SYDNEY, Australia – The use of mobile apps increases people’s adherence to cardiovascular medication, according to a recent study by researchers at the University of Sydney and published in Heart. “Patients with coronary heart disease can become overwhelmed with the amount of pills they are taking as they are often prescribed up to four different types of medication, which need to be taken sometimes up to three times a day,” said Julie Redfern, senior author of the published article. The randomized clinical trial followed 160 patients over a 3-month period and compared the medication usage of patients in usual care to those using medication apps. Researchers also compared the use of basic apps to those with more advanced features, and found no additional benefits were gained from using apps with advanced features. Lead author Dr. Karla Santo from the University of Sydney said the results from the trial are very encouraging. “It’s exciting that a basic app—some of which can be accessed for free—could help improve people’s medication use and prevent further cardiovascular complications,” she said. Next step: explore whether apps can be used to sustain medication adherence over a longer period, and whether they can be applied to other conditions like cancer, lung disease and stroke.
WOONSOCKET, R.I. – Medication adherence is a persistent challenge for people with serious and chronic health conditions but studies have shown that digital tools can help.
Dr. Surya Singh, chief medical officer of CVS Specialty, the specialty pharmacy of CVS Health, shared how the company is using digital tools to engage patients in taking care of their health and sticking to their care plans.
HHTN: How is CVS leveraging technology to improve medication adherence for people with serious and chronic health conditions?
SINGH: For people living with rare or complex conditions that require treatment with a specialty medication, day-to-day disease management can sometimes be challenging. For example, patients may struggle to start or refill their therapy or have unanswered questions about medication side effects, laboratory monitoring and other aspects of their therapeutic regimen. For years, CVS Specialty has provided highly personalized telephone support from a patient’s CareTeam, a team of specially trained pharmacists and/or nurses. Recently, however, we have enabled our patients to access this same type of personalized support digitally, with a secure messaging capability that allows specialty patients to send and receive secure messages from a member of their CareTeam through the CVS Specialty website or mobile app. Enrolled patients receive therapy-specific information and reminders via text-based alerts and can reciprocally ask questions of our clinicians, to which they receive a timely response.
HHTN:What is the impact of this kind of intervention?
SINGH:In a pilot of this capability completed in 2017, we saw dramatic improvements in medication adherence for patients with chronic myeloid leukemia. In fact, for those enrolled, up to 30% more patients achieved optimal medication adherence. Similar results have been demonstrated with rheumatoid arthritis, multiple sclerosis and cystic fibrosis. As research shows, better medication adherence can help improve clinical outcomes and reduce overall health care costs. This digital offering is now available to nearly all of our CVS Specialty patients, and we are seeing patients prefer digital communications with 80% of them engaged in our messaging programs.
HHTN:How does technology empower patients to take more control of their own health management?
SINGH:In specialty pharmacy, many of the drugs have higher rates of side effects and complications, which can cause a patient to stop taking their medication. In turn, medication discontinuation can negatively impact a patient’s disease prognosis and overall health outcomes. By enabling this highly personalized secure platform, we are able to connect with a patient during a critical time in their care, in between doctor’s visits, when they are thinking about their health and are thus more receptive to coaching.
HHTN:How does it work?
SINGH:Powering this capability is a proprietary, company-built database that is loaded with therapy and indication-specific clinical information. For example, for certain therapies indicated for a specific condition, we know that, based on clinical trial data and the drug’s label, patients will likely experience nausea during the first week of therapy. Based on that information, we will time an outbound message to the patient when the nausea is most likely to occur. The message is sent to their mobile device in a text-based alert letting them know that they may be experiencing nausea, which is a known side effect, with a link to ask a medication-related question. The patient and pharmacist can then move into a secure messaging exchange in real-time via mobile device or website, or take that conversation by phone, depending on the patient’s preference. Whether the interaction is digital or by phone, there is a clinician on the other end, helping that patient work through whatever they are experiencing and making recommendations to help best address their health care needs at the time they need it most.
Also included in our CVS Specialty mobile app are condition-specific educational material, lab monitoring information, medication refill reminders, shipping alerts, information on easy ways to order refills, refill order tracking and account information. Altogether, this helps empower the patient to stay on top of their care and better adhere to their therapeutic regimen. Furthermore, when patients are experiencing an issue, the app offers patients an easy-to-use, convenient platform that puts potential solutions at their fingertips.
HHTN: Does CVS have plans to incorporate other digital health technologies?
SINGH: As technology is becoming a critical component of effective and highly personalized health care delivery, CVS Specialty is also investigating other technologies, including wearable devices that monitor patients’ biometrics and provides information to the CVS Specialty CareTeam for evaluation and intervention as appropriate.
EDISON, N.J. – Hackensack Meridian Health has invested in Pillo, an intelligent health care companion which leverages voice technology and artificial intelligence to connect patients at home with their care teams and family members. This is the first product funded through the Hackensack Meridian Health’s $25 million innovation program to support the improvement of health care delivery. “We are excited to invest in Pillo Health,’’ said Robert Garrett, co-CEO of Hackensack Meridian Health, in a statement.“We see this as a landmark moment for Hackensack Meridian and for our commitment to leveraging innovation to improve the lives of our patients and countless others.’’ The Pillo device reminds people to take medication at the appropriate time, dispenses their medications and digitally coordinates prescription refills. “We’re excited to engage with experts at Hackensack Meridian Health to revolutionize the way health care is coordinated, managed and delivered in patients’ homes,” said James Wyman, co-founder and COO of Pillo Health, in a statement.
BALTIMORE – Video directly observed therapy can be an effective way to help people with tuberculosis adhere to their treatment and lower costs, according to a study published recently in Oxford Academic. A team of researchers from Johns Hopkins School of Medicine studied 28 patients to determine whether the video platform emocha could be an alternative to increase treatment flexibility and better meet patient-specific needs. “Video DOT is an acceptable and important option for measurement of TB treatment adherence and may allow a higher proportion of prescribed treatment doses to be observed, compared with in- person DOT,” wrote Samuel Holzman, one of the researchers, in the study. Medication adherence with vDOT was comparable to that of in-person DOT, but the researchers found an estimated cost savings with vDOT of $1,391 per patient for a standard six-month treatment course. “Video DOT may be cost-saving and should be considered as a component of individualized, patient-centered case management plans,” Holzman wrote.
BALTIMORE – Mobile health company emocha, which uses video-based technology to improve medication adherence, is building on a flurry of recent activity to push into additional markets.
The startup, which currently serves the public health market in areas like Washington, New England and Texas, was recently named among Fast Company’s 2018 Most Innovative Companies, ranking No. 9 out of 10 in the health category. It also named Tom Carroll as COO, charging him with leading the company’s market expansion.
“We’re going to push into broader markets like payers and hospitals—even life insurance,” said Carroll, who has more than 25 years of experience in health care finance, including at investment banking firms Stifel Nicolaus and RuxtonPark Healthcare Capital. “We’re really looking across the board regarding constituents.”
Patients use emocha’s mobile app to video-record themselves taking their medication. The videos are uploaded to a platform for care providers to validate and collect dose-by-dose adherence data. Communication tools are also built into the platform so providers can send messages of encouragement to patients or check in if a dose was missed.
Carroll said emocha is about to launch its new platform, which includes an update to the back-end and can address more pervasive diseases, in addition to hepatitis C, tuberculosis and opioid use disorder.
“It’s the grown-up version of what we’ve been working with and can reach a broader group,” he said.
The Fast Company ranking recognizes pioneering companies across 36 categories, from health to artificial intelligence to wellness. The company was cited for its use of technology to improve medication adherence for the treatment of high priority health challenges.
“Our technology allows people to leverage something low-tech like a smartphone and prove that through directly observed therapy, people tend to do what they’re supposed to be doing in terms of health care,” Carroll said.
SAN JOSE, Calif. – Flex has expanded its connected health care products line with BrightInsight, a managed services solution built on the Google Cloud platform that can aggregate data and deliver real-time insights for connected device, drug or combination products. “We saw the need for a secure cloud platform designed to support highly-regulated connected drug delivery and medical devices, going beyond simple connectivity to deliver real-time intelligence and actionable insights,” said Dr. Kal Patel, senior vice president of digital health for Flex, in a statement. The Google Cloud platform enables BrightInsight to securely store, analyze and gain insights from health information, without pharmaceutical and medical technology customers having to manage the underlying infrastructure. Advanced use cases for BrightInsight may include controlling connected devices, drug dosing, decision support, personalized patient interventions, trend analysis and artificial intelligence-driven insights. “Google Cloud is committed to leveraging our deep engineering expertise to accelerate innovation in digital health care,” said Dr. Gregory Moore, vice president of health care at Google Cloud, in a statement. “With a partner like Flex, we will enable our customers to develop innovative solutions and leverage machine learning-based analytics that can turn new data sets from wearables, medical devices, therapies and apps into actionable information for patients and providers.”
SAN MATEO, Calif. – New Zealand-based Adherium, a provider of digital medication monitoring systems for people with chronic respiratory conditions, has opened a corporate headquarters in the U.S. “Our headquarters at 1800 Gateway Drive deepens our existing footprint in Silicon Valley, as we take the success we have experienced globally and concentrate it here to meet U.S. demand for solutions that unlock stronger, more seamless partnerships between physicians and their patients,” said Arik Anderson, CEO of Adherium, in a statement. “In California’s tech ecosystem we can accelerate the process of bringing it to its full potential.” The company received clearance last year from the U.S. Food and Drug Administration for its SmartTouch for Symbicort inhaler monitoring device for AstraZeneca’s Symbicort aerosol inhaler, a device installed onto a patient’s inhaler to monitor and encourage medication adherence as part of a self-management plan.
HOUSTON – Technology from emocha was successful in helping Harris County patients with tuberculosis manage their medications in the aftermath of Hurricane Harvey last September, according to a recent report by the Centers for Disease Control and Prevention.
Of the 61 patients enrolled in the state’s video directly observed therapy program for TB, 59 did not miss a single dose, the CDC found.
Directly observed therapy of patients, where a patient takes each dose of their TB medication in front of a health care provider either in person or virtually, is a cornerstone of TB control activity, said Sandra Morris, TB controller for the Texas Department of State Health Services.
“Video-enabled DOT using electronic devices, such as smartphones, has become a useful tool for patients who cannot visit, or be visited by, a health care provider,” she said.
The Texas Department of State Health Services uses federal and state funding for TB surveillance, prevention and control activities in eight health service regions and 31 local health departments, Morris said. In advance of major storms, protocols for providing patients with medications to take on their own are activated.
Harris County has been using emocha’s VDOT technology for three years following a successful pilot, said Sebastian Seiguer, CEO of emocha. The technology has a high rate of success because, when patients know someone will be watching them take their medications, they are more apt to do it, he said.
“The fact that a provider cares enough to make an appointment with you to watch you take your medications strengthens the patient-provider relationship,” he said.
During the hurricane, patients recorded themselves taking their medications on a smartphone. The video was saved until services were restored, then automatically uploaded to their provider through a mobile app.
“During Hurricane Harvey, the high proportion of patients successfully managed through video-enabled DOT demonstrates that it can help ensure TB treatment completion when regular treatment options have been disrupted by a major storm or other disaster,” said Morris.
ST. LOUIS, Mo. – Health care startup Epharmix is building on its clinically proven SMS-based adherence technology and looking to scale up as quickly as possible.
Epharmix uses automated text messages and phone calls to help people with chronic diseases better manage their condition and improve outcomes.
“We’re just going to continue to advance the research and build out our portfolio,” said Jason Roche, growth engineer at Epharmix, which is currently partnering with several large health systems.
The company was recently selected as one of seven health care startups for Dreamit Health’s ninth cohort. The 14-week accelerator program provides one-on-one coaching, opportunities to pitch to dozens of potential customers, meet with top-tier venture funds and gain access to a network of Dreamit alumni and other resources.
Epharmix’s technology has been clinically proven to drive lasting patient engagement and improve adherence through several published papers including the Journal of Medical Internet Research, Scientific Reports and JMIR Diabetes.
“Patients don’t always have the time to troubleshoot Bluetooth devices or walk through new mobile applications,” said Roche. “Our technology collects patient-reported outcomes in a form patients and providers understand most—phone calls and text messages.”
Epharmix’s system automatically collects biometrics and symptoms for 24 disease states and several chronic conditions. Roche said the technology is currently being used in 10 different states and is live on 100 platforms, with a focus on medically underserved patients in the home who are hard to engage.
“The technology is helping health care to move into a ‘true value’ space,” Roche said. “With increasing connectivity, clinicians can oversee more patients.”
VIENNA – A new partnership combines SHL Group’s drug-delivery systems and QuiO’s ConnectedRx solution to improve adherence. The companies hope to integrate connectivity into drug-delivery devices to boost user experience and improve adherence. “As the health care industry embraces digital and people increasingly take their treatment into their own hands, our natural next step is connectivity that seamlessly captures high-quality data to form a detailed picture of the patient to improve clinical decision-making,” said Roger Samuelsson, founder of SHL Group founder, in a statement.