A need for disruption

My favourite app on my iPhone is Uber. I love it. All the issues of having to stand around on street corners, waiting for a taxi and flagging down empty cabs as they race by you are easily and conveniently eradicated with a simple few clicks of the app on my phone. No need to worry about having cash on you – or dealing with the frequently not-working credit card machine in the car. Get in, get to where you need to go, get out. And sometimes there are snacks!

I have used Uber around the world and I love that it doesn’t matter if I am in Stockholm, New Orleans, Melbourne or New York, it works the same.

I had the most delightful Uber drivers in New Orleans a few weeks ago, including one who picked me up from a burger place in the middle of nowhere (thanks to Fredrik for always finding the most obscure, out of the way local haunts!) and chatted happily with me for our 10-minute ride back to my hotel. She gave me some terrific tips for the city and asked me about Australia.

Another night, also in New Orleans, we were picked up in a red jeep by a funny and friendly guy called Kevin who, if we had said ‘You know, we’re not done yet; how about we go to another blues bar,’ would mostly likely have joined us. And shouted us beers.

When we got to New York, we collected our bags at JFK and walked out to grab a cab. We settled into the back seat for the hour long trip to our hotel and mindlessly watched the little screen on the back of the driver’s seat. And there, we saw that New York’s iconic yellow cabs had a new app, Arro, which allows passengers to hail a cab and pay for their ride using their smart phone.

This was clearly in response to Uber and the convenience and ease it has afforded users.

Uber is an example of disruption in an industry that previously had absolutely no competitors and was happily providing a rut of a service that users simply had to use. It came about because the system was broken.

Healthcare hasn’t had that disruption. And it needs it, because this system is broken.

One of the most interesting sessions I attended at the ADA was an out of hours event hosted by the innovative team at diaTribe. I know that we can always count on to get us thinking.

The Musings Under the Moon session was billed as a discussion on digital health. But it was much more than just a state of play update.

I sat down with some DOC friends at had a good look who was presenting. There in front of us, all together sharing one stage were absolute leaders in digital health and technology, including the CEO of Bigfoot Biomedical, the President of Medtronic Diabetes, the CEO of Dexcom and an Executive VP at Novo Nordisk. And outside the specifically diabetes space we also had the Chief Health Officer at IBM and the VP and Chief Medical Officer at Qualcomm Life. The panel was expertly moderated by diaTribe’s Adam Brown.

To assemble such a panel is one thing. To have them candidly talking about the what is going on in the digital health space – and being challenged on why it is not moving faster – is another.

Perhaps the most candid and, for my money, the most interesting commentary came from Jeffrey Brewer from Bigfoot Biomedical. A couple of things he said have obviously resonated with many others in our community because they have been shared over and over on social media. Like this:

He is right and it is no wonder his words were met with such overwhelming support from people with diabetes. Brewer is not backwards in coming forwards and this comment also shared not only his, but many in the community’s, frustrations.

We have become conditioned to simply accept the status quo when it comes to developments in diabetes technology. We accept that the drivers of not only the developments, but the speed in which they arrive in our hands and attached to our bodies, are the companies whose skin in the game is, for the most part, is return on investment. I get that and, as is the case with any business, it to be expected. I also understand approval bodies and their debilitatingly slow processes.

Except it’s not really okay when the result is that we are not moving as fast as we should be.  Or that we begin to believe that what we do have at our disposal is as good as it gets.

Today, we would never believe the idea of sharpening needles or checking urine is an adequate way to to manage our diabetes. Not when there are other tools available.

And yet, we think that it is perfectly acceptable to use BGL checking four times a day (or six or ten or twenty…) as a way to manage our diabetes. This is old technology that gives a snapshot with no more information – no arrows, no suggestions of where we are going or where we have been. How is that still okay when we have CGM and flash glucose monitoring available that we know provides more information, more data, better ability to make smart management decisions?

We do nothing because we can’t or we simply accept that we use what we have. This doesn’t for a moment take into consideration the trailblazing Open APS users (currently 88 people around the world according to this tweet from Dana Lewis), and movements such as #WeAreNotWaiting.

Healthcare needs disruption. The current situation is not okay; the system is broken and it needs fixing. Because right now, we are being shortchanged. And it’s not good enough.

I have absolutely no connection to Bigfoot Biomedical other than I am very fortunate to be friends with Melissa Lee who works for them. But I did win one of their t-shirts in a competition at ADA and I proudly wore it on the streets of New York!