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Rick Altinger is the CEO of Glooko. Glooko is an innovative diabetes management tool that allows you to coordinate with your doctor or caregiver to help control your diabetes. The process starts by seamlessly working with your glucose meter (practically every meter!) and smartphone to report your results. However, this is just the initial convenience of this remarkable program.
While we refer to Glooko as a mobile app in the interview, Glooko is much more than just another mobile app! Come learn more about how Glooko is changing the quality of care that is possible for people with diabetes.
INTRODUCTION
DWB :Today, we’re excited to welcome Rick Altinger to the show. Rick is the CEO of the new mobile phone app called the Glooko. Glooko allows you to synchronize your glucose meter with your smart phone so that you can track your readings much more easily than a traditional paper or electronic logbook. Glooko has been named one of the Top 25 new tech health start-ups, and the review has been very positive from both users and industry experts. However, what you should know is that Glooko is not just your average diabetes app. So, we are happy to have Rick come and explain this great new tool to us. Thank you for joining us, Rick.
GUEST: Thank you for having me.
DWB: Now Rick, you just recently joined Glooko in January as its first CEO. What was your background prior to joining Glooko? And, Why did you decide that Glooko was the right company to join at this time?
GUEST: So, I’ve been in health care information technology for over 16-17 years now. I was early employee at a company called Healthscape that became Healtheon, and now is more known as WebMD, which was one of the acquisitions we did along the way. They had a catchy name. At that company, I joined in 1996 I guess it was, I learned a lot about the complexities of health care in a number of different areas. We were a little early at that point in trying to leverage technology to change the way health care is delivered and consumed by patients or consumers. So, I was there for almost six years, when we had about a billion in revenue and 5,000 employees.
Most recently, I worked at Intuit, who was the makers of Quickbooks and TurboTax in helping form their health care business unit which was focused on a patient portal space in trying to get patients engaged in their health care. But the focus there was really more on the administrative transactions. So, it was about doing appointment requests, and filling out forms, and such.
What led me to Glooko, specifically, were the accountable care organizations. The government is pushing for more patient engagement. The ground is ripe for a change. There is also the technology as, finally, to the point with both electronic health records being used at provider organizations, and smart phones in use to virtually all people at this point, or it is soon to be virtually all. So, the ground is really ripe to change the way health care is delivered, and specifically to engage patients in their care. If you look at the top chronic diseases, diabetes being one of them, it needs a new solution. To be transformed. We’ll get into a little bit more about how we’re doing that. So, the timing was ripe. The technology was ripe. Honestly, the team, the founding group here at Glooko, including Yogen and Sunni, really had the right special sauce and had developed an interesting innovation that no one… A lot of other people had tried to do it, but no one has succeeded in doing it.
GLOOKO OVERVIEW
DWB: Well, perfect, that’s a great thing to lead right into what exactly the Glooko app does do, and how it makes life easier for people with diabetes.
GUEST: Yes. So, our first challenge is, obviously, to make things easier for people with diabetes. Really though, it’s more than an app. So, you’ll see we’ll be putting up a new website in a couple of weeks that talks about, really, the Glooko diabetes management solution. It cuts across both patients using an app. That is how it starts. Also, with clinicians, endocrinologists, and diabetes educators also using our system inside their clinics to help patients and get access to this data, and then nudge patients in the right direction, or coach them in the right direction. So, at a high level we’re trying to really transform the way patients and the health care team interact and manage diabetes.
We’re leveraging the power of a mobile platform to do that, with the ultimate goal of improving outcomes, of course, and lowering costs for all involved. So, the way we do that, the first innovation, is basically to build this smart interconnected device or cable that, today, connects with about 21 meters, blood glucose meters. It makes it easy for a patient to create that logbook. So you simply, as a patient, connect it to one of your meters. We’ve got all the major brands from the OneTouch to the Accu-Cheks, and such. They are there. You simply connect and synch.
The first time, you think that it’s a wonderful first use experience because you’re bringing in the hundreds of readings that are in your meter. You bring them into your phone in a place w here it’s convenient for you.
On an on-going basis, though, you can then sync individual readings. That’s just the start of it. Once you do that, the data is put into an account for you. You can choose to share that with either your oldest daughter who is helping you manage your diabetes, or with your health care professional.
The other use case, by the way, is that you walk into your physician’s offices using the product where you walk in and they say, “I’m using Glooko now.” because it’s hard for me to get, in a lot of cases, in the majority cases, patients do not keep a logbook. So I’m using Glooko now. Come over to this kiosk. We’re going to take your meter and take your data out. If the patient would like, they can create an account for themselves. They get an e-mail from Glooko in the practice. They have access to that when they get home.
So, the patient then can start to be engaged in seeing their data. We have unlocked the data out of this meter, and give it to the provider. Then, the provider can start to engage the patient and say, “Okay, I can see that, three days ago, you had a high reading of 240.” What happened? Let’s talk about what’s going on there. That’s a typical interaction. But then, the provider or the diabetes educator can say, “Let me show you this Glooko app, and how you can look up food.” for example.
In this case, the patient may have said, “I went to a subway and I ate that meat ball sub at Subway.” The diabetes educator can say, “Look, if you just enter SUB in the food look-up system here in the app, it brings up the full Subway menu, and shows you all the carb data. Then, you can see that, that sandwich has 98 carbs in it. You’re going to need to bolus in order to handle that amount of carb.”
So, those types of things in the app help people get more educated. It is also convenient. You’re pulling out your phone to look at that type of information. There is no stigma. If you’re a 14 year old girl trying to do that, it’s completely acceptable to pull out your phone as opposed to anything else where you’re afraid to draw attention to yourself.
So, that just an overview of some of the features and functionality, and what the app actually does.
DWB: So, it seems like the whole overriding premise is to be able to use not only your smartphone to set up a dialogue where it’s not just where you visit the doctor every three or four months, and then he says, “How are you doing? Let’s check your A1c.” This is a much more proactive and interactive experience to try to get a handle on things, and coach a person on how to get better.
GUEST: Exactly. That coaching aspect is a great word. The coach comes in numerous formats.
Today, the coach is the dietician, or the diabetes educator. You only see them when you in the clinic. The coach could also be that person acting on your behalf, and calling you or sending you a message via our system that says, “Hey, I see you’ve over corrected three days ago.” This is because your data is all there now. “You went too low. Let’s talk. Let’s analyze that situation.” while it’s fresh in their mind. So it’s continuous. It creates a feedback loop for the patient that is more real-time and in a convenient manner for them.
The coach could also be, though, the oldest daughter that is visiting their mother on a Sunday, and it’s the oldest daughter that has the smart phone. So, they walk into the house and they take the parent’s meter, and rather than ask the parent, “Hey, have you been testing? How has it been going?” you take the meter, you plug it in of course with the patient condition, your mother in this case, and you pull the data in.
Immediately, in your smart phone, you have access to all their readings, and you can see graphs of it. So, you can see, “Oh, at 10AM, there’s a regular problem here. Mo, what’s going on at 10AM?” “Oh, my friends and I actually walk to the Dunkin Donuts down there that just opened up around the corner.” and then, boom, you’re then coaching your mother and saying, “Look, let’s talk about taking your medication at a different time or a different quantity.” or “Let’s talk to your health care provider about that to make sure that your care plan fits with your lifestyle.” This is an on-going process.
So, the coach can be that older daughter type of thing or the coach can be the parent. The parent can be working with their child, again in, in a way that is convenient for the child. The child spends half their life in their smartphone these days. So, the smart phone is, sort of, the right hub for this type of coaching and diabetes management.
IMPORTANCE OF FDA APPROVAL OF GLOOKO
DWB: So, let’s touch upon… It seems that what it significant about the way that this happened which is different than a lot of others, sort of, revolves around the way… It’s worth touching upon the FDA approval process. But, Glooko actually received FDA approval. Now, this is pretty significant. Very few diabetes mobile apps… I’m not even sure if any other apps receive this approval.
Why is the FDA approval so important? How does it make Glooko a better app?
GUEST: Yes. When I joined Glooko, I actually was a little concerned about the FDA processes and such. Now, I’ve actually become a fan because, basically, the FDA is making sure that we have safety with regard to how different apps work and such.
In our case, because we’re connecting directly to a Class Two medical device, the blood glucose meter, and integrating with it, you’ve got to make sure that you do that appropriately and in a safe manner.
So, when you pull the data out, you’ve got to make sure that you do not alter the data in any way, shape, or form, or a bad clinical decision can be made. So, if you’re in the clinic mode where you’re inside the clinic, and a health care professional is using your meter and taking the data out, and then they’re going to make clinical decisions based on that information, the data has got to be accurate and valid. I think the FDA appropriately set some guidelines that say, “You have got to put this through rigorous testing to ensure that the data maintains its integrity.”
In our case, we’re only reading data out of the device. So, you’ve also got to make sure that you don’t interact with or damage the meter or any of the electrical parameters. A big part of our innovation, by the way, is this single smart meter sync cable can deal with all the different electrical parameters of the different meters. So, some of them communicate using a serial three volt communication. Others will use a five volt. Our electronics can switch and deal with that, knowing which meter you’re connected to. But because we’re changing the voltage levels and such, that we send to that meter, we have to be very careful that we don’t do any damage or alter the data in that meter.
So, the FDA is making sure that we do understand that we’re not just some fly by night app, with a bunch of guys in a garage that are throwing together code and throwing it out there and making, trying to get people to use it for a buck a purchase or for free. They want to make sure that we are delivering an end to end quality system. That is a big part of what it means to be FDA certified. It’s not just getting their stamp of approval, but having a quality system so that… Some things, for example, if we change the view of data on a report, we don’t ask for FDA clearance for that. But we have to have a quality system to make sure that it is verified and validated, and that it goes through usability testing if it warrants it.
So, in our case, I think the FDA is a very positive thing, and they’re acting to help and insure safety with people with diabetes in particular.
HOW GLOOKO IS A BREAKTHROUGH IN DIABETES MANAGEMENT
DWB: So, if I could summarize a few things, it seems to me that, number one, you have the whole ease of data entry. If you’re testing three, four, to five times a day, you don’t have to manually enter it in number one. Number two, it also promotes sharing of your entry. If the data is being entered into the smartphone automatically, that allows for a more and better health care experience. Three, it seems like it has also been because you’re not tied to one particular meter. So, you’re not hooked into that $300 meter that only works with that meter, and may have some of this functionality. But your particular app may have a couple of different meters. That’s been my understanding.
GUEST: Yes, that is actually… I’ve never realized the importance of this feature functionality. But we were presenting to a diabetes educator recently. She literally said, “Look, I’ve got goose bumps because you can take data from multiple meters.” We sat there, and sure enough, a patient with diabetes came in an hour or two later. We were testing your system in the clinic mode.
They had an Accu-Chek meter from ROCHE. They also have a Lifescan or a OneTouch meter. We were able to connect to both meters and bring the data into one view. It puts it in one data set, and presents that. For health care providers, they’ve never been able to do that in the past. So now, you’ve got a true picture of this person. In this person’s case, they had a meter that they kept in their desk at work, and then, they had their main meter that they kept, that they did most of their readings with. But it told a very different picture when you’re able to bring that data together.
The other key thing is that it’s not just about blood glucose. So, the process here starts with blood glucose. But, to manage diabetes really entails bringing together other data to complete a full picture, and to educate yourself, and make it part of your lifestyle, and part of your day to do this without having to expend a lot of CPU cycles in your brain. So, in addition to blood glucose, it also makes it easy for you to tag your results. So what’s this? Is it a fasting result? Had I just eaten? Also then, it is to keep track of what carbs and what food you’re using.
The food database is getting an increasing amount of usage where you can… There are over 200,000 entries in our food database where, including all the menus that we’ve talked about earlier, you can look up and you can also build meals and such, and continually educate yourself on the food that you’re eating, and the carbs in that to help you understand what medication or insulin you should be taking. Lastly, it is to keep track of exercise in there.
So, it’s all those. It’s not just blood glucose. It’s all those pieces of data having it convenient in your hand. Also, it’s being able to look back and say, “Okay, the last time I went into Subway, what happened?” You can look back very easily and get a sense for when was the last time you ate that Meatball Sub, and what took place.
We’re going to be adding features and functionality where you can, using the geo location on the phone, keep track of where you are. It can prompt you to say, “You just walked into the Subway.” When you bring up the app, and you’re inside of a Subway, it says, “Would you like to look at the Subway menu?” or “Would you like to look at your log, and see what happened the last time you were in a Subway restaurant?” for example.
CONNECTIVITY AND WRAP-UP
DWB: Okay. My understanding is that this app only works with the iPhone, currently? Are there any plans to, maybe, work with Android?
GUEST: That’s a perfect question. I have it right in my hand, right now, is the Android version. We’re about to start usability testing on it in about two weeks. The Android is a little more challenging because there are a lot of different phone platforms that are available, and form factors and such. But that is a key deliverable for us. That sort of a next key deliverable, to be honest with you, is to get the Android version out. The team has been working hard on that. Then, it will work with the majority of Android devices.
But then, it also puts the same data in the cloud. So if, in the case of a friend of mine who has a child with diabetes, the parent has an iPhone and the child has an Android. Basically, it puts the data in one account. The parent can look at it with their iPhone, and the child can be looking at it with their Android, in entering their data from there.
DWB: That’s interesting. Hopefully, the upcoming Android users. Do you have any other plans that you want to share with the audience about what you have coming up in the future?
GUEST:Sure. One thing we haven’t talked about yet is the Bluetooth version. So this is going to make it even more convenient for patients and people with diabetes. Basically, we would turn all meters that we support today into Bluetooth enabled meters. So, instead of… There will still be something that connects to the meter.
But then, instead of having to physically connect to your phone as well, your phone can stay in your pocket. You simply test and hit the button on the Bluetooth adapter that is connected now to your meter with a little dongle, or a tiny little cable. It stays in your case at all times. Then, boom, the reading is in your smart phone. Assuming that your smart phone is connected to the internet, it’s also in your cloud based account, so that your overall care team can see it. So, that is going to make it a lot more convenient for folks.
We are developing that now. There is an early round of, or early versions of the design. We’re hoping to have that out in the fall.
DWB: Okay. Where could people find out more about Glooko?
GUEST:It is mainly from the website. Particularly, patients with diabetes can go to www.glooko.com and see more information on that website. You’ll be able to… We’ll be updating that website in a couple of weeks to include content for health care providers. I’ve talked a little bit about the clinic mode, and using the product inside of a clinic.
There also is another constituent which is more of the payer organizations that will be talking to the value for them. Some of their back end coaches can also be using this product to help patients with diabetes, understand their disease, and understand how to manage it on an ongoing basis.
DWB: Rick, I want to thank you again for being such a great guest and speaking in our program, Rick. We enjoyed having you. Hopefully, this will take off like it should.
GUEST: Thank you very much for the opportunity.