A case study in open source innovation: developing the Tidepool Platform for interoperability in type 1 diabetes management.
OBJECTIVE
Develop a device-agnostic cloud platform to host diabetes device data and catalyze an ecosystem of software innovation for type 1 diabetes (T1D) management.


METHODS
An interdisciplinary team decided to establish a nonprofit company, Tidepool, and build open-source software.


RESULTS
Through a user-centered design process, the authors created a software platform, the Tidepool Platform, to upload and host T1D device data in an integrated, device-agnostic fashion, as well as an application ("app"), Blip, to visualize the data. Tidepool's software utilizes the principles of modular components, modern web design including REST APIs and JavaScript, cloud computing, agile development methodology, and robust privacy and security.


CONCLUSIONS
By consolidating the currently scattered and siloed T1D device data ecosystem into one open platform, Tidepool can improve access to the data and enable new possibilities and efficiencies in T1D clinical care and research. The Tidepool Platform decouples diabetes apps from diabetes devices, allowing software developers to build innovative apps without requiring them to design a unique back-end (e.g., database and security) or unique ways of ingesting device data. It allows people with T1D to choose to use any preferred app regardless of which device(s) they use.


CONCLUSIONS
The authors believe that the Tidepool Platform can solve two current problems in the T1D device landscape: 1) limited access to T1D device data and 2) poor interoperability of data from different devices. If proven effective, Tidepool's open source, cloud model for health data interoperability is applicable to other healthcare use cases.
Department of Medicine and Center for Digital Health Innovation, University of California, San Francisco, CA, USA aaron.neinstein@ucsf.edu aneinstein@gmail.com.
Aaron
A
Neinstein
Department of Pediatrics and Madison Clinic for Pediatric Diabetes, University of California, San Francisco, CA, USA.
Jenise
J
Wong
Tidepool, Palo Alto, CA, USA.
Howard
H
Look
Tidepool, Palo Alto, CA, USA.
Brandon
B
Arbiter
Tidepool, Palo Alto, CA, USA.
Kent
K
Quirk
Tidepool, Palo Alto, CA, USA.
Steve
S
McCanne
Department of Pediatrics, University of California, San Francisco, CA, USA.
Yao
Y
Sun
Department of Medicine and Center for Digital Health Innovation, University of California, San Francisco, CA, USA.
Michael
M
Blum
Department of Pediatrics and Madison Clinic for Pediatric Diabetes, University of California, San Francisco, CA, USA.
Saleh
S
Adi
D003922:Diabetes Mellitus, Type 1 / Q000628:therapy*; D006801:Humans; D010067:Ownership; D012984:Software; D018511:Systems Integration
blood glucose self-monitoring; computer-assisted; decision making; diabetes mellitus type 1; insulin infusion systems; mobile applications