  {"id":15843,"date":"2016-11-17T15:19:41","date_gmt":"2016-11-17T20:19:41","guid":{"rendered":"https:\/\/digital.hbs.edu\/platform-rctom\/submission\/the-digital-solution-to-overeating\/"},"modified":"2016-11-17T15:20:27","modified_gmt":"2016-11-17T20:20:27","slug":"the-digital-solution-to-overeating","status":"publish","type":"hck-submission","link":"https:\/\/d3.harvard.edu\/platform-rctom\/submission\/the-digital-solution-to-overeating\/","title":{"rendered":"The Digital Solution to Overeating"},"content":{"rendered":"<p>Can a digital solution have a greater clinical impact than a drug?<\/p>\n<p><strong>Problem &amp; Solution<\/strong><\/p>\n<p>Chronic disease management sits at the bulls-eye of the healthcare cost challenge. Currently, chronic diseases account for \u201c$1.1 trillion annually, or one-third of total US healthcare expenditures.\u201d<a href=\"#_edn1\" name=\"_ednref1\">[i]<\/a> Diabetes alone costs $230 billion.<a href=\"#_edn2\" name=\"_ednref2\">[ii]<\/a> The disease affects 9.5% of the population and costs employers $4,500 per year in lost productivity and higher medical costs.<a href=\"#_edn3\" name=\"_ednref3\">[iii]<\/a> Projected cases of diabetes are expected to skyrocket:<\/p>\n<p><a href=\"https:\/\/d3.harvard.edu\/platform-rctom\/wp-content\/uploads\/sites\/4\/2016\/11\/DiabetesEpidemic.png\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-medium wp-image-15610\" src=\"https:\/\/d3.harvard.edu\/platform-rctom\/wp-content\/uploads\/sites\/4\/2016\/11\/DiabetesEpidemic-300x176.png\" alt=\"diabetesepidemic\" width=\"300\" height=\"176\" srcset=\"https:\/\/d3.harvard.edu\/platform-rctom\/wp-content\/uploads\/sites\/4\/2016\/11\/DiabetesEpidemic-300x176.png 300w, https:\/\/d3.harvard.edu\/platform-rctom\/wp-content\/uploads\/sites\/4\/2016\/11\/DiabetesEpidemic-768x451.png 768w, https:\/\/d3.harvard.edu\/platform-rctom\/wp-content\/uploads\/sites\/4\/2016\/11\/DiabetesEpidemic-600x352.png 600w, https:\/\/d3.harvard.edu\/platform-rctom\/wp-content\/uploads\/sites\/4\/2016\/11\/DiabetesEpidemic.png 900w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/>\u00a0<\/a><a href=\"#_edn4\" name=\"_ednref4\">[iv]<\/a><\/p>\n<p>The most effective method of managing diabetes \u2013 even more so than powerful drugs like Metformin \u2013 is lifestyle changes, specifically avoiding a sedentary lifestyle and losing weight.<a href=\"#_edn5\" name=\"_ednref5\">[v]<\/a> Realizing this, many physicians prescribe diabetes programs to help their patients lose weight.\u00a0\u201cThe operating model of traditional diabetes programs involves a 16-week program at a brick-and-mortar, where the patient has to get in their car, drive to a center, sit there for 60-120 minutes, and potentially find a babysitter.\u201d<a href=\"#_edn6\" name=\"_ednref6\">[vi]<\/a><\/p>\n<p>Omada Health, a startup based in San Francisco, realized the friction in this operating model and developed a digital solution. The Omada <em>Prevent<\/em> program enrolls patients in groups of 10-12 into a 16-week program focused on healthy eating and exercise. Each group is assigned a \u201chealth coach\u201d, who lends support through text messages and voice calls and tracks each patient\u2019s progress digitally. The program is rooted in behavioral science and leverages the social networking power of groups; members encourage one another to continue to make healthy decisions. <em>Prevent<\/em> also features quizzes and learning modules; the digital operating model allows for asynchronous learning, as the material has been optimized for mobile, tablets, and laptops.<a href=\"#_edn7\" name=\"_ednref7\">[vii]<\/a><\/p>\n<p><iframe loading=\"lazy\" title=\"The Omada Experience\" width=\"640\" height=\"360\" src=\"https:\/\/www.youtube.com\/embed\/knhirNtEWgM?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe><\/p>\n<p>The <em>Prevent <\/em>program also provides patients with hardware, including a \u201czero-configuration\u201d wireless scale and pedometer. The wireless scale and pedometer transmit weight and steps automatically to a private profile, shared only with the health coach. The scale also makes progress much more difficult to fake, a longtime problem in the space.<\/p>\n<p>For those who successfully complete the program, the \u201cSustain\u201d program offers lower touch follow ups to keep the weight off for the long-term.<\/p>\n<p><a href=\"#_edn8\" name=\"_ednref8\">[viii]<\/a><\/p>\n<p><strong>Results<\/strong><\/p>\n<p>The combination of hardware, software, and behavioral science has produced impressive results:<\/p>\n<p><a href=\"https:\/\/d3.harvard.edu\/platform-rctom\/wp-content\/uploads\/sites\/4\/2016\/11\/WeightLossPrevention.png\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-medium wp-image-15611\" src=\"https:\/\/d3.harvard.edu\/platform-rctom\/wp-content\/uploads\/sites\/4\/2016\/11\/WeightLossPrevention-300x157.png\" alt=\"weightlossprevention\" width=\"300\" height=\"157\" srcset=\"https:\/\/d3.harvard.edu\/platform-rctom\/wp-content\/uploads\/sites\/4\/2016\/11\/WeightLossPrevention-300x157.png 300w, https:\/\/d3.harvard.edu\/platform-rctom\/wp-content\/uploads\/sites\/4\/2016\/11\/WeightLossPrevention-768x401.png 768w, https:\/\/d3.harvard.edu\/platform-rctom\/wp-content\/uploads\/sites\/4\/2016\/11\/WeightLossPrevention-600x313.png 600w, https:\/\/d3.harvard.edu\/platform-rctom\/wp-content\/uploads\/sites\/4\/2016\/11\/WeightLossPrevention.png 900w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><a href=\"#_edn9\" name=\"_ednref9\">[ix]<\/a><\/p>\n<p>In traditional in-person weight loss programs, typical engagement is in the 6-7% range and weight loss is roughly 2.4%. In comparison, Omada has shown engagement of 65% and weight loss of 4.7%. Not only that \u2013 Omada has published these results in third-party, peer-reviewed journals.<a href=\"#_edn10\" name=\"_ednref10\">[x]<\/a><\/p>\n<p><strong>Revenue model<\/strong><\/p>\n<p>Given the clinically-proven results and unorthodox solution, Omada sells the service with a revenue model more aligned with traditional weight loss programs. Omada uses a pay-for-performance billing model, where it does not collect fees unless it has demonstrated results. This is in stark contrast to typical diabetes weight loss programs, which charge for their service regardless of outcome. This revenue model has allowed Omada to scale to over 20,000 participants as of 2015 with blue-chip customers such as Kaiser, Humana, Lowe\u2019s, Iron Mountain, and Costco.<a href=\"#_edn11\" name=\"_ednref11\">[xi]<\/a><\/p>\n<p>Omada is also well-positioned for several developments in the healthcare landscape:<\/p>\n<ul>\n<li><strong>Shift in reimbursement model to fee-for-value. <\/strong>The US healthcare system is transitioning from fee-for-volume to fee-for-value, where provider reimbursement levels are tied to quality outcomes. Omada is well positioned for this shift as its solution is both scalable with low incremental costs and twice as effective as current treatment.<a href=\"#_edn12\" name=\"_ednref12\">[xii]<\/a><\/li>\n<li><strong>Increased burden for consumers to pay for care. <\/strong>Many employers have adopted coverage shifting cost burden onto employees in the form of higher premiums, deductibles, and cost-share. As consumers become less insulated from large bills, they have become more willing to adopt cost-effective digital tools to manage their health, including Omada.<a href=\"#_edn13\" name=\"_ednref13\">[xiii]<\/a><\/li>\n<\/ul>\n<p><strong>What\u2019s next? <\/strong><\/p>\n<p>Omada has created a new category of digital therapeutics and can take a number of steps to improve its offering. First, Omada can push healthier behavior in more high-touch (and potentially intrusive) ways. Omada could consider giving its patients weights with sensors to monitor how much they exercise. Perhaps the company could also push notifications to its users when they are making food choices e.g. at the grocery store or in their home pantry. Omada could also consider moving \u201cupstream\u201d to remote tracking devices related to diabetes \u2013 perhaps integrating with IoT glucose monitors or blood pressure monitors to create a fuller view of diabetes management for a clinician. Lastly, Omada should consider expanding to more chronic disease states. The coaching plus technology approach can encourage better behavior for those looking to quit smoking, beat insomnia, and control hypertension.<\/p>\n<p>Word Count: 735<\/p>\n<p>&#8212;&#8211;<\/p>\n<p><a href=\"#_ednref1\" name=\"_edn1\">[i]<\/a> David Roman and Kyle Conlee, \u201cThe Digital Revolution Comes to US Healthcare\u201d, Goldman Sachs, June 29, 2015.<\/p>\n<p><a href=\"#_ednref2\" name=\"_edn2\">[ii]<\/a> <em>Ibid.<\/em><\/p>\n<p><a href=\"#_ednref3\" name=\"_edn3\">[iii]<\/a> Alexander Fogel and Joseph Kvedar, \u201cSimple Digital Technologies Can Reduce Health Care Costs\u201d, <em>性视界 Business Review, <\/em>November 14, 2016, <a href=\"https:\/\/hbr.org\/2016\/11\/simple-digital-technologies-can-reduce-health-care-costs?utm_source=feedburner&amp;utm_medium=feed&amp;utm_campaign=Feed%3A+harvardbusiness+(HBR.org)\">https:\/\/hbr.org\/2016\/11\/simple-digital-technologies-can-reduce-health-care-costs?utm_source=feedburner&amp;utm_medium=feed&amp;utm_campaign=Feed%3A+harvardbusiness+(HBR.org)<\/a>, accessed November 2016.<\/p>\n<p><a href=\"#_ednref4\" name=\"_edn4\">[iv]<\/a> Balaji Srinivasan, \u201cSoftware Gets the World to Stop (Over) Eating\u201d, <em>Software is Eating the World <\/em>(blog), <em>Andreesen Horowitz, <\/em>April 9, 2014, <a href=\"http:\/\/a16z.com\/2014\/04\/09\/omada-health-behavior-change\/\">http:\/\/a16z.com\/2014\/04\/09\/omada-health-behavior-change\/<\/a>, accessed November 2016.<\/p>\n<p><a href=\"#_ednref5\" name=\"_edn5\">[v]<\/a> Diabetes Prevention Program Research Group. \u201cReduction in the Incidence of Type 2 Diabetes with Lifestyle Intervention or Metformin.\u201d <em>New England Journal of Medicine. <\/em>Volume 346, Number 6. February 7, 2002. p. 393-403.<\/p>\n<p><a href=\"#_ednref6\" name=\"_edn6\">[vi]<\/a> Arundhati Parmar, \u201cWhy Intermountain chose Omada Health to provide diabetes prevention services\u201d, <em>MedCityNews<\/em>, August 2, 2016, <a href=\"http:\/\/medcitynews.com\/2016\/08\/intermountain-chose-omada-health-provide-diabetes-prevention-services-patients\/\">http:\/\/medcitynews.com\/2016\/08\/intermountain-chose-omada-health-provide-diabetes-prevention-services-patients\/<\/a>, accessed November 2016.<\/p>\n<p><a href=\"#_ednref7\" name=\"_edn7\">[vii]<\/a> Omada Health. \u201cAbout Us.\u201d <a href=\"https:\/\/www.omadahealth.com\/about\">https:\/\/www.omadahealth.com\/about<\/a>, accessed November 2016.<\/p>\n<p><a href=\"#_ednref8\" name=\"_edn8\">[viii]<\/a> Omada Health. \u201cOur Solution.\u201d https:\/\/www.omadahealth.com\/solution, accessed November 2016.<\/p>\n<p><a href=\"#_ednref9\" name=\"_edn9\">[ix]<\/a> Balaji Srinivasan, \u201cSoftware Gets the World to Stop (Over) Eating\u201d, <em>Software is Eating the World <\/em>(blog), <em>Andreesen Horowitz, <\/em>April 9, 2014, <a href=\"http:\/\/a16z.com\/2014\/04\/09\/omada-health-behavior-change\/\">http:\/\/a16z.com\/2014\/04\/09\/omada-health-behavior-change\/<\/a>, accessed November 2016.<\/p>\n<p><a href=\"#_ednref10\" name=\"_edn10\">[x]<\/a> S. Cameron Sepah, Louhua Jiang, and Anne Peters. \u201c<\/p>\n<p>Translating the Diabetes Prevention Program into an Online Social Network.\u201d <em>The Diabetes Educator. <\/em>Vol 40, Number 4. July\/August 2014. p. 435-443.<\/p>\n<p><a href=\"#_ednref11\" name=\"_edn11\">[xi]<\/a> Omada Health, \u201cOmada Health Raises $48 Million to Fight Obesity-Related Chronic Disease,\u201d September 16, 2015, <a href=\"https:\/\/www.omadahealth.com\/news\/omada-health-raises-usd48-million-to-fight-obesity-related-chronic-disease\">https:\/\/www.omadahealth.com\/news\/omada-health-raises-usd48-million-to-fight-obesity-related-chronic-disease<\/a>, accessed November 2016.<\/p>\n<p><a href=\"#_ednref12\" name=\"_edn12\">[xii]<\/a> David Roman and Kyle Conlee, \u201cThe Digital Revolution Comes to US Healthcare\u201d, Goldman Sachs, June 29, 2015.<\/p>\n<p><a href=\"#_ednref13\" name=\"_edn13\">[xiii]<\/a> <em>Ibid.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Creating the &quot;digital therapeutics&quot; category<\/p>\n","protected":false},"author":2460,"featured_media":15844,"comment_status":"open","ping_status":"closed","template":"","categories":[1137,2062,208,2236],"class_list":["post-15843","hck-submission","type-hck-submission","status-publish","has-post-thumbnail","hentry","category-diabetes","category-digital-health","category-health","category-omada"],"connected_submission_link":"https:\/\/d3.harvard.edu\/platform-rctom\/assignment\/digitization-challenge-2016\/","yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.3 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>The Digital Solution to Overeating - Technology and Operations Management<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/d3.harvard.edu\/platform-rctom\/submission\/the-digital-solution-to-overeating\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"The Digital Solution to Overeating - Technology and Operations Management\" \/>\n<meta property=\"og:description\" content=\"Creating the &quot;digital therapeutics&quot; 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