend, and Glooko. It’s terrific to see Abbott opening its sensor data, a critical move to stay competitive with Dexcom. And as a sign of the times, even long-proprietary Medtronic will integrate with Glooko soon. We’re thrilled to see companies moving beyond proprietary data siloes, though with several emerging universal data platforms – diasend, Glooko, Tidepool, Apple’s HealthKit – what then? Will these platforms work together, or are we creating more siloes? Who will most seamlessly integrate with EMRs? What impact will Google and IBM Watson have on the analytics front? We share more questions and discussion on this front below.

In separate news, Glooko also recently announced an Office Kiosk for in-clinic diabetes care. The system was previously available only to health systems and ACOs, and this launch will expand its availability to smaller clinics. The “Kiosk” provides the Glooko platform minus the remote monitoring capabilities for $300 per month plus one-time hardware costs ($59.95 for the MeterSync Blue device and $150 for an Android tablet). We see this as a necessary move for Glooko to scale its platform, though like any digital health company, the business model is always tough. We compare the diasend Clinic, Glooko, and Tidepool products below. Better data downloading is of course worth paying for, but clinics will have to make tradeoffs – how much is it worth paying for? Will these systems integrate with existing workflow? Who offers the most actionable data output?

Glooko’s Integration with Roche, LifeScan, and Abbott

  • The expanded Roche, LifeScan, and Abbott integrations add to Glooko’s growing list of compatible devices: now 40+ blood glucose meters, activity trackers, and CGM/pump data from Dexcom and Insulet. Medtronic and Glooko announced a data partnership during ADA 2015, though there is still no timing on when it will launch. Still, with that pending integration, Glooko will be able to download an impressive 90% of glucose meters, 65%+ of insulin pumps (not Roche, Tandem, or Animas), and both CGMs in the US.
  • J&J has demonstrated an increasingly open approach to data of late; this integration news builds on the August agreement to give Tidepool access to Animas pumpers’ data. The compatibility is expected to launch in the coming months, enabling Vibe and Ping users to upload their pumps to Tidepool’s platform and Blip application using the existing Animas IR cable and the Tidepool Uploader. This expands access to Animas pump data beyond diasend and J&J’s proprietary software (ezManagerMax).
  • Device-agnostic data management platforms are moving ahead with full-steam, though there are some differences. Diasend is currently available to patients and clinics and compatible with pumps/CGMs (Animas, Dexcom, Insulet, Roche, Tandem) and many glucose meters. Diasend has the broadest device compatibility and strong penetration in Europe. Glooko is the second most-established player, with increasing compatibility and a very notable agreement with Medtronic. Last, a public release of Tidepool’s Uploader and Blip are expected later in 2015 – they are currently in a private beta.
    • It remains to be seen how these players can work together going forward, though we are encouraged to see the efforts – few patients download and few clinicians have more than a couple minutes to deal with data downloading. There is plenty of room for multiple software platforms to co-exist in diabetes, and perhaps patients and clinicians will prefer one depending on personal preference, particular devices, and circumstances.

Table 1: Diabetes Data Management System Competitive Landscape

Company

Product/Approach

Status

Recent Coverage/News

Glooko

- Android and Apple mobile app + MeterSync Blue adaptor for downloading meters, pumps, and CGM

- Population Tracker: Flags health systems and payers when patients experience risky high/low glucose trends

- Launched October 2014

 

- Launched February 2014

 

MeterSync Blue launch

 

Population Tracker launch

 

Medtronic partnership

 

Dexcom and Omnipod launch

Diasend

- Web-based device agnostic platform allows upload of data from BGM, CGM, FreeStyle Libre, and pumps. New mobile app allows data viewing.

- Expands platform in October 2014

- New mobile app and integration with Dexcom’s G5

Expansion of platform

EASD 2015

Apple HealthKit

- Resides on iPhone and seamlessly transfers health data between apps

- Available, though most devices don’t post data to HealthKit. Dexcom is the most notable and active partner. Apple is also partnered with EPIC to seamlessly pull data into the EMR.

Meal Memory test drive

Tidepool

- Free, device agnostic, open-source diabetes data platform; includes Google Chrome app device uploader + apps that pull the data (web-based Blip application to start)

- Uploader and Blip in private beta; launch expected later in 2015

Animas partners with Tidepool

Glooko Office Kiosk

  • The recent announcement marks the official full-scale launch of Glooko’s Kiosk, making it available to clinics of all sizes. It had previously been offered to large health systems and Accountable Care Organizations, but not smaller clinics. We see the full-scale launch as a step in the right direction, making data management more convenient and accessible for a wider scope of providers.
  • The launch is a strategic addition to Glooko’s business model, which has been largely large enterprise-focused to date. The company continues to negotiate contracts with payers and health systems, who give the Glooko system for free to patients in exchange for a per-patient fee. With the addition of the Office Kiosk, smaller clinics not currently participating in diabetes remote monitoring will pay a monthly subscription fee for access to the Kiosk platform, which will be available for use in-clinic only (e.g., patients will not get access for home use).
    • The new Kiosk platform will use an Android tablet to download data. Previous versions of Kiosk have been available on iOS, though the move to Android will enable a broader range of compatibility moving forward.
  • The Kiosk comes with an upfront cost of $59.95 for the MeterSync hardware plus an additional $150 for an Android tablet. Clinics will be able to test-drive the system during a four-month free trial, at which point they will be asked to pay a $300/month subscription fee moving forward.
  • Glooko will offer a “starter kit” for clinics interested in upgrading from the Office Kiosk to the remote monitoring Population Tracker. As a reminder, the Kiosk is just the uploading hardware and software, minus remote monitoring. As such, if a clinic that purchases the Kiosk wishes to engage in remote management, Glooko will transition the clinic to its remote monitoring services ($300/month for 20 patients) and waive the Kiosk fee. It’s a clever move from Glooko to seed the market by introducing clinics to its software’s full capabilities in a subset of patients.
  • Glooko’s offering is priced in the ballpark of diasend’s Clinic offering, though will be more expensive than Tidepool’s free offering – see below for a detailed cost comparison. Of course, Tidepool is a non-profit, so its business model is entirely different than Glooko or diasend. Depending on how many transmitters a clinic uses, Kiosk could be more or less expensive in practice.

Table 2: Glooko vs. Diasend Cost Comparison for Clinics

Company

Monthly

Startup Cost

Incentives

Other Costs

Glooko

$300

$59.95 (+$150 for tablet, if needed)

4-month free trial

N/A

Diasend

$215

N/A

60-day free trial

$50 per additional transmitter

Tidepool

Free

Free

TBD

TBD

  • What business model is best suited for diabetes data management to ensure the best innovation, adoption, and scale (see below)? Will the business models of the various platform providers make access by other application easy? Which business models will offer the lowest friction and barriers for patients and caregivers?
    • Diasend charges clinics to use its platform. It is free for patients;
    • Glooko charges providers/health systems to offer it free to patients. If their payer or clinic doesn’t use it, patients can pay $59/year for access;
    • Tidepool is a non-profit supported by philanthropy (e.g., JDRF), but also has an industry-facing model: device manufacturers could pay Tidepool on a regular basis, and in exchange, the organization would host device data and provide apps for patients and clinics to use.
    • Device makers could continue to develop software in house and provide it free.

Close Concerns Questions

  • Among diasend, Glooko, and Tidepool, will one data management platform emerge as the most provider-friendly? The most patient-friendly? The most payer/health system friendly? What will drive adoption?
  • Will diasend, Glooko, and Tidepool add compatibility with Apple’s HealthKit and ResearchKit? Will these platforms take off like iTunes, or should we expect lesser uptake?
  • When, where, and how will patients have access to their own data? Will patients be able to take their data with them wherever and whenever they want?
  • How will the data be monetized/valued? If value is created by one stakeholder and extracted by another, how will incentives be aligned to encourage the flow of data? Will vendors charge patients twice – once for the device, and a second time to access their own data from the device? Some worry that data will be resold to third parties while the patients themselves are prevented from accessing their own data.
  • Where is the line to be drawn between the patient’s physiologic data and the manufacturer's device data? Is alarm data or CGM calibration data or insulin dosing considered device data or physiological data?
  • Are there regulatory or legal or security or privacy concerns to exposing APIs to patients? (e.g., “FDA won’t let you have your own data” or “We have to secure things against hackers so you can't have your own data” or “HIPAA won't let us give you your own data”).
  • Will an ecosystem of diabetes data management apps emerge? Will patients be able to choose which apps they wish to use to manage their therapy? What apps would patients find most useful? What’s the business model for apps that sit on top of platforms? Who will develop such apps? Will they need regulatory approval?
  • What data management solutions are most needed by the diabetes community? Clinical decision support for providers? Therapy recommendations for patients? Population health management?
  • In a world where all data goes to the cloud automatically (e.g., Telcare, Livongo, Dexcom’s Gen 5), how many patients will care to look at it? The historical barrier to data management has been a painful downloading process; now that this is changing, what fraction of patients will elect to engage with their data?
  • What’s the best way to make providers’ lives easier? We continue to hear alarming stats on shortening appointment times (as the patient population grows faster than the number of doctors to care for them) – what do providers most need?
  • Will remote data analysis see improved reimbursement over the coming years? To what extent is this a barrier now? Will it change once data is easier to download?
  • How will healthcare reform affect data management? Will population-level data management become increasingly important? As providers take on more risk, will they engage with data more?
  • Where is the patient's voice in all of this? How will patient feedback be incorporated into product design, data sharing policies, user agreements, regulations, etc.?

-- by Varun Iyengar, Adam Brown, and Kelly Close