Automatic monitoring and control of medication

AUTOMATIC MONITORING AND CONTROL OF MEDICATION

 

Gunnar Hartvigsen, Professor, Norwegian Centre for Telemedicine, University Hospital of North Norway & Dept. of Computer Science, Faculty of Science, University of Tromsø, Norway

 

Many senior citizens use medications on a daily basis, and more than 25% of the senior population takes 4 or more prescriptions daily. As medication becomes an increasingly important part of everyday life, it is inevitable that controlling the timing and dosage of the medication becomes important. For many elderly, remembering what medication to take and what they have already taken as the treatment become more complicated can be difficult. Non-compliance, i.e., patients not complying with the prescription given by their medical doctor, is an increasing and serious problem and may cause loss of effect of treatment and severe health problems for the patient.

For the health personnel involved in a patient's caring, treatment and supply, e.g., pharmacists, nurses, general practitioners and hospital doctors, it is important to have access to an updated medication list, and information about non-compliance. This information is best provided through a common electronic health record (EHR). For people having problem with remembering when to take what medicine (and what dosage) an automatic notification system may be of great help. Such a system is also expected to aid the professional caretakers to monitor "problem-patients", who are having severe problems complying with their doctor's prescriptions.

The healthcare system, not only in Norway, but all over the world has considerable potential when it comes to improving the quality of the information flow between the different levels of health services. Patients have normally a permanent general practitioner taking care of their medication and drug use problems. However, they may get hospitalized and brought in and out of nursing homes from their homes. Many persons in different institutions may get involved separately in complicated medication regimes. Errors in prescriptions and medication schemes are only two of many issues on this matter, but they are important. Errors lead to degrade in quality of life, as medication fails to work properly, or to increased side-effects. The human and economic costs are great.

At the Norwegian Centre for Telemedicine we have built a system that uses an automatic pill dispenser to aid patients in complying with their prescription. The goal has been to construct an electronic health record- based system for automatic monitoring and control of medication. The dispenser reports regularly back to an electronic health record (EHR). Through the EHR, doctors and nurses: (1) are able to view the automatically collected data on compliance, and they (2) can remotely control some of the dispensing. E.g., they can remotely change the number of on-demand medications that the patient is able to dispense per day. The system has been tested in private homes.