Tidepool: Where Data, Innovation and Healthcare Connect

Tidepool is a non-profit, open source effort with the mission of reducing the burden of managing Type 1 diabetes. The platform allows people with diabetes to easily upload data from all their devices, so that they can see all their data in one place. They keep control of their own medical data, and can choose to share this data with their healthcare practitioner.

We met with TechHub member and Device Engineer, Gerrit Niezen, to discover more about how this fascinating platform is making a real difference, on a sizeable scale.

What brings you to Tidepool?

In 2012 I moved to Swansea to work as a postdoctoral researcher at Swansea University on making medical devices safer. A lot of our work centred around infusion pumps, like insulin pumps used by people with diabetes, and hospital syringe drivers used for palliative care. I started working on building my own open-source hardware infusion pump, as it became clear to me that open systems can be much safer than closed, proprietary systems. When my university funding ended in 2015 I started looking to work with a remote team that would allow me to stay in Swansea and came across Tidepool. Here was a startup developing open-source software for medical devices - it just ticked all the boxes.

Can you give us a breakdown of devices you cover and what are the most widely used?

People with diabetes use blood glucose meters to check their glucose levels. If it’s too high, they need to give themselves some insulin. Typically this is done using either MDI (Multiple Daily Injections) or an insulin pump. They may also use a Continuous Glucose Monitor (CGM), a small sensor that sits just below the skin to measure interstitial glucose levels and uses a wireless transmitter to send the measurements to a mobile phone or a receiver unit. Since one of the main advantages of the Tidepool software is that it allows you to see the data from all your devices in one place, our goal is to support as many devices as we can. We currently support all the major brands of insulin pumps, as well as all the CGMs that are currently on the market. We also support ten of the most popular glucose meters out there, and we are working on adding more.

What issues do your customers struggle with and how do you help?

Uploading diabetes devices on the computer can be a time-consuming and error-prone process. Most devices have their own USB driver software that needs to be installed first. We’ve created our Tidepool Uploader as an all-in-one package, that contains the USB drivers for all of the devices we support. So you basically only have to install one piece of software, and then we automatically install the required drivers and also auto-update the drivers and software when necessary.

What's on the roadmap for Tidepool?

One new technology that excites me is the WebUSB standard that just became available on Google Chrome. This could eventually mean that you wouldn't even have to install any software to upload your devices. We could use WebUSB to develop user-space drivers so that you don't have to install drivers either. Imagine just going to a website, plugging in your device and uploading via the website. We're also going to start integrating exercise data (e.g. from Fitbit and Strava) into the Tidepool platform and are busy working on an open API to make it easier for third party developers to integrate their apps with Tidepool.

Tell me a bit more about your agile approach to development and how it fits with your product and industry.

In the medical software industry it is very typical to use a waterfall approach for software development, as that is typically what the quality management system (QMS) requires. We have developed our own QMS that works with modern tools like GitHub, Trello and Google Docs. It allows us to use an agile kanban method to develop medical software, while still ensuring that everything is done in a safe and effective manner that adheres to regulatory requirements. We've published our QMS on our website so that it can help other organisations who want to do the same thing.

Gerrit will be joining us at #TechHubTuesday Demo Night, 14th November to share how they develop software in the medical domain and what it's like to work remotely with a team that's distributed all over the world.

He'll also be demoing their Electron-based Uploader tool, web-based visualisation software and their mobile app that reads data directly from Apple's HealthKit.