Tidepool CEO Howard Look on Creating an Interoperable Ecosystem for Diabetes Data

June 25, 2019
Medtronic recently announced it would develop a Bluetooth-enabled pump compatible with Tidepool Loop. Look explains the significance.
Tidepool.org’s mission is “making diabetes data more accessible, actionable, and meaningful for people with diabetes, their care teams, and researchers.”

The Palo Alto, Calif.-based nonprofit organization is working to allow people with diabetes to see the data from their insulin pump, continuous glucose monitor (CGM), and blood glucose meter all in one place. Founder and CEO Howard Look, who has a daughter with type 1 diabetes, is a Silicon Valley veteran, who worked at TiVo, Pixar, and Amazon. In 2015, he was awarded the White House Champions of Change award for Precision Medicine on behalf of Tidepool’s work. Healthcare Innovation’s David Raths recently conducted an e-mail interview with Look about some significant recent developments.

Healthcare Innovation: Tidepool is developing an FDA-regulated, open source automated insulin delivery app for iPhone and Apple Watch, and Medtronic recently announced that it would develop a Bluetooth-enabled pump that would be compatible with Tidepool Loop. How will this increase the options available for people with diabetes to manage their own condition?

Look: Ultimately, the goal of Tidepool Loop is to work with any insulin pump that receives the ACE (Alternate Controller Enabled) pump designation from the FDA, and for any continuous glucose monitor that receives the iCGM designation. Tidepool Loop will work with both Medtronic and Insulet Bluetooth LE-enabled pumps, and over time we hope there will be more choices.

We believe that people living with diabetes should have a choice, and by creating Tidepool Loop we will be demonstrating the power of an interoperable ecosystem. Some people may prefer a patch pump, others may prefer a tubed pump. Tidepool Loop will also let people with diabetes choose to control their diabetes therapy directly from their iPhone or Apple Watch, which is also a very attractive option for many people. 

HI: Can you help explain to healthcare execs who don’t work specifically in the diabetes space how significant this is? 

Look: People with diabetes often have to choose, or are forced into a siloed ecosystem for their diabetes management depending on their insurance coverage and availability. Tidepool Loop, when it is released, will be an interoperable system allowing people with diabetes to choose the devices they want to use for their automated insulin delivery. This kind of choice has not been available to people with diabetes in the past.

HI: Are these collaborations something Tidepool has been urging vendors to consider for a while? Have they tended to create vendor-specific systems in the past? Is there a particular reason this development is happening now? Pressure from patient groups or the FDA?

Look:  We’ve been advocating for interoperability since Tidepool was founded over six years ago. Making good on this mentality, we’ve built a data platform that supports a wide range of insulin pumps, continuous glucose monitors, and blood glucose meters, that standardizes the data and presents diabetes data in an accessible manner for people with diabetes, their care teams, and clinicians.

Device manufacturers have built proprietary software that supports their own devices, and that may be fine for some people, but we think that there's value in letting people engage with their diabetes data using a unified interface that's independent of the type of device they choose to use.

HI: Are there other insulin pump makers you have integration plans with?

Look: Yes, Insulet was the first insulin pump partner we signed an agreement with to integrate their Omnipod system into Tidepool Loop.

HI: Tidepool Loop will be an automated insulin delivery app for iPhone and Apple Watch that connects to an insulin pump and CGM using Bluetooth LE. Does the organization have a projected timeline for when it hopes to make this available? And a timeline for the integration with a Medtronic pump?

Look: We do not have a public timeline for the availability of Tidepool Loop, nor do we have a timeline for integration with Medtronic’s future Bluetooth-enabled MiniMed pump. 

HI: In the electronic health record (EHR) space, there is a long-term focus on the pain points of interoperability. Are there similar issues being worked through in the medical device space?

 Look: Agreements like this create wonderful opportunities for collaboration, but there’s still a lot of work to make sure everything works as intended. This is uncharted territory for most of us, but we’re determined to provide an interoperable automated insulin delivery system that is both safe and effective, supporting multiple in warranty insulin pumps and CGMs. 

HI: Isn’t it unusual that Tidepool is a nonprofit in Silicon Valley? How did that come about?

Look:  It might be unusual to some, but we felt strongly about our mission to make diabetes data more accessible, meaningful, and actionable. Being a nonprofit organization means our stakeholders are people with diabetes, not shareholders.

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