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Beyond Compliance, Adherence, & Concordance – Supporting The Patient’s Implementation Of Optimal Treatment

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Popularizing Patient Compliance Technology

August 19th, 2008 at 7:37 pm · · Enhancements · No Comments


Zuri – Medication Reminder and Compliance Recorder


An article in today’s (August 19, 2008) Wall Street Journal, Tools Help Patients Interface With Doctors By Victoria E. Knight, opens with this excerpt, a success story about the Zuri, an electronic medication reminder and compliance recorder still in beta:

When Tajel Shah sought laser surgery to correct her shortsightedness, the surgeon said she would need to use eye-wetting drops every hour and take a medication for three weeks to ready her eyes for the procedure — a tough regimen for the working mother of two to follow.

“I thought there’s no way I am going to be able to do this unless I have some sort of physical reminder,” said the 38-year-old from San Francisco.

Then a friend told her about the Zuri, an iPod-sized device that sends patients reminders to take their medications and records their compliance, which users and, if they choose, their doctors can track through a companion Web page.

The Zuri’s maker, Zume Life Inc., a San Jose, Calif., start-up, was looking for beta testers. Ms. Shah signed up.

Technicians put Ms. Shah’s medication schedule on a Web page and downloaded the information into the device. When the device beeped, Ms. Shah could see which medication she needed to take on its screen, and, by pressing a button, confirm whether or not she had taken it. Aided by the device, she said she was able to adhere to the surgeon’s plan, and she had the surgery in January.

… Rajiv Mehta, Zume Life’s chief executive, said the company expects to launch a version of the product next spring. The device will cost about $200, and users will pay a $40 or $50 monthly subscription fee for the Web-based services.

The article goes on to extol the virtues and promise of

“self-care”1 tools that companies including Intel Corp. and Microsoft Corp. are developing to help people monitor their own health and receive feedback from caregivers.

In oversimplified terms, both Intel’s Health Guide and Microsoft’s HealthVault store, organize, analyze, and distribute a variety of healthcare data gathered from a wide array of sources.


The Evolution Of The User Interface In Healthcare Technology

On reading the WSJ article, my first response was – well, OK, my first response was “Where do you sign up to have the WSJ open an article with five paragraphs of a success story featuring your business’s product?”

My very next thought, however, was that the user interface of these gizmos is likely to evolve as have other technological marvels, such as the automobile and the computer. The extent to which new tools are put into use by the population, however obvious their value, is limited by the difficulty, expense, and unfamiliarity of that tool.

In other words, what are the chances my Aunt Hazel from Broken Arrow, Oklahoma will find the Zumi a must-have healthcare device as long as it is a $200 pseudo-iPod with a $40 per month fee that technicians have to set up?

Of course, Aunt Hazel wasn’t interested in driving a car until automatic transmissions became widely available and her best friend began driving her own Ford.

I suspect the the responses by patients to the instruments like the Zuri fall into one of three broad classes:

  1. Patients like Ms Shah who have the right problem, the right circumstance, and the right perspective to embrace and use the tool as is, right off the shelf.2
  2. Patients who mistrust and are adamantly resistant to (choose one or more) electronics, doctors, healthcare recommendations, sharing personal information, …
  3. Patients, like Aunt Hazel, who won’t use a medical tool like the Zuri until it is easier, cheaper, more well known, …

Group #1 is on board already. Group #2 is unlikely to buy into the process regardless of logic, persuasion, or receiving lottery tickets as incentives. But Aunt Hazel’s group? That’s where the action is. Make those electronic whizbangs less intimidating, less difficult, and less expensive.

Then, ask Aunt Hazel to try it out.



Footnotes

__________
  1. The quotation marks enclosing self-care are the work of the WSJ folks, and, no, I don’t know the rationale for this punctuation practice.
  2. It isn’t clear that if Ms Shah was charged for the Zuri’s use or if it is offered free while still in beta. An out of pocket cost of $240 to enhance compliance of a 3 week course of treatment might have rendered the Zuri less attractive to Ms Shah

Tags: Enhancements