Generally One in three Americans, or 96 million adults, has prediabetes – but only 2-3% are offered the support to prevent the disease from progressing to full-blown disease.
Of course, the medical implications of diabetes are significant—affecting vision, circulation, and even, in severe cases, requiring amputation. But there are other implications, too. With untold health care resources devoted to managing the myriad medical risks of the disease, Tackling diabetes – and ideally preventing it – would save American taxpayers a huge amount of money.
Remote patient monitoring RPM holds great promise in helping treat and improve the lives of patients with chronic diseases, including diabetes. And developments in artificial intelligence and automation offer great opportunities to improve RPM technology.
Oren Nissim is the CEO and co-founder of Brook Health, a developer of AI-powered remote monitoring tools. He is also a type 2 diabetic.
We interviewed Nissim to discuss the challenges of treating diabetes, how RPM can help overcome some of these challenges, how AI can advance RPM technology when treating chronic conditions, how effectively addressing diabetes can save taxpayers money, and what Nissim calls the “next generation of remote care.”
Q. What is the current diabetes situation in the US and what are some of the major challenges?
ONE. Whenever you hear about diabetes these days, the number one topic is that GLP-1 drugs have taken off in a really big way in recent years. And it’s been a transformative experience for people who take them for two reasons. First, they help you control your blood sugar better. Second, and this is probably the one that gets the most attention, people who take GLP-1 drugs are losing a lot of weight.
This is a good thing. The problem is that these are permanent drugs, meaning that patients have to commit to taking them for life. I doubt anyone wants to do that, but they all end up there because people become dependent on these drugs.
But not everyone should take GLP-1 drugs, and they are not always covered by insurance. So there is a growing trend of people paying for these drugs out of pocket, which is extremely expensive and therefore unfair.
In addition to these inequities, there are still many “food deserts” in the United States, which only exacerbates the overall poor eating habits in the country. Additionally – the lack of access to dietary management is another obstacle that too many people face. We need to make support from a nurse or food coach more accessible to help people manage their blood sugar. But improving access to care for people who live under a bridge or have had amputations due to diabetes is a whole other challenge.
Most people with diabetes have type 2. For these people, controlling their blood sugar levels – while still managing everything else in their lives – can be a real challenge. Many wonder if they can do it on their own.
It’s no wonder a “wonder drug” is such an appealing option. But aside from pharmaceutical companies, who really benefits from a drug that a patient must take for the rest of their life when there are other options?
Q. How can RPM technology help overcome these challenges?
ONE. Remote patient monitoring tools can be used to help people with diabetes in a number of ways. They allow clinicians and other caregivers to monitor an individual’s blood sugar levels, provide reminders, and help them create a health care plan.
Additionally, I think the immediacy of highly personalized information is really key when you’re trying to create and form new habits. Not only is this type of personalized data highly informative and relevant, access to this data can be both motivating and empowering – emotional states that are essential to driving change and overcoming challenges.
Let’s say you go to the supermarket and you’re trying to choose a yogurt. If you have diabetes, the chances of you finding a yogurt product that’s right for you are extremely low, almost zero. And you really have to pick up each container and read the label to know for sure. If you’ve ever been to the dairy section of a supermarket recently, you’ll know that there are many different types and brands of yogurt.
The food industry has made it incredibly difficult to make good choices when you’re lactose intolerant. Now imagine being able to use AI technology remotely to help you understand those labels, read them faster, and give you recommendations as you go about your life and make those everyday choices.
This is just one example of how you can make a significant change that improves people’s health through remote patient monitoring technology.
Q. How can AI leverage RPM technology when addressing chronic diseases like diabetes?
ONE. A lot of it is about how to make that intelligent agent support you on a daily basis and in the best way possible to create positive change. That’s where AI can really shine.
Many people mistakenly think that AI should mimic nurses or doctors. But that’s not the right perspective. Ultimately, AI is really about encouraging healthy habits and behaviors and providing healthy guidance for making important daily choices.
The reality is that blood sugar control can also be achieved through lifestyle changes and awareness. This can be achieved with the right tools and support. No one should have to go to the point of having their leg amputated because their diabetes is not controlled, but Each year, 120,000 Americans with diabetes undergo leg or foot amputation.
Furthermore, AI can take into account an individual’s medical health beyond their diabetes, such as other underlying conditions that need to be factored into their recommendations, suggestions, and health care plans. This is more of a lifestyle intervention than a medical intervention, but the ultimate goal is the same: better patient outcomes.
Q. How is what you call “the next generation of telemedicine” improving outcomes for this patient population? And how could tackling diabetes head-on, especially prevention, save U.S. taxpayers money?
ONE. Most Americans with diabetes don’t use AI or other advanced digital tools to help manage their condition. But those who do use them have a unique agent on their side who understands what’s going on in their daily lives.
This agent can help them make better, smarter, easier choices on the go. That makes a significant difference in these people’s lives because otherwise they’re making dietary and lifestyle choices based on their current habits – and their current habits aren’t getting them where they need to go.
Today, people with diabetes can see a doctor or health professional. They will go into a transactional experience where they are told what to do and now they need to go home and do it. Unfortunately, that system doesn’t really work because only people who are extremely motivated to change their habits will be successful.
The way to help more people manage their disease successfully is to move from a transactional, encounter-based model to one where disease management is woven into the patient’s life. Most people today are so accustomed to digital technology that they can easily integrate these tools into their daily lives.
Addressing diabetes adequately, especially through prevention and better management, could save U.S. taxpayers enormous amounts of money by targeting a major source of health care spending. With 90% of Medicare costs related to chronic conditions like diabetes, focusing on prevention and effective management could significantly reduce overall health care costs.
While new drugs like GLP-1 inhibitors are effective, they are extremely expensive and create lifelong dependence. Instead, leveraging ubiquitous technologies like smartphones and AI-driven apps could help people make better everyday health decisions at a fraction of the cost. This approach is not only cheaper but also more scalable than traditional medical interventions or expensive drugs.
By empowering individuals to better manage their diabetes, costly complications such as amputations can be avoided, further reducing healthcare costs. With the United States currently spending more than 20% of its GDP on healthcare, better prevention and management of chronic conditions such as diabetes can significantly reduce this economic burden.
Ultimately, promoting self-management and education can empower people to make healthier choices and better understand their condition, reducing reliance on costly medical interventions and saving taxpayers significant amounts of money in the long run.
Follow Bill’s HIT coverage on LinkedIn: Bill Siwicki
Email him: [email protected]
Healthcare IT News is a publication of HIMSS Media.
The HIMSS Healthcare AI Forum is scheduled for September 5-6 in Boston. Learn more and register.
