Diabetes type 2 can be reversed for 56
Diabetes (type 2) can be reversed for 56% of patients within 12 months* Introduction to Liva Healthcare Rune Bech, co-founder *Journal of The American Medical Association (JAMA): 2017; 318(7): 637 -646. doi: 10. 1001/jama. 2017. 10169
Lifestyle diseases (like diabetes) is a ticking bomb under healthcare; public as private 425 million (2017) 629 million (2045)
Diabetes prescriptions now cost NHS £ 1 billion a year, up 40% in ten years • 3 m people in England now have diabetes • Doubled over the last two decades • Continuing to grow. • Nearly 100, 000 diagnoses per year • 92% are type 2 • 67% of men are overweight or obese • 58% of women are overweight or obese
Why Liva is in demand: Unmanaged Diabetes is expensive € 26, 035 per patient can be saved annually by successfully stopping the progression of diabetes complications (from level 1 to level 3) Annual costs attributable to diabetes per patient (Case: Denmark 1) € 35, 000 Healthcare incl. pharmaceuticals and nursing services Productivity loss € 32, 232 Societal Costs per Patient € 30, 000 incr ons ti € 20, 000 a plic m o sc et a ts Cos € 15, 000 € 5, 000 e eas € 25, 000 € 10, 000 Additional costs k roc sky € 14, 080 € 6, 197 € 0 Diabetes patients without complications Share of diabetics: 55 % Diabetes patients with minor complications 20 % 1. Diabetes patients with severe complications 25 % Sortsø et al. , “Societal Costs of Diabetes Mellitus in Denmark”, Modern Economy, 2015 4
JAMA study shows that diabetes (type 2) can be rolled back for 56% of patients through lifestyle change 56% reversed! 80% 70% 60% 17. 10% Discontinue medication 50% 40% 30% 20% 10% 56. 40% Professor Bente Klarlund with 13 colleagues documented in JAMA in August 2017 that diabetes can be rolled back through lifestyle intervention. 11. 70% 14. 70% 0% Lifestyle intervention Standard treatment Mette Yun Johansen, MSc; Christopher Scott Mac. Donald, MSc; Katrine Bagge Hansen, MD, Ph. D; Kristian Karstoft, MD, Ph. D; Robin Christensen, Ph. D; Maria Pedersen, MD, Ph. D; Louise Seier Hansen, MSc; Morten Zacho, MSc; Anne-Sophie. Wedell. Neergaard, MD; Signe Tellerup Nielsen, MD, Ph. D; Ulrik Wining Iepsen, MD, Ph. D; Henning Langberg, DMSc; Allan Arthur Vaag, DMSc; Bente Klarlund Pedersen, DMSc; Mathias Ried-Larsen, Ph. D JAMA. 2017; 318(7): 637 -646. doi: 10. 1001/jama. 2017. 10169
Liva’s scalable e-coaching platform reverses and stops progression of lifestyle diseases 1 Patient app (Personal coach in the pocket) Patients 2 Coach dashboard (Scalable personal e-coaching) (Real) Health Coaches 3 Outcomes dashboard (Real time/world outcomes data) Healthcare provider
From the LIVA town hall meeting introducing the Liva platform in Aabenraa, Denmark: 850 lifestyle patients showed up
Personal relationships are key to succeeding with a lifestyle change Support community of fellow patients (peer-2 -peer) Ongoing personal e-coaching Asynchronous via app by text and video Health coach Personal lifestyle plan Each plan is tailored to the individual patient’s needs Patient “A real personal coach in your pocket” Relationship based: Behaviour psychology agreements and commitments Personalised content Motivational material and other content is carefully targeted and timed Easy lifestyle and goal tracking E-coaching made scalable via AI Data makes the intervention more personal and the health coach better Automatic tracking (e. g. , steps) or easy manual tracking (e. g. meal photos) 8
LIVA pilot in process with NHS England (Healthier You, DDPP) LIVA selected for the NHSE’s Digital Diabetes Prevention Programme (DDPP). Pilot with 5000 patients began Dec 1 st, 2017, running for 18 months. NHS has announced an intention to enrol 100. 000 patients a year (2019 -2022) in their “physical” NHS DPP program Up to 20% of these will be pure-play digital. Liva is co-bidding with two providers. 9
Liva’s outcomes with pre-diabetic patients – real time / real world 6. 9 kg 75% 50% after 6 months pre-diabetics reversed after 6 months* weight loss after 6 months Real world Liva data. Trend. Real world Liva data. reduced Hb. A 1 c Real world Liva data. LIVA retention rates using personalized coaching: • 3 months: 76% • 6 months: 66% • 9 months: 63% *Hb. A 1 c below 42
The Liva Patient Pathway Step 1: Referral Patient referred by - Family doctor (GP) Insurance company Local health authority Pharma company Step 2: Personal meeting Patient meets allocated health coach (physical meeting or live video) - Establish a personal relationship Identify health issues Set up personalized lifestyle plan Agree on actions and commitments Step 3: Programme begins Patient adherence - Follows program Self reports on agreed metrics Takes photos to record diet, etc. Ongoing dialogue with coach Part of online support community Step 4: Ongoing coaching Personal e- coaching - Coach guides via video/text - Coach monitors progress - Motivational therapy via app Healthy lifestyle. Disease reversal. 11
The Liva Platform – The Data Mining View of outcomes (clinical and ROI) for executives Driving real-world and real-time reporting and insights Liva provides a real-world data reporting cockpit, which gives customers: § § § Compliance reporting Real-world and real-time evidence and outcomes Patient data mining 12
How Liva differentiates from the competition 1. Real Person Coaching - Not Robots 3. Scientifically Proven Outcomes § Liva is based on a real personal relationship between patient and a real coach. § No robots here: It takes a real person with empathy to drive real and lasting changes in lifestyle and behaviour. § The patient is in touch with their coach digitally but it’s a real person. § Wherever you go, you have your personal coach in your pocket. § You’re part of a community of peers/mentors § Five studies have so far validated clinical outcomes and ROI efficiency of the Liva Platform. § Currently six new studies are in progress to further expand on the outcomes of the Liva Platform by University of Southern Denmark. 2. Highly Scalable and Effective § With Liva one coach can handle 4 -600 patients, thanks to intelligent data use, workflow management, algorithms and library features. § Liva allows coaches to tailor-make personalised, specific recommendations for each patient. 4. Continuous Refinement Since 2002 § First launched in 2002 the platform has since been refined and improved continuously based on extensive empiric experience. 5. 140, 000 Patients and Counting § Since 2002, the team behind Liva has served over 140, 000 people with effective digital lifestyle coaching making it a proven and mature solution.
Contact details From the founders of Net. Doctor. com LIVA Healthcare A/S Danneskiold-Samsøes Allé 41 DK-1434 Copenhagen K DENMARK www. livahealthcare. com Rune Bech, co-founder Tel. +45 20 28 96 66 rb@livahealthcare. com LIVA Healthcare UK Ltd 12 David Mews Marylebone, London W 1 U 6 EG United Kingdom www. livahealthcare. co. uk
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