The cost of managing chronic diseases is the largest portion of health care expenditures in developed countries. For example, the prevalence of adult acquired diabetes has been rising in the United States, in concert with increasing rates obesity. The CDC has termed it an “epidemic”, especially in light of the massive costs incurred by the health care system due to diabetes.

The deleterious health effects of many chronic conditions can be diminished by behavior modifications. While few would underestimate the difficulty of having patients lose weight or exercise more, good management of blood sugar in diabetes is both objectively measurable and strongly correlated with reduced end-organ damage.

This is among the reasons why Research2Guidance has recently nominated diabetes as the condition most likely to be most targeted by mobile medical software and devices (mHealth). This finding is part of their recently published Global Mobile Health Market Report 2010-2015. This is the same report that also predicted that, in the future, medical apps are likely to be distributed by physicians and health care institutions.

This time Research2Guidance is highlighting the portion of the survey where they looked into where mobile devices have the most potential to affect health outcomes. While other chronic conditions such as hypertension and obesity have larger populations, the market researchers felt diabetes had the largest market potential due to the huge cost saving potential, the demographic & geographic overlap between smartphone users and diabetics and the real potential to improve sugar management using mobile devices. As per Research2Guidance,

To manage patients diabetes in “real time” and “on-the-go” situations, shared information within the healthcare industry and especially between medical professionals whilst “on-the-go” is essential.

34532saqw1.jpgMedgadget recently reported that Sanofi-Aventis and AgaMatrix have deployed in Europe the iBG Star, an integrated iPhone app and glucometer for measuring and recording blood sugars. This app stores recorded sugars and allows for data to be easily “communicated to healthcare professionals.” Unfortunately, this likely means that the app sends an email. And thus, it demonstrates one of bottlenecks for behavior modification by mHealth, i.e. the lack of integration into health care professionals’ workflow. In this vein, the efforts of EHR vendors such as Practice Fusion to develop APIs for direct, real time importation of patient data could be a key ingredient.

Nevertheless, the excitement around mobile medical software and devices is evident in this quote in the blog Diabetes Mine from noted endocrinologist Bruce Bode, MD:

The user experience is so rich and just amazingly simple. When you look at the iBGStar, you just know what to do with it – plug it into the iPhone, stick a strip in, and test! Amazing! The potential for this connectivity to the healthcare providers, family members, and smart software systems will change how we manage diabetes in the future. …I have never seen such an incredible device in my 25 years as an diabetologist.

Even then, the major driving force for adoption will remain the potential cost savings. Again, as per Research2Guidance, the direct costs alone of diabetes for a patient with diabetes in Western European countries are between 4,000 and 5,000 EUR annually. In the United States, adoption of these technologies will also hinge on FDA approval and adoption of more rational payment structures for physicians (e.g. medical homes and ACOs) that reward improved disease management, not just office visits.