Vitality, Connecting Pill Bottles to the Internet, Nudges People to Remember Their Meds

If you’re the kind of person who needs a little help remembering to take your prescription meds, Cambridge, MA-based Vitality might have just the technology you need. It’s a wireless, Internet-connected medicine bottle cap that blinks and plays a tune when it’s time to down your pills.

The company’s “GlowCaps” system, which goes on sale today for $99, is designed to appeal to baby boomers looking for ways to keep their aging, forgetful parents out of expensive nursing homes or assisted care, says Vitality founder and CEO David Rose. But eventually, users might not have to pay for GlowCaps at all, because Vitality thinks the technology will also appeal to health insurers—and to pharmaceutical companies that want to recover the billions they lose in revenues when prescriptions aren’t used as directed or refilled on time.

The GlowCaps system is available exclusively through Amazon. It’s intended for people with hypertension, diabetes, and other chronic problems that can only be controlled through regular daily medications. In one beta test involving 50 Boston-area residents, Rose says, the system prompted patients to take their medicines on schedule 86 percent of the time, compared to the average adherence rate of about 50 percent.

And that’s bound to interest a couple of big constituencies. “There are really two primary customers for our company,” says Rose. “One is pharmaceutical companies that want to sell 25 pills a month rather than 15. If you’re a company like Novartis and you have a $2.5 billion drug like Diovan [a blood pressure medication] and it costs $4 a pill, that’s a lot of revenue you should be getting.” There’s also plenty of literature, Rose says, showing that high adherence rates lower the overall cost of care. “The other path to market, then, is the companies who pay for healthcare—both insurance companies and large self-insured employers.”

For now, though, Vitality is trying to build a market beachhead by selling the GlowCaps system directly to consumers. Inside the box are three components—a GlowCap, a reminder nightlight, and a small Wi-Fi router.

The GlowCap is the key component. It fits on top of a standard plastic pill bottle, and contains an LED light, a tiny sound chip, a wireless chipset, a watch battery, and a sensor that can detect when the bottle is opened. Most of the time, the LED emits a cool blue light, but when it’s time to take a pill, it switches to a pulsing orange light and plays a little electronic ditty. If the bottle isn’t opened, the ditties get longer and more insistent.

Vitality GlowCaps reminder lightAfter two hours, the cap sends a wireless message to the patient’s home Wi-Fi router, which relays it to Vitality’s servers via the Internet. (For the system to work, the user’s household needs a broadband Internet connection with an available Ethernet port—and obviously, the cap needs to be within range of the router.) Vitality’s system can then initiate an automated phone call to remind the patient to take their medicine.

Vitality keeps records of each time the GlowCap is opened, and uses this information to produce a weekly “adherence report” that can be e-mailed to the patient or an appointed caregiver or loved one. The data can also be shared with doctors via online personal health record systems like Google Health, Microsoft HealthVault, and Dossia.

Then there’s the nightlight, which plugs into a kitchen or bathroom outlet and connects wirelessly to the router. It shines orange or blue in synchrony with the GlowCap, providing an extra reminder.

The whole system is about creating “persuasive feedback loops” that start with unobtrusive lights and electronic sounds, and escalate to less ignorable messages, including phone calls and social feedback from relatives or doctors, Rose explains. That philosophy makes sense, given Rose’s background as the founder and former CEO of Ambient Devices, a Cambridge company that pioneered the idea of using household objects to convey digital information. The popular Ambient Orb, for example, can be programmed to glow green when the stock market is up and red when it’s down (sending owners scurrying to their Etrade accounts). “One thing we learned at Ambient is that if there is a data display that’s presenting data you care about and can do something about, these pervasive displays can become persuasive displays,” Rose says.

At Vitality, he’s applying this idea to a huge and urgent problem. Medication “non-adherence,” as the healthcare industry labels the phenomenon, leads to 125,000 deaths each year in the United States, researchers believe, not to mention avoidable illnesses that cost medical payers an estimated $200 billion to $300 billion a year. Today’s state-of-the-art adherence programs usually consist either of snail-mail letters, often sent out weeks after someone has stopped taking a medicine, or expensive live phone calls, so there’s a very big incentive for health plans and employers to find faster, cheaper ways to increase adherence.

And if people actually took their medicines as directed and refilled their prescriptions on schedule, pharmaceutical companies would obviously sell a lot more pills. “At the same time as we’re selling on Amazon, we’re sending the devices to brand managers at pharmaceutical companies and CEOs of insurance companies, and even to the Secretary of Health and Human Services, trying to spread the idea,” says Rose. “That’s more important to us than making a lot of money from selling the initial units.”

In fact, those initial units won’t be on the market for long; Rose says a much-improved version of the GlowCaps system is coming this winter. It is a two-piece system with an AT&T cellular modem built directly into the nightlight. That way, data from the GlowCap can be relayed to Vitality’s servers without the need for a wireless router or a local Internet connection.

Vitality has “less than 10” full-time employees, according to Rose, and is funded so far by a group of angel investors who include MIT Media Lab founder Nicholas Negroponte and Patrick Soon-Shiong, the executive chairman of Abraxis BioScience, a Los Angeles-based biotech firm. (Rose calls Soon-Shiong a “super angel, a Big Angel.”) Rather than raise venture capital, Rose hopes to bootstrap the company through direct distribution deals with pharmaceutical companies and self-insured employers—“Companies like EMC that are big enough to feel the effects of negative health outcomes” from non-adherence, Rose explains. “Historically, those are the companies who are more innovative in terms of supporting employee health programs around things like exercise and dieting.”

Rose says Boston is probably “the world’s best place” to be building a startup dedicated to melding digital devices, wireless communications, computing, and healthcare. “The research hospitals are here, and there are people really thinking carefully about connecting the dots between behavorial change and healthcare costs,” he says.

Vitality is working with Partners Healthcare’s Center for Connected Health, as well as Duke University’s Fuqua School of Business, to run several 1,000-member randomized trials to document whether the GlowCaps system can actually do what Rose thinks it can do—help patients live healthier lives with chronic conditions like high blood pressure. “At the Center for Connected Health, they really believe in the vision of low-cost, pervasive sensors and displays in the home, and in the inevitable dispersion of healthcare into the home,” Rose says. But whether a connected home is really a healthier home is something the researchers, and Vitality’s customers, will have to determine over time.

Wade Roush is a freelance science and technology journalist and the producer and host of the podcast Soonish. Follow @soonishpodcast

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