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ANDHealth and Novartis Present
Digital Health:
Clinical Evidence and Patient Impact
ANDHealth Members::
#ANDHealthSummit |@ANDHealthAU | @Novartis
KEYNOTE
Disrupting Diabetes!
Hitting the “Sweet Spot” with AI and
Machine Learning in the Treatment of
Chronic Disease
ANAND IYER
MS, PhD, MBA, CO-FOUNDER & CHIEF STRATEGY
OFFICER, WELLDOC
©2018 WellDoc, Inc. Intellectual Property. All rights reserved
Disrupting Diabetes!Hitting the “Sweet Spot” with
AI and Machine Learning in
the Treatment of Chronic
Disease
Anand K. Iyer, PhD, MBA
Chief Strategy Officer, WellDoc
Sydney, Australia
May 3, 2018
©2009-18 WellDoc, Inc. Intellectual Property. All rights reserved. Proprietary and Confidential. Not permitted to be duplicated or reproduced without the express written consent of WellDoc, Inc. WellDoc and the logos associated therewith and all other WellDoc marks contained herein are trademarks of
WellDoc. All other marks contained herein are the property of their respective owners.
©2009-18 WellDoc, Inc. Intellectual Property. All rights reserved. Proprietary and Confidential. Not permitted to be duplicated or reproduced without the express written consent of WellDoc, Inc. WellDoc and the logos associated therewith and all other WellDoc marks contained herein are trademarks of
WellDoc. All other marks contained herein are the property of their respective owners.
©2009-18 WellDoc, Inc. Intellectual Property. All rights reserved. Proprietary and Confidential. Not permitted to be duplicated or reproduced without the express written consent of WellDoc, Inc. WellDoc and the logos associated therewith and all other WellDoc marks contained herein are trademarks of
WellDoc. All other marks contained herein are the property of their respective owners.
2000
1988-2000
% of patients A1C <7% of patients A1C <7
Source: Casagrande SS et al. The prevalence of meeting A1C, blood pressure, and LDL goals among people
with diabetes, 1988-2010. Diabetes Care. http://care.diabetesjournals.org/content/early/2013/02/07/dc12-2258.full.pdf
2005 2007-2009 2010-2012 2013 2014 2015
44%2000-2005
44.1%2005-2010
57%2010-2015
52.3%
©2009-18 WellDoc, Inc. Intellectual Property. All rights reserved. Proprietary and Confidential. Not permitted to be duplicated or reproduced without the express written consent of WellDoc, Inc. WellDoc and the logos associated therewith and all other WellDoc marks contained herein are trademarks of
WellDoc. All other marks contained herein are the property of their respective owners.
1Picture courtesy of Chris Crockford and Erik Johanssen
©2009-18 WellDoc, Inc. Intellectual Property. All rights reserved. Proprietary and Confidential. Not permitted to be duplicated or reproduced without the express written consent of WellDoc, Inc. WellDoc and the logos associated therewith and all other WellDoc marks contained herein are trademarks of
©2009-18 WellDoc, Inc. Intellectual Property. All rights reserved. Proprietary and Confidential. Not permitted to be duplicated or reproduced without the express written consent of WellDoc, Inc. WellDoc and the logos associated therewith and all other WellDoc marks contained herein are trademarks of
WellDoc. All other marks contained herein are the property of their respective owners.
©2009-18 WellDoc, Inc. Intellectual Property. All rights reserved. Proprietary and Confidential. Not permitted to be duplicated or reproduced without the express written consent of WellDoc, Inc. WellDoc and the logos associated therewith and all other WellDoc marks contained herein are trademarks of
WellDoc. All other marks contained herein are the property of their respective owners.
©2009-18 WellDoc, Inc. Intellectual Property. All rights reserved. Proprietary and Confidential. Not permitted to be duplicated or reproduced without the express written consent of WellDoc, Inc. WellDoc and the logos associated therewith and all other WellDoc marks contained herein are trademarks of
WellDoc. All other marks contained herein are the property of their respective owners.
12
Enter Stage Left: Digital Health
©2018 WellDoc, Inc. All rights reserved
• Solutions that use digital technology in the attempt to improve patient engagement and therefore, health outcomes and/or costs
• Encompass a wide variety of tools, ranging from wearable sensors and portable diagnostic equipment to data-driven software platforms, telemedicine tools, and mobile health care apps
• Empower individuals to track, diagnose, manage, and improve overall health and well-being, including how to choose and access health care services
Confusion
314 Wearables available worldwide
60% of apps are just general wellness
Patie
nt C
hurn
200 new apps each day20% of large health systems have full-scale digital health programs
Source: IQVIA 2017 Report “The Growing Value of Digital Health”
SVB Analytics, “Consumer Digital Health: How Market Shift is Leading to New Opportunities”, 2016
15
Enter Stage Right: Digital Therapeutics (DTx)
©2018 WellDoc, Inc. All rights reserved
DTx: A subset of digital health, but that:
• Are SaMD: Software as a Medical Device as defined by IMDRF
• Have demonstrated outcomes and efficacy as evidenced in multiple RCTs, conducted by independent third parties, published in peer-reviewed journals
• Are cleared by the regulatory authorities for patient safety and GMP
• Adhere to the latest cybersecurity guidelines and best practices
• Leverage AI and MI as their “mechanisms of action”
• Deliver value that’s integrated into mainstream healthcare delivery
Source: Digital Therapeutics Alliance www.dtxalliance.org
16
Digital Therapeutics Have the Potential to Help Healthcare Systems Achieve 5 Important Goals
©2018 WellDoc, Inc. All rights reserved
1. Helping patients become more engaged in their own care
2. Closing communication gaps
3. Identifying patients’ needs and tailoring services to meet them
4. Enabling consumers to get care in convenient, cost-effective ways
5. Improving decision-making by consumers and providers
What We Built: BlueStar®: Engaging Patients and Their Healthcare Providers
©2009-18 WellDoc, Inc. Intellectual Property. All rights reserved. Proprietary and Confidential. Not permitted to be duplicated or reproduced without the express written consent of WellDoc, Inc. WellDoc and the logos associated therewith and all other WellDoc marks contained herein are trademarks of
WellDoc. All other marks contained herein are the property of their respective owners.
▪ Clinical Parameters: BG (manual & connected), BP, Lipids, Labs, etc.
▪ Medications: All medications, vitamins, herbal supplements, etc.
▪ Activity: Direct and through IoT sensors
▪ Food: Direct and through restaurant locators
▪ Symptoms: Notes and context around entries
▪ Psycho-social: Behavior modification support
How: Supporting Patients and Care TeamsWhat: Managing the “360o” of Diabetes
BlueStar®: What it Does and How It Works
▪ Journey: Guided, BlueStar-U or “at-will”
▪ Patented Real-time Feedback Engine: Precise, Personalized, Contextual, On or Off-line
▪ Insights: Weekly summaries and “why’s”
▪ Care Team: SmartVisit report, Population reports
▪ Device Integration: Meters, IoT Sensors, Others
©2009-18 WellDoc, Inc. Intellectual Property. All rights reserved. Proprietary and Confidential. Not permitted to be duplicated or reproduced without the express written consent of WellDoc, Inc. WellDoc and the logos associated therewith and all other WellDoc marks contained herein are trademarks of
WellDoc. All other marks contained herein are the property of their respective owners.
Data Capture Frequency
DataCapture Source
Patient
Non-Patient (e.g., Provider, 3rd party,
EMR, Labs, etc.)
Low(~Static)
High(~Dynamic)
• System-generated KPI’s, alerts, trends
• System and feature-level utilization data
• Absence of data
• Physiologic data • Symptom data• Lifestyle data• Medication data
• Registration data (e.g., demographics, medication history, daily regimen, etc.)
• Psycho-social data (health literacy, cultural, social, etc.)
• Labs and screenings• Evidence-based
guidelines• Medication regimen• Metabolic targets and
ranges• Clinical rules• Physician instructions
Increasing Variety, Volume, Veracity and Velocity of Data
©2009-18 WellDoc, Inc. Intellectual Property. All rights reserved. Proprietary and Confidential. Not permitted to be duplicated or reproduced without the express written consent of WellDoc, Inc. WellDoc and the logos associated therewith and all other WellDoc marks contained herein are trademarks of
WellDoc. All other marks contained herein are the property of their respective owners.
Discover: Using known data to draw insights• Pattern recognition• Discriminant
functions (SDF, LDF)• Clustering• Behavioral patterns• “Why”
Inform: Presenting primary analyses of the data• Engagement or usage
data• Clinical value data• Population data• “What”
Extrapolate: Using existing data to model patterns and predict future occurrences• Bayesian, Markov• Machine learning
based models• “When”
Data Status
Analysis Intent
“Don’t Know What I’m
Looking For”
“Know What I’m Looking
For”
“Have Data” “Don’t Have Data”
Adapt: Using learning techniques to provide new insights and choices for optimizing outcomes • Dynamic feature and
service configuration• “How”
IDEA!
Sweetening the Value Proposition: An IDEA!
©2009-18 WellDoc, Inc. Intellectual Property. All rights reserved. Proprietary and Confidential. Not permitted to be duplicated or reproduced without the express written consent of WellDoc, Inc. WellDoc and the logos associated therewith and all other WellDoc marks contained herein are trademarks of
WellDoc. All other marks contained herein are the property of their respective owners.
John:
Basal Insulin
Mary:
MDI
Same BG of
226 mg/dL
Informative: Key to Precision and Personalization“What happened?”
©2009-18 WellDoc, Inc. Intellectual Property. All rights reserved. Proprietary and Confidential. Not permitted to be duplicated or reproduced without the express written consent of WellDoc, Inc. WellDoc and the logos associated therewith and all other WellDoc marks contained herein are trademarks of
WellDoc. All other marks contained herein are the property of their respective owners.
Summary and Insights for:
BG Meds
Carb Summary & Insight
Activity Sleep
Discovery: Multi-variate Correlative Insights“Why did it happen?”
©2009-18 WellDoc, Inc. Intellectual Property. All rights reserved. Proprietary and Confidential. Not permitted to be duplicated or reproduced without the express written consent of WellDoc, Inc. WellDoc and the logos associated therewith and all other WellDoc marks contained herein are trademarks of
WellDoc. All other marks contained herein are the property of their respective owners.
Extrapolative: Human vs. AI Machine“When will it happen?”
Iyer, A; Abstract presented at Chief AI Officer Conference, Corinium, San Francisco November 2017
©2009-18 WellDoc, Inc. Intellectual Property. All rights reserved. Proprietary and Confidential. Not permitted to be duplicated or reproduced without the express written consent of WellDoc, Inc. WellDoc and the logos associated therewith and all other WellDoc marks contained herein are trademarks of
WellDoc. All other marks contained herein are the property of their respective owners.
Phil has a low BG (65)
in the morning
Phil takes his BG later (92);
indicates before exercise
Reminder to bring a snack along
for exercise due to Phil’s low
earlier in the day, plus current BG
Adaptive: Engaging People“Keeping it from happening”
©2009-18 WellDoc, Inc. Intellectual Property. All rights reserved. Proprietary and Confidential. Not permitted to be duplicated or reproduced without the express written consent of WellDoc, Inc. WellDoc and the logos associated therewith and all other WellDoc marks contained herein are trademarks of
WellDoc. All other marks contained herein are the property of their respective owners.
Adaptive: Engaging People“Making it happen!”
©2009-18 WellDoc, Inc. Intellectual Property. All rights reserved. Proprietary and Confidential. Not permitted to be duplicated or reproduced without the express written consent of WellDoc, Inc. WellDoc and the logos associated therewith and all other WellDoc marks contained herein are trademarks of
WellDoc. All other marks contained herein are the property of their respective owners.
Getting to the “Sweet Spot”:Combining BlueStar’s A1c “Shifting” Effect …
©2009-18 WellDoc, Inc. Intellectual Property. All rights reserved. Proprietary and Confidential. Not permitted to be duplicated or reproduced without the express written consent of WellDoc, Inc. WellDoc and the logos associated therewith and all other WellDoc marks contained herein are trademarks of
WellDoc. All other marks contained herein are the property of their respective owners.
On average, a
2-point drop in A1c
4X what’s required
for a new drug
Top 15 drugs today
average 0.8
… With Average Population “Starting A1c Points”
30%
34%
16%
20%
Current Distribution for Non-Medicare Patients
% with A1c < 7 (In Control) % with A1c 7 to 8 (Elevated)
% with A1c 8 to 9 (High) % with A1c > 9 (Not Controlled)
41%
35%
14%9%
Current Distribution for Medicare Patients
% with A1c < 7 (In Control) % with A1c 7 to 8 (Elevated)
% with A1c 8 to 9 (High) % with A1c > 9 (Not Controlled)
*Current A1c Distribution Source: MarketScan database, a product of Truven Health Analytics, an IBM Company. The MarketScan database contains employer-based healthcare claim information for more than 122 million patients in the US represented by more than 130 unique carriers, and includes laboratory test results for over 1.67 million patients.
… With Real, Adjudicated US Claims Data
In both populations, average cost in each A1c band increases as a step function as A1c increases
*Source: Truven MarketScan Database: Annual Cost Per Patient is average amount paid for any healthcare claim within 365 days for: 1) patients with at least two lab results within the same A1c range ; and 2) patients with four lab results within the same A1c range. Percentage in Band Today is based on national attrition levels in Truven database.
Converting AI into Economic Return: Sweet!
©2009-18 WellDoc, Inc. Intellectual Property. All rights reserved. Proprietary and Confidential. Not permitted to be duplicated or reproduced without the express written consent of WellDoc, Inc. WellDoc and the logos associated therewith and all other WellDoc marks contained herein are trademarks of
WellDoc. All other marks contained herein are the property of their respective owners.
WellDoc Validates Potential of Its Digital Therapeutic, BlueStar®, to Significantly Reduce Healthcare Costs.
Cost savings based on reductions in acute medical incidents, supplies and medications, and co-morbid conditions.
3-5XAverage ROI Average Savings/User/Month
$254-$271
©2009-18 WellDoc, Inc. Intellectual Property. All rights reserved. Proprietary and Confidential. Not permitted to be duplicated or reproduced without the express written consent of WellDoc, Inc. WellDoc and the logos associated therewith and all other WellDoc marks contained herein are trademarks of
WellDoc. All other marks contained herein are the property of their respective owners.
www.welldoc.com
Thank You!
Anand K. Iyer, PhD, MBAChief Strategy Officer
aiyer@welldocinc.com
@DrAKIyer@WellDoc@BlueStar
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