Children's Mercy Uses Big Data, Digital Innovation to Improve Diabetes Care

The Kansas City health system has launched an innovative alliance that uses predictive analytics and digital technology to create new care management programs for young adults living with diabetes.

Children's Mercy Kansas City has launched a new program that uses predictive analytics and digital health technologies to help young patients living with diabetes manage their health and address concerns before they become serious.

Called the Rising T1DE Alliance, the program brings together clinicians, patients, caregivers, and researchers to harness the data being gathered throughout the healthcare experience and use it to predict and improve health outcomes.

"Predicting outcomes through analytics is great, but at the end of the day, you still have to do something with it," says Mark Clements, MD, PhD, a pediatric endocrinologist, professor of pediatrics, and the Rick and Cathy Baier Family Endowed Chair in Endocrinology at the health system.

Financed by a $8.5 million grant from the Leona M. and Harry B. Helmsley Charitable Trust, the program seeks to improve care management through simple, personalized steps. The alliance selects an outcome —such as lowering one's A1C level, reducing insulin use or even reducing weight—and creates a model that will use technology to reach that outcome. The model, called a Change Package+, includes guidance on how to predict outcomes, collect and track data, and make changes to improve performance.

Clements says the interventions are designed to be simple and targeted, to get clinicians out of the mindset that new ideas need to go through trials and pilot projects before being used. They also take advantage of the latest in digital health technology that allows the patient to be an active part of the process, rather than just a test subject. And they're also designed to move healthcare out of the clinic or doctor's office and closer to the patient.

"The person with diabetes … knows what's best for them, and we clinicians should be listening more to them," he says.

The programs address Type 1 diabetes, an as-yet uncurable chronic disease that affects some 1.6 million Americans, including some 200,000 people under the age of 20. Those numbers are rising steadily, projected to hit 5 million Americans and 600,000 young adults by 2050. Also increasing are the costs associated with treating diabetes, which the American Diabetes Association estimates at $16 billion per year.

All that attention has also fueled innovation, particularly in digital health. Wireless devices can now measure one's blood glucose level on demand, transmitting that data to a wearable or smartphone app, and then on to caregivers. Devices can also store, measure, and even administer insulin, either manually or through digital commands, while telehealth platforms allow those with diabetes to access resources or connect with caregivers at any time.

That's where the Rising T1DE Alliance comes into play.

"Type 1 diabetes is something that patients and their families live with 24/7," Leonard D'Avolio, PhD, an assistant professor at Harvard Medical School and Mass General Brigham and CEO of digital health company Cyft, said in a November 2021 press release announcing the new program. "It's one of the few diseases that asks patients to self-administer variable doses of a potentially deadly drug on a daily basis, yet most patients speak with their clinician once every three months if they're lucky. It's the perfect opportunity to put data to work to better support patients and their families."

The program uses Cyft's predictive analytics technology as the backbone for its treatments, which use data and technology to predict outcomes and map out the protocols to reach those goals. Among the interventions being developed through Rising T1DE are a remote patient monitoring platform that allows patients to connect with their care providers to share data and hold virtual visits, a virtual program called PEEPS (Patients Encouraging and Engaging Peer Support) that pairs teen with young adults for mentoring, and an mHealth platform that delivers personalized "nudges" through one's mobile phone to support positive habits and goals.

Clements says many of the programs use data to drill down to the direct point in which technology can affect an outcome, and then create just-in-time interventions to create those outcomes. This, in turn, would lead to better outcomes over time, a healthier lifestyle, improved self-management, reduced healthcare costs, and fewer hospitalizations.

"We have spent about 15 months creating the landscape and looking at these interventions," says Clements, adding the organization will make these models available to other health systems in time. "We're trying to understand how to break out from the (traditional lab-based approach) and start learning from these examples. That's going to involve more partnerships."

He says the program can also expand, using digital health tools and platforms to understand how the social determinants of health—from transportation to diet and exercise to financial resources and employments—have an impact on care management.  

"It takes a lot of bringing people along to see what is possible," he says. "Leaders in healthcare still need to be convinced."