It’s tough to find an excuse for forgetting to take your medications nowadays. And if you’re thinking of a good excuse right now, chances are that companies and technologists in the Boston area have already addressed it with an information technology invention.
Poor adherence to medications has been a bugaboo in the healthcare system for a long time. When sick patients don’t take their meds, they often get even sicker and end up in the hospital. The problem is expensive because of all the extra care these patients need. So it has caught the attention of entrepreneurs from MIT and physicians affiliated with Harvard Medical School, leading to the creation of several IT devices or services that are gaining more traction in the healthcare field.
Eran Shavelsky, for one, says he formed his Newton, MA-based startup, MedMinder Systems, after learning about the challenge of getting patients to take their medications while he attended the Sloan School of Management at MIT several years ago. In May, his firm launched an electronic pill box called “Maya” that uses wireless technology and sensors to alert patents with chronic diseases when they don’t take their pills on time.
Health insurance companies have a reason to pay attention to such efforts: patients who don’t take their medicine when they’re supposed to cost the U.S. healthcare system a mind-boggling $290 billion per year, according to the New England Healthcare Institute, a nonprofit health policy group in Cambridge, MA. Yet the challenge for MedMinder and its competitors is that patients and doctors have few financial incentives to adopt their technologies, and health insurance providers often want to see studies to show the economic benefits of the systems before paying for them, according to people familiar with the problem. However, interest in the medication-reminder technology is growing, Shavelsky says.
“I’m encouraged to see many efforts because it shows that it’s a major problem,” says Shavelsky, MedMinder’s CEO. “I’ve really noticed that organizations are paying more attention to this problem and are taking steps to try to improve [medication] adherence.”
MedMinder’s pill boxes communicate wirelessly with the company’s servers, which store details about patients’ medications that enable the system to provide reports and automated messages. (Cellular technology is used to communicate with the servers when patients lift cups of pills from their pill boxes.) The system can, for example, send a patient or their caregiver an e-mail or an automated phone call if medications aren’t taken at the right time. The pill boxes can also light up and provide audio signals to patients as reminders to take their meds. Shavelsky says that his firm’s system can improve medication adherence from the dismal average of around 50 percent to around 90 percent, but the company is still working on proving this result in clinical studies.
The firm, founded in 2007, has made some recent inroads with healthcare groups with a stake in improving medication compliance, especially among patients with chronic illnesses. Harvard Pilgrim Health Care, a Wellesley, MA-based health insurance provider, said last summer that it would study the benefits of MedMinder’s system with some of its members who have chronic kidney disease. In September, MedMinder revealed that New York City’s Metropolitan Jewish Health System would test its system for six months with patients who get kidney transplants.
“We all believe that better medication adherence will lead to improved quality of care,” says Joseph Kvedar, director of Partners Healthcare’s Center for Connected Health. The center, which studies how IT systems can improve care outside of hospitals, showed last year in a small trial that people who received text messages on their mobile phones with reminders to apply sunscreen actually used sun lotion nearly twice as often as people in the study who didn’t get the prompts.
Kvedar, who is also an associate professor of dermatology at Harvard Medical School, says that he actually uses a medication-reminder technology called GlowCaps for his daily cholesterol-lowering pill. GlowCaps, which fit onto standard pill bottles, were initially developed at the MIT Media Lab and are now marketed by the Cambridge-based firm Vitality. The system that Kvedar uses got him out of bed one night after his wife heard it beeping to tell him that he had forgotten to take his cholesterol pill. (The bottle caps are designed to light up before they beep.)
Even though such systems have shown to be effective, according to Kvedar, there’s still a question of who should pay for the technology. GlowCaps can be purchased online for $99 and require users to have a broadband Internet connection to their homes. As for MedMinder’s system, individual patients pay $50 per month for use of the firm’s electronic pill boxes and the online services the company provides. The field is also rife with other competition, from iPhone apps like MediMemory to pills from Redwood City, CA-base Proteus Biomedical that deliver wireless signals after they are swallowed. Then there are services like those from Newton, MA-based Aprexis Health Solutions (formerly InnovationRx), which provide e-mail reminders and other outreach to get patients to take their meds.
“The way that the economic models are currently set up,” Kvedar says, “it’s the patient’s responsibility to take their medication, and nobody will give them a cash subsidy to cover a program like this.”
A potential shot in the arm for MedMinder and Vitality could come with potential healthcare reform in Washington. One proposal in payment reform is to give doctors bonuses for improving the health of their patients, which could create an incentive for them to recommend IT systems and other methods to remind patients to take their meds. For now, the companies might get business from health plans that have existing disease-management programs in place that aim to improve outcomes for seriously ill patients, according to Tom Hubbard, a senior program director for the New England Healthcare Institute.
At MedMinder, the firm is focusing its marketing efforts on organizations that have a stake in controlling costs for chronically ill patients, Shavelsky says. “This is the population that industry, health insurance companies, and healthcare providers are really focused on, because that’s where you can suffer the greatest costs if [patients] don’t take their medication on time.”
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