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Personalizing the Precision-Medicine Pathway

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Managing diabetes outcomes is a full-time effort, requiring mental alertness, resolve, and vigilance. Navigating through high and low blood glucose readings can take an exhaustive emotional toll.   Despite that, HCP visits for people with diabetes generally focus on physical and not mental health.  Is it any surprise that diabetes outcomes have not improved significantly, despite the meteoric pace of technological advancement over the last 40 years?

A new tool and approach from Spotlight AQ aims to infuse emotional health care into the physical treatment of diabetes, thereby improving overall patient care and the efficiency of diabetes healthcare checkups.   Spotlight AQ was awarded the American Diabetes Association’s (ADA) coveted Innovation Award during this year’s (2024) ADA conference in Orlando, Florida.  This week, I had the opportunity to sit down with Dr. Katharine Barnard Kelly, the Chief Science Officer and co-founder of Spotlight AQ, to learn more about this game-changing tool.   In addition to winning awards in both the United States and Europe (Berne Center), Spotlight AQ is a member of StartUp Health’s T1D Moonshot.


Ten Questions for a Healthcare Innovator:

  1. How does Spotlight AQ evolve the current healthcare visit for people with diabetes (and obesity)? Spotlight-AQ represents the first step in the personalized component of the precision-medicine pathway – namely, it elicits the patient’s perspective right at the start.  Without this, there really is no precision medicine.
  2. How does the software work? Our system comprises pre-clinic assessments, immediate presentation of results and mapping of evidence-based resources to meet every possible unmet need of each patient…There are currently five Spotlight-AQ pre-clinic questionnaires, these are for adults with type 1 diabetes, type 2 diabetes or obesity; as well as for children with diabetes and their parents.  The questionnaire can be completed up to a week before the routine visit or in the waiting room ahead of the visit.
  3. What problem does Spotlight AQ solve? It enables every patient the opportunity for their voice to be heard, and for their unmet needs to be addressed. It really is that simple.  If we can hear our patients in clinic, then we can help.  Without Spotlight-AQ in a routine visit, it is almost impossible to understand what the real need or barriers to optimal health are. On average, patients are interrupted 18 seconds after they start to describe the problem, visits are focused on physical health outcomes and patients as well as healthcare providers are often frustrated and helpless to find effective solutions. Spotlight-AQ completely transforms every visit for the better and we’re seeing spectacular results for patients, healthcare providers and health systems.
  4. Are there statistics that suggest depression is a co-morbidity of diabetes? Depression prevalence is 2-3 times greater amongst people with diabetes than the general population.  Sadly, rates of suicide are 3-4 times higher. Diabetes is a uniquely burdensome disease that impacts every aspect of people’s lives.  If it were all about glycemia and math, then it would be a whole lot easier… Healthcare that addresses physical, mental, and social wellbeing is crucial to support people living their best life possible despite their pancreas!
  5. What kind of questions does Spotlight AQ ask, and how does it adapt to patient responses? We have literally hundreds and hundreds of questions that cover many different aspects of a person’s life with diabetes or obesity and the impact it has both ways.  So, the focus could be on quality of life for example, or social well-being; or it could be on avoiding hypoglycemia during exercise; or it could be about sexual health and how to overcome issues such as erectile dysfunction or vaginal dryness.  It really depends on the priorities of the individual. The questionnaire is AI driven, so it very quickly learns what matters to each person and presents questions that are most relevant to those unmet needs.
  6. How does the Innovation Award change your trajectory? Winning the American Diabetes Association Innovation Award was such an honor, we’re absolutely thrilled. I am immensely proud of our team who work tirelessly to improve the lives of people with diabetes and of healthcare providers every day. The award has given us visibility and potential funding opportunities that can help us expand and scale in a sustainable way.
  7. Does your tool integrate with any others? Yes, our tool can integrate with connected care platforms, EMRs, and other platforms.
  8. How does the tool analyze survey responses? We have some whizz-bang algorithms that drive the data analyses.  Of course, I can’t tell you any more about those because they are trade secrets and subject to patent protection; however the machine is extremely complex and efficient at getting to the root of the unmet need very quickly, and meeting that need effectively for better outcomes.
  9. How does Spotlight AQ address the problem of equity in diabetes care? Spotlight-AQ reduces inequalities in healthcare delivery by providing every person with diabetes the same opportunity for their voice to be heard. We know it can be extremely difficult to articulate the challenges faced in trying to manage diabetes; particularly in the face of a paternalistic and often biased healthcare system. We also know that it can be disproportionately harder for different sectors of society. It is well-documented that disparities exist across healthcare in terms of access to, and uptake, of therapies and devices that PWD are entitled to. HCP inherent bias also limits some people’s ability to access therapies or devices, despite regulatory guidelines. Spotlight-AQ removes these barriers by providing every user the same opportunity for their voice to be heard, along with tailored resources to meet unmet needs, regardless of their background. This enables HCPs to deliver high-quality care to all patients equally.
  10. What types of resources can patients expect to be directed toward? There is a huge library of resources on hand to meet any possible identified unmet need the patient may have.  These come in many different formats, written, visual, audio for example and cover physical, mental and social well-being.  People can expect to receive specific information about a particular aspect of living with diabetes like exercise and hypoglycemia, or about diet or about communicating more effectively with other people who they rely on for support. Resources can be technical, medical, psychosocially leaning or more broadly related to something else entirely. The most important thing is that the patient actually connects the dots between their life and personal situations and their care plan. This connection fosters more engagement and better outcomes.