Linda Parks 2018 Transcript

Linda Parks talks about digital therapeutics and how both patients and HCPS can use the Glooko app for diabetes management.

To see this interview in full, click here.

Freed:  This is Steve Freed and we’re here at the American Diabetes Association, 78th Scientific Sessions. And we have with us a special guest, Linda Parks. And maybe we can just start off and tell us a little bit about yourself.

Parks: Okay. Thanks, Steve. So, my name is Linda Parks, as he said. I’m a Diabetes Educator and have been I’d say — actually I stopped at 20 years, so 20-plus years I’ve been a diabetes educator. And I’ve worked on both the clinical and on the industry side, mostly medical devices. And I currently work at Glooko as their Director of Clinical Research and Development.

Freed: Okay. I know you’re a certified diabetes educator. But in order to be a certified diabetes educator you need to be nurse, a pharmacist, a physician–

Parks: Exactly.

Freed:  –if they have a medical background or a PhD in one of the medical sciences. So, tell me if you’re–?

Parks: Exactly. So, I’m a nurse.

Freed: Okay. So, why don’t we start out with — because Glooko has changed dramatically from the first day that they went public. And maybe you can start off and tell us who they were and what they are today, because I see it’s a huge difference. It’s like two different companies.

Parks: And it has evolved. And so, Glooko is still a privately held company. It was started back in 2011. Yogen Dalal was the founder. An interesting story around him, he was one of the original people in Silicon Valley. He did the Ethernet Protocol, so a very tech-wise guy, and he developed pre-diabetes. And so, he went to his doctor. The doctor talked about blood glucose monitoring and the data around diabetes, and gave him a log book, and he’s like, “Wait a minute, this is 2009, 2010, and we have all this technology.” And so, he looked for data management systems and there were really none out there that would take data from the different diabetes devices, so he started his own company. And we started Glooko, again, it was 2011. And it really started with MeterSync Blue, a device that could turn your meter into a Bluetooth device. And so, then you could download it into one platform. And so, it really started off as a patient oriented company, so that people could see their own data.

But as we were in this space longer, you could see that it’s not only patients who need the data but they need to share that with their clinicians. And so, Glooko then devised an office solution and so there’s the kiosk or a device that will go in the office and it can download all the different devices in the office, so that then the health care providers could see the information. And certainly then as you go along, we know that people want to use their smart phone for everything and so we developed an app. So, there is a Glooko App. And all these information goes up into the cloud into the same space. So, your health care provider is looking at the same data as the patients and they’re constantly downloading their data. Now, certainly with all these devices and Bluetooth, we get data from devices in many different ways. So, we can get it app to app. We can get it direct download. There’s an uploader on the computer that you can upload your information that way. But it all goes into the same spot in the Cloud, so that both the health care provider and the patient can view it.

Freed: So, it collects the information?

Parks: Mm-hmm.

Freed: And how does that present the information? Because each company has their own software, each meter has their own software.

Parks: Yes.

Freed: So, is it your software or they still use the company software for the blood glucose monitoring?

Parks: No. It’s downloaded and it goes into the Glooko platform. And so, it is a standard way to look at your blood glucose, your CGM data, and your pump data, so we have standard graphs and displays. Statistics, we’ve actually added now, so we do insights as well. So, we have algorithms that can show you what your best day is, comparing one day to another, telling you about your hyperglycemia or hypoglycemia, if it’s going up or down, so we’re starting to put insights into it as well.

Freed: Technology and diabetes. Diabetes changes every day. Technology changes almost every day. So, how is Glooko poised to be successful in this digital technology revolution with all these diabetes apps and platforms?

Parks: Yeah. And that’s a great question. And I think really Glooko wants to be that uniform platform that’s device agnostic, so we’ll work with all devices. And we are able to download more than 95% of the devices on the market whether they be pumps, CGMs, like Glooko’s meters, soon insulin pens, like the connected insulin pens. And then as devices come out, we’ll partner with those companies and then to show it in a standard way, because I do believe that that’s probably one of the reasons why people get so confused and don’t download their data is because there’s so many ways to view it. And so, I think it’s great if people have one standard platform and then they know where to go, what reports to go to see the data they need to see.

Freed: So, what’s the difference between digital health and digital therapeutics?

Parks: So, digital health is having that information. Digital therapeutics is now when you take that same information and now you’re able to make therapeutic decisions. And so, case in point, Glooko just had a module that goes through the Glooko App cleared by the FDA and it’s an insulin titration app, so it’s called the Mobile Insulin Dosing System or MIDS. And it’s a module that a physician will write out the treatment plan and put all the parameters around the insulin titration, and then deliver it through the Glooko App to the patient. The patient accepts it and then the insulin titration is automatic. So, Glooko knows what the fasting blood glucose is. Glooko can capture the insulin data. And so, then every three days or every seven days, however many days the physician has decided this titration period should be, the patient will get a notification through their app on their iPhone or Android device and we’ll walk them through the titration. So, it will look at their fasting blood glucose, it will look at their insulin, and then make the decision based on the treatment plan.

Freed: When I first started out, this was back a number of years when we started using software with blood glucose monitors, and I was working with Abbott and their product. And I was working with patients and one of the patients — I was just starting out, so I wanted to make a good impression, so I put together this beautiful report, it was 28 pages. I had reports on the weekends, in the evenings, and pie charts, and linear charts in technicolor, and I put it in this leather binder because I was just so excited. And the doctor happens to walk into the pharmacy and I jumped over the counter and I said, “Doc, doc, you got to see this. Look at this fantastic report.” And he looked at me and he took about two seconds to look at the report, he says, “Are you out of your mind? You know if you want to send me a report, do it on one page. I don’t have time. I’ve got hundreds of patients. This is just too much.” So, how does Glooko, what do their reports look like? Do they condense it? Is it easy for the physicians? Is it limited to the amount of information?

Parks: Now, there’s lots of different ways that you can look at the data. And people look at it for different things; are they trying to change pump settings or are they just trying to see generally, in target or out of target. So, Glooko has probably — I’m trying to think of how many different reports, six, eight, ten reports. But one thing we’ve just recently done is we’ve worked with IDC and we have the AGP report in it. And I think really the hope for that is that does become the standard report that physicians know how to look at or providers know how to look at and be able to analyze the data pretty quickly, because it’s all about saving time, making good decisions, and really efficiently in their busy, busy offices.

Freed:  How does Glooko help health care professionals in caring for people with diabetes?

Parks: I think they’re really connecting all the dots, so patients could be at home with their blood glucose monitoring, but the providers can see that data in a population stratified form with our population trackers. And so, that they can see — in the morning, if they went into their office they could quickly look at the population tracker. And we have flags there that talk about the clinical incidence whether they’re high or low and that’s something each provider sets for their own. And so, the people — their patients who may have had hyper or hypoglycemia will float to the top, so that they can quickly identify who needs to be contacted. And I think Glooko is just trying to make it a little bit easier to capture all that data in one spot, in one standard way, regardless of whatever meter or device that they’re using.

Freed: As I’ve said before technology is changing. I personally believe that we’ve come to the point in time where the blood glucose monitor is going to be the Ford Model  T—it’ll be in the museum because CGM is going to replace it. If you don’t have to stick your finger, why would you want to stick your finger 10 times a day? It is painful and there are people that don’t like the sight of blood. So, I can see that eventually there will be CGMs on the drugstore shelves and the prices will be relatively actually less than blood glucose monitors. So, what are you guys doing in that area?

Parks: Really, that’s a great point because there’s so much more dense data with the CGM which is harder to analyze. And I think products like the AGP and then Glooko will help define and analyze that data, and present it in such a way that it’s easy to look at and make decisions from because that’s what it’s all about, actionable data.

Freed: I always like to ask, what’s in the pipeline for Glooko?

Parks: So, we have lots of things in the pipeline. As we’ve talked about, it has evolved over the seven years that it’s been on the market and it will continue to evolve. One of the most exciting things now is these different advice modules that go through Glooko. So, we talked about MIDS which is for type 2 diabetes and titrating your long-acting insulin. And we also have a partnership with DreaMed which takes that CGM information and it goes through the DreaMed  engine in the background and they can recommend pump settings. And then, it’s delivered back through the health care provider through Glooko and then if the health care provider accepts the pump setting changes, then it’s delivered to the patient through their Glooko App. And DreaMed just got FDA clearance last week.

Freed: Your background, is it diabetes educator?

Parks: Yes.

Freed: That means you’re educating patients. What do you do at Glooko as far as the education process?

Parks: So, again, I do research. We have a couple of different research studies that are ongoing now, looking at clinical outcomes, using digital health and digital therapeutics. I’m also in Clinical Development with Glooko. So, as they develop new products, I’m there educating our software engineers and product managers on diabetes. And so, as they are coming up with new ideas, I talk about how that will work in an office setting or — really, it’s that gap that needs to be filled for people with diabetes. So, I still feel like I’m the resident diabetes educator. I just educate a different crowd.

Freed: Well, I want to thank you for your time! I found it very interesting.