Tag: diabetes

Boston Globe quotes David Williams on BI Lahey purchase of Joslin Diabetes

November 13th, 2020 by
diabetes 1270350 640
Goodbye independent Joslin

Diabetes is a costly illness that affects tens of millions of Americans. Joslin Diabetes Center is a world renowned specialist located in the heart of Boston’s Longwood Medical Center. It seems like it should be booming, but in fact diabetes treatment is not a great business and Joslin has not had strong financial performance.

Cancer, cardiology and orthopedics –with their invasive procedures– are much better for making money. But good diabetes care means coordinating lots of people to examine and guide the patient. That’s expensive to provide but not well reimbursed.

And standalone specialty hospitals, even prestigious ones, need strong connections to integrated health systems if they want patients.

So it’s no surprise that Beth Israel Lahey plans to acquire Joslin. As David Williams told the Boston Globe (Beth Israel Lahey Health plans to acquire Joslin Diabetes Center), the deal makes clinical and financial sense and is unlikely to attract regulatory scrutiny.

 

BI Lahey to buy Joslin Diabetes. I’m quoted in the Boston Globe

November 13th, 2020 by
diabetes 1270350 640
Goodbye independent Joslin

Diabetes is a costly illness that affects tens of millions of Americans. Joslin Diabetes Center is a world renowned specialist located in the heart of Boston’s Longwood Medical Center. It seems like it should be booming, but in fact diabetes treatment is not a great business and Joslin has not had strong financial performance.

Cancer, cardiology and orthopedics –with their invasive procedures– are much better for making money. But good diabetes care means coordinating lots of people to examine and guide the patient. That’s expensive to provide but not well reimbursed.

And standalone specialty hospitals, even prestigious ones, need strong connections to integrated health systems if they want patients.

So it’s no surprise that Beth Israel Lahey plans to acquire Joslin. As I told the Boston Globe (Beth Israel Lahey Health plans to acquire Joslin Diabetes Center), the deal makes clinical and financial sense and is unlikely to attract regulatory scrutiny.

By healthcare business consultant David E. Williams, president of Health Business Group

Joslin Diabetes CEO faces 'big challenges' –I'm quoted

December 1st, 2015 by
It's tough to win in the diabetes business
It’s tough to win in the diabetes business

Diabetes is a huge health problem, and Joslin Diabetes Center is a renowned, world-class institution. You’d think it would be a good moneymaker, or at least able to break even. But, as the Boston Globe explains in Big challenges ahead for new Joslin CEO, that’s not the case.

Here’s the part of the article where I’m quoted:

Diabetes typically doesn’t require the kinds of expensive treatments or surgeries used to fight illnesses such as eye diseases and cancers. That means Joslin doesn’t have the same opportunities to generate revenues as other specialty clinics in Boston, such as Dana-Farber Cancer Institute and Massachusetts Eye and Ear Infirmary.

“Diabetes is not as profitable a market as more procedure-oriented specialties,” said David E. Williams, a Boston health care consultant

Several years into health reform, it seems odd that we’re still rewarding expensive interventions rather than the type of coordinated, prevention-oriented care that Joslin provides. In some fields, prevention has an uncertain payoff, yet for diabetics proper care helps head off terrible and expensive downstream complications such as amputation, blindness, heart disease and kidney failure.

Joslin has a couple other things going against it:

  • Big healthcare systems have focused on keeping all care within their own systems, preventing “leakage” to other providers even when those providers are excellent
  • Joslin derives a fair amount of its revenue from research. Unfortunately for Joslin NIH rules such as salary caps and COLA freezes make research a loser from a purely financial standpoint. There’s also a lot of competition for grant dollars

Joslin has actually done a good job of recognizing these problems, and has built a substantial commercial business to license its knowhow and brand. But that hasn’t been enough to make up for all of the headwinds.

I am wishing new CEO Dr. Peter Amenta the best of success as he tries to turn this ship around.

Image courtesy of smarnad at FreeDigitalPhotos.net

By healthcare business consultant David E. Williams, president of Health Business Group.

Invokana makes diabetes fun again!

November 17th, 2015 by

 

Question: What do obese, middle-aged and older, mute Americans with Type II diabetes do for fun?

Answer: At least according to this TV commercial for Invokana, they wander around waiting for frisbees with alluring images to glide down from the sky, then clutch the discs tight to change their lives.

I was struck by this 2-minute ad, which I saw a couple times while at the gym. The group really does personify the obesity and Type II diabetes statistics you read about. The ad makes the pill sound quite promising –explaining how great it is for glucose control and adding that it can even help patients lose weight.

The actors keep enjoying new frisbees right through the extensive discussion of side effects. It seemed odd to see a woman clutch a frisbee with what looks a lot like a diagram of the female pelvic anatomy at the same time the urinary tract infection and genital yeast infection side effects are discussed. Check it out around 1:07.

Screenshot 2015-11-16 16.49.10

At first I thought this was an ironic and unintentional placement but when I watched it again I noticed that during the dehydration side effect around 0:50 the guy pulls down a frisbee with a water bottle on it and packs it up for his hike.

Screenshot 2015-11-16 17.38.11

The commercial is somewhat surreal but on the whole I do find it communicates effectively. I bet it will be a success.

As much fun as it looks to have Type II diabetes, I still prefer this video from Virgin America , which takes the boring airplane safety video and turns it into something much more exciting and active than expected. It also includes actors holding on to things from the sky, in this case safety cards.

Screenshot 2015-11-16 17.48.30

 

(And you’ll see there is absolutely zero cast crossover…)

[youtube https://www.youtube.com/watch?v=DtyfiPIHsIg]

 

By healthcare business consultant David E. Williams, president of Health Business Group.

Apple Watch: Continuous glucose monitoring

May 13th, 2015 by
Watch this!
Watch this!

Looking for something useful to do with your Apple Watch? Dexcom, the maker of a continuous glucose monitor (CGM) for diabetics, suggests you use the watch to monitor CGM –your own or someone else’s. This functionality has been available as a smartphone app, but the watch version is designed to be more convenient and discreet.

Dexcom answered my questions below:

  1. Is the Apple Watch useful or more of a toy or gimmick?

For people with diabetes, their family members and loved ones, the Apple Watch is an extremely useful tool. It lets people access their blood glucose data right from their wrist, providing superior convenience and discretion.

  1. What opportunities does the watch provide for people with diabetes? What is the incremental improvement from a smartphone?

The Apple Watch allows greater convenience for those who want this important information in an easy-to-use and discreet form. We share Apple’s commitment to making technology more accessible, relevant and personal.

  1. How does the Dexcom CGM work on the Apple Watch? What are patients really getting?

Dexcom CGM provides patients the opportunity to track their glucose levels and trends right on their wrist with the Apple Watch. Here’s how it works: The user downloads either of the Dexcom apps, Share2 or Follow to their iPhone. The Dexcom G4 PLATINUM System with Share transmits that user’s glucose information to the Share receiver using BLE (Bluetooth Low Energy) wireless communication technology. The Share receiver then sends the information through the iPhone to the watch. The Dexcom apps on the iPhone sync with the watch to provide caregivers and people with diabetes continuously updated glucose information and trend graphs. Additionally, patients or “Sharers” can invite up to five people to view their glucose information and send an alert when the sharer’s glucose levels are outside the norm.

  1. What are the benefits to allowing other users to “follow” your glucose levels on their own devices?

The Dexcom apps will now enable users to monitor glucose on the Apple Watch so that people with diabetes can discreetly view their own information while parents and caregivers can conveniently view a child or loved one’s glucose data, giving them peace of mind and reassurance when they are apart. Examples of people who may benefit include a parent who can monitor a child’s blood glucose levels at night, while the child is at a sleepover, or away at camp or college. Or, a spouse can monitor their loved one’s glucose while they are away on a business trip. It’s useful for anyone who wants to monitor or share glucose information from a remote location.

  1. What information can a person with diabetes or caregiver get when they log into the apps?

Through the Dexcom apps, Share2 and Follow, caregivers and people with diabetes have access to glucose data in real time. They allow both users and “followers” to view glucose data directly on their phone and now on the watch.

  1. Does the Watch set off alarms for patients and followers?

Yes, with an iPhone and the Follow app installed, the watch can alert the Sharer and follower when the Sharer’s glucose levels are outside the designated range, allowing appropriate action to be taken.

  1. Can patients just use the watch and no longer wear the receiver?

Patients will need to have the Dexcom receiver in order for the glucose data to be sent to the iPhone and the watch. For the Apple Watch to work for this purpose, the receiver and the phone are both needed.

  1. What is the benefit of CGM in relation to other methods for monitoring and managing diabetes?

For someone with diabetes, monitoring blood glucose, or blood sugar, levels is a very important part of managing their diabetes. The traditional method for monitoring blood sugar levels is with a blood glucose meter where only a point in time reading is viewed a few times per day. But CGM is a dynamic tool that provides continuous glucose readings (up to 288 readings per day) along with the speed and direction that the glucose levels are headed. In addition, CGM has alerts to let the user know when they are heading too high or low so that action can be taken prior to it reaching a level of concern. Continuous glucose monitoring, or CGM, is considered the most significant breakthrough in diabetes management in the past 40 years.CGM augments the use of glucose meters for the management of diabetes. Meters are still required to calibrate CGMs and for guidance in making therapy and meal decisions.

  1. How do patients with diabetes go about getting the diabetes app? Is it included with the watch, is there an additional cost?

The Share2 and Follow apps can be downloaded for free through the App Store.

  1. Is CGM for Type 1, Type 2 or both?

A Continuous glucose monitor, or CGM, can be used by any person with type 1 or type 2 diabetes on insulin who is concerned about his or her diabetes management. People with diabetes who take insulin must monitor their blood glucose levels frequently. Uncontrolled glucose can cause health complications and can even be life-threatening.

  1. There have been concerns about the Apple Watch battery life. Is there any impact on CGM?

The Dexcom receiver houses all the CGM capabilities. In order to get CGM functionality on the Apple Watch, patients must have their receiver with them at all times.


By healthcare business consultant David E. Williams, president of Health Business Group.

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