Alexa, When's My Next Medication Dose?

MARCH 04, 2018
The smart home is on its way. I imagine in the next few years when consumers buy a house; its marketability will include how adaptable it will be for integration of smart appliances and services. Looking at the current setting, it's not hard to imagine. You've got your smart pal Alexa (or Apple's or Google's versions) sitting on your shelf, your smart refrigerator sends a notice to your phone what supplies are low, and Amazon just slides your deliveries into your home through the smart lock you installed.
 
Yeah, we're there, so what does that mean for our health care? A lot I would say. It's not hard to co-opt a lot of these items for health possibilities. Amazon deliveries? Just slide your drugs inside. Smart fridge? Keep track of your meds (for refrigerated items), etc. But those home health assistants, that's the kicker. I mean, yeah, we can tell it to order something for us, ask about the weather, read us a story or even play music, but what else?
 
I suppose it comes down to what you are comfortable with at this current time, especially regarding connecting your health data with such devices. With Apple finding ways for users to put their health records on their phones, it's not hard to have a home assistant have access to that data as well. When's the next medical appointment? What medications are due next? Should it order a refill for you? Your diabetes test strips are low; have Amazon ship it. See where I am going with this?
 
But that's just the cusp of the issue. It's one thing for the organization and for helping you put your health concerns together logistically, but tackling disease treatment and lifestyle modifications is the next step, and companies recognize this. One company worth keeping an eye on is Orbita, a Massachusetts-based digital health company seeking ways to make smart home assistants address health care issues.1 They've already teamed up with a few others, such as Pillo2 and one UK-based telemedicine company called Argent Telehealthcare.3 Pillo, is a smart robot that dispenses medications but also is built around a smart AI that can help patients with associated health care concerns, such as diet and exercise by integrating data from apps and devices. But Argent Telecare puts this process to shine by tying in Orbitas program to a network of adult social care patients to help manage their health.
 
The pilot will enable users to track weight, exercise, vitals, and other data points related to their health. It will also allow them to communicate with home care professionals (like a VNA service), and schedule appointments and transportation. The niche is aimed at patients who cannot adequately use a touch-based device (such as a smartphone) due in part to disease issues or vision deficits. Voice assistants give these patients an alternative means of engaging with technology to help them with their diseases, by taking assessments and recording data for health professionals to utilize to guide therapeutic decision making. 
 
It may come a time where when a patient is discharged; they receive a voice assistant to take home. The device could have a suite of programs designed around the user's health needs. Take for instance someone who just had a heart attack. The device could remind the patient to take their meds, track adherence, provide cardiac rehabilitation reminders and exercises walkthroughs, and recipes for cardiac diets. This gets rid of all the paperwork that patients have a hard time to digest and read through (and toss out), and instead, it's practically an FAQ or troubleshoots guide for them to use at home. Clinicians and health systems may like this technology, especially if it can help reduce calls that tie up nurses and staff for items that could be quickly answered, and triage important issues that need to be addressed right away. 
 
I see no reason why Amazon and other companies wouldn't want to expand this potential, as it aligns with many of these companies aims to get into health care, and what better way than through patients home? For pharmacy companies, this technology may be useful as a means for medication reminders and valuable for basic drug information requests patients may have. It could also be tied into a system to encourage patient purchases of other health products in stores (or delivered) and build goodwill for patients across the board.
 
One item I would be curious to see is how fast this sector will grow in the next few years. Perhaps we'll see more targetted adds here shortly or use by health systems for patients related to the power of these voice assistants, and that a few clinical trials will be published soon. Thus far, the only trial I know in the process is one from Johns Hopkins University, the Physical Activities by Technology Help (PATH) study, which is currently recruiting.4 The study aims to evaluate the use of educational material for cancer survivors to become more active. The study will compare 3 arms, including standard of care (printed material), text messages, and voice assistants. I'm excited to see where this one ends up, as it may pave the way for more directed studies and research surrounding whether we are moving to an era where Alexa or related device helps directs our health at home. 

References:
  1. Orbita. Available from https://orbita.ai/
  2. Wicklund E. New mHealth Projects Turn Amazon’s Alexa Into a Home Health Aide. mHealthIntelligence. Available from https://mhealthintelligence.com/news/new-mhealth-projects-turn-amazons-alexa-into-a-home-health-aide
  3. Muoio D. Orbita's AI, voice tech supports Pillo's home robot and other digital health deals. MobiHealthNews. Available from http://www.mobihealthnews.com/content/orbitas-ai-voice-tech-supports-pillos-home-robot-and-other-digital-health-deals
  4. Physical Activities by Technology Help (PATH). ClinicalTrials.gov. Available from https://clinicaltrials.gov/ct2/show/NCT03212079?term=alexa&rank=1
     


Timothy Aungst, PharmD
Timothy Dy Aungst, PharmD, is an assistant professor of pharmacy practice at MCPHS University. He graduated from Wilkes University Nesbitt School of Pharmacy and completed a PGY-1 Pharmacy Practice Residency at St. Luke's University Hospital, and then a Clinical Geriatric Fellowship at MCPHS University. He is passionate about the rise of technology in health care and its application to pharmacy. He has published primarily on the role of mobile technology and mHealth, and made multiple national and international presentations on those topics. He blogs at TheDigitalApothecary.com, and you can find him on Twitter @TDAungst.
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