The Therapeutic Mindset Goes Digital

Mansur E. Shomali, MD, CM
August 29, 2019

Health care providers are being asked to see more patients in less time while simultaneously documenting more extensively in the electronic health record.  The system seems to favor the most efficient providers rather than the most empathetic ones. We “old school” physicians are often rushed and unable to take the time necessary to develop therapeutic relationships with our patients that engenders their trust. The time was right for a technology solution that could support the provider-patient interaction.

When we built the artificial intelligence behind BlueStar, our diabetes digital health platform, we felt that the tone of our coaching messages would be critical to the product’s success.

A computer coach does not get rushed for time and can interact with users as often or as little as needed to provide just the right amount of support. All interactions and entries of data into the new digital platform would be appreciated, no matter how high the blood glucose or how few the number of steps from the pedometer.

When we looked back at the first few sets of BlueStar data coming in, we were amazed at how much the users told BlueStar. They put in notes when they were stressed or when they ate something they shouldn’t have. Amazingly, the users who put in text annotations were more likely to continue to use BlueStar and had better diabetes outcomes than users who didn’t put in annotations.1 BlueStar was no longer just an app; it had become an integral part of the users’ treatment.

The BlueStar coach would not be judgmental but would point out ways to get better.

With chronic diseases like diabetes, a therapeutic alliance between providers and patients is critical for success. In my medical practice, my knowledge of the hundreds of molecules involved in diabetes is worthless if my patient doesn’t trust me and the treatment plan that I prescribe. How well I convey that trust, in the limited amount of time available, is an important determinant of success. One of the ways digital tools can support patients is by continuing to build upon the therapeutic mindset that their providers create, thus amplifying the efficacy of the treatment plan. Furthermore, digital tools like BlueStar that take raw data and help users contextualize their data, help users gain insights, make connections, and eventually improve health-related behaviors. And, I might add, with 0% side effects.



1Dugas M, Crowley K, Wang W, Iyer AK, Peeples M, Shomali M, Gao G. Beyond Tracking: The Benefits of Contextual Annotation in a Diabetes Digital Therapeutic. Presented at the 79th Scientific Sessions of the American Diabetes Association, June 7 – 11, 2019, San Francisco, California


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