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>View discussions about this entry Country: United States
Organization: Glymetrix
Year work began: - 2007
Focus of activity - Service/process
Positioning in the Mosaic of solutions
What is your signature innovation in one sentence? - A diabetes management program using games to attract and motivate patients to become more involved in their self care.
Describe your innovation. What makes your idea unique and different than others doing work in the field? - Glymetrix helps people with diabetes manage their disease and insurance providers lower over all medical costs by building online communities centered around games to create an interactive, motivational, and educational program for intensive diabetes management.
The software is designed to improve self management of diabetes. In the process it generates data about diabetes management, learning and motivation. The management program is client server based, using the internet to connect patients and clinicians, and uses game like interaction to motivate, educate and generate an unprecedented level of data regarding patient activity. Finally the product is targeted at men over the age of 45. On the whole men do not manage self diabetes as well as women. We picked them because they need the help more. In time the game will be adapted for women, different age groups and selected populations that suffer disproportionately from diabetes What barriers exist that are creating the problem your innovation is hoping to address/change? - This is a very complex problem. Some barriers are:
1) Cultural attitudes about the use of healthcare 2) Feelings of helplessness in the face of the disease 3) Depression 4) Education programs that may not fit with the individuals learning style 5) Cost Our first game is a quiz game that is designed to motivate in several ways, including rewarding good diabetes management with advantages in game play, and with prizes for reaching ceratin scores. Delivery Model: How do you implement your innovation and apply it to the challenge/problem you are addressing. - Glymetrix's marketing plan is designed to raise awareness of the product among people with diabetes, physicians, insurers and government and private sector payers so that physicians will offer the product to their patients, and patients will ask their physicians for access to it.
The game is a client/server application delivered over the internet. Glymetrix is device agnostic, the game can be run on a PC, a handheld device, interactive television or adapted for a game console. The game will be distributed on a CDrom and through digital download. Physical copy will go to clinics and other locations that provide diabetes care and can also be mailed to a patient. Glymetrix is evaluating free distribution of the product. This could be with a partner, for example the product could be bundled with Roche Diagnostic’s ACCU-CHEK glucometer. How do you plan to scale your innovation? - One of the powerful aspects of this innovation is its scalability.
The software is based on servers in a secure data center. Support is provided by customer care reps, and the customer care organization includes medical professionals to help deal with disease related questions and real time medical emergencies. Much of the content and focus of the program mirrors programs developed as part of the Robert Wood Johnson Foundation Diabetes Initiative. Though these programs are effective they require large numbers of professional care givers to implement. By using software and the internet it is possible to: • Provide self management support services However the program does not require a high ratio of medical professionals to patients. Globally, Glymetrix is working with partners in Canada, Australia and the EU to bring the software to other countries. Provide one sentence describing your impact. - A diabetes management game to motivate patients to
become more involved in their self care, improving health, and reducing medical costs. What impact has your innovation had to date? Exactly who are the beneficiaries of your innovation? - The innovation is in design, but not in use. Eventual benificiaries will be patients with diabetes, the physicians who treat them and the insurers who cover thier care.
Please list any other measures reflective of the impact of your innovation - Glymetrix and its partners have support from individuals in the US Veterans Administration, the Joslin Diabetes Center, the Calgary Health Region and others. Their support shows both the power of the innovation and also the great need for new strategies to improve diabetes self management.
What are the main barriers to creating your impact? - Funding for further development is a near term barrier. Scepticism about the innovation may be a barrier in the future. However we have found the medical community to be very receptive to the innovation.
How is your initiative financed? - Glymetrix has been funded by the founder, and with money from friends and family. The company is actively seeking angel investment to complete the game and get it in service.
Glymetrix and it’s partners are filing applications for grant funding of peer review medical studies in several countries. Some of these grants include funds that can be used to develop the product, others are strictly to prove efficacy in a patient population. The intention is for this innovation to be a for-profit service much as insulin, glucometers and test strips are produced by for profit companies. Provide information on your finances and organization: annual budget, annual revenue, number of staff: - Annual budget, annual revenue generated, size of part-time, full-time and volunteer staff. It would be unwise for Glymetrix or any similar organization to release this information on a public web site. We are certainly happy to have a private discussion with any legitimately interested person or organization.
What is the potential demand for your innovation? - Diabetes is reaching epidemic proportions in the developed world. According to the World Health Organization:
"Diabetes is a major threat to global public health that is rapidly getting worse, and the biggest impact is on adults of working age in developing countries. At least 171 million people worldwide have diabetes. This figure is likely to more than double by 2030 to reach 366 million." Over time this innovation should help millions of people. What are the main barriers to financial sustainability? - This is a very cost effective innovation. Glymetrix designed it as a for-profit innovation to create sustainability. The barriers faced by the company and its partners are barriers to getting the game built and into use. Once patients see there A1c levels drop by a point (which reduces the risk of heart attack by 40%) there is likely to be significant demand.
What is the origin of this innovation? Tell us your story. - The concept originated in a request by a Capital Health in Canada to our partner company Terris-Hill Productions, for a game to educate people about their diabetes. Since type II diabetes is in part a behavior driven disease Glymetrix and THP suggested that a game to change behavior might be even better.
As we looked into this it became clear that major positive impacts could be created with a well designed game. We chose quiz games because they have proven appeal in the demographic that suffers the most from diabetes, people over 50. Patients who use the game log in, and they are given an option to report information about thier diabetes management. For example if they report thier blood glucose readings the number of points they can score for anwering a question correctly doubles. This is good on many levels. It gives them an immediate reward for checking blood glucose, and it helps them score more points faster so they can win prizes more quickly. The initial response to this suggestion was supportive, and additional research showed that a game designed to change behavior could have very significant, positive impact. Since that time a great deal of work has been done on the game, and also on the businesses needed to support it. Please provide a personal bio. Note this may be used in Changemakers marketing material - Tom Hunter the founder and CEO of Glymetrix and lead designer of the game to motivate improved self management of diabetes. He is interested in games that teach skills and change behaviors. Prior to starting Glymetrix, Mr. Hunter was a consultant at Qittitut Consulting, where he worked on projects covering financial, medical and game industries . Before joining Qittitut Mr. Hunter held marketing and strategy positions at several software and telecom firms including Sprint and Comverse.
Contact Information:
Tom Hunter
CEO Glymetrix (Business) thunter@compassrosegames.com 121 Loring Ave. Suite 342 Salem, MA 01970 United States Tel: 978-740-5900 Website: This field has not been completed Discussions about this entry |
Improving Diabetes Self Management
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The information that you provide in the "Task of Self Management" section of one of your discussions is helpful in understanding your innovation. It would be great if you would consider adding part of it to the official entry.
Good luck,
Dana Frasz
Changemakers Team
Tom:
You said..." Glymetrix is device agnostic, the game can be run on a PC, a handheld device, interactive television or adapted for a game console."
Our entry is a computer system that attaches to cardiovascular exercise equipement, and I know CV exercise is important for diabetes management. I wonder how much work would be required to adapt to for the exercise equipment platform?
Mark Martens, President
Pantometrics, Ltd
Mark,
Adapting the game is easy. Dealing with the business issues is the hard part.
I am happy to take a discussion off line if your interested.
Regards,
Tom
Tom:
About the business side of things being a problem, yes I agree. I think it's partly because disease prevention and G4H are inherently disruptive, and distribution channels are not mature. Also large chunks of the value accrue to different stakeholders, each of whom would rather the other stakeholder pay the cost, and they just reap the benefits.
Happy to talk offline too, I sent you an e-mail.
Mark Martens, President
Pantometrics, Ltd
Diana,
I am answering your questions in order, hopefully the questions and answers are clear, the bulletin board software is reformatting my text.
Your game is targeted to those with Type 2 diabetes, no?
Correct, we are focused on type II because it is so affected by behavior.
if so: i wonder what you make of the NYT article on type 2 diabetes published earlier this week It argues that only about 7% of type2 patients are obtaining all the treatments they need, or are doing all they need to do, to protect themselves -- largely because both patients AND DOCTORS lack understanding as to what is required to manage diabetes 2. It argues that the typical patient comes to understand from a doctor that controlling blood sugar is the one, central task that will limit the worsening of health problems, when -- to really extend their lives -- patients should also be aggressively addressing their cholesterol levels and their blood pressure, since it's typically heart disease that actually kills diabetes sufferers. I wonder: does your game address all of these factors in a way that's consistent with what's described in this article, or do you -- or those responsible for the RWJF Diabetes Initiative -- view the problem in a different way?
I read the article and found it interesting but not very surprising. There article is a bit confusing, the reporter mixed several issues, which I am going to separate.
The first is blood sugar control, the reporter mixed blood sugar control and rigorous blood sugar control (sometimes called tight or intensive blood sugar control) without explaining the difference between the two. Blood sugar control is a continuum, ranging from totally uncontrolled, to controlled, to tightly controlled.
Uncontrolled blood sugar can be very dangerous, if blood sugar levels go too low a person can pass out. If they don’t get medical care they can die. If they are consistently very high the consequences are also severe and can be deadly or very damaging.
Controlled blood sugar is good, because it helps a person with diabetes avoid the side effects mentioned above.
Tightly controlled blood sugar is still a subject of debate. There is a real question as to how beneficial it is for a type II to test 8 times a day like the man mentioned in the article. I am not qualified to answer that question, but I am aware of the debate.
If a person with diabetes comes to the conclusion that they do not need to control their blood sugar at all because of the article, then the Times has done them a great disservice.
The second subject is: “are people with diabetes and their doctors doing everything they should to keep themselves healthy.” Any person familiar with the delta between the ADA standards of care and what patients actually get would answer no to that question. There is a very wide variation in quality of diabetes care in the US. Some of that is provider driven, and some of it is patient driven. The Times does a good job of pointing out the knowledge gap, and how it can hurt patients.
It seems that the game is supposed to serve in the place of medical professionals. Might you explain how, exactly, the the game does that -- what story the game tells and how its design motivates players?
In no way does the game replace or serve in the place of medical professionals. This quote is taken from the Diabetes Management Initiative’s web site:
The Task of Self Management
Managing diabetes is a “24/7” job for the rest of an individual's life. Practice guidelines recommend 3–-4 medical appointments a year – about two hours for the average patient. For the remaining 8,764 hours a year, an individual with diabetes is responsible for managing his/her disease – taking medicines as prescribed, measuring blood sugar and adjusting medications accordingly, eating a healthy diet, getting regular physical activity, and avoiding or managing stress and negative emotions. All of this needs to be incorporated into the complex routines of family, workplace, and daily life.
The game is designed to help with those 8,764 hours that individual is managing diabetes without a medical professional immediately available. Many people struggle with this, and they need a cost effective way to help.
The exact workings of the game are explained in a document that is now over 100 pages long and still growing. At a very high level games are algorithms, and so is good diabetes management. We are mapping the game play algorithm to the diabetes management algorithm. The two work together to motivate, educate, and guide the patient towards better self management.
I wonder: how do (or will) the online communities work?
Look at the online communities around World of Warcraft, online poker, or other games and you will see where we get our inspiration.
You call "cultural attitudes about the use of healthcare" a barrier to your innovation. I wonder what you mean by that?
I am sorry if this was not clear, the form asked: What barriers exist that are creating the problem your innovation is hoping to address/change?
A problem we are hoping to change is cultural barriers that dissuade men from good diabetes self management. Women often take responsibility for the health of their families. The perception that health is not a man’s issue can be a barrier to good self management for men with diabetes. We hope our game will help men to overcome that cultural barrier.
Cultural attitudes about the use of healthcare are not a barrier to our innovation.
You say that earlier tools intended to educate diabetes patients have not "fit with the individuals learning style".
Looking at the document, I said earlier tools may not fit. I am not slamming existing diabetes education tools, there are some excellent tools out there, some of them developed by people who are providing input on the game!
However there are many different learning styles. By adding game based learning to the mix of available tools we give diabetes educators one more option. It is an option that did not exist in the past and it is likely to reach some individuals who were not reached by the tool set educators have right now.
I wonder whether you might worry that your game might be another tool with a similar problem, since your target population (men over 45) are a bit older than most gamers.
We can be absolutely certain that the game will have the same problem. Some people learn best from books and we already have books for them. The game will work poorly for those people. Other people learn better in an interactive environment and the game will work better for them than the book they are provided with today.
There are a number of issues specific to men over 45 that are addressed in the design. That said there are 15 million people in the US with diabetes, and the game will not reach all of them.
Does your program have a mechanism designed to bring non-gamers into gaming, or do you have reason to believe that your target population will pick up your game readily?
The target group is very familiar with quiz games, even if they have not played on on-line. A segment of men with diabetes will play, certainly not all of them. But that is fine, if the game moves 10% of the men with poorly managed diabetes into the well managed category that is several hundred thousand men. Thousands of heart attacks will be avoided, eyes will keep seeing, legs will be walked on instead of amputated, it’s a good thing.
Kind regards,
Tom Hunter
Glymetrix
Thanks a lot for your responses, Tom, They prompt a few more questions.
What I extracted from the article was not that blood sugar level was unimportant but that, while blood sugar gets nearly all the attention of/from some patients and doctors, both need to give other things (eg.a patient's cholesterol level and his/her blood pressure) more attention than they typically do. Does your game teach or engage players about these other things? and if it does so, might your product's more rounded perspective not constitute another way in which your game is innovative? It seems to me it might, if the bulk of the other products in this market concentrate nearly exclusively on blood sugar levels.
I confess to being confused about something. While, in your response to my questions you wrote "In no way does the game replace or serve in the place of medical professionals" you did write in your initial entry "Much of the content and focus of the program mirrors programs developed as part of the Robert Wood Johnson Foundation Diabetes Initiative. Though these programs are effective they require large numbers of professional care givers to implement. By using software and the internet it is possible to: .... However the program does not require a high ratio of medical professionals to patients." So you do seem to suggest that your innovation BOTH makes people better at self management AND diminishes their need for health professionals help. Is that so? and if its so, can the reduction in a need for health professionals be quantified in some way? (eg: this game helps a player reduce his/her for health professional help by 2 hours per month compared to a patient without the game -- or some such...) I push these points only with the goal of teasing out ALL that your game does (and precisely ALL of the places where your game might produce, say, reductions in costs associated w/health care, since those are important parts of your innovation- things you'd want to present, in maximal clarity, to those evaluating your work.)
I look forward to hearing your responses.
Best,
Diane
Changemakers
Diane,
The basic premise of the article, that there is more to diabetes care than blood sugar control is correct. Our game does take that into account, in fact we look at dozen’s of variables. I am not comfortable saying that our perspective is more innovative than other innovative programs. I will say that we are using the best material out there for our game, so if a patient does not currently have access to the best material we will offer them improvement.
We do offer an opportunity to improve consistency of care, and that will have a beneficial effect. Also we can propagate new information quickly, since a change in the software goes out to all users at the same time. Looking at the Times article, I am sure there are some physicians who read that, had an “ah ha!” moment and improved their quality of care. We can be equally certain that there are others who were on vacation, don’t read the Times or otherwise missed it.
Moving on to the second question, the need for health professionals: The problem is that there are 15 million people (in the US alone) with diabetes. Some self manage well with a few hours of professional support per year but many do not.
People who do a bad job at self management often improve if they get more attention from medical professionals. But this becomes cost prohibitive, a doctor, nurse or dietician can only spend so much time on a patient each day, week or month.
The patient has to manage diabetes every day, but the medical professionals cannot help every day. Software can help every day, software can provide support every day for a month at the same cost as 10 minutes of time from a physician.
To help explain lets define two kinds of care, pro-active and re-active. Pro-active is a physician putting a patient on cholesterol lowering drugs, re-active is rushing them into the OR with a heart attack.
The game does not replace pro-active diabetes care. Patients still need to see their doctors and meet their nurse educators. The game does provide the doctors and nurse educators with information about the patient that will help them make better decisions.
The game does reduce the patients need for re-active care. Patient who become motivated to check blood sugar, eat better and exercise will avoid heart attacks, amputations and blindness. All of those things cost a lot of money and take up a lot of physician time. On a humanitarian basis they hurt to even think about.
There is a huge need for pro-active care in the population of people with diabetes. That need is not being met, because there are too many patients, too few providers and it is just too expensive. This software is designed to fill that gap, and generate cost savings as a result.
The level of detail you mention at the end of your post is difficult at this time. We have applied for an SBIR grant to do a double blind peer review study to answer the question in great depth. That is a two stage process that takes more or less 2 years. I can say that we are aiming for A1c reductions of 1% or more, and a 1% reduction cuts the risk of heart attack by 40%.
Getting into ALL of the things the game is designed to do is time consuming, and some of it is either proprietary or still in the research stage. But if you have more questions we are happy to respond.
Regards,
Tom
hi, Tom,
Thanks for your very interesting entry. It prompts some questions.
Your game is targeted to those with Type 2 diabetes, no? if so: i wonder what you make of the NYT article on type 2 diabetes published earlier this week (20 Aug: http://www.nytimes.com/2007/08/20/health/20diabetes.html?_r=1&oref=slogin) It argues that only about 7% of type2 patients are obtaining all the treatments they need, or are doing all they need to do, to protect themselves -- largely because both patients AND DOCTORS lack understanding as to what is required to manage diabetes 2. It argues that the typical patient comes to understand from a doctor that controlling blood sugar is the one, central task that will limit the worsening of health problems, when -- to really extend their lives -- patients should also be aggressively addressing their cholesterol levels and their blood pressure, since it's typically heart disease that actually kills diabetes sufferers. I wonder: does your game address all of these factors in a way that's consistent with what's described in this article, or do you -- or those responsible for the RWJF Diabetes Initiative -- view the problem in a different way?
It seems that the game is supposed to serve in the place of medical professionals. Might you explain how, exactly, the the game does that -- what story the game tells and how its design motivates players?
I wonder: how do (or will) the online communities work?
You call "cultural attitudes about the use of healthcare" a barrier to your innovation. I wonder what you mean by that?
You say that earlier tools intended to educate diabetes patients have not "fit with the individuals learning style". I wonder whether you might worry that your game might be another tool with a similar problem, since your target population (men over 45) are a bit older than most gamers. Does your program have a mechanism designed to bring non-gamers into gaming, or do you have reason to believe that your target population will pick up your game readily?
I look forward to hearing your responses.
Best,
Diane
Changemakers
Hi, Tom,
Can you please provide more information about how the entity at the core of your application works? I and others remain unclear as to whether the entity is a game, a platform, a piece of software -- all of them, none of them, or something else altogether. I'd also like to understand better what the player will experience in "playing" it. Is there a story, experience or adventure in which the player feels him/herself participate? Your goals and motivations for building your tool remain more clear to the reader than the shape of the tool itself.
I look forward to hearing your response.
Best,
Diane
Changemakers
Diane,
(Diane and I had a phone conversation, some of which I will include here)
I tried to add some description of the game and game play to the entry. I am also going to take a crack at it here in the comments section for the benefit of anyone else who reads this.
Our first game is a quiz game, we chose that because we know that the genre appeals to people in the age range most affected by diabetes, 45+. There will be additional games over time, but the quiz game is first.
The game is a piece of software (an application). When we say we are "platform agnostic" that means we will run on anything. The game can be delivered to your PC, or your PDA, Cell phone or via your television if you have one of the more capable interactive cable TV systems. There is no hardware at all from us.
There is no story as such in the quiz game. There is competition, because we know that competition motivates people to take action. In this case some of the competition may be between players, but the focus is on beating your disease, not beating other people playing the game. In that respect we do hope, over time, to have the patient make thier own story of improving health. Even this is not a story in the sense that ReMission has a back story, but we will show patients views of thier improving health.
the quiz game itself rewards people with in game advantage if they report efforts to manage their diabetes. So if they check their blood sugar they can score more points. If they lose wieght they may gain a special power in game, for example the ability to change wrong answers to correct answers. This is nice to have in solo play, but in team play where your team is competing for a prize it could be very valuable. by structuring the game and rewards correctly we can build a management tool that provides motivation and rewards in a highly customized way.
I hope that helps,
Tom
Diane,
I tried sending you a private message a day or two ago, I need a bit of clarification to answer the questions you posted.
Can we get in touch off the forum, via email, or preferably a phone call? Sometimes things can be clarified much more quickly in a conversation than writing back and forth.
Regards,
Tom