Entrevista a Lisa Huse. General Manager, Roche Diabetes Care Spain

Roche Diabetes Care Spain is focused on delivering digital solutions that integrate into the daily lives of people with diabetes, the second most expensive chronic condition after cancer.

Entrevista a Lisa Huse. General Manager, Roche Diabetes Care Spain

Lisa Huse, Roche Diabetes Care

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 Roche Diabetes Care Spain is focused on delivering digital solutions that integrate into the daily lives of people with diabetes, the second most expensive chronic condition after cancer.


 The number of people with diabetes worldwide is expected to increase by 50% in the coming 20 years. Are healthcare systems ready to manage that burden?

A key challenge in Spain is that there are over 5 million people with diabetes, but almost half of them are undiagnosed (FEDE) . For the system to better manage today’s challenge and tomorrow’s increase, more needs to be done to diagnose the missing millions. Beyond diagnosis, healthcare systems are more equipped to manage acute illness than they are chronic illness. Diabetes truly is a “do-it-yourself” condition where the patient spends, at best, 4-6 hours with a healthcare professional every year focused on their diabetes treatment plan. The remaining 8.754 hours of the year, they have to self-manage. Roche Diabetes Care recognizes this self-management challenge. We are focused on developing solutions that enable people with diabetes, and their healthcare teams, meet this self-management challenge but still maintain a high quality of life by spending more time in range and thinking less about their diabetes.


How can connected devices and mobile applications support and trigger healthy behaviours among citizens with chronic conditions?

Diabetes is the second most expensive chronic condition after cancer. It is not expensive because of insulin, medications, or blood glucose monitoring products. The major costs are due to complications, but 80% of these complications are avoidable. Connected devices and mobile applications create new ways to educate, engage, monitor and support people with diabetes, with the involvement of their healthcare team. And, the beauty is that many of these devices and applications are a part of our daily lives. In Spain, 88% of people have smartphones and more than 80% of internet users access it through mobile devices . One third of these internet users are over the age of 65. Roche Diabetes Care Spain is focused on delivering solutions that integrate into the daily lives of people with diabetes. We believe that when data is fully activated, it enables personalization, prediction and participation and we are deploying solutions like the emminens platforms and the Accu-Chek Connect app and online diabetes management systems to help reduce the challenges faced by people with diabetes, their caregivers and the healthcare system. 


“Patient empowerment and engagement are keys in order to achieve clinical results and reduce costs”


Do you feel people with diabetes are getting more used to integrate these new technologies for the treatment of their condition?

The key for new technology is to speed up adoption. We are all consumers of new technologies in our daily lives, but it is not uncommon for us to lag behind in using technology as a tool for our healthcare. However, more and more, people are recognizing the important role that technology can play in helping us make decisions, connect with others for support and take action. Systems like the Accu-Chek Connect app offer the potential to guide patients in determining the insulin dose required to bring the glucose level back to the target range. In this sense, someone with diabetes can enjoy the meal without worrying about the math. Another system, the Accu-Chek Insight insulin pump, helps people with diabetes with an easy to use pre-filled cartridge, a remote to control bolus and an integrated insulin calculator that helps to take fast decisions. These examples of connected technology are what really make a difference by helping people with diabetes to better self-control and maintain their values in range. As more and more healthcare professionals and patients adopt new technology and experience the benefits, the more comfortable they will become. But in the end, technology is a tool; a vehicle that needs to be centered on peoples’ needs and fit in their lives to make things simpler, especially when it comes to chronic conditions like diabetes. 


Seems that patients are adopting these new digital solutions even before healthcare professionals know about them. How can the industry manage to keep up with the fast changing ecosystem?

While the daily management of this chronic condition is self-guided, true success will always rely on engaged healthcare professionals. In chronic care, patient empowerment and engagement are keys in order to achieve clinical results and reduce costs. Guidance, education and support from a healthcare team remain of the utmost importance to manage the complexities of diabetes and empower patients to take control over their disease. Digital solutions will play a role of increasing importance in this patient-health provider interaction. To manage the speed of change, the industry must be flexible and open. For us all to benefit from what digital solutions can offer, is important to take action and adapt these solutions, helped by technology, to transform the way we are currently delivering healthcare and base our achievements on both quantitative and qualitative outcomes. We have proven that integrated care models like Terapia Go! and D360º, already in place in different Health Centers in Spain, help healthcare professionals to better monitor patients remotely, manage stock and avoid unnecessary visits. Specifically, The Primary Health Care Center in Vallcarca (Barcelona) conducted an evaluation on their first year of work with D360º. This evaluation showed a 25% reduction in blood glucose monitoring test strip budget and a reduction in workload of nurses and administrative staff. Furthermore, only 20% of patients were considered poorly controlled and needed follow up visits3. 


Do you think that doctors and the rest of professional carers have enough training or support to be aware of the available solutions in the marketplace?

There is no doubt that a learning curve exists as it relates to emerging digital solutions. It is clear that there is a need for more education. We believe that supporting Healthcare Professional education is part of our responsibility for the solutions we provide. Education should be a common effort between industry and the healthcare system, working as partners, to together improve the quality of care we provide. 


How can a traditional brand like Accu-Chek offer in order to improve nowadays the lives of diabetic patients?

Accu-Chek is a brand with over 40 years of experience providing solutions and products to improve lives for people with diabetes. We are moving forward by also providing their healthcare teams with solutions to make faster and more accurate decisions and better monitor patients. Thanks to new digital solutions, like the emminens platforms, we can enable better pattern recognition and support clinical and management decisions. Our aim now is to provide integrated care by facilitating new models to better deliver care and optimize resources as we are committed to the sustainability of the Healthcare System. Roche Diabetes Care Spain has developed a model for the integrated management of the diabetes population that delivers information about actual resource consumption, detects poorly-controlled patients and adapts consumption to each patient’s real needs. Our solution offers different services according to patient-specific circumstances. For example, patients can receive test strips to control their diabetes at home and share their glucose measurement data with their healthcare professional. In the health centers where it is implemented, not only economic savings are greatly appreciated as one of the many benefits of the project, but also the change that has taken place in product distribution. This has led to a very important reduction in the workload of nursing professionals, auxiliary nursing staff and administrative workers. This is how Roche Diabetes Care Spain is showing the role that an established diabetes management company can make in improving the lives for patients and the healthcare teams guarantying also the sustainability of the system. 


Digital solutions will play a role of increasing importance in the patient-health provider interaction


Can this new integrated model based on personalized care reduce costs and improve outcomes in healthcare systems? 

Roche Diabetes Care Spain offers personalized and integrated diabetes management solutions that encompass blood glucose monitoring, data management and insulin delivery, allowing for a personalised and more effective diabetes management resulting in improved medical outcomes. This new and integrated diabetes management model also includes training and education programs which enables healthcare professionals and patients to take better control of diabetes. In this sense, our approach, implemented by means of the emminens system, have already been able to demonstrate its health-economic benefits in the report conducted by Oblikue in Spain. The results presented at the ISPOR meeting in 2015 show that the total treatment costs could be reduced by up to 12%, with reductions of around 34% in outpatient costs. Not only optimizing resources, but also clinical outcomes and patient satisfaction are important to reach a high quality care. A study conducted in the Hospital 12 de Octubre where were using Terapia Go! a model that integrates Accu-Chek products and emminens solutions, showed a slight improvement in clinical results (0.1 HbA1C after using Terapia Go) but a really high patient satisfaction (95%) with the personalized attention they were receiving through different services (call centre, 24 hours security line, education, home delivery of glucose monitoring test strips) 


You have just arrived to Europe from the US. In your opinion, what are the main differences regarding the adoption of digital solutions in healthcare?

The US has a number of dynamics at play related to the development and adoption of digital health tools. The US Federal government has instituted a series of benefits for US Healthcare systems that can impact the adoption of digital solutions. For example, adopting electronic medical records, reducing hospital admissions, improving patient satisfaction and improving clinical metrics, like HbA1c, can come with financial incentives. These programs create an attractive environment for new digital solution entrepreneurs. As a result, many of these new technologies have been developed and piloted in the US. Besides, the financial burden for healthcare being placed on US consumers, digital health solutions are entering the market rapidly. Over $1 trillion annually is spent on chronic disease management, with heart conditions, COPD and diabetes in the centre. Payers, employers and individuals are creating varied and rapidly growing digital business models in the US market to impact this large and growing expense. As a result, the volume of digital health introductions in the US is large compared to other markets. Certainly, this speed of introduction differs, but I do see many similarities across the globe when it comes to the barriers to adopting digital health and new technology. All markets are challenged to find ways to fit digital solutions into existing healthcare workflow. Accessibility of digital solutions to all populations can be a barrier and factors like income, age and language make it difficult to execute digital solutions across large populations. Clinical evidence of sustainable value from digital solutions is lacking and costly. This lack of clinical evidence then has a profound impact on reimbursement. Finally, uncertainties about privacy, risk and regulatory, make digital health implementation challenging. For any system or for industry to be successful, we have to find ways to address these barriers to adoption. 


In general terms, what is the whole potential of digital health solutions for the treatment of chronic diseases in the next future?

Across many countries and healthcare systems, elevating costs, increasing populations and the growth of chronic illness put tremendous strain on the system. The current methods of delivering care are unsustainable and we must identify and implement new, easier models to deploy integrated care. Digital solutions offer a tremendous opportunity to meet the needs of people with diabetes and create sustainable and measureable care delivery systems but we need to work together. Roche Diabetes Care is fully committed to leverage the use of digital health solutions, with integrated models of care based on individual needs, to play an important role in this evolution.