Livongo Founder and Executive Chairman said:
what we’ve done today is we have wonderful technology we have apps and we have devices and we have medications and we have health coaches and all of this and yet for people with chronic conditions it hasn’t gotten any better with all of this effort. and what we have to do is put that together into an experience that people have and that’s really what we’re doing at Livongo today and we call it applied health signals. and that is taking this information aggregating all this information from people’s bodies from their pharmacy records or healthcare records or electronic health records interpreting what that means for those people and then applying it getting it back to those people and doing what Amazon and Netflix and others do so well iterating to see did it work and if it worked do more of it and if it didn’t do less of it.
Livongo may not be doing any fancy stuff but they are trying their best to close the loop of all the disconnected pieces and serving their patients through iterations. We could call them a system integrator. While it is relatively easy to list out patient’s wants and needs, it is not easy at all to create an environment that will satisfy all your patients.
Livongo supports AI+AI for our members across a variety of uses cases. Here are just a few experiences that we’re already doing for Livongo members.
EXPERIENCE #1: Medication Optimization (in Partnership With a Pharmacist) for Diabetes
Problem Statement: Medication optimization (enabling the use of the right medication at the right dosage, and evaluation of the impact of that medication/dosage) is considered one of the most difficult things to improve in medicine. A member is on a number of different medications and is having a hard time knowing what to take when, maintaining refills, and is seeing a decline in staying on their medications due to that confusion and sense of being overwhelmed. As a result, their blood glucose levels are increasing. Livongo’s AI+AI Solution:
Livongo’s AI+AI engine uses a data science and behavior change approach that drives actionable and personalized impact in tight partnership with pharmacists from the leading national pharmacy chains.
First we Aggregate a variety of data: eligibility, formulary, current medications, pharmacy claims (to understand what conditions a member has), biometric screening data where possible, and their ongoing blood glucose data (from their Livongo blood glucose meter).
Then we Interpret that data and ascertain a set of signals that tell us the member is not taking to their medications, and that’s why their blood glucose levels are spiking. We know this, because the member’s blood glucose values are high, and they are intermittently refilling their prescriptions.
We then use our Livongo live coaching application (Apply) to help understand the member’s medication barriers. When the member speaks with our coach, we probe about why they aren’t taking their medication. If the member identifies a side effect of the medication, we identify an alternate medication that is on their formulary and connect them live with their pharmacist (by phone) to discuss the switch, or directly with their provider. The pharmacist (or provider) formalizes the switch to the new medication and guides them to make sure they are taking their medication optimally. The pharmacist has the new medication delivered to the member’s doorstep.
As the member uses their new medication, Livongo observes that their blood glucose is improving and Iterates the coaching messages, nudges, and encouragement to help keep the member on the medication.
In doing this, we reduce the complexity of the back and forth for a member with their pharmacist and providers trying to manage their medications and getting the right medication for them to be as healthy as possible.
EXPERIENCE #2: Medication Affordability for Diabetes and Hypertension
Problem Statement: A member has both diabetes and hypertension and is struggling to pay for their medications to stay healthy.
Livongo’s AI+AI Solution: In this scenario, Livongo can provide a special AI+AI solution for a member who is working for clients of ours that have put in place a program to completely pay for medications (with $0 co-pay for their employees) if a member performs certain health-related activities, such as measure their blood pressure regularly using the Livongo for Hypertension program.
So in this case, Livongo Aggregates the data that tells us which meds are in that $0 co-pay program and the criteria to be eligible for the program. We combine that data with the tracking data about how individuals are performing against those criteria. We mix in all the data we described in the last scenario: pharmacy claims, blood pressure values, blood glucose values, formulary, medications.
We Interpret all that data and create clear health signals that tell us that a specific member would use the medications more consistently if they are offered a $0 co-pay plan. And we also ascertain that the member often has a lag between prescription refills, so that signals to us that they may be having trouble getting to the pharmacy to actually pick up their prescriptions.
As part of a live coaching session, a Livongo coach Applies these signals by introducing the $0 co-pay opportunity to the member, and offers to help ensure delivery of their hypertension medication refills. The member is excited and uses the Livongo cellular-connected blood pressure cuff to measure their blood pressure consistently over the next month. They are then eligible for their $0 co-pay medication.
Livongo passes this eligibility information, blood pressure signals, and blood glucose values back into the engine, ensuring that the member’s next refill is a $0 co-pay, observes that the member’s blood pressure is improving, and Iterates the next coaching session content to congratulate and encourage the member to keep up their great progress.
In doing this, we reduce the costliness of healthcare for the member while also helping them achieve their health goals.
EXPERIENCE 3: Smarter Coaching for Weight Management
Problem Statement: A member has recently decided to take control of their weight but has been unsuccessfully using a traditional weight-loss program before. The coaches called them during the workday. They were too embarrassed to even talk to the coach, and so avoided the calls and had a bad feeling about the whole experience. They had one call and felt that the coach really didn’t know anything about them specifically and wasn’t a good “fit” at all so they gave up.
Livongo’s AI+AI Solution: For the member experience on Livongo’s Weight Management program, we Aggregate their eligibility data, nutrition and exercise data, psychographic information, and communication preferences. We have a powerful set of algorithms that allow us (from a few member-provided responses) to understand the profile of the member and how to most appropriately coach them in terms of content, style, and tonality. We also aggregate nutritional data, as well as Fitbit® exercise data.
We then Interpret their data and create a weight management curriculum that is most appropriate for them.
As we Apply that weight management curriculum, via digital, voice, video, or group-based coaching, we observe the member’s interactions and patterns. Members use Livongo applications to track nutritional data, Livongo’s digital scale to track their weight, and they interact with their Fitbit, which feeds data iteratively back into Livongo’s Aggregate layer.
Then we Iterate the coaching content and determine how best to deliver it specifically for them, continually tailoring the program to their needs. We also watch for signs of burnout and encourage them in the tough moments. For example, we may suggest they join a group coaching session to learn from their peers. Such advice is not based on speculation, rather on actual signals we’ve generated through AI+AI about what they need and what would work best for them (patterned on what we’ve seen work for others).
In doing all of this, we reduce the confusion around the set of options that work for a specific person to have impact on their weight. We help people understand what specifically works for them, and help them achieve their weight management goals!