Medication Adherence Telehealth Platform

The eMedonline platform engages patients in a real-time "conversation" about their medications which results in positive behavior change and significantly improved medication adherence to 98% in numerous randomized control studies among patients taking up to 27 medications per day. Patients find eMedonline to be useful, reliable, and engaging.

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eMedonline Platform

eMedonline controls and reports on medication events that occur in outpatient and ambulatory settings. A server-side application allows clinicians to configure, schedule, control, and monitor patient adherence and outcomes related to specific medication events.

Medication instructions and tailored content are downloaded to a patient's smartphone, iPad, or internet appliance, which can interface to other medical sensors and is used for behavior modification or intervention. Sensors can be integrated with the smartphone via expansion slot or wireless interface. Electronic validation of an appropriate medication or medical device can be made using barcode or radiofrequency identification (RFID).

At the completion of a medication event, patient adherence and outcomes data are transmitted to the server over the Internet. eMedonline extends the boundaries of patient care to anywhere cellular service or Internet access is available.

eMedonline Workflow

eMedonline is a fully integrated medication management system that is much more than a medication reminder on the user's cellphone. There are a number of notable differences.

Behavorial Framework

The system design for eMedonline incorporates theoretical models that define health beliefs and behaviors relative to adherence, where adherence is defined as compliance plus persistency. Various models suggest that the primary factors that affect adherence are:

The conceptual framework of medication adherence for eMedonline was derived from two models: Park's Model1 and the Health Belief Model2.

Above: Conceptual Framework of Medication Adherence Derived from Park's Model and the Health Belief Model

Applying this model practically, the adherence of an elderly man with severe hypertension could be predicted by three factors: (1) how seriously ill he thought he was and whether or not he understood that taking medication might prevent a stroke (illness representation); (2) his ability to understand and remember instructions associated with the medication (cognitive function); (3) his strategy for organizing and reminding himself to take the medication (external aids). In Park's model, if an individual does not believe he is ill or if the medication is perceived to be ineffective, nonadherence is likely regardless of symptoms.

eMedonline translates this theory into practice.

Above: eMedonline Translates Behavioral Theory Into Practice

eMedonline addresses cognitive functioning in several ways:

The Theory of Planned Behavior suggests that in addition to attitudes, subjective norms and perceived behavioral control affect an individual's intention to engage in a specific behavior. Subjective norms are the extent to which individuals perceive that important others in their lives want them to engage in a specific behavior. Perceived behavioral control is the extent to which individuals feel that they have control over whether they engage in a specific behavior (self-efficacy). Patients in our studies reported that the technology "makes you feel confident that you're going to have the very best available opportunity to manage your illness—whatever it may be."

eMedonline engages the patient, creates a touchpoint between the patient and prescription, and establishes a relationship between the patient and the service:

References:

1 Park DC. (1992) Applied cognitive aging research. In F.I.M. Craik & T.A. Salthouse (eds) Handbook of Cognition and Aging. 449-493. Hillsdale, NJ:Erlbaum.
2 Fishbein, Martin and Ajzen, I., Belief, Attitude, Intention and Behavior. Reading, MA: Addison-Wesley. (1975).
3 Eraker SA, Kirscht JP, Becker MH. Understanding and improving patient compliance. Ann Intern Med. 1984;100:258-268.
4 Salovey, P., Schneider, T.R., & Apanovitch, A.M. Message framing in the prevention and early detection of illness. In J.P. Dillard & M. Pfau (Eds.), The persuasion handbook: Theory and practice. Thousand Oaks, CA: Sage Publications. (2002).