DME – there’s an 
app for that

New digital platform to manage DME patients

Dermot McGrath

Posted: Sunday, September 1, 2019

Vision Coach aims provides patients with access to important sight score data to facilitate more active management 
of their disease
A novel digital platform designed to promote better communication and interaction between patients and doctors in the context of diabetic macular oedema (DME) is currently being trialled in Italy, Spain and the United Kingdom, with other countries set to follow in the near future.
Vision Coach, an initiative financed and supported by Bayer AG in association with Healthforge, a UK-based startup specialising in healthcare software, aims to improve treatment adherence and visual outcomes for patients and clinic efficiency and capacity management for clinicians.
The development of the Vision Coach platform was inspired by the DR Barometer study conducted in 41 countries with more than 7,000 participants to identify gaps in vision care for people with diabetes, which is now a multidisciplinary network of thought leaders and organisations working together to address these (
“The idea is to give patients access to key data and educational resources required for greater engagement, persistence and improved outcomes. For clinicians, the benefit is to have access to novel tools to promote patient activation and ultimately, we hope, improved persistence and outcomes,” said Bill Aylward FRCOphth, Clinical Director of Healthforge.
The platform consists of three components: a patient application (available on iOS and Android), a web application for physicians and a patient website.
The potential demand for such an app is enormous, points out Dr Aylward. DME is the leading cause of vision loss in the working age population, affecting an estimated 21 million globally in 2010 and is set to grow significantly in future, driven in part by growth in the underlying diabetes population.
The standard of care for most patients with DME is anti-VEGF therapy. However, a large number of DME patients who are treated with anti-VEGFs fail to adhere to therapy, contributing to suboptimal visual outcomes.
Vision Coach aims to improve adherence by providing patients with access to important sight score data to facilitate more active management of their disease. It helps them to set meaningful goals targeting health-promoting behaviours, and tracking progress against them. The app also provides accessible educational content to help increase patient self-confidence and take charge of their DME.
On the clinician side, the app enables workflow support for patient and appointment management, treatment plan creation, and recording encounters and sight scores. A dual data entry model allows patients to enter sight score data and clinicians to modify this data if it is incorrect. It also gives the physician a view of patient activity between appointments.
Dr Aylward said that the pilot programme will be trialled 
in about two-to-three centres in each 
participating country.
“We’re aiming to recruit around 500 patients this year and the pilot will last for 2019. From that we’ll study the quantitative key performance indicators (KPIs) around user numbers, utilisation, and early data on persistence, and qualitative KPIs on usability and pain points to mass adoption,” he said.
While an older population group might not seem the ideal target for a mobile app, Dr Aylward believes that tech penetration is on the rise in this demographic.
“A decent proportion of DME patients are of working age, in their 50s, and smart phone penetration is higher in this group. The median age of patients in 
the aflibercept phase III studies, for example, was early 60s, which is 10 years younger than patients in the wet AMD studies,” he said.
The app marks something of a new departure for Bayer into broader areas of patient-clinician interaction 
and education.
“Vision Coach is an innovative platform designed to engage, empower and educate patients with DME, with the ultimate aim of improving patient outcomes” said Dr Rafiq Hasan, VP & Global Head of Ophthalmology at Bayer.
Although DME is the initial focus of Vision Coach, Dr Hasan said that other ocular diseases might also benefit from the platform.
“DME was where we happened to choose to start. However, age-related macular degeneration and retinal vein occlusion are diseases where there may also be utility. Based on experience in the pilot, and strategic priorities for Bayer, we will decide on which to extend to next,” he concluded.