HealthIT & mHealth: What separates Medisafe from other medication adherence applications?
Jon Michaeli: The first thing we usually talk about is that we are not an app, we are a platform. There are some programs in the app store that are just apps, you download it and get reminded to take your medications, that’s it. Forgetfulness is a major reason why people do not take their medications, but there are many other reasons such as: support systems, motivation, cost of medication and side effects.
As a platform, we try to address all the underlying causes, not just forgetfulness. In order to tackle all of these issues, you cannot just be an app that you download. You have to be connected to the broader health system because it is not just enough for the patient to remember to take their meds. Patients also need intervention from the outside from the doctor, the care team, and payers to stay out of the hospital. We have a cloud-based infrastructure and the app is a consumer channel. The app is what patients use, but it is not the only thing. Data flows and interaction capabilities are all stored in the cloud; we are bringing in data from the outside for the patient so that they can connect to the patient portals and import their medications. This helps alleviate user input issues and personalize the experience for patients.
Medisafe’s caregiver component, the Medfriend, allows any user to add a family member or a professional caregiver. That Medfriend is notified if the patient misses a dose. The caregiver can also view the medication schedule and see how the patient is doing. We also have a partnership with GoodRX to provide coupons to users for their medications. We are currently doing pilots with hospital systems and PBMs. The University of Arkansas Medical Sciences group did a study on four-hundred-sixty-one adherence apps and Medisafe came out first. We have 2.2 million users and nearly 100,000 reviews in Google Play and the Apple app store with an average rating of 4.5 out of 5. We have already begun to look at data from patients with high blood pressure and found that users of the Medisafe platform lower their systolic levels by an average of 19.3 mmHG within 30 days.
HealthIT & mHealth: Do the push notifications ever annoy patients or do they just hit the “snooze button”?
Michaeli: Our users are engaged and what we hear from most users is that they rely on the platform to be reminded to take their medications. The notifications are keeping them adherent to their medications and when they hear that sound they are very thankful that it is there. What we have done to make it more human and personal is to allow users to choose different voices to remind them to take their medications. You can even have Obama, Austin Powers or Elsa from Frozen remind you to take you pills. The users really like it and they look forward to getting the notification. Alert fatigue may affect some users, but we have not seen a decrease in engagement from the majority of our users.
HealthIT & mHealth: How do you integrate with EHRs to collect medication data?
Michaeli: We work with a middleware company called Human API and there are others out there that are starting to do similar things connecting data. It is patient-enabled; the user goes to the Medisafe app and clicks on a button to import their meds. The user is then taken to the middleware company that allows them to find their hospital or clinic in a list. Once the user has selected their clinic, they will input their login information for that particular clinic and it will automatically import the medications to the user’s profile in the platform.
HealthIT & mHealth: Do patients ever worry about privacy or security issues?
Michaeli: We are HIPAA compliant. A lot of users hear about us from their pharmacists, doctors or friends, which helps to engender a trusting relationship with the user and reinforces our credibility. Our CTO came from Checkpoint Software, a cyber security company, so we take privacy and security very seriously.
HealthIT & mHealth: Will the app alert you of possible side effects or drug interactions?
Michaeli: We have access to the Drug Interaction Database, but we are not using it to its full capability today because it was not one of the first issues of non-adherence that we were seeking to solve. There is a lot that goes into the decision tree of who you would notify when there is an interaction and what responsibilities that person has once they have received the interaction information.
HealthIT & mHealth: What were some of the questions you received from the panel that you were on at Health 2.0?
Michaeli: The panel was basically companies that were addressing medication non-adherence in different ways. There were four of us and we presented a demo of our solutions and fielded questions. Some of the questions participants had were: what differentiates you from the competition, what is unique about you product, and why are you relying on user input and is user input an accurate way to reflect medication adherence.