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Helping Hand From Computer Giant Enhances Drug Delivery

Wed, 10/11/2006 - 7:37am

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This article describes how a design-centered company leveraged its innovative consumer design expertise from the audio-visual world and transferred this knowledge to its drug delivery device affiliate, while receiving the collaborative assistance from a computer technology leader.

By Chris Perrera and Henrik Kagenow
As the old saying goes, drugs don’t work in patients who don’t use them. Even though the pharmaceutical industry spends billions of dollars each year on research and clinical trials to improve their drugs, if patients continue not to take their dose as prescribed (known as patient non-compliance), the drug will never make the impact it should. A Cochrane Review paper issued in 2003 stated, “Innovations to assist patients to follow medication prescriptions are needed.”1


The Helping Hand tablet dispenser, a wholly owned product of Bang & Olufsen Medicom
 
Approximately 15 years ago, the Bang & Olufsen (B&O) group—better known for their audio-visual products—expanded its horizons into the medical device arena. Since then, Bang & Olufsen Medicom has been working diligently behind the scenes developing drug delivery devices. The medical devices are designed with one key function in mind—to aid patients in the consumption of their medication. While this may seem like a simplistic concept, the lack of patient compliance with regard to taking their prescribed medicine is widespread and affects 50% of the population on average.2 This behavior is not only extremely harmful to the patient’s health, but it also costs the health care industry and government billions of dollars in revenue each year. If B&O Medicom can help to alleviate some of the patient non-compliance issues that exist today, it can only serve as a positive for all involved parties.
Innovation With a Purpose
B&O Medicom takes this issue very seriously and about five years ago started looking into the reasons for non-compliance, trying to evaluate what kind of innovation they could design to help patients with this daily issue. The main reasons they discovered were:
  • Forgetfulness
  • Lack of understanding of condition, treatment or medication
  • Drug side-effects
  • No immediate therapeutic response
  • Confusing dosing schedules
What the company considered was solving some of these issues with technology to empower the patient and help solve the most common problems associated with patient non-compliance:
  • Develop a technology to help remind the patient—to alleviate forgetfulness
  • A signal that visualizes compliance—increase awareness
  • Improve information and involvement—give feedback and motivation
Innovation Process
B&O Medicom has a special innovation process that they use to develop new and unique concepts. The brief they described was “to increase the value of oral treatment by increasing compliance.” The concept would be based on the blister card packaging solution—a plastic coating shell that surrounds the medication. In addition, the final product needed to be of a high quality but at a low cost.
Evaluation of the Users
In order to really understand the patients’ problems and their concerns, B&O Medicom undertook an exercise to evaluate user insights. It found that the key issues related to a lack of consistency with the patients taking their medication corresponded directly to their daily habits and storage patterns of the medication.
  • Drug hidden in cup-boards—out of sight
  • Did not want to be seen taking drug—discretion matters
  • Required motivation to continue taking their medication
  • Reminded to take medication only when linked to daily habits
Once enough information had been compiled to help determine the criteria for what the device should do (remind users, protect the blister card, and guide them on their compliance usage), the next step was to brainstorm around the design itself.
Inspiration for Shape Idea
The shape of the device was inspired by the very powerful metaphor of a “Helping Hand.” Most patients commented in the user surveys that they needed something to help them remember to take and track their medication. So the Helping Hand stuck with the designers and, in fact, became the inspiration for the actual design and name. The device is cupped like the inner palm of a hand.
The Helping Hand
Based on the feedback, the design team compiled a complete list of everything that the Helping Hand needed to be and designed a product that should offer a number of key features.
  • Discreet and non-medical protection of blister card
  • Suitable for existing blister cards (blister cards house the tablets in a protective foil and the device can be adjusted to company specific requirements)
  • Programmed to a specific drug and treatment (visual/acoustic settings)
  • Simple to use
  • Reminds to take the drug
  • Registers each time the blister card is removed
  • Keeps track of compliance
  • Durable and inexpensive
When the Helping Hand was available, B&O Medicom conducted web surveys with the users of the device (sample of 134 people). The following comments were received from patients and doctors.
  • 87% said the protection of the blister pack was excellent or acceptable
  • 90% found the reminder function excellent or acceptable
  • 81% wrote that the patient feedback/guide function was excellent or acceptable
  • 19 out of 22 (86%) of medical doctors think that the patients would benefit from the dispenser
The survey was subsequently expanded and the company is currently analyzing data from more than 500 respondents.
Patient Compliance Feedback
The Helping Hand also offers a lighting code that informs the user how compliant they have been over a specific period of time. For example, during one week, if the user has taken six out of seven or seven out of seven tablets, they receive a green light. If they have only taken three or four tablets, the device displays an amber light. Taking less than three during the course of the week, the patient would see a red light. This feedback function, which could be extended to measure compliance over a rolling four week period as well, has been well received by patients. In addition, pharmaceutical partners like the idea for clinical trials and some physicians have approached B&O Medicom for a version that could upload data in real time.
Collaboration With IBM
Collaboration between the engineers of the IBM Technology Collaboration Solutions unit and B&O Medicom has led to an enhanced Bluetooth-enabled version of the Helping Hand, which is aimed at helping patients on long-term drug therapy.

Statistics on Patient
Non-Compliance
  • Non-compliance costs healthcare payers an estimated $100 billion annually.
  • Every year, non-compliance with drug treatment results in 125,000 deaths from cardiovascular diseases such as heart attack and stroke.
  • Medication non-compliance leads to an estimated loss of 20 million workdays annually (corresponding to $1.5 billion in lost revenue).
  • Non-compliance accounts for 10% of hospital admissions at an annual rate of $15.2 billion.
  • Non-compliance comprises 23% of nursing home admissions at an annual cost of $31.3 billion.
Source: Caremark: Clinical Up-date Aug. 2001 Office of the United States Inspector General
This device will automatically track patient compliance with medication therapy, and seamlessly and effortlessly transmit data about individual compliance—in a secure manner—to caregivers. It also allows for two-way communication back to the patient, although the current prototype only sends data from the device to a server.

The patient’s drug taking record can be seamlessly transmitted to a computer, PDA, monitor, or other device to help the physician or investigator track the patients’ overall compliance rates. This device application can also be useful, for example, in post-market studies, clinical trials, and with currently approved drugs. Furthermore, B&O Medicom is working on a version of the Helping Hand that can be adapted to plug-in applications or via a transponder to help make data upload possible.

B&O Medicom wanted to collaborate with a company that had expertise in the wireless area, could help them engineer and collaborate on a wireless solution as the software applications are outside of their internal focus area, and had deep industry experience. This is why they elected to work with the engineers of IBM Technology Collaboration Solutions. Working with IBM allows B&O to focus on its core competencies and deliver greater value to its clients. The combination of IBM and B&O Medicom allows Medicom access to new tools, research, and intellectual property across IBM that, in turn, allows for a highly integrated solution to the patients and healthcare providers.

IBM Technology Collaboration Solutions creates an opportunity for clients like B&O Medicom to engage more deeply with IBM above and beyond the data center, aligning with clients, partners, and channels in the development, distribution, and manufacturing of new products. This enables clients to collaborate with IBM to rethink and reinvent their R&D operations and the products they bring to market.
References
1 Interventions for helping patients to follow prescriptions for medications (Cochrane Review). Haynes RB, McDonald H, Garg AX, Montague P. In: The Cochrane Library, Issue 2 2003. Oxford: Update Software.2 WHO Report 2003g, “Adherence, Evidence for Action”
ONLINE
For additional information on the technologies and products discussed in this article, see the following websites:
  • www.medicom.bang-olufsen.com
  • www.ibm.com


  • Chris Perrera is a principal in the Engineering & Technology Services Group at IBM. He works with medical device companies to develop innovative and differentiated devices using IBM assets, intellectual property, and resources. Perrera can be reached at 802-769-3683 or perrera@us.ibm.com.

    Henrik Kagenow has been CEO of Bang & Olufsen Medicom A/S since its formation in 1999. Bang & Olufsen Medicom maintains industry expertise in the design, development, and supply of innovative drug delivery device solutions and sensor-based technologies. Kagenow can be reached at hkw@bang-olufsen.dk.
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