The 40-Year-Old Startup

N4a, with its 40 years of experience in looking at chronic disease, including diabetes, offers a wide range of services to the elderly in their homes and communities, across the country.
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On July 16th, 2012, n4a Diabetes Care Center received $100,000 as the winner of the 2012 Data Design Diabetes™ Innovation Challenge. The challenge, in its second year and sponsored by Sanofi US, encourages innovation in addressing diabetes. Several dozen startups applied for the challenge with five finalists, including n4a, receiving $20,000 each.

n4a Diabetes Care Center is the most unusual startup among the applicants because it has been 40 years in the making. The startup is actually a two-way partnership between n4a the National Association of Area Agencies on Aging (seriously) and the National Health Index (NHI). Together, they have real feet on the ground in the form of the n4a's nationwide field offices with workers that call on the elderly, including a large number of diabetics, and real big data from the NHIs more than decade old database on diabetics and their characteristics. In other words they have real potential to mitigate the progression of diabetes for thousands of people.

n4a, with its 40 years of experience in looking at chronic disease, including diabetes, offers a wide range of services to the elderly in their homes and communities, across the country. According to the 2005-08 National Health and Nutrition Examination Survey and the 2010 US resident population, 26.9 percent of U.S. residents 65 and older have diabetes. The NHI has the most comprehensive zip code level data on diabetics and other diseases as well as deep analytical capabilities. Of particular interest to n4a is NHI's capability to predict when and which of these diabetics are at increased risk for a major event, which will not only be devastating but expensive for themselves and the system. A consultant to n4a, Ms. Courtney Baldridge, states that when she and Dr. Puckrein of the NHI started discussing their respective strengths, they "knew there was something special possible." One of the real drivers behind helping diabetics at risk, for example, is locating them. The NHI knows where 80 percent of diabetics are: in 8,000, or 20 percent, of the zip codes in the U.S. They also understand which factors diabetes correlates with (e.g., dietary considerations, age and ethnicity), in-depth. This translates to the ability to pinpoint at-risk individuals. The joint effort will introduce carefully located diabetes care centers with the objectives of improving outcomes and lowering costs by intervening before additional events occur.

Through the union of these two groups, big data met a big feet-on-the-ground network, and more than a startup was born. Rather, we have a model and inspiration for other startups and established companies alike. This inspiration comes in the form of two thought provoking questions: The first is "What can big data do for my effort?" Tapping into the tsunami of big data and Application Programming Interfaces (APIs) opened up by government, industry, and nonprofits is certainly not a new idea -- it's been going on for at least four years with the help of Todd Park, current U.S. Chief Technology Officer and former Health and Human Services CTO, and others. Many of tomorrow's healthcare, and other industry, winners are seeing this opportunity today and will leverage big data while the leveraging is good. The second question asks, "Is there a 40-year-old partner that I should be considering?" Unusual partners can make for unusually powerful solutions.

There are definitely other folks out there sitting on a 40-year-old startup. They may just need to find the right partner.

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