November 13, 2020

Diabetes Care Around the World

Diabetes challenges the entirety of health systems around the world. A person diagnosed with diabetes, over the course of his or her life, is likely to need the services not only of primary care providers but also community health workers, dentists, pharmacists, endocrinologists, podiatrists, ophthalmologists, and nephrologists

Nascent health systems struggling to provide basic primary care or specialty care are often ill- equipped to offer the timely diagnosis and treatment that people with diabetes require to avoid disability and early death, and more advanced systems too often fail to coordinate diabetes care and leave patients with expensive, disjointed and fragmented information and services.

 Spurred by conversations we had in November 2014 at a Diabetes Working Group meeting in Mexico City, Innovations in Healthcare and the Brookings Institution teamed up in a new paper published by Health Affairs to highlight how our innovators are working to prevent and treat diabetes and how policy makers can encourage and facilitate innovation.  We examine innovative approaches by ClickMedix and Pro Mujer.  Pro Mujer is working to prevent and screen for diabetes throughout Latin America by integrating clinical tests and health information with financial services marketed to low-income women.  ClickMedix operates e-health technology platforms throughout the world to improve patient self- and team-management of diabetes care. Both organizations offer bundled diabetes services directly to patients at a lower cost than available alternatives. 

 The paper looks at the path to scale for each organization and the regulatory and payment challenges they faced working with the public sector in different countries. We then offer a framework to highlight policy barriers—institutional, regulatory, and financial—to the diffusion of transformative innovations in diabetes care. This framework builds on accountable care principles that support better patient-level outcomes at lower cost and could have implications for helping policy makers better address the challenges of diabetes and other chronic diseases.

Diffusing innovation in diabetes care is not easy, but is a crucial task right now for policy makers around the world. Although many promising innovations exist, they are too often not reaching the people who need them the most. We hope in writing this paper to spur more thinking and discussion about public-private partnerships among policy makers and to help innovators in thinking about paths to scale as they spread their innovations from country to country.

We are grateful to our innovators, supporters and partners who helped make our Diabetes Working Group meeting a success and who helped to inspire this research. We are especially thankful for the time and attention of Ting Shih, CEO and Founder of ClickMedix and Jana Smith, medical director of Pro Mujer.

 For more information on this paper, please contact Jennifer Cook.