At Medgadget we cover a lot of companies that either build medical hardware or create software platforms and tools for healthcare. But what happens when you align medical hardware from one company with complementary software from another to work in tandem? Arguably the best of both worlds. Today we had the opportunity to hear from James White, President of Common Sensing, and Chase Hensel, CEO of Welkin Health, to learn about how these two businesses’ recently announced partnership is seeking to change the paradigm of at-home diabetes management.
Common Sensing represents the hardware side of the equation in the Gocap, an insulin dosing capture device that snaps right onto an insulin pen. Welkin Health brings both a software platform, into which data from the Gocap and other sources create a diabetes profile for each patient, and clinical support in the form of Certified Diabetes Educators (CDEs) that remotely review data and coach patients. With an end-to-end digital health program, Common Sensing and Welkin Health are together seeking to improve insulin adherence and overall health outcomes for patients with diabetes.
Mike Batista, Medgadget: Let’s start by learning a little about what each of the two companies in this partnership, Common Sensing and Welkin Health, do respectively.
James White, Common Sensing: Common Sensing is a company that is reworking the home treatment side of chronic disease. Diabetes is a huge burden on our population and healthcare system. Most people fail to recognize that success managing the most expensive chronic disease in the US doesn’t happen in the clinic, it happens at home. And most people are currently unable to use insulin at home to meet their goals.
We’ve created Gocap, a device and system that monitors and supports people between doctor visits, not only tracking every single insulin dose and time, but also wrapping them in a network of passive and active support for success with their treatment.
We are the first company that is monitoring and delivering home insulin use support in a scalable way. This is important because a person with diabetes spends 365 days of their year deciding how and when to use insulin, but often only one hour with a physician. They typically have no support for that treatment in-between visits. The road to success in chronic disease will include at-home support with day-to-day treatment activities, and we are paving it.
Chase Hensel, Welkin Health: Welkin Health is a digital health company founded out of a need to improve proactive and participatory healthcare. Each year in the U.S., chronic disease is responsible for 70% of deaths and over 80% of healthcare spend. That amounts to $2.5 trillion dollars. Patients are often tasked with self-managing complex diseases such as diabetes, and left to the task of learning to manage a variety of necessary medical devices in order to do so—insulin pens, blood glucose meters, pumps, and continuous glucose monitors. Welkin is embedding these products into a holistic offering with the aim to improve patient outcomes.
We have developed a configurable software platform that helps our partners create and in some cases run coaching programs that improve the health outcomes of patients living with chronic disease such as diabetes, addiction, chronic pain, and heart failure.
Medgadget: Since your new partnership is aimed at improving insulin adherence among individuals with diabetes, what are the challenges someone with diabetes has today when it comes to at-home insulin delivery?
James (Common Sensing): Challenges of at-home insulin delivery have been well studied, and the data we have on insulin users has matched up well with these studies. Complexity and burden of medication regimens, fear of adverse events, perception of efficacy/safety, and lack of a strong provider relationship are commonly named as the key factors associated with non-adherence. All of these represent a lack of control, trust, and purpose in the user. Common Sensing is rebuilding these pillars of self-care through deep coaching relationships powered by our monitoring tools and now, Welkin’s configurable coaching platform.
Chase (Welkin Health): Welkin’s platform equips coaches to perform remote outreach to patients. In our partnership with Common Sensing, CDEs will provide real time support to patients in order to address the multitude of psychosocial challenges patients face with insulin therapy.
Medgadget: Now that we have a sense of what each of your companies does and the problems you’re trying to solve, tell us about the new partnership.
James (Common Sensing): We are in the business of selling success with home insulin treatment. The first step to success is measuring success, which our tools are currently being used for in a study at the Joslin Diabetes Center in Boston. The next step is data-driven intervention, which we plan to accomplish through a variety of channels. For many people, there is no replacement for the relationship and services of a dedicated coach to improve home treatment. That is where Welkin comes in.
Chase (Welkin Health): Common Sensing is doing exciting work by manufacturing a smart insulin pen cap that can automatically track and send insulin dosage data. We are excited to couple their hardware expertise with our software expertise and to pave the way for improving comprehensive diabetes management for insulin users. Welkin Health provides the platform so that information can be combined with real-time blood glucose data and delivered to a patient’s care team, which helps them provide faster and better quality care for diabetes management. With Common Sensing’s hardware in the Gocap and Welkin Health’s software for personalized, on demand health coaching, our partnership will modernize diabetes care management.
Medgadget: Is this a consumer-directed program for the individual or something directed to a patient through their provider or payer?
James (Common Sensing): This program will be prescriptive and won’t cost the individual a penny. If someone is having issues treating their chronic disease or comorbidities, the complications, short-term and long-term, cost payers a lot of money, $10-20B/yr in the US. In our model, payers and in-network providers will refer individuals to be on the program based on their data analytics and expertise. Then, Common Sensing, supported by Welkin Health, immediately becomes part of the provider’s team for that individual, extending their reach with coaches and tools, intervening with home care, and monitoring the results.
Medgadget: For the individual managing diabetes, how does the program work, what is the user experience?
James (Common Sensing): For the individual, we are designing the program to be a gift and a safety net, not a burden. They receive the tools they need at the provider, as they learn to use their insulin pen and take blood glucose readings. Then, they no longer need to worry about logging anything-it all happens automatically. Over the first few weeks of use, the individual gets to know their personal coach and learns more about their tools and treatment, via phone, text, or email, whatever works for them. Once the individual is self-reliant, their coach is still always available to answer questions and their data is monitored for any signs of complications. If they ever have trouble with a device or accidentally damage one, support and replacements are a call away.
Chase (Welkin Health): Welkin and Common Sensing have worked collaboratively to create a program for Common Sensing to market to Payers. This program is structured such that patients will receive the Gocap insulin pen cap, and be paired with a Certified Diabetes Educator (CDE). The Gocap pen will wirelessly transmit data about their insulin dosage and frequency of use Welkin. A CDE will log-into to Welkin and have the patient’s relevant health data at their fingertips empowering them to provide more accurate and timely diabetes coaching support. CDEs will use Welkin to prioritize which patients to follow up with and when and to manage multi-channel communications in one platform.
Medgadget: What is the role of a Certified Diabetes Educator (CDE) and how does the program interface with the individual user’s doctors and nurses?
Chase (Welkin Health): CDEs are an important part of the patient’s care team when it comes to managing the complexity of diabetes. CDEs act as the ongoing health coaches for people managing diabetes, supplying the tools and support for adapting the necessary lifestyle changes to improve health. While patients will still communicate and visit their care team during scheduled checkups with their doctor and/or nurse, the relationship between the patient and the CDE is far more constant and offers on the go support, capturing teachable moments, and filling the gap between those visits.
Medgadget: On the technology side, what is the current status of the Gocap and its FDA or CE Mark approval? Is it already available?
James (Common Sensing): The Gocap is currently available in limited first service roll-outs with payers. It was registered with the FDA in June 2016, before starting clinical trials in Q4 of last year. The device is compliant and ready to use in the US, our first market. CE Mark timing has not been disclosed yet, but we’re seeing more and more interest for insulin monitoring and intervention in the EU.
Medgadget: There are other insulin-tracking pen caps on the market, some of which have been covered previously by Medgadget. What makes Gocap stand out?
James (Common Sensing): The biggest thing that stands out about the Gocap is that it’s already out there collecting data and being used to inform conversations with insulin users in a way that is already scalable to the millions of disposable pen users in the US. We’ve been testing the product and patented technology with all types of users for two years now, in and out of the clinic. We have learned so much and iterated on the product multiple times. Additionally, we are proud to target a broad market-not just the tech-savvy, but also the 72-year-old user that is completely new to insulin, has dexterity issues, and has never used a cell phone before. These are the people that often need support most. Finally, there is a huge problem and opportunity in home diabetes treatment today, so our team imagines that there will be many shapes and sizes of solutions, tailored to fit different user groups and preferences.
Medgadget: There are multiple types of insulin pens that individuals may use. Is Gocap usable across all brands? Can Gocap be used with both disposable and refillable, or cartridge-based, insulin pens?
James (Common Sensing): The Gocap technology has been tested with all disposable insulin pens used in the US. So that the end user doesn’t have to configure anything, we ship a Gocap tailored to fit on the insulin pen(s) the individual is using. We will be rolling out compatibility with all insulins based on demand. Although the technology works with refillable and cartridge-based systems, disposable pens have the vast majority of the market share in the US and EU, so they will be our first target.
Medgadget: How is blood glucose data captured and incorporated into the analysis of a user’s status?
James (Common Sensing): Wireless blood glucose meters have been on the market for several years now. One reason we chose the ubiquitous Android and iOS operating systems is because they maintain the ability to be a hub for multiple devices related to care, such as blood glucose monitors (BGMs), weight scales, or blood pressure monitors. We have already tested home use of Gocap-integrated BGMs, and both types of information can be displayed on our clinical dashboards. This has had a huge impact on ability to troubleshoot insulin dosing and titrate insulin users. Moreover, this information can be shared in real-time with Welkin’s coaching platform.
Chase (Welkin Health): Blood glucose data is being automatically and wirelessly transmitted from the Gocap to the Welkin Health platform via an API that we have developed. The platform’s rules engine identifies triggers, such as a drop in glucose levels or a missed insulin dose, and prompts the CDEs to offer real-time feedback and coaching to the user. Welkin has found that our ability to capture real-time data from our partner’s medical devices, and couple it with real-time coaching creates a valuable service for our partners to extend to their end users or patients, which is ultimately where we are striving to have the most impact.
Medgadget: It seems like an important part of what you two are doing is going beyond the technology to wrap an entire program around Gocap. What are the benefits of this added layer to the user and their clinicians?
Chase (Welkin Health): The combination of coaching, software, and connected medical devices is transforming chronic disease management. Welkin is creating value by coupling medical devices and supporting the development of services with the aim to improve patient outcomes, and provide tangible competitive advantages. With Gocap, we’ll have insight into how and when patients are using their insulin (and when they’re not), an especially important kind of data when considering that 62% of patients starting insulin stop in the first 3 months, and 82% within the first year. By combining insulin dosing data and real-time blood glucose data, as well as additional information gleaned from a patient’s care team, centralized in one platform, we are better equipped to empower both the patient and the care team to proactively work together to improve insulin adherence.
Medgadget: What are the current plans for rolling out this program? When will individuals be able to begin participation in the program?
James (Common Sensing): Common Sensing is coordinating several partnerships that will test the efficacy of the Gocap program in a real-world environment this year. This will be an opportunity for Welkin and Common Sensing to optimize the system for a great user, provider, and payer experience. We are planning a broad release to insurers and self-insured employers in 2018 to revolutionize the way diabetes treatment is delivered in the US and EU.
Medgadget: Can you touch on any success stories you’ve had running similar programs where real-time coaching played a pivotal role in improving user compliance, engagement, or satisfaction?
Chase (Welkin Health): Driving engagement and adherence, two integral components perpetuated by health coaching and supported by our platform are vital when it comes to managing chronic disease. While the benefits of health coaching are established within diabetes management, we’re also seeing exciting applications for other chronic diseases where real-time coaching makes a difference in people’s lives. One example is Welkin’s partnership with Face It TOGETHER (FIT), a national network of addiction recovery programs, where we developed Axis, their integrated addiction support platform used by their recovery coaches. By empowering recovery coaches with the tools to provide continuous and quality support to people with addiction, we’re also able to track improved outcomes using their proprietary Recovery Capital Index, which measures health, wellness and patient engagement.