IoT: Reality Must Shape Development

Feb 23, 2016

Recently several companies have announced the development of pills that let doctors know when (and whether) a patent has taken his medicine on time, and in the appropriate fashion—with or without food, say, or on an empty stomach. The companies say this data will be delivered directly to the practitioner, allowing her to track compliance (one of the biggest factors in improving patient care), and then remind recalcitrant patients about the right time and ways in which to stay on top of their meds.

Sounds good, right? An innovative use of Big Data that will have a direct impact on patient outcomes, likely reducing emergency room and other medical visits in the process. But let’s consider how this will actually play out in the real world—you know, the one in which doctors are already overwhelmed, and the poorest patients are the ones least likely to follow protocols for follow-up care, and only half of all practitioners use electronic health records that include any functionality (that is, the ability to actually do anything with the data).

What, exactly, is a doctor supposed to do when she receives an alert that Mr. Smith has not taken his diabetes medication? Probably nothing, since she is already juggling too many patients in too little time, along with managing a practice that requires hours spent on paperwork and compliance. The message could go to the nurses’ station, along with, presumably, dozens of others, so that a nurse can call Mr. Smith and remind him to take his meds. But most offices set aside specific chunks of time for patient call-backs, which means it could be hours before Mr. Smith gets a reminder. And it’s hard to see how getting a call from a nurse hours after the fact will be very helpful, when the alert could simply go to Mr. Smith in the first place.

Of course, patients who don’t take their medicine on time or as needed are more likely to be poor, uneducated, and/or elderly, which means they are less likely to be able to receive an alert (many don’t have smart phones or landlines or email) in the first place. And if they have the technology and wherewithal to receive and obey such a notification, why couldn’t they simply set an alarm to tell them beforehand that it’s time to take their medication, rather than after it’s too late?

There is an argument to be made that getting a call from an actual person—a doctor or nurse the patient knows—will result in better compliance. But at what cost, to the patient and the doctor?

This is not to say there isn’t value in such a pill—but the benefits lie in Big Data analytics, rather than real-time action. If every medication were outfitted with this capability, pharmaceutical companies and medical researchers could learn a lot about how and when patients take (or don’t take) their meds, and then design pills and protocols accordingly. For instance, we might discover that people are more likely to take medicine before bed than at any other time of day, spurring directions that say “take one pill at bedtime” rather than “take once a day.” Or, maybe people are more diligent about taking pills that are blue or pink than ones that are white. Or, perhaps capsules result in better compliance. Long term, this information could go a long way to making medicines better—not based on ingredients, but on marketing and design.

As innovators come up with new ways to leverage the information that is all around us, 24/7, they mustn’t forget the ways in which people actually live, work, and play. Anthropology, sociology, and psychology will be just as important as technology when it comes to defining our connected future.


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Melanie Turek

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