Innovation Challenge Blog

2013 Data Design Diabetes Winner PHRQL is Shifting Wellness Care from the Clinic to the Community

This is a guest post by Paul Sandberg, the CEO of PHRQL. 

PHRQL (freckle) is focused on shifting wellness care from the clinic to the community. Our Connect & Coach product helps supermarkets deliver nutrition counseling and diabetes education to their customers in the store, and receiving reimbursements for their services from insurers. We’re also taking it one step further; by tying our programs into stores’ customer loyalty programs, consumers can receive rewards and incentives for eating healthier, and retailers can measure how the services are changing consumer shopping behavior. It’s a win for everyone, leveraging a delivery model that shows potential to reach a vast amount of consumers, including the 100 million people with diabetes or pre-diabetes.

We haven’t always been focused on this approach. PHRQL started in 2011 as a research project at Carnegie Mellon University. Our initial research was directed at finding patient-centered solutions for improving diabetes self-management. We learned there were a number of success factors that were pretty consistent: people need to know their numbers, they need to know how to manage those numbers, they need a support network of family and friends, and they need regular access to a health professional, like a diabetes educator. We found 23 connections that were important in a patient-centered model, and 17 were functioning poorly or not at all for most people.

Many of the weak or broken connections could be reinforced using technology, so this is where we started. Initially, we designed and developed mobile applications to help people collect their numbers (Blood Glucose, Carbs, Activity, and Insulin), see the relationship between them, and share them with their support network using our “Share & Compare™” feature. We conducted a pilot study using this application with a group of adolescent and young adults with T1 diabetes. One interesting finding from the study was a positive correlation between improvements in blood glucose control and how socially connected a participant was.

But we still didn’t have an effective way to connect individuals with an educator or dietitian. To help us do this we partnered with Flipside Media. Flipside developed both Chronicle Diabetes and AADE7, the two diabetes education electronic record systems used by the American Diabetes Association and the American Association of Diabetes Educators respectively. Working with Flipside we developed an electronic health record system designed to deliver nutrition counseling and diabetes education. Now we could close the loop between the health professional and their patient. The technology enabled sharing of data and communication for ongoing counseling and coaching. We called the system Connect & Coach.

In our original research, we discovered weak or missing links in a typical self-management program. Our technology was now capable of repairing many of those links, but we needed a way to deploy it. Delivering nutrition counseling and diabetes education services in retail supermarkets and pharmacies seemed like the perfect solution. We learned that retailers were hiring registered dietitians and certified diabetes educators to deliver services to their customers. This was a way for the retailer to participate in the growing demand for health & wellness services, differentiate themselves, improve customer loyalty, and drive purchasing of healthy food.

Unlike the clinic, the retailer did not have legacy information systems to manage this kind of service. We worked closely with one of the countries largest supermarket chains to adapt our system to fit their specific workflows and information needs. Our technology, designed to meet the needs of a health professional and their patient now also met the needs of a supermarket retailer. This included a connection to their customer loyalty program, integration with their web site, specific features to support in-store education activities not available in a clinical setting, and more.

Connect & Coach is ready to help any of the 36,000 supermarket stores around the country deliver quality nutrition counseling and diabetes education to their customers, get reimbursed by insurers, and measure the change in consumer purchasing behavior and health outcomes. This is a sustainable delivery model, because reimbursement is available, but the real value to the retailer is improved customer loyalty and increased consumption of higher value healthy food items. It creates convenience for consumers as well—the supermarket is convenient, it’s a place they already frequent, and parking is free. Finally, it doesn’t matter where you get your education or nutrition plan, you will eventually end up in the food aisles of your local grocer, facing 30,000 food choices. Wouldn’t it be nice if you had your personal dietitian there beside you to help navigate the choices and implement your plan for a healthier lifestyle?

About the Author

Paul Sandberg is the CEO of PHRQL. Paul was an original member of the PHRQL team at Carnegie Mellon University, and he brings an outside perspective to health care efficiency improvement.