Medtronic officials want the world’s largest medtech company to do more than just make medical devices: They want to help manage chronic diseases. Here are thoughts from the VP helping to lead the shift.Medtronic executive Sheri Dodd had a cousin — one of only four — die from Type 2 diabetes complications at the age of 47.
Lainie Dominguez was already high risk because her dad had diabetes, and she was obese. She became pre-diabetic. She was diagnosed as a Type 2 diabetic, watched her carbohydrates, took oral medication, did finger sticks, became insulin-dependent, and developed end-stage renal failure. She went in for orthopedic surgery and died of diabetes-related complications.
“I think about this all the time, and I think, ‘What did she need in her journey so that she could have avoided getting Type 2 in the first place?’” Dodd said in September at DeviceTalks Minnesota. [Discover more great medtech expertise at DeviceTalks West, Dec. 9–10, 2019 in Santa Clara, Calif.]
Dodd is in a unique place to help answer the question. She’s VP of two Medtronic businesses at the forefront of the company’s shift toward helping people manage their chronic diseases: Medtronic Care Management Services and Non-Intensive Diabetes Therapies.
Medtronic and medical device companies in general can’t make the transformation alone, Dodd said. “You can’t think that you’re going to come in alone and solve the problem.”
If Medtronic is going to move beyond selling insulin pumps and glucose monitors, for example, it needs to help people with diabetes monitor their nutrition. The result is that Medtronic in November 2018 announced it was acquiring Tel Aviv, Israel–based Nutrino Health and its nutrition-related data services and artificial-intelligence-based analytics.
Partnerships with health payers and providers are important, too. Dodd mentioned Medtronic’s five-year value-based healthcare partnership with the Lehigh Valley Health Network. The company is using its technological know-how and data-crunching skills to tackle up to 70 major medical conditions, with the goal of helping the Northeastern Pennsylvania health system improve the lives of as many as 500,000 people, create efficiencies, and reduce healthcare costs to patients, payers, and the health system by $100 million over five years.
“There’s a technology play, but there is a behavioral play that Medtronic is not uniquely expert at, and that’s why partnerships and building out solutions is going to have to happen in that area of chronic management,” Dodd said.
Here are five additional things that Dodd thinks Medtronic and other device companies need to accomplish if disease management is going to become a major focus of the business:
1. Access to data
Data on day one can be very different from data on day two, three or four.
“With longitudinal data, you start to understand trends,” Dodd said. “When you understand that, you can get to predictive.”
2. Process is very important
A medtech company can gather discreet pieces of data, but how are they going to come together?
“Call it what you like, but there’s an element of getting into care delivery, care management, and chronic disease management that has to be around process. It’s handing pieces of data off to somebody else, and something meaningful has to be done with that information,” Dodd said.
3. Waiting for value-based healthcare
Medtronic and other medical device companies are transforming because both public and private healthcare payers have a goal of transitioning health providers toward more value-based arrangements. Unlike the dominant fee-for-service models, value-based healthcare rewards based on how efficiently and effectively certain patient populations are managed.
For Dodd, value-based healthcare reminds her of how her father-in-law had a sign that said, “Free beer tomorrow.”
“I’m building business models for this ‘free beer tomorrow’ day. … It is coming. It’s just in a very awkward stage right now between fee-for-service and value-based healthcare,” Dodd said.
For now, medtech developers need to realistically look at whether they can demonstrate to health payers that their offerings will have a significant impact in terms of dollars and/or impact large numbers of members, according to Dodd.
“If you fall somewhere in between, then I would re-look at your channel and think about who else can you get to pay for it or bridge the discussion between a payer and a provider,” Dodd said.
4. Combining clinical and economic data
Medtronic leadership put Dodd into a position in which she was in charge of both clinical and economic studies. What happens when clinical trial data combines with payer claims data is enlightening, she found.
“You can actually look populations who receive a clinical intervention and then look at claims data and see, all things being equal …, ‘Did that patient population have a decrease in healthcare utilization, if you will, in terms of avoidable cost?’ and create a really good story,” Dodd said.
5. It’s still about people
Healthcare is about people — people concerned about their health and people helping those people get better.
“I can’t envision a day when there is not a person involved in the delivery of healthcare, and I’m a big medtech fan,” Dodd said.
“How do you use technology and data and process and people? I think when all that can come together, we’re going to be in a good place.”