1. Integrating Health IT to Develop a Patient-Centered Approach to Medication Management
Erin Sarzynski, MD, MS  David Weismantel, MD, MS  Ronald Melaragni, RPh
College of Human Medicine, Michigan State University, East Lansing, MI
Sparrow Health Systems, Lansing, MI
The research reported in this poster was funded by: MSU-Sparrow Center for Innovation and Research
Problem
50% patients with chronic illnesses do not take their medications as prescribed.
Medication management applications (apps) for smart phones provide automated dosing alerts
Commercial apps are not clinically tested
Do medication management apps improve adherence to chronic medications?
Apps limited by:
Manual data entry
Inability to share information with providers
Solution
Develop a patient-centered electronic health (eHealth) medication management app
Use the app to assess patient adherence to chronic meds
Improve health information exchange (HIE)
Methods
Design – feasibility & acceptability study
Automate drug name & dosing information
Picture of medication label – Rx meds
Scan UPC barcode – OTC meds
Manual entry – any meds (FDA database)
Feasibility: Accuracy of automated data entry
Acceptability: Pilot study of patients
Assess accuracy of automated data entry
Assess acceptability
Validated user interface survey
Exit interviews
Determine adherence to chronic medications before/after utilizing app
Validated adherence survey
Pharmacy fill history
App’s daily diary
Inclusion criteria – age , 3+ daily meds, single pharmacy, single electronic medical record (EMR) system
Exclusion criteria – minor, incapacitated adult
Feasibility
Step 1
 Take picture
Scan barcode
Step 2
Assess medication entry:
Auto-populated?
Accurate?
Results
Feasibility & Accuracy
Drug name auto-populated 100%
Correctly >98%
Drug dose auto-populated 87%
Correctly 94%
App errs on side displaying no results rather than incorrect results
Acceptability & Adherence
Enrolled 13 patients so far
Accuracy of auto-populated fields similar
Patient retains ability to modify incorrect entries
Researchers review entries via HIPAA-secured remote database
Preliminary adherence rates >95%
Conclusions
Using our innovative patient-centered med management app, it is feasible to:
Use the smart phone camera to auto-populate medication dosing information
Assess patients’ adherence to chronic medications
Securely manage patients’ medication lists
A personal health record (PHR)
Accuracy depends on several features
Flat medication labels (not on curved bottle)
Picture quality – good lighting, avoid blur
Researchers verify accuracy
Await exit interviews - patient feedback
Vision for Future
Auto-focus feature
More patient-centered features
Pill pictures
Indication (why I take this medication)
Common side effects & warnings
Improve transitional care
Integrate with EMRs
Patient education – interdisciplinary team
Medication Label Information: % auto-populated (blue) and % auto-populated correctly (green)
Feasibility – Photos of 30 medication labels were taken for incorporation into the app. Results indicate whether medication information was auto-populated (blue), and if yes – if auto-populated correctly (green).