Proteus, the “digital pill” company is producing a special pill that has a chip in it. As it is currently designed and used, the patient digests the sensor separately from the medication, although the company hopes that eventually the chip will be included inside every prescription pill . The system works like this, according to the Smart Planet report:
- The patient swallows the pill and it dissolves away from the sensor (which later passes out of the body as waste);
- Two metals—magnesium and copper—help activate the sensor as it comes in contact with stomach acids;
- Signals are sent to the patch worn on the outside of the patient’s body;
- The patch registers the time medication was taken, heart rate, activity, and rest patterns and sends this data wirelessly via Bluetooth to a smart phone app;
- The patient decides to send this information to a physician, family member, or other contact.
Investors must like the device. Proteus lately raised more than $172 million in funding, bringing the company’s total funding close to $400M.
To our opinion, their system presents a somehow complex and expensive solution to real-time monitoring of drug use, because they require the patient to take an extra pill, to wear a patch, and replace the patch every week. In addition, it is of little help in those cases when a patient makes an innocent mistake and takes a wrong pill, because when the pill is inside the body, it is too late to take any corrective steps.
We strongly believe in Proteus vision, as expressed by Arna Ionescu, the company’s Vice President of User Experience and Design: “We’re trying to make the process of taking medicine much richer”. But our way of achieving this vision is substantially different.
We believe that enabling smart phones to “see” and identify the medications just before swallowing, keep a log, and alert the patient if they are about to make a medication error, not only makes medication “digital”, but it delivers more value, is very scalable, and comes at a fraction of the cost of alternative solutions.
It seems that the industry is in a path towards more holistic approach of health tracking. The Apple, Google, WebMD, Qualcomm and Samsung mobile health platforms recently announced are all about collecting and aggregating sensors data. Currently, most of these sensors are about the outputs of our bodies, where the inputs, such as food, vitamins and medications, play a major role in our health, but cannot be tracked by these systems.
The recognition that the real frontier is in tracking the inputs to our body is starting to emerge, for example in a recent post by GigaOm:
Indeed, thanks to fitness trackers, connected scales, blood pressure and heart monitors and even connected mattress pads, we know a lot about what’s happening in our bodies and our energy outputs, but inputs are still a mystery. Additional ideas such as SRI’s photo-analysis of foods, TellSpec’s laser spectrometer and Consumer Physics’ handheld connected laser spectrometer are focusing on what we eat. Buying a fitness tracker is easy compared to figuring out how to find an accurate caloric content of your food.
At Irody, we are developing the world’s first ‘pill sensor’. All is takes is just a smart phone camera and our computer vision algorithms, to identify oral medications in a second. This technology can be used for plurality of use and business cases. Because all that is needed is a smart phone, this technology is extremely cost-effective and can scale quickly. Our MyPillSense app (currently available for Android devices) is just an example of how easy and useful such a ‘pill sensor’ can be.
In a report just published by Wall Street Journal, Laura Landro covers a growing trend where providers are using tech tools and personalized approaches to get patients more engaged. The term “engaged” is referring to “hospitals, doctors and public-health officials are pushing patients to keep track of their medical data, seek preventive care and stay on top of chronic conditions. They’re measuring how motivated patients are to manage their own health and adopting a wide range of strategies to help them do better”.
The article reviews a spectrum of strategies taken by providers. Starting with better and easier access to information contained in electronic medical records by patients, going through spotting patients who are non-compliant with their regimen, ending with mobile applications help clinicians keep a closer eye on patients’ progress in things like diet and exercise.
Within this continuum, we are providing a novel capability for providers and for patients to keep track of their medications, prevent patient medication error before they happen and keep an accurate log – backed by an evidence – creating an important information infrastructure for patient engagement that never existed before and fits well to the current healthcare focus on technology and solutions that help patients help themselves and help their provider.
- At the doctor’s: ActivPrescription technology can optimize a patient’s care by providing their doctor unprecedented insight into medication-taking patterns and how the patient is responding to therapy.
- Going home: ActivPrescription technology helps people successfully manage the transition to home, also known as continuity of care.
- At home: When people are working to manage daily care, ActivPrescription technology ensures they are taking their medications properly, and stay connected with their families and providers.
In a recent video (watch here), Bruce Hellman said he is astounded that when he goes to an ecommerce site it will know all about how he has been spending his money since his last visit; when he visits his doctor after a six-month break, they will have practically nothing on him and what he has been doing during that time. Instead, he envisages a digital healthcare ecosystem in which “apps are going to be used as often as antibiotics”.
At Irody we believe this will indeed happen, with a slight change: apps are going to be used with antibiotics (and with other medications too). To get to the level where our doctor will know about our lifestyle, a reliable and objective documentation of our medication use is critical within this context, as medication use by patients is probably the most common medical intervention.
When it gets to chronic disease and medication management, an image of an elderly person comes to mind. Many of the people who are taking medications are elderly and many are not. Chronic conditions affect young and old, unfortunately. Still, this image exists and we are often being asked whether our pill scanning technology using a smart phone, which seems futuristic (any new technology seems futuristic at the beginning) – will be useful for the elderly population.
A recent post at the London Telegraph provides some more insight and is addressing this question. According to current research, internet use more than tripled for those 65 and older between 2006 to 2013. According to their data, with a growing number of tech-savvy senior citizens, the demand for digital health services is also growing. According to new research by Accenture, 27 per cent of senior citizens in England are self-tracking some aspect of their health.
Our own experience with elderly patients has shown that they can certainly use mobile health technologies and at Irody we are working hard to provide old and young with the mHealth technology that is adapted to and suits their needs.
In a recent post at Forbes, Todd Hixon commented about the huge impact of digital health. His conclusion is that “In U.S. healthcare the pain (literally) is huge, and everyone cares. Relieving some of that pain makes the prospect of Digital Health exciting”. The three main pain point he listed are: high prices, poor care coordination, and chronic diseases. He also mentions that “combination of wearable sensors and smart phones creates personalized feedback on health parameters that is surprisingly effective in changing behavior”.
Needless to say, we totally agree with this post. At Irody we believe that the most common medical intervention is by use of medications, and there is no way to reliably track medication use by patients. Even the most futuristic ‘tricorder’-like devices are all about measuring the outcomes (as an example, measuring pulse or blood pressure but not measuring the medicines that patient has taken that affect these parameters). The automatic medication identification using smart phone camera technology, that Irody has invented, is a relevant component in a big technology shift that is all about improving health and reducing costs for everyone.
In a very detailed publication – Can Personalized Medicine Improve Drug Safety? InformationWeek provide a review of recent advances in artificial intelligence and data mining to study and possibly prevent medication errors and other risks linked to medication therapy.
One of the conclusions is that information derived from patients, using web sites and mobile apps, can be helpful for consumers sharing experiences about their bad–and good–outcomes related to medical treatments. The problem is that unless patient-reported information is somehow monitored, vetted for accuracy, and analyzed by medical experts or researchers, potentially relevant correlations between different treatments, side effects, and patient types aren’t likely to be “officially” discovered or disseminated to the clinicians prescribing those treatments.
The authors express their hope that software will be used “to glean insight into social media postings, can be used to improve post-market surveillance of drugs and help doctors and patients make safer treatment decisions. Then doctors can tailor their treatments to sick patients–and avoid the unintentional harm that comes from bad drug reactions, whether their patients are 80 or 18.”.
At Irody we address this exact challenge: provide technology that can assist patients provide and share more accurate information about which medications they use, including dose and time, to make their report about their experience more validated.
In a recent conference at the at the University of Chicago, Dr. Scott Stern, Professor of Medicine at the University of Chicago and moderator, said developing applications to help doctors is “really a no-brainer in terms of need.”
Dr. David Beiser, U of C Assistant Professor of Emergency Medicine, said a number of apps already exist. But they aren’t geared to the average patient who may not be technically expert.
“A lot of the stuff that I’ve seen isn’t really for my patients,” Beiser said. “Most of it seems primarily designed for hipsters with chronic diseases.”
Irody’s experience in providing mobile health tools to patients is exactly this. Our aim is to empower patients to track their medication use merely by “showing” their smart phone what they are taking. The phone automatically identified the type and the dose, and matched these with the patient prescription. This way not only the patient keeps an accurate log of the medications used but is also getting the benefit of protection against medication errors.
We have a technology that’s sophisticated behind the scenes but whose basic use is pretty straightforward. The user (patient, parent, or caregiver) sets up the patient’s medicine regimen by scanning pictures of each medicine dose and registering the times the patient takes them. When the patient is ready to take his medicines, he or a caregiver scans them with their mobile device’s camera.
If all is good, the event is recorded and the right people are notified; if there’s a problem, the app intervenes, either by saying, “Wrong medicine,” sending a text to a caregiver, or notifying the appropriate parties that a dose is about to be missed.
This is an ideal standalone solution for patients—plus the anonymized data can be used by clinical researchers—but this technology can also interface with other devices or HL7-compatible platforms to potentially do so much more. For example, we can interface with:
- Patient diaries to show how medicine compliance correlates with symptoms, side-effects, mood, etc.
- EHRs to correlate medicine compliance with lab results
- Devices like glucometers to create a fuller picture of patient health for specific health conditions
How do you think medicine identification/medication management could help patients and/or providers? Contact us or leave a comment to explore the ways we can use this technology to improve medicine compliance and outcomes.
We recently wrote about Express Scripts’ ScreenRx program, which uses data analysis to understand who is at risk for not taking their prescriptions correctly and intervenes accordingly. As we do, Express Scripts has an interest in understanding medicine adherence. They take an active part in understanding the issues by publishing their annual Drug Trend Report.
One of the findings in the report is that patients with chronic conditions are not as compliant with their prescriptions as they think they are. That’s a good argument for condition-specific apps, like our My Epilepsy Diary. Apps like these may help specialists have a better handle on what is going on with their patients. (My Epilepsy Diary enables patients to share their diaries with their providers if they choose, so there is more of a partnership in care.)
Express Scripts puts the dollar value of medicine nonadherence at $317.4 billion in unnecessary medical costs. We applaud their ongoing efforts at understanding this number and being part of the solution. We’re part of that effort, as well—in terms of understanding adherence and what can be done to improve it as well as putting a dollar value on the effects of improved compliance. Our previous research has focused on using our diary app to improve seizure reporting. We’re excited to be a part of this changing landscape and the promise of cost savings and improved outcomes.