Helping Rural Older Americans Thrive

USDA's Senior Farmers Market Nutrition Program helps seniors like Janice Potts (right) of Owingsville, KY purchase more fresh fruit and vegetables.

There are things everyone wants for their families, friends and neighbors: a safe place to live, access to good health care and healthy food. Yet as we get older, sometimes meeting basic needs can become more challenging. Next week the 2015 White House Conference on Aging will focus on the policies that impact older Americans across the country. Often, older Americans who live in rural areas are isolated, with fewer transportation options and limited access to other important services. Knowing these unique challenges is one reason USDA and other federal agencies are investing in housing, health care and nutrition programs for our country’s rural seniors.

A World beyond Mobile!

Breaking News: The world is now mobile…and it the mobile revolution is here to stay, but if “going mobile” is a thing of the past, one must wonder, what is next? What is the next wave in technology evaluation?

Observing recent movements in the technology market give us a clue to answer that question. Whether its Google buying smart thermostat maker Nest for 3 billion dollars or Apple recently launching the Apple Watch, one thing is clear: connectivity is leaping beyond the “smart phone” and infusing itself into our daily lives. Everything we touch could be connected. In addition to convenience, this new world of universal connectivity is producing something else in mass quantity: data. And, with data comes the need for its meaningful interpretation through algorithms, or data science. The use of data science in this newfound world of connectivity is delivering what used to be considered the realm of science fiction, like autonomous drones, self-driving cars and 3-D printers. To put it simply, it looks like the next leap in technology will take place at the intersection between data and how users experience technology. That is, the next revolution will change how we engage and interact with data in our daily lives through the medium of technology.

Every industry (from retail to defense) stands to gain from this evolution. However, I believe that healthcare is uniquely positioned to reap some of its most significant benefits. In fact, I truly believe that, over the next 50 years, healthcare will be fundamentally reshaped as a more personalized and precise care delivery model. And, this reshaping of healthcare will be driven by the gains in data science.

My own journey at this intersection began with a youthful zeal for technology. But, it kicked into high gear with my involvement with the Quantified-Self movement - a niche community based the premise of “self-knowledge through data”. While we are all self-proclaimed data geeks, we were driven by the intrinsic belief that the solutions to our most dire and critical healthcare needs would be unlocked by the power of data lurking beneath the surface. Through my involvement with this group, I quickly realized that data science would be the face of precision medicine and it would be the wave of the future. But I was left wondering: how could I put hope into action? And how could I spread the word from a group of geeks interested in this future to everyone that had a stake in their healthcare?

The answer to that question has been revealed through my journey in the world of entrepreneurship. I have built Babyscripts, a company whose sole focus of improving pregnancies using data. We created a product that enabled obstetricians to remotely monitor pregnancies through simple tools like connected weight scales and blood pressure cuffs. We showed that using such a tool could not only enhance the care that providers deliver, but also improve access while lowering costs. More importantly, we are showing that we are now beginning to tap into the power of data to improve outcomes. What is even more exciting is that we are not the only ones tapping into that power. Welldoc, a company in Baltimore, is also fundamentally changing diabetes management with data. Another company, Adhere tech is changing the way medication adherence is being handled with connectivity, while AliveCor is doing the executing similar changes in ECG monitoring. It is truly amazing to see how innovators across the nation are moving the needle towards precision medicine by using data and integrating it into our daily lives.

So what makes our company and the products of these innovators unique and effective? As I see it, there are two salient elements. First, we are designing the experience of technology, and its management of our health, to be more intuitive, more ambient and ultimately more seamlessly integrated into the human experience – a term that we at Babyscripts have dubbed “Human Experience,” or “HumEx,” for short. Second, we are uncovering patterns in the data and, through those patterns, dynamically reacting to medical issues in real time. We call this Data Science as a Service, or DSaaS, for short – a term that we have borrowed from our good friend Anand Iyer at Welldoc. But, most importantly, we do not treat HumEx and DSaaS as discreet, independent elements that might lead to a successful product; to the contrary, DSaaS and HumEx form an integrated, coordinated and unified whole. As data is gathered (or better, generated) from the human experience, interpretation of data seamlessly and automatically informs the human experience. This infinite back and forth between data and human activity ultimately forms the basis for the intelligent and genuine improvement of the human experience – in our case, the medical experience. Thus, the union of HumEx and DSaaS together constitute the future of healthcare: Precision Medicine, which is, treating each patient as unique and holistic to truly solve their problems.

Anish Sebastian is the founder of Babyscripts.

Diabetes Innovation Can Come from Anywhere

Tidepool is honored to be a part of the Champions of Change for Precision Medicine initiative. Tidepool is part of the larger #WeAreNotWaiting movement, a Twitter hashtag symbolizing the powerful notion that patients should own their own health and therapy data and that innovation can emanate from anywhere. Engaged patients armed with data can be active participants in their own care, leading to innovative solutions and healthier outcomes on a timescale much faster than traditional medical device development.

My personal story began when my daughter Katie was diagnosed with Type 1 Diabetes (T1D) in 2011. Prior to that, I knew nothing about diabetes. I didn’t know that there were different kinds of diabetes or what the day-to-day treatment meant. Type 1 Diabetes is an autoimmune disease that causes the pancreas to stop producing insulin, a hormone necessary to metabolize food and absorb energy. I certainly didn’t know how burdensome T1D is to manage nor how high the stakes are for getting it right. People with T1D face both the daily risk of a seizure, coma or death from low blood sugars (hypoglycemia) caused by taking too much insulin, and also long-term risks of nerve damage and organ failure due to high blood sugars (hyperglycemia). To make managing T1D even more challenging, exercise, sickness, stress, menstrual cycles and many other factors also affect how your body will react to insulin.

With the stakes so high you might think that there would be a vibrant ecosystem of applications to help people manage T1D. Unfortunately, until very recently, most diabetes devices like insulin pumps, continuous glucose monitors and blood glucose meters came with their own hard-to-use proprietary software. Fortunately, as Tidepool and the #WeAreNotWaiting movement have gained momentum, this has changed. Most diabetes device companies now embrace the notion that patients own their own data and that patients should be able to use whatever software they want to access it.

At first, the prospect of delivering regulated medical software seemed daunting to us. Fortunately, we received great advice to engage early and often with the FDA, which we’ve done. By being transparent about our activities and involving the FDA as our software has evolved, we’ve found the team at CDRH to be completely pragmatic, encouraging and supportive. Like our software, we’ve chosen to make our regulatory quality system freely available, which we hope will help other healthcare startups.

Tidepool chooses to be a non-profit because it is the best way to make it clear to patients and industry that our efforts are not about building a business or monetizing patient data. Instead, our goal is to give away our software – we are a free and open source software project – and to enable an ecosystem of application development and diabetes research.

Tidepool is one of many projects that have embraced the notion that empowered patients and parents with access to diabetes data and device protocols can make a profound difference. The NightScout project and “CGM in the Cloud” community have enabled remote monitoring of loved ones’ blood sugars. OpenAPS, Bigfoot Biomedical and others have done work that enables automated delivery of insulin. Like Tidepool, these projects all began as do-it-yourself projects by engaged parents and patients, all making it clear that the T1D community will not stand idly by waiting for innovation to occur. Innovation in healthcare is as likely to come from a garage or home office as it is from the labs of a large device company.

Howard Look is the Founder and CEO of Tidepool, a non-profit, open source effort dedicated to reducing the burden of managing Type 1 Diabetes. His teenage daughter has T1D.