Chronic diseases are responsible for seven out of 10 deaths in the United States each year, according to the U.S. Centers for Disease Control and Prevention. Many think a key to reducing chronic disease deaths is personalizing the information sent to each patient, to increase their chances of better managing their health.

Glen Tullman, chairman and CEO of Livongo, will speak at a panel called “Tech-Enabled Services Supporting Chronic Populations” at the upcoming HLTH conference on May 7. Tullman, a former CEO of EHR software company Allscripts, recently spoke with Health Data Management on the role analytics can play in managing chronic conditions. An edited version of the interview follows.

HDM: Livongo Health’s stated mission is to help people with chronic conditions using a “whole person” approach. Tell us about that.
Tullman: Livongo has traditionally been known as a company that helps people with diabetes. But if you look at our vision statement, we talk about empowering people with chronic conditions to live better and healthier lives. And the reason our statement doesn't mention diabetes is because we have always understood that you can't treat people in silos. We've always realized that we had to treat the whole person because that's who we are as people. We're not a disease. We're not a diabetic. We're not a heart patient. We have to look at the whole person. We have to have that kind of approach.

HDM: What role does technology play in helping those with chronic conditions?
Tullman: We use technology not as an end but as a means. What we're interested in is not just the technology; it’s how do we create a personalized experience that makes it easier for someone to stay healthy. Now, having said that, we have at Livongo a two-way, over-the-air updatable glucometer that enables us to help people in the moment. When someone checks blood sugar, that information is sent up to the cloud, and then it's distributed to friends and family — people who you want to know if you were in trouble. If your blood sugars were too high or too low or you weren't feeling well, they can provide immediate help. That's one place that information goes in real time.

At Livongo, we also have a group of certified diabetes educators. These are people who have had more than 1,000 hours of training on diabetes, nutrition and diet. And those people, 24/7, anywhere in the world, are monitoring to see a signal that your blood sugar is dangerously high or low. They will call you within 60 seconds. That's also why we're so effective in keeping people out of the emergency room, out of the doctor's office and healthier.

HDM: How is advanced analytics creating personalized experiences for patients with chronic conditions?
Tullman: Our data scientists are using the information that comes back from each of our members to create a personalized care plan that really treats them as a whole person. That says for you, you should do this, based on your history and all the information we have about medications you're on and everything else we know about you. So we're using data science and what's called reinforcement learning to create a whole new way to experience health. That's making a big difference in terms of the results we're getting.

HDM: What does reinforcement learning entail?
Tullman: Think of reinforcement learning as systems that keep learning instead of a system in which you have to write a program with "if X, then Y." This is a system that keeps getting smarter and works a lot more like our brains work, based on all the experiences that we see happening.

HDM: You talked about how technology can help patients. But what about doctors? Interoperability — their ability to get information from different systems — has long been a challenge. And that has to hinder their care of patients with chronic diseases.
Tullman: Interoperability is a tough challenge. What we want to do is make sure that our information is available when the people who need it can actually access it and use it. Say you're a physician using Cerner EHR software and one of your patients is using Livongo glucometers — you can, today, actually pull out not just Livongo blood sugar data but information on the impact of the data and have it available in the EHR when you're there to see and counsel that patient. I think you will see more and more, maybe not interoperability, but accessibility and transparency across the system. At Livongo, we enable data exchange with partners using Fast Healthcare Interoperability Resources APIs, which is recognized as the standard for exchanging healthcare records. These APIs are defined by the HL7 standards organization and make it easier to integrate a variety of EHRs and other healthcare tools. We're happy to send data to anyone.

HDM: What does the future look like for the management of chronic conditions using technology?
Tullman: I've been in healthcare for 25 years, and I've never seen more change than I have in the last 12-month period. I've never been more excited about our ability to deliver high-quality care at affordable costs using some of the latest technology. And I think within three to five years, we will look back and say that we have fundamentally transformed healthcare from a system of treating sick people to a system of keeping people healthy.

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