How connected devices help drive usage and company success. Key takeaways from 6 use cases.

Digital health solutions struggle to keep users engaged and keep them using their online services. Adding a connected device can improve engagement, tracking and adherence. We look at 6 use cases where the companies used a connected device as a part of their offerings and have been noticeably successful.

Would a user adhere to a fitness program better if supplied with tracking devices such as a connected weight scale and a pedometer. Evidence seems to suggest so. As a digital health analyst and consulting company we routinely monitor the success factors and discuss with market participants, what approaches they deem to be working better than the others. Including products and services such as connected devices, coaching, medical supplies and a large digital ecosystem, seem to be one part of that big puzzle. In this blog, we focus on connected devices. Connected Devices can be defined as smart devices that have communication capability. This may be achieved through physical cables, but more often it’s managed wirelessly through a technology such as Wi-Fi, Bluetooth or a cellular network.

There are some explanations why a connected device could be a stickiness-factor for a digital health solution, enlisted as under:

FOR A USER

• People like to have gadgets – Users like to appear to be tech-savvy and even basic products with new age technology and design can hold excessive appeal for them. A successful case in the category is One Drop. Its Apple-sque blood glucose monitor has ensured people don´t see a BGM as a medical device anymore. Additionally, the company provides accessorizing options such as carry cases, water bottles and even a carry bag.
• No need for manual input – Humans by nature are lazy or too busy to keep themselves occupied with routine manual logging into an app. In such a scenario, an automated, auto-sync device exporting data to an app or a central database reduces much of the mundane tasks of recording and sharing data.
• Proactively replenished supplies – No need for visits to hospitals or clinics and no filling forms to replenish medications. No long waits in queues and no separate bills. Having connected devices automates most of these processes and eases the life of the user. For example: An add-on cap for respiratory inhalers, counts the dozes taken and the frequency of usage. Apart from collecting other significant medical data, this also allows the medical company to anticipate the need and time for replenishing supplies.

FOR A PROVIDER

• Patient monitoring – Often the patient populations are large and resources such as medical professionals stretched and limited. A dashboard system which allows for quick and easy monitoring of patients eases the tasks and leads to better monitoring.
• Continuous medical data and better decisions – To make better clinical decisions in real-time and document changes in a patient’s condition at every stage, it is equally important to first have the data to make that assessment. Connected devices solve the dual problem of real-time data as well as clean data. Considering, a device automatically syncs in all the readings, the scope for manipulation by the user is also limited. Leading to an overall improved decision making at the care provider´s end.
• Operational efficiency – As a care provider, prioritizing which patients/ users needs the most help or on an urgent basis can lead to better results and user satisfaction. Data from the connected devices can help in achieving this result.
• Improved personalization – What if the doctor (or the system) knows, that a user is most likely to become a habitual offender of not adhering to prescribed medications, if they have failed to take medication four times in a row. A timely intervention can help the doctor in keeping the patient away from the threshold right after the third missed dosage, for example. Or, in another instance, as per the system´s statistics for John, an asthma patient. If he misses his Inhaler dosage and the weather forecast suggests a high SPM level for the next two 2 hours, all pointing to a possibility of John suffering from an Asthmatic attack if he goes out of his home, the system can issue an alert to both John and the care provider to take appropriate action.
• Enhancing communications – As in above cases, the devices can help in timely intervention and help the care provider team take appropriate measures/ communicate with the user.

In all the above cases, however, the need for a connected device is a must, to provide that data to the doctor/ system to create individual profiles, facilitate real-time monitoring, and/or providing suitable follow-throughs and recommendations. This leads to a better service delivery, and, hence, a satisfied customer.

Below listed are some cases, where the companies have included connected devices as a part of their offering, or added a digital offering to their medical products and have achieved significant success:

• Case 1: Noom – Fitness coaching – Noom is an app-based nutrition and weight-loss program employing connected devices such as weight scales and activity trackers. Evidence of success – As per Noom’s claims and a study published in 2016, ‘’Researchers analysed data from 35,921 Noom app users over the course of about nine months and found that 77.9 percent reported they lost weight.’’ The company claims a worldwide user base of 45 million and reported $60M in revenues in 2018.
• Case 2: Abbott – Diabetes – Abbott’s FreeStyle Libre system is a flash glucose monitoring system, which helps the user monitor blood sugar levels continually for upto 14 days. Its app complements the meter and incorporates features such as pattern detection and alerts and notifications. In 2018, the company launched country versions of its app to improve localization. Evidence of success – ‘’To meet anticipated demand for the upcoming FreeStyle Libre 2, Abbott is planning to boost its manufacturing capacity. The goal is to ramp up manufacturing of the device to between 3 to 5 times of current production levels. Overall, the firm expects to reach sales of $1.5 billion for the Libre system this year.’’
• Case 3: Propeller Health – Respiratory – Propeller’s products treat chronic respiratory disease and aim at improving clinical outcomes for patients through connectivity, analytics, and companion digital experiences. With the help of the app a user can auto sync dosage data, which when combined with other information generates insights into possible causes of symptoms escalation. Additionally, a user can create medication reminders and share reports with their HCP. Evidence of success – Propeller’s studies claim its users experience more symptom-free days and up to 79% fewer asthma attacks. In December of 2018, ResMed announced that it has entered into a definitive agreement to acquire Propeller Health for $225 Million.
• Case 4: Carrot – Smoking cessation – Carrot operates a program called Pivot which helps users decrease or control their smoking frequency. The program consists of an app, an FDA-cleared carbon monoxide breath analyser, human coaching and pharmacotherapy encouragement. It is divided into five sequential stages delivered over the course of 14.5 to 18.5 weeks. Evidence of success – A recently published study by the company reported that nearly a third of enrolees successfully quit smoking by the program’s end, with many who did not report a reduction in average cigarettes consumed per day. “Demonstrating a quit rate of 32.4% exceeded our expectations, mainly because so many participants were not ready to quit smoking when they enrolled in the study,” Dr. Jennifer D. Marler, senior director of clinical and medical affairs at Carrot and the study’s lead author, said in a statement.
• Case 5: Proteus – Medical Equipment – Proteus Discover works on tracking medication adherence and comprises ingestible sensors, a small wearable sensor patch, an application on a mobile device and a provider portal. Once activated, Proteus Discover displays patient health patterns and medication treatment effectiveness, leading to more informed healthcare decisions for everyone involved. Evidence of success – The company has more than 500 issued patents and has raised close to $500M till date. Recently, the company expanded into the oncology treatment area.
• Case 6: Fitbit – Wearables as Medical devices – While wearables like physical and sleep activity trackers are not considered as medical devices, their application and importance in gathering important user data can be significant. The data can be used in conjunction with other medical data to monitor a user’s condition, as well as design personalized curriculums. Company in News – We discuss the case of Fitbit, which has already amassed a significant user base through its wearables and apps and is now looking to emphasize on its services segment. As per a recent release, Fitbit Health Solutions, which includes services like coaching as well as solutions for employers, health plans, and other organizations, is expected to generate around $100 million of revenue this year. The services business will get a boost over the next year from a deal with the government of Singapore. In the company’s first major integration with a national health program, Fitbit will provide free devices for those willing to commit to a year of the company’s premium service. This deal is expected to account for more than 5% of health solutions revenue, according to a Fitbit spokesperson.

Some other companies/ use cases to look at – Biobeat, DexCom, NuvoAir, and Xyz.

The above-mentioned use cases highlight a significant role of the relationship between devices and digital solutions for a company’s success. A company focussing on only one-side of the solution is likely to face lesser success, compared to the one, which has a robust combined device-digital solution offering.

There are also some studies, which point to increased engagement when the device and the complementary digital offering work in tandem.

• Walgreens conducted a study titled, ‘’Self-Monitoring Utilization Patterns Among Individuals in an Incentivized Program for Healthy Behaviours’’ to evaluate health data self-tracking characteristics of individuals enrolled in the Walgreens’ Balance Rewards program, including the impact of manual versus automatic data entries through a supported device or apps. One of the key findings: Individuals who entered activities automatically through supported devices or apps participated roughly four times longer than their manual activity-entering counterparts (average 20 and 5 weeks, respectively).
• A study was conducted to investigate medication nonadherence (occurs in 20–60% of persons) for people with bipolar disorder (BD). The study is titled, ‘’Use of automated medication adherence monitoring in bipolar disorder research: pitfalls, pragmatics, and possibilities’’. One of the key findings: Automated devices such as MEMS can assist investigators in evaluating adherence in patients with BD. Knowing the anticipated pitfalls allows study teams to implement pre-emptive procedures for successful implementation in BD adherence.

To recap, there is merit in focusing on both the medical device and its complementary digital health solution together. Quite often it is witnessed that a medical device company ends up focusing too much on its device and is lackadaisical in the implementation of the complementary digital offering (For example, the case of some Continuous Glucose Monitor (CGM) manufacturers). The two should be seen as indispensable parts of one complete offering. Similarly, a health or fitness app company can benefit from linking its app solution to a connected device, even if only basic instruments such as a weight scale or an activity tracker. The process can improve collection of data, help build a holistic user profile and offer personalized services such as coaching programs or insurance plans.

Do you have any personal experience using such a solution or have ideas on how to further improve patient engagement? Please feel free to connect with us and share your views.