Omada

Summary

Omada is a 16-week online digital health program specifically targeted at individuals at risk for developing diabetes, cardiovascular disease, or obesity. Inspired by the NIH’s Diabetes Prevention Program, Omada aims to empower individuals to make lifestyle changes by partnering participants with an online professional health coach whose role is to advise, support, and track their food consumption and exercise. In addition, this support is supplemented by interactive weekly health lessons and a social network of other participants that provide motivation and accountability. The average time commitment for participants is 2–3 hours per week, and the 16-week intervention costs $520, with an additional $12 per month for ongoing access if paying as an individual. These costs can also be covered by health plans and employers; Medicare also began reimbursing CDC-recognized providers for administering the Diabetes Prevention Program, including Omada Health, in March 2016. Research on the efficacy of Omada indicates that the total engagement of participants using Omada is 65% at 12 months, compared to 6.6% in a leading commercial weight-loss program. Furthermore, users of the program experienced increased weight loss compared to other health and wellness programs (4.7% versus 0.5%) as well as reduced A1c levels.

Keys to Success

Accessible and Convenient

Omada is the first online program to meet the requirements set by the CDC’s Diabetes Prevention & Recognition Program (DPRP). In other words, it is the only Diabetes Prevention Program (DPP) translation to be carried out online that is approved for reimbursement by Medicare. Because the program is online instead of scheduled, in-person sessions, Omada is much more accessible to people for whom scheduling or transportation to a program might serve as a barrier. While relatively few studies report on patient experiences with DPP translations, at least one study of patient experiences with Omada found that the convenience with which the program can fit into daily life was a major draw for many participants.^[1]

Establishing social networks

The development of communities—and the motivation and accountability that they can bring—is crucial to the success of group-style DPP translations, but could easily be lost in an online platform. Omada is deliberately designed to compensate for the loss of face-to-face community. Each enrollee in Omada is placed in a 10–15 person support group based on matching personal and demographic characteristics. The members of the group progress through the program together but don’t all have to complete weekly lessons at the same time.^[2]The support group communicates with each other and its assigned a personal coach to create a sense of shared effort and accomplishment, as well as accountability.

Personalized interactions

While Omada does not involve face-to-face health coaching, each participant is assigned to an advisor with whom they interact via the web platform.^[3] This allows for a far more personal experience and individualized plan than would be possible through, for example, an automated app. Omada thus strikes a balance between the convenience of digital health and the precision and customizability of personal care.

Long-term maintenance

Omada, unlike many DPRP-approved DPP translations, has demonstrated the impressive outcome of weight-loss maintenance through the second year of the program with no significant change from the end of year one.^[4] In other words, Omada participants—at least those who could be reached for a two-year follow-up—kept off their weight on average better than those in most DPP translations. One possible reason is that Omada has a continued program meant to maintain weight loss. This follow-up program is less hands-on, but all participants who have completed the four-month core program continue to access certain health tracking tools and online group discussions.^[5] For individuals, this weight-loss maintenance program costs $12 each month, compared to the $130 per month cost of the core program. (Pricing is negotiated for employers and health plans.) For individuals with impaired fasting glucose of 110–125 mg/dl, Medicare covers $450 for the first year of a DPP and up to $180 for each year after the first, meaning the maintenance portion of Omada could be entirely reimbursed after the first year for qualifying persons with prediabetes.^[6]

Ability to Inspire

The clearest indication of Omada’s demonstrated successes is its CDC recognition—Omada was the first online-only platform to receive this designation.^[7]

Cost Effectiveness

Omada contracts with employers and health plans, negotiating prices and operating on a “bill-based-on-results” policy.^[8] Because Omada does not charge employers or insurers, in this system, for those participants who fail to demonstrate the intended outcomes, it has the potential to be even more cost-effective. If Omada truly can achieve comparable long-term outcomes to the original DPP study, it demonstrates impressive cost-efficiency.​

Drawbacks and Limitations

While the advantages to accessibility are clear, the convenience of online platforms should not be overlooked. Convenience comes with lower commitment, meaning that low engagement and non-completion may be especially significant problems for Omada.^[9] Additionally, participants have reported certain drawbacks to the online platform. An online support group lacks the face-to-face intimacy and interactivity of an in-person one, and therefore may be less effective in establishing the strong social networks that are so important for lifestyle changes. What’s more, figuring out the technical components of using an online platform and regularly logging info can be tedious or challenging for some participants.^[10]