Omada Health is a virtual-first healthcare provider that offers personalized, evidence-based programs to help individuals manage chronic conditions such as prediabetes, diabetes, hypertension, and musculoskeletal issues.
Why did you choose to join Omada Health?
I spent decades in biopharmaceuticals, running several businesses across the globe. However, a pivotal moment came while I was managing the diabetes business in China for Eli Lilly. During a visit to a rural clinic, I found two vials of insulin about to expire in a doctor's refrigerator. When I asked the doctor why he was not using them, he explained that he feared missing a dose and harming a patient. This moment made me realize that technology was the key to scaling care and supporting doctors, especially in underserved regions. In 2011, I worked with WeChat to launch the first diabetes connected care network in China, which connected tens of thousands of patients with their doctors. This experience solidified my belief in technology as a solution to chronic diseases, and when I met Sean, Omada’s co-founder and CEO, it became clear that Omada’s vision aligned perfectly with mine.
What differentiates Omada from other digital health platforms?
Omada stands out due to its focus on bending the curve of chronic diseases like diabetes, hypertension, and obesity, which have not seen significant improvements despite rising healthcare costs and innovations. Our goal is to make a lasting impact on disease incidence and severity, which we hope will be recognized in the coming decades. Our approach addresses a critical issue: 80-90% of factors that impact health outcomes occur between doctor visits. Most healthcare resources are allocated to appointments and hospitals, while patients need support outside those settings. Omada creates a persistent, engaging healthcare experience that’s always available, whether someone has two minutes or 20 minutes to engage. This model has proven effective through numerous peer-reviewed studies and sets us apart from others in the field.
Our multi-condition approach is another key differentiator. Chronic conditions often overlap, meaning treating one in isolation isn’t effective. For example, you cannot address diabetes without considering obesity, and you cannot treat MSK issues without tackling weight management. Omada offers an integrated program that addresses multiple conditions simultaneously, creating a more holistic and efficient care plan. Additionally, our human-led care model combines AI and human interaction. While we leverage AI for efficiency, the core of our care is built around personal relationships between members and their care teams. This human touch, along with the data we collect from millions of members, helps us personalize care at scale.
How are you utilizing AI and medtech in your platform?
Omada uses AI in multiple ways, combining machine learning, natural language processing, and generative AI to provide personalized care. When members join, we use AI to assess their needs and tailor care plans based on data from similar individuals. As members progress, we update their care paths to ensure they’re receiving the most effective support. Additionally, we integrate biometric devices like continuous glucose monitors and connected blood pressure cuffs to collect both structured and unstructured data, which enhances the AI’s ability to generate personalized care.
We are also deploying generative AI to support our care teams. For instance, if a care team member notices something unusual in a patient’s data, AI helps by summarizing relevant information and providing a holistic view of the patient’s history. This not only saves time but also allows for more efficient decision-making. We are also training our own large language models (LLMs) on our data, which will enable us to improve the quality and consistency of care. These AI tools are being developed with privacy in mind, ensuring all patient data remains secure within our system, which will be essential as we scale.
What are the biggest challenges in integrating digital therapeutics into traditional healthcare systems?
Integrating digital therapeutics into traditional healthcare is challenging for a couple of reasons. First, there is no existing billing system for the type of care Omada provides, which doesn’t involve traditional doctors’ appointments. In the U.S., healthcare systems work around appointment-based billing, but with Omada, care happens outside those appointments, making it difficult to charge for small, frequent interactions. To address this, our co-founder and CEO, Sean Duffy, worked with the American Medical Association to create the first Category 3 CPT code for digital health, which allowed us to negotiate payment for our services through insurance or employers.
Another challenge is becoming a fully accredited healthcare provider in a virtual space. To ensure the quality and privacy of care, we had to become a HIPAA-compliant entity, similar to traditional healthcare providers. Additionally, convincing the healthcare system that digital therapeutics can deliver the same level of care as in-person visits required rigorous evidence and certifications. Omada is now accredited by several organizations that also accredit major health systems, which has helped establish trust in our model.
Can you share a patient story that has inspired you?
One patient story that stands out is Steve, an elderly gentleman with a long history of diabetes. Despite his busy life, he struggled with managing his condition due to the limited time he could spend with his doctor. Over the course of nearly two years, Steve worked with his coach through Omada’s platform, communicating regularly and receiving personalized guidance. When Steve and his coach finally met in person, it was an emotional moment that demonstrated the deep, human connection fostered through virtual care. Steve’s story encapsulates the impact we can have on people’s lives, as his coach became a vital part of his health journey, even though they had never met face-to-face.
How does Omada approach the democratization of healthcare?
Omada is committed to making healthcare accessible to everyone, regardless of location or economic status. Unlike traditional healthcare systems, where access to quality care can depend on geographic location, Omada ensures that members from anywhere in the U.S., whether they are in rural or urban areas, receive the same level of care from the same highly-trained care teams. This is a significant step towards democratizing healthcare. Additionally, Omada works with health plans and employers to ensure that our services are available at no cost to the member, removing financial barriers to access.
When it comes to technology, Omada uses AI to make healthcare available anytime and anywhere, breaking down the limitations of traditional care. AI enables continuous care and immediate access, providing support to members whenever they need it. As we scale, we are also focused on ensuring the responsible use of AI, with privacy as a top priority. We are dedicated to maintaining strict safeguards to protect patient data while ensuring our AI tools deliver accurate and reliable care.
