[telecom] Diabetic Tester That Talks to iPhones and Doctors

Personal Technology Diabetic Tester That Talks to iPhones and Doctors

by Walt Mossberg January 4, 2012

While consumer technology advances by leaps and bounds, the devices patients use to manage diseases often seem stuck in the past. A glaring example is the glucometer, the instrument diabetics use to measure the sugar in their blood-information they use to adjust their diet, exercise and medication.

These meters, which analyze drops of blood drawn from fingertips, typically resemble crude PDAs from 10 or 15 years ago. They offer little feedback and can't connect to the Internet to show results to caregivers. Most diabetics who use them log their readings on paper, which they hand doctors weeks or months later.

But that is beginning to change. Next week, a small start-up will introduce a new diabetes meter it says is the first with wireless technology that instantly transmits a patient's readings to a private online database, which can be accessed by the patient or - with permission - by a doctor, caregiver or family member. This system charts the results to highlight trends and spot problems, and can be accessed via a Web browser or an iPhone app. It automatically transmits relevant feedback - such as whether your readings seem high or low - and allows doctors to respond.

I've been testing this new meter and service, which is called Telcare and comes from a Bethesda, Md., company of the same name. As a Type 2 diabetic myself, I found the Telcare meter a refreshing change, and a significant step toward bringing consumer medical devices closer to the world of modern technology.

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***** Moderator's Note *****

Mr. Mossberg, despite his qualifications to evaluate the convenience of a new glucose testing system, has not mentioned the /reason/ that medical instruments such as glucometers change very slowly. It is that medicine is not supposed to be a sales vehicle for electronic gadgets which saddle their users with never-ending, unavoidable fees that take yet-another bite out of the fixed incomes of retirees and add unneeded complexity, expense, and inconvenience to the practice of medicine.

This device costs $99.95 from the "Telcare" website, /if/ customers subscribe to a "plan":

Test Strip List Price: $55.95 Your Price: $35.95

"The plan requires the purchase of at least 4 Telcare Test Strip vials per quarter at its reduced contract price."

... which translates into $35.95 times four vials times four quarters, or $575.20 per year, and the site also offers a "care" plan that will replace the meter /once/ in a year for $6.95 per month, or $83.40 per year. Any customer that doesn't buy the 16 vials of test strips is, according to the "terms and conditions" page, obligated to pay a one-time fee of $100.00.

In other words, this is an expensive and unnecessary solution in search of a problem. The only "need" it addresses - and I'm very surprised that Mr. Mossberg doesn't realize this - is that of the Health Maintenance industry, to deliver electronic data to low-paid physicians in foreign countries, who can, in turn, deliver cheap advice to patients they have never met.

Bill Horne Moderator

Reply to
Monty Solomon
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:***** Moderator's Note *****

:Mr. Mossberg, despite his qualifications to evaluate the convenience :of a new glucose testing system, has not mentioned the /reason/ that :medical instruments such as glucometers change very slowly. It is that :medicine is not supposed to be a sales vehicle for electronic gadgets :which saddle their users with never-ending, unavoidable fees that take :yet-another bite out of the fixed incomes of retirees and add unneeded :complexity, expense, and inconvenience to the practice of medicine.

Do you know what test strips for other meters cost?

:... which translates into $35.95 times four vials times four quarters, :or $575.20 per year, and the site also offers a "care" plan that will

Because that's pretty much what they cost.

There is, apparently, a thriving black market for stolen test strips

- or in at least one case, strips that were recalled because they were defective - because they're so expensive.

There are good solid technical reasons they're expensive, too. They're pretty impressive bits of applied chemistry and electrical engineering, and they need to have a failure rate of pretty near zero.

- - sig 81

***** Moderator's Note *****

I'm not a diabetic, so I've no direct experience with glucometer test strips. However, even if they cost /exactly/ the same amount as those for traditional glucometers, I object to the assumption that diabetics should spend their dollars for a system that I think is obviously geared to moving the jobs of American physicians overseas, and, in the process, lowering the standard of American medical care several notches down on the scale.

The system of electronic health-care information gathering is, IMNSHO, a ticking time bomb that is going to go off right after the election, with HMO's, insurance companies, and other players licking their chops at the thought of being able to deny life insurance coverage, deny health care coverage, and deny employment applications, all based on electronic information provided by patients who assumed that they were protected.

If this thought doesn't scare you, then it should: there are /already/ commercial databases in use which reflect the "predisposed" /possible/ medical conditions of potential employees whose parents had medical issues that /might/ have been passed on to their children. Once such data is gathered, it /will/ be used.

Bill Horne Moderator

Reply to
David Scheidt

In point of fact, it is -not- all that expensive, comparatively speaking.

List price for major-brand meters is about $100 for ones with a data- upload "capability". To _use_ that capability, you have to buy a special cable and software, another $30-50. And you have to have the PC to run the software on. The Telcare meter has a _cellular_ data link built in, And does everything on their secure web-server. That they're doing it all for the same price as a dumb serial (not USB) link is, in a word, amazing.

Test strips for major brand meters run about $1/test. (~$55 for a package of 50 strips.) No-name strips are around $0.70/test. (~$35 for a package of 50) I've seen 'specials' where they give away (or nearly so) a meter that uses the high-priced strips; never for one that uses the inexpensive ones.

There are less expensive meters -- without any data export capability; also no-name meters that use the less-expensive strips. The less-expensive ones also tend to need bigger drop of blood to process. Also _repeatability_ is significantly lower than with the big name (higher-priced) ones.

The real gotcha is that all the test strips are 'proprietary' -- you have to buy the specific type of strip that works with that specific meter. And there's only -one- source for those strips -- from the meter manufacturer. (It's the old King Gillette safety razor story.)

Four vials of 50 strips per quarter is enough for two tests a day, allowing for a few botched readings. This is 'typical', conservative, testing frequency for many diabetics.

The Telcare non-subscription price on strips is on a par with strips for any of the name meters. The subscription price is as good as the least- expensive no-name ones.

Note: _local_ physicians generally prefer the data-recording patient meters to the non-recording ones -- it's far too easy for the patient to lie when they're keeping a paper record.

In short, Telcare 'consumables' -- including 'subscription' supplies -- are priced favorably relative to the competition; the meter is priced comparably to other systems with equivalent capabilities, and offers a number of 'convenience' features that other meters don't.

Compared to a brand name meter, the TCO for a year is significantly lower for the Telcare meter.

name brand -- 16 sets of strips @ $55/set $880 "Freestyle" meter 80 === $960

Telcare -- 16 sets of strips @ $36/set $576 meter 100 'care plan' 84 === $760

The Telcare meter is 20% less expensive. Close to 30% if you don't buy the 'insurance'.

Reply to
Robert Bonomi

:***** Moderator's Note *****

:Mr. Mossberg, despite his qualifications to evaluate the convenience :of a new glucose testing system, has not mentioned the /reason/ that :medical instruments such as glucometers change very slowly. It is that :medicine is not supposed to be a sales vehicle for electronic gadgets :which saddle their users with never-ending, unavoidable fees that take :yet-another bite out of the fixed incomes of retirees and add unneeded :complexity, expense, and inconvenience to the practice of medicine.

Medicare covers most of the cost, which translates in my case to a co-pay of $13.74 for 100 strips, which I pay maybe twice a year. I would find it very annoying to have to read my blood sugar level off some more complicated or different device, when I can look at the display on my glucometer and read off the figure after 5 seconds. If you like gizmos, OK, but I don't see the point in what is a simple activity, probably simple because once the complications of making the test strips and the meter are mastwered by the maker of the device, it is simple for the user. Physicians and hospitals use the same kind of device, often the same make and model I use. Wes Leatherock snipped-for-privacy@yahoo.com snipped-for-privacy@aol.com

Reply to
Wes Leatherock

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