Patients who don’t take medication as prescribed are at risk of worsening health, increased hospitalization, and a greater chance of mortality.
Just in the U.S., non-adherence has been attributed to over $100 billion in avoidable healthcare costs.1 In developed countries, among patients with chronic illness, approximately 50% do not take medications as prescribed.2
"Increasing the effectiveness of adherence interventions might have a greater impact on the health of the population than any improvement in specific medical treatment."
Our explorations led to the concept of Florence — a personal companion that would help patients understand and manage their medication regimen. A chatbot at heart, patients would converse with her through text and picture messages.
If developed, a simple, familiar interface would hide her powerful intelligence. Behind the scenes, machine learning and behavioral modeling would enable her to offer a tailored, human experience based on each patient’s needs.
As you start taking new medications, Florence will follow up to see if you’re experiencing side effects.
She can offer additional information to help you understand if your experience is typical — or if you should talk with your doctor.
With complex regimens, days often blur together. Florence will show you what you’ve taken today — and what’s left to take.
Because Florence knows your regimen, she can find you ways to reduce the cost of care.
Generating believable messages that don’t feel artificial or templated is key to maintaining the illusion. Tools like Automated Insights Wordsmith hint to possibilities where content can be produced on the fly and personalized to each user.
Florence’s conversational style will encourage users to speak to her like a friend. Natural language processing, like those offered by IBM’s Watson, will be needed to extract meaning and respond intelligently.
Florence can generate many different messages which, unchecked, could make her a little too friendly. A system that learns the preferences of users will be helpful in tailoring which kinds of messages are sent, when, and in what frequency.
The emergence of connected adherence devices like Proteus pills and Smrxt bottles, combined with the popularity of health devices like Fitbits and Qardio, can provide a more rounded view of patients. Aggregating and synthesizing that information, perhaps using services like Validic, would help Florence interact more appropriately.
Florence should keep patient data secure. Managing Personal Health Information (PHI) exposure is a real challenge and SMS is an insecure medium. While HIPAA doesn't preclude sending PHI via SMS, it's unclear if remediation tactics like end-user consent forms satisfy the Security Rule. 8
If created, Florence will use technology to help address significant causes of medication non-adherence. The broader challenges are complex, however, and work must be done on a variety of factors such as socio-economic, education, healthcare access, and treatment models. Technology is just one means of attack, not the only one.
If you’re interested in learning more about this problem, we encourage you to read the World Health Organization’s report Evidence for Action. It provides a digestible overview and deep analysis into the problem.