RememerMed: Pill Reminder System
Medical Need
From 1999 to 2009, the population “older Americans” (defined as 65 years and older), increased 12.5% to approximately 40 million people. This demographic is expected to continue to rise as modern medicine extends life expectancy. Furthermore, more than 75% of the elderly population is on regular prescription medication, a significant portion of whom take several drugs per day.
While a small percentage of the elderly are institutionalized (living under direct supervision, either in a hospital or nursing home), an overwhelming majority live at home, and approximately a third live by themselves (with no spouse, family members, etc.). For this demographic, taking large numbers of pills at regimented time points becomes a daunting task.
Home caregivers provide assistance to a limited percentage of these older Americans, but even with such help, taking medications is a burden for many elderly people. Consequently, they frequently skip doses, which often exacerbates medical problems. Most medication organizers only have an average compliance rate of about 60%. Obviously a better system is required.
The “RememberMed” serves two primary purposes. First, it is a scheduling and reminder tool which serves to alert the user (elderly patient) as to what medication to take and when. The device displays a picture of the pill to be taken at the given time, along with any warnings or advice that the doctor may want the patient to know about the specific medication. Secondly, the device contains a logging function to illustrate whether or not the patient actually took the pills as the prescribed time. With this capacity, a caregiver or doctor can see whether the medications are being taken as directed in case of any health concerns. So the RememberMed benefits both the patient and the caregiver.
Competitive Technologies
The “e-Pill” company produces several “medication reminder” systems that would directly compete with the RememberMed. Although they have slightly different products, the main concept is an alarm system, which tells you to take a certain “cocktail” of drugs, which has been prepared—essentially a pillbox organizer with an alarm indicating when each compartment should be taken. Some of their technologies also include an electronic “dispenser” which automatically distributes the specific pills at certain time points, but the same concept is present. An advantage of these technologies is that because the cocktails are prepared beforehand, there is little chance of taking the wrong medications—the patient simply takes all the pills in a given compartment. Also, all the pills are centrally located, so the patient doesn’t need to search through different bottles to find what they need. Additionally, e-Pill has this alarm technology in a variety of forms, including a watch. The portability of this aspect is very useful because people aren’t always within audible range of their medications. However, there are some drawbacks as well. First, there is no specific reference to what medications need to be taken, only the compartment or cocktail “number.” So if the cocktail isn’t prepared for a given time point, there is no way of figuring out what must be taken. A great deal of forethought is required, which for many seniors is difficult. Also, there is no record keeping function for physicians or caregivers to follow. Users can simply silence the alarm without taking the medicines.
A more advanced technology is the “MedMinder Maya” system, a product with numerous similarities to the RememberMed. This product is another electronic pill organizer where flashing lights indicate which compartment is to be taken. There are also sensors which monitor whether or not the pills have been removed from their compartments, and additional notifications are issued if too much time passes (first an audible alarm and then a phone call). The system is connected wirelessly to the internet and a software program monitored by MedMinder Systems. Schedules of medications can be set using this software, and a support staff contacts caregivers and family with updates. Also, this device solves the problem of preparing the pills beforehand by allowing the users’ pharmacy to fill the “tray” for them. So the Maya system essentially has all of the advantages of the e-Pill systems without the drawbacks. However, that is not to say it is flawless. A glaring problem is that a wireless connection is imperative—without it, the alarm system doesn’t function at all. This could be very dangerous should the network ever go down. Also, using the online software requires a monthly subscription; the cost of using this system for an extended period of time would be significant.
Reverse-Engineering: MedMinder Maya
There are numerous components to the Maya system that make up the final product. The first aspect is the online software. This software is where all the important information is stored, rather than in the unit (dispenser) itself. As a result, most of the devices complex coding is handled by a computer and then sent wirelessly to the physical system. So the user programs the medication schedule using the software. The software on the central computer has a real-time clock, so it can wirelessly trigger specific alarms on the unit. It can also alert the MedMinder staff to call the patient, or send e-mail updates to the family.
The actual organizer consists of 28 pill compartments (4 time points per day for 7 days). Each compartment has a plastic lid that covers a removable plastic “cup” in which the pills sit. When the software alerts the unit that it is time for medication to be taken, LEDs surrounding the specific compartment flash to notify the patient. A pressure sensor under the pill cup detects whether or not the patient removes the pills (presumably to be taken). If too much time passes without the pressure sensor being activated, an audible alarm is produced, in addition to the flashing lights. If even more time passes without the cup being removed, the system transmits a signal back to the central computer requesting a phone call. Also, the unit has safeguards in place—if the wrong pill cup is removed from its compartment, an alarm sounds to notify the patient of the incorrect medications.
MedMinder Systems is privately held company, so much of their financial dealings are unknown. However, last year it organized its first round of “institutional investing,” raising $1.3 million among 11 different investors. Although not explicitly named, persons identified from the SEC filings indicated two of the investments were from MerWin Growth Partners and Eliassen Group, two Massachusetts-based consulting firms.
Pricing-wise, MedMinder practices what’s commonly referred to as the “razor-blade” strategy. That is, they sell the basic pillbox for a moderate price, but the bulk of the revenue is made from the monthly software subscriptions. For the Maya, the organizer costs approximately $80, and the monthly subscription costs around $40. This also includes IT support and service, such as phone call reminders, emails, and helping with setup. Refill trays (containing replacement pill cups) can also be purchased for $10.
MedMinder’s website claims to have patent protection for the Maya’s technology but does not explicitly state what technology. However, Bela Labovitch, the vice-president of engineering, holds several patents for different methods of data transmission and receiving. Presumably, these patents are applied to the wireless transfer of patient medication information from the central computer to the unit.
Description
Rather than completely removing all agency in their taking medications, the RememberMed clearly tells the user what they are taking, shows them what it looks like, and includes additional information relating to the individual medication, such as warnings or instructions. Ideally, the device would be connected to a computer, where a caregiver of the user can input their medication schedule using software. They can input several alarms per day, specify a picture to be displayed at the specific time points, and write out the instructions to accompany this picture. After this “programming” step, the RememberMed would be an entirely standalone product, powered by an internal, rechargeable battery. When the specified times are reached during the day, alarms are triggered: the screen will flash, a sound will play, and the earlier entered image and instructions will be produced on screen. Then the patient simply presses “Yes” or “No” if they did or did not take the specified pill. This information is stored in the device’s memory, and a caregiver or physician can periodically check on the patient’s compliance. This memory can be reset as needed. For our prototype, we simply “hard coded” the alarms and images into the Arduino microcontroller.
Specifications
| Specification | Value, Value Range, or Quality relating to Specification | Comments about or rationale for specification |
| Amount of alarms | At least 3 per day | Many medications are required to be taken more than twice a day. It is necessary for our device to be programmable for at least three time points throughout the 24-hour day. |
| Time Keeping | No more than 5 minute drift per week | It is necessary for our device to keep real time so that the alarms go off at the proper times. |
| Medication Image Display | Display image for at least one minute | One minute would be enough for a person to see the shape and color of the pill and read the description of how to take the medication. |
| Information Display | No more than 10 words in description | The LCD would not be able to accommodate long messages, and instructions should be as concise and unambiguous as possible. |
| Alarm Light | Flash for at least one minute after alarm time | An LED light must flash for as long as the medication information is on the screen so to grab the patient’s attention. |
| Information included in log | Time of alarm/ medication type/ medication taken (y/n) | This must include a concise and comprehensible report |
| Amount of information stored | At least 600 entries | This accounts for five alarms everyday for a month before the log having to be cleared manually. |
| Information retention upon loss of power | Retain indefinitely | Information must be stored and kept indefinitely if power is lost to the device until power is regained and information can be manually cleared. |
| Size | Maximum 6in length by 6in depth by 2 in depth | This device must be transportable so that medications can be taken and logged properly when the patient is not at home. Ideally fit into a purse or fanny-pack. |
Block Diagram
The RTC module keeps track of the date and time relays this information to the Arduino through an inter-integrated circuit. Specific alarms are coded into the microcontroller, along with the programmed shapes and text for each. This information is relayed to the LCD screen at the specified time points. At this point, the LEDs flash on and off, the buzzer emits a tone, and the LCD screen displays the pill name, the picture, and the text. This alarm continues until one of the two switches on the LCD breakout board, labeled “Yes” or “No”, is pushed. After one of these switches is pressed, the Arduino records the time, the pill type, and the button press in EEPROM. Finally, the Arduino connects to a computer via the serial port. With this, a user can read the EEPROM memory to check past alarms and compliance. Also, the user can clear the EEPROM through the serial port as well in order to prevent data overflow.
Pictures
Feature/Benefit Table:
| Feature | Benefit |
| Sleek, simple design | The device is small enough to be carried around discreetly by the user in a purse or bag. Also, fewer buttons leads to less confusion; “Yes, I took the pill” or “No I did not.” Additionally, the device has a “cool” factor, drawing from the recent interest in tablet devices; there is no age minimum for this device, so younger users with multiple medications may also find this system attractive. |
| Visual reminder system | Most competitive reminder systems tell the user to take a specific “cocktail” of drugs, but this can lead to dangerous mistakes if the pills are not compiled properly. There is no way of checking what is to be taken. The visual system of the RememberMed displays each pill at the proper time to ensure the correct type and dosage. The accompanying specific instructions also inform the user if any precautions should be taken, something other systems lack. |
| Multiple alarm capacity | Alarms can be customized to go off at any time of the day, and multiple alarms can be set to accommodate the complex medication regiments many patients may have. The specifications list a minimum of 5 distinct alarms per day, but this can feasibly be increased to whatever the patient wants. |
| Data Logging | When a patient feels ill, physicians or caregivers can have a difficult time diagnosing the cause. But often, the problem is simply that the patient is not taking their medications. The RememberMed records whether the user presses “Yes” or “No” to taking their pills and stores it in the microcontroller memory. Then a caregiver can display a log of recent alarms to see whether the patient took a given medication at the prescribed times. This feature can greatly speed up the diagnosis of problems |
Circuit Diagram (using a program called Eagle):
In Conclusion:
The RememberMed is a medication reminder system that sets itself apart from its competitors because it doesn’t treat its users as invalids. We deliberately intend for our users to become involved in their medication regiments and understand what they are taking and why. So we did away with pillboxes and organizers, allowing the user to gather their pills themselves by showing them what to take (displayed on a large, easy-to-read LCD screen) and providing additional information. Multiple alarms can be programmed for specific times during the day, and the system’s memory keeps a record of whether or not the medications are taken. Because of our design, the system is not merely limited to older users—younger generations with multiple-medication schedules are also potential targets. One drawback is the need for a computer connection and software to input the medication schedule. We could not foresee maintaining the simple design we envisioned if we were to internalize this scheduling function. If we had more time, we would have liked to illustrate an actual image being projected onto our screen. To simplify matters, we merely constructed “cartoon” pills from the shapes built into the LCD library. To further validate our prototype, the conversion of an image file would be needed.
