Voice-enabled technologies are changing the landscape of digital health by offering a new channel to engage patients who are managing their chronic conditions. To leverage this opportunity, Macadamian, a software design and development firm, and the Children’s Hospital of Eastern Ontario – Ottawa Children’s Treatment Centre (CHEO – OCTC), have partnered to develop My Diabetes Coach, a voice activated service. The initiative is part of CHEO – OCTC’s Health Innovation Program, where ideas from within the organization are matched with technical resources to turn innovative concepts into reality.
My Diabetes Coach will seek to address the challenge of empowering younger populations of patients, that tend to be less engaged through traditional modes of communication, but who stand to realize significant long-term medical benefits from achieving blood sugar targets. Diabetes-related complications that pediatric patients face, when failing to engage in healthy behaviors that support appropriate blood sugar levels, include kidney failure, blindness, early heart disease, and amputation. In addition to the incorporation of an intelligent, voice-enabled Amazon Alexa skill, My Diabetes Coach also includes a custom mobile application and Bluetooth glucometer, all three of which tie into a patient portal and database. The Alexa skill will encourage patients while providing advice and guidance to those who need additional support, and gamification will also incorporate rewards as incentives for ongoing interactions.
Dr. Stasia Hadjiyannakis, Medical Director of CHEO – OCTC’s Centre for Healthy Active Living, leads the clinical side of the project along with a team of University of Ottawa Masters of Engineering students. Dr. Hadjiyannakis agrees that, “Establishing and encouraging good diabetes self-management at an early stage will provide significant benefits to patients over the years by mitigating the risk for diabetes-related health complications.” Working with the clinical team, Macadamian is developing My Diabetes Coach on top of Hive, the company’s HIPAA-compliant, distributed IOT platform.
Medgadget had a chance to get a few more details on the partnership and technology from Timon LeDain, Director of Internet of Things at Macadamian.
Medgadget, Michael Batista: There are already digital health solutions on the market for management of adult diabetes. Are there solutions out there today for pediatric diabetes?
Timon LeDain: Our market research has not identified any solution that specifically targets pediatric diabetes. Solutions offered to address this demographic are adapted from solutions available for adult diabetes and, unlike My Diabetes Coach, are not designed specifically to address the needs of young patients.
Medgadget: Why do you think the pediatric diabetes market has not been tackled before?
LeDain: Likely because leveraging existing solutions in the adult diabetes market to manage pediatric diabetes is “good enough” or the market isn’t large enough to warrant development of a custom solution. My Diabetes Coach was developed specifically to manage pediatric diabetes based on insights provided by Dr. Hadjiyannakis and her team. As a result, the patients’ parent or guardian are a core component of the solution, as they form an integral part of the circle of care. The concept of peer mentorship is also integrated, allowing a youth who has been able to manage their care to be paired with a new patient to act in the capacity of a “Big Sister” or “Big Brother,” and share words of encouragement as well as best practices via secure chat capabilities built into the platform.
Medgadget: Pediatric patients have a number of tools at their disposal through My Diabetes Coach, including the mobile app, Alexa skill, and Bluetooth devices. With a goal to strengthen teamwork across all stakeholders, how are parents and clinicians engaged?
LeDain: Parents are a key stakeholder in the solution, and are provided with access to their child’s data in order to help track progress and offer words of encouragement, to support them as part of their circle of care.
My Diabetes Coach is also intended as a tool for a clinician to support their pediatric diabetes patients between clinical visits. Because of this, the clinician is the central stakeholder in the solution. They set the targets that the solution is designed to help the patient achieve and access patient data at any time to see how they are progressing. The solution also offers a secure chat capability between the clinician and patient, such that they can stay in touch between visits without the clinician having to share his/her mobile phone number with patients.
Medgadget: Will My Diabetes Coach incorporate machine learning or artificial intelligence to personalize and evolve interactions as patients engage with the technology?
LeDain: Absolutely! The functionality presented in the My Diabetes Coach video [see below] is not possible without incorporating AI and machine learning. The key value proposition in integrating AI into the solution is to be able to pickup on patterns that highlight when the patient typically has the greatest challenges for the collective benefit of the patient, parent, and clinician. Does the patient struggle primarily in school or at home during the weekends? What is the connection between their sleep quality, exercise level, and diabetes management? These are answers that My Diabetes Coach looks to address through AI.
AI will provide the personal interactions through Alexa that will drive patient engagement levels. By personalizing the interactions to each patient’s unique needs and challenges, better health outcomes are expected.
Medgadget: Will My Diabetes Coach eventually require FDA approval?
LeDain: Yes. As a solution that manages patient health information, supports clinicians, and integrates into hospital EMRs, My Diabetes Coach would fall under HIPAA in the US and PIPEDA in Canada. As artificial intelligence is leveraged to predict potential high blood sugar events and make recommendations to the client to mitigate them, it would fall under the purview of the FDA as well. Macadamian has expertise in developing healthcare solutions that are certified to meet both FDA and HIPAA/PIPEDA regulations.
Medgadget: When do you project My Diabetes Coach to be in the hands of patients?
LeDain: Last week we had a chance to meet with CHEO type 2 diabetes patients and their parents and the reaction to My Diabetes Coach was overwhelmingly positive. They found the voice interactions “cool,” easy to use, and something they could see themselves leveraging to help better manage their care. Macadamian is continuing to develop the solution and is in discussions with large healthcare companies interested in licensing opportunities. We hope to see the solution in the hands of patients sometime in 2018.
Here is the video mentioned above which also shows a short demo of how My Diabetes Coach will work in practice:
Related announcement: Macadamian and CHEO partner to develop voice-enabled app to help youth with diabetes…