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We are going to create a 21rst century patient facing medical experience. The experience of going to a pharmacy sucks, and is obsolete. The entire medical ind
by LPTS 18y ago
We are going to create a 21rst century patient facing medical experience.
The experience of going to a pharmacy sucks, and is obsolete. The entire medical industry is complacent in allowing 100 billion in unnecessary medical costs because of non-adherence to medications. The doctors don't consider it their job to make their patients adhere. The pharmacist maybe talks to you for a few minutes and hands you a sheet of medical and legal jargon that says, on page 3, how important it is to take medicine. The drug companies also fail to ensure adherence. Yet patients don't know enough to care.
None of these people have stepped up to the plate. So we're gonna do it, and when we solve the problem, we can start upending all the parts of the patient facing medical experience where bad decisions and stupid compromises have been calcified into the shitty experience that anyone who has had a sick family member knows all to well.
We are not exactly a web start up though. We must design some actual stuff people will use too. The computer science part of our project is that all this adherence stuff can actually reduce to a flow of information problem given a few assumptions and the right way of conceptualizing the problem from a psychological and brain science standpoint. The computer science forms the informational backbone along which we can build a medical experience that doesn't suck and isn't full of compromises that suck for the patient. From a computer science point of view, we are applying existing techniques to a new problem, but from the point of view of the medical establishment, we are solving a currently unsolved problem of huge proportions.
Information about your medication is some of the most important information you encounter, because it directly influences how long you live and how well you live. Edward Tufte is an old man now, and the pharmacies are still basically acting like it's 1952 in the way they present this vital information.
- maxklein 18y agoYou are of course aware that there is strong legislation in force protecting pharmacists and that industry? And that people are not allowed to decide on their own medication?
- LPTS 18y agoI know how the system works, yeah.
- jacobbijani 18y agoSince when do people resist taking medicine prescribed by a doctor? Why see a doctor if you aren't going to do what he says.
- LPTS 18y agoThe largest cause of disease progression in HIV is adherence between 70 and 90 percent. Hypertension, Diabetes, etc. All these long term problems have adherence rates less then 70%. Resistance is low on the list for reasons for nonadherence. More common reasons include forgetting (because human brains are lousy alarm clocks), not getting refills, not renewing the rx, and not being able to afford it. One problem that happens is people fail to take meds as prescribed, get sicker, go back to the doctor, get a higher dose, take it right, and take too much since the doctor was operating under the assumption that the previous dose was taken. This is responsible for about 10% of hospital and 24% of nursing home admittances, at a cost of 100 billion. There are many 2007 and 2008 medical journal articles about how this is a huge problem desperate for a solution. Its not that people don't want to take the med, in most cases. Its that it takes more then wanting to adhere to make it happen, and the medical industry has no good solution.
- aaronblohowiak 18y agoThat is a huge problem. It also addresses the desire to do good while you're trying to do well for yourself. I wish you the best.
- xenoterracide 18y agojust to find out what's wrong. Doctor's tend to over-prescribe.
- yummyfajitas 18y agoWoman: Doctor, my daughter has trouble breathing. House: Have you been keeping up with her medication? Woman: She doesn't use that except in emergencies. Pharmaceuticals are very risky. House: You know what else is risky? NOT BREATHING. That has some minor side effects such as DEATH. Your doctor, after carefully weighing all the options, decided that NOT BREATHING is more dangerous than [insert minor side effect of pills]. (Paraphrased, I don't remember the exact lines.)
- Alex3917 18y agoI'm interested in your approach because I'm working on something similar. I'm also interested in seeing the research on reasons for non-adherence. Send me an email: alex DOT krupp AT gmail
- LPTS 18y agoYou'd have to go to a medical library to do research, or pay 15 dollars per article. There are easily 2 or 3 hundred bucks worth of journal articles (at 15 or 20 a pop) that are required reading. The most valuable articles will be studies on medication adherence protocols that failed, and then reasons for non adherence, and then consequences of non adherence. For some reason, the articles on non adherence for diabetes and AIDS were the most useful articles in the consequences catagory. I would suggest combining the research with reading the first 2 large sections of the HIG. They are complimentary, in that the HIG gives principles for correctly presenting information, and the research points out what information to present, how and why the current system fails, etc. You should also find articles describing the current best practices for this problem. I almost cried when I read a 2007 group health article on current best practices (which are really laughably weak). I'm not feeling inclined to just hand over all of my cites. There are too many and it would take too long to sort through. But, I'll see if I can dig up a couple of the meta studies that have further links to other research in them later tonight. If you have those and some motivation, you can fill in the rest. How can you start a project like this without having already encountered all that research? I don't understand. I went and sequestered myself away for a month and researched and read all that stuff. The more I read about the problem, the more I was convinced my solution worked and is desperately needed. But many of the ideas I had intuitively changed when I did the boring work of reading medical journals all the time.
- Alex3917 18y agoThanks for the advice. "How can you start a project like this without having already encountered all that research?" My project actually has to do with parenting, not medication. I'm basically interested in applying models from many areas of academia to parenting, including the research on medical non-adherence. However I'm only interested in ameliorating one or two very specific issues, and medical adherence best practices will probably end up playing only a supporting role to research from other areas of academia. Also I'm still in the kitchen table phase of the project; I just finished my undergrad two days ago so today is really day one in the library. If you could find the meta studies, that would be excellent though. EDIT: I'm also interested in whether there are applications of adherence medical research in athletics, in terms of understanding why people don't do stuff (like working out) in general.