A slew of offerings in healthcare innovation were presented at the January 2010 OneMedForum in San Francisco. One of the organizing principles of the conference was the healthcare industry’s increasing focus on consumer-driven care.

 

There is a strong industry-wide belief that an informed patient ultimately will be a less costly patient, and that patients availing themselves of smarter, connected health data and monitoring solutions will be more likely to take their prescription medicine, to follow preventative measures and reduce the need for emergency trips to the hospital.

 

With the advent of new consumer healthcare applications, in smart products as well as in the realms of online health and telemedicine, consumers and particularly baby boomers are starting to play a more central role in the payment, decision-making and management processes associated with healthcare. One of the appealing things about online health information from a consumer point of view is that it’s easily accessible and it’s usually relatively inexpensive if not free. According to OneMedForum panelists, many people do not want to pay for healthcare information and services – creating a challenge for providers.

 

Hospitals and other healthcare entities looking for new ways to deliver technology and products to customers are also implementing smart health monitoring products and mobile health information applications – and looking for ways to document the ROI of these solutions. The dissemination of information is only a small part of the smart health technology offerings aimed at changing patient behavior. If connected smart products and wireless applications can help the patient to maintain his health more effectively and save money on hospital trips and co-pays, the hospitals and insurance companies will be major beneficiaries of adoption.

 

One of the major compliance issues facing the healthcare ecosystem today has to do with patients remembering to take their medications. In earlier posts, Dr. Cronin has discussed the numerous smart phone applications that remind consumers to take their medications as well as the alternative approach of dedicated, connected devices such as Vitality’s GlowCap. At the OneMedForum panel, West Shell applauded the GlowCap’s value-add as a smart product that reminds patients to take their pills on an escalating basis, and reports on missed doses, based on observed behavior (removing the pill cap at the expected time to take the dosage) compared to many of the smart phone applications that rely solely on a patient’s report of compliance.

 

However, several presenters at the consortium weighed in on the pros and cons of the GlowCap.

 

The most explicit criticism of the GlowCap was launched by MedicaSafe, a competitor producing alternative compliance/adherence solutions. MedicaSafe pointed out the high cost of the GlowCap compared to disposable pill bottles which are virtually free. The GlowCap retails on Amazon for $99, and its cost is not yet covered through insurance reimbursement.

 

In an effort to compete with free solutions, MedicaSafe offers a low-cost, considerably lower-tech alternative to the GlowCap which is “straightforward and practical” according to the company’s Web site. The product is monitored by a centralized tracking system which can limit the patient’s drug access or prompt him to correct underuse.

 

The most consumer-driven, not to mention the least expensive, solution that I encountered at the conference was Personal Caregiver, an iPhone (News - Alert) application that simply reminds consumers to take their medications one half hour prior to and one hour and one half after the determined dosage times. This application is available for free or in a premium version that costs $4.99 to download. The premium version not only reminds patients when to take their medications and tracks their dosage history, it also provides drug-specific instructions for dealing with a missed dosage. The application can be used by the entire family for the fixed rate, whereas each GlowCap and MedicaSafe dispenser applies to one prescription.

 

The largest difference between the legion of smart phone applications and the product-specific alternatives is whom they benefit. The iPhone applications are attractive to consumers as they are less expensive and can be more easily integrated into their daily lives. But applications such as Personal Caregiver are almost entirely maintained by the consumer. Although the patient may indicate to his smart phone that he has taken his meds by, say, disabling an alarm, he does not necessarily have to prove that he’s actually ingested the pills. The patient may also have taken his medication without remembering to disable his mobile reminder. The reminder service may be of personal benefit to the individual patient, but it is less valuable as a compliance vehicle for the health provider and insurer sectors.

 

To save money, hospitals and insurance companies must find a way to properly monitor patient-prescription compliance, and to convince consumers of the value of these smart products, especially if they expect patients to pay for them. OneMedHealth participants pointed out that GlowCap and MedicaSafe dispensers also lack full assurance of patient compliance; however the fact that both devices require that the patient physically interact with the pill dispenser indicates that the patient is at least one step closer to actually taking his pills. These devices may not be able to fully document patient compliance, but they can certainly monitor and flag non-compliance; if a pill bottle is not opened, its contents are not being taken. This fact is likely to make them more valuable additions to a preventive medicine solution.