Deborah Greenwood is no stranger to our D-Size now, as the California diabetes educator actually served as president of the American Association of Diabetes Educators (AADE) a few years back and over the past decade, has helped paved the way for the online patient community to become more recognized and mainstream.

We saw her at the big annual educators' conference this past August, and learned that she's joined a young startup company focused on building a "cloud" experience for patients heading into hospitals for procedures or care.

Today, we're happy to talk with Deb and find out more about her new position at , which she describes as aiming to build "the Netflix of healthcare."


An Interview with Deborah Greenwood

DM) Congrats on the new gig, Deb. Can you tells us about Mytonomy?

DG) Mytonomy is a patient experience, cloud-based software company, as in . The company also produces high-quality video-based patient education and leverages learning and behavior sciences to provide a personalized patient education and engagement experience.

For example, if a patient has an upcoming procedure, Mytonomy would help them prepare and recover using powerful '' video material delivered through their cloud, and accessible on any device – a laptop or a smart phone or in the hospital. This allows them to see how they are going to need to set up their home, what the surgery room looks like, and meet their care team virtually, all before the procedure started.  

What is the company doing in diabetes specifically?

For our focus in diabetes, Mytonomy helps engage patients and support self-management. What’s unique about this is that we develop a behavioral profile, based on participant responses to clinically validated mental health and patient activation surveys like the or , or knowledge questions that are developed by the care team, and then use this information to deliver a highly tailored, personalized experience, virtually.

Did the company begin with a focus in diabetes?

Mytonomy actually entered healthcare in March 2016 in cardiology, focusing on the pre-procedure based education with 85-90% patient usage across a diverse patient base (n=3500 patients). There were also results that showed real business benefits – cost savings and time saved – and nurses viewed Mytonomy as a virtual assistant.

In February 2017, we expanded into type 2 diabetes, with a focus on education for people new to insulin.

What does your role entail?

As the Chief Digital Research Officer for Diabetes, my role spans clinical research, marketing and product development in the diabetes space. 

And you're passionate about their mission and potential to help PWDs...?

Yes! What excited me about Mytonomy was the fact that they understood the challenges of living with type 2 diabetes. When I watched the microlearning videos, it was clear to me that the team respected the person with diabetes, focused on reducing the stigma associated with diabetes to decrease the emotional burden, and planned to support them on their journey.

The content was really unique and the way it was delivered (through their Patient Experience Cloud) made it so easy to log in and absorb the information. I was impressed that they were repeatedly seeing, in both research studies and in commercial rollout, very high usage rates. Mytonomy patients were watching a lot of content!

Can you tell us about the Sanofi partnership on multicultural diabetes education?

Mytonomy and Sanofi partnered to develop multicultural diabetes education using peer-to-peer learning, clinical narrative style, Pixar-like animation and the more traditional video scribe. They focused on addressing the cultural and social unmet education needs of three of the fastest growing populations: African-Americans, Hispanics/Latinos and South Asians. The content was developed to focus on cultural foods and understanding and overcoming biases related to their cultures.

Is there a research component to this?

Yes, I also liked that Mytonomy was a research-driven company. Right from their start in cardiology, they came out of the gate with an FDA-approved clinical research study on their pilot rollout. Same with diabetes, they found great academic and healthcare system partners who were willing to study the impact of the Mytonomy system with their patients new to insulin -- the institutions were Columbia, New York Presbyterian, Duke Health and the Medstar Diabetes Institute -- which encompasses Washington Hospital Center and Georgetown. 

This pilot study just finished in early November. The goal was to demonstrate ease of use and satisfaction with the system and to determine the effect of the ‘microlearning’ education on patient activation and attitudes towards insulin. Interim results indicate very positive results. The full data set is being evaluated now and will be presented soon.

Can you expand on what microlearning is all about?

Microlearning is a perfect fit for diabetes self-management education and support! These 30-second to 3-minute videos are patient-centered, focusing on helping the person with diabetes understand their condition. Many videos are from the patient point of view, sharing real life stories and their successes.

When you think of Mytonomy, think “Netflix of Healthcare.” When people log in, they see their playlists and specific videos in their library. These libraries can be configured by each individual health system or clinic. The system can be used within the hospital on iPads or personal devices or the person can engage in their own home, at a time that is convenient for them. We’ve see similar trends as Netflix as does, including “binge watching” of the content. We’ve also seen many videos watched multiple times, where people need reinforcement of a concept.

Does Mytonomy go beyond just hospital care into other healthcare settings?

We envision Mytonomy as a solution that can support multiple models of care and education. A great opportunity exists for people being discharged from the hospital to support continued learning and hopefully prevent re-admission -- especially if someone recently started insulin.

Mytonomy can also support population health management programs as a solution to deliver content while also helping the clinician to learn about their patient’s engagement patterns to customize their experience. Hospitals, health systems and clinics can incorporate Mytonomy into their practice as an additional resource to scale education and support in conjunction with in-person visits.

And how is the service "personalized"?

We are rolling out new personalized delivery capabilities and smart survey algorithms that are going to be used with in-patients at a major healthcare system later this month. Essentially, the Mytonomy system can easily deliver precision care or tailored feedback with specific videos suggested for people to watch based on patient-reported outcomes. The system allows for the generation of logic models to target specific actions (additional surveys, videos, provider engagement, etc.) based on the answers to a wide range of patient survey questions or based on patient generated health data.

Is the service focused solely on type 2 diabetes?

No. Although Mytonomy started in type 2 diabetes, they have already been approached to develop a similar approach in the type 1 diabetes space. I see a great opportunity for microlearning videos to help young adults transition from pediatric to adult care, so they can learn about their diabetes from their own perspective. Many diabetes educators have noted that there is a lack of good video content for the pediatric population.

What does all this mean for diabetes education across the board?

In diabetes, we already know that tailored education, based on patient-generated health data, incorporated within a technology enabled self-management feedback loop, has shown to improve A1C outcomes. But typically, diabetes education or care coordination has relied on coaches, care coordinators or diabetes educators, which can be expensive resources. Mytonomy has developed a virtual care management approach that is incredibly powerful (based on usage and engagement patterns from our pilot study) and yet a fraction of the cost of employing large call centers. Our next step is to conduct a clinical trial to validate our assumptions. I’m leading the planning and design of this research and very excited about it.

Finally, how did your experience leading AADE come into play?

As AADE president, I helped to advance our strategic plan in the direction of digital health and technology enabled self-management education and support. While chairing the 2017 revision of the National Standards for Diabetes Self-Management Education and easy eat hand, we saw the mounting evidence to support digital health. We published a systematic review of technology tools and developed a model to evaluate digital health solutions. The Mytonomy solutions falls within this model. I believe Mytonomy fills a gap that exists in the diabetes self-management education space. I see great opportunities for partnership to implement patient-centered systems.

In short: High-quality microlearning video education that can be curated and tailored to the individual, by leveraging patient generated health data, is needed. Netflix uses our consumer data to drive viewers to specific entertainment content offerings, so it’s about time we in healthcare also leverage the power of online behavior, viewership and patient-reported data to improve healthcare outcomes of all people!


Fascinating. Thank your for sharing, Deb.