Next at the podium was Qolpac’s VP Hajo Janse, a Netherlands-based company focused on adherence problems. He delivered an interesting talk about how poor adherence costs the US $300bn a year. The company has developed a medication adherence monitoring system, already in use in Denmark and based on NFC technologies. It consists of several parts, one part being used at the pharmacy that is distributing the medication and another part is represented by sensors built into the tablet blisters. These blisters work together with a smartphone used by the patient. The idea is simple, the smartphone registers when a pill is popped out of the blister pack and can thus monitor medication adherence.
This offers a lot of possibilities, like alerting the children or caregivers of elderly patients when they seem to be forgetting to take their pills, but of course immediately raises the is-this-useable-by-seniors question. Qolpac claims to have done several studies in the EU, though I couldn’t find them on PubMed. He put weight behind one study in particular, comparing a cohort of over 80 year olds with a control group of 60 year olds. In this study they allegedly found that, with half an hour of instruction by a nurse, the 80+ seniors fared even better than the 60 year olds (without training) in terms of compliance. Their system is indeed fairly simple: a receiving device has to be nearby (I do not know how close) when a patient pops out a pill, which breaks a circuit in the blister package which can be detected by this device. Thus seemingly the only way the system in the patient’s hands can fail is if this receiving device is not nearby or turned off. Though Qolpac certainly adds overhead to the prescription and medication distribution process and patients may feel uncomfortable having the doctor know when and where a pill is being taken, their system strikes me as a good implementation of NFC.
Last to present was John Peeters, MD, CEO of Gentag, which, amongst other products, develops NFC-enabled skin patches with temperature, pressure and chemical sensors. A comprehensive interview with Dr. Peeters and Gentag was recently published on iMedicalApps. Gentag has partnered with a team of cystic fibrosis disease experts to develop a skin patch that can help detect medication compliance in CF patients by measuring skin chloride. This application in particular highlights Peeter’s vision: Skin patches that monitor specific drugs, guided by the company’s “golden” rule: “1 mutation – 1 sensor – 1 App”.
Gentag has also developed NFC-enabled immunoassays, capable of detecting specific biomarkers such as PCADM-1, a marker for prostate cancer. In showing a generic pregnancy test, he made a good point that the underlying detection technology is proven and solid.
However, a generic pregnancy test is just as useful without any NFC capabilities, as would be an immunoassay turning red if it detects PCADM-1. I am probably missing something here, and admittedly NFC-enabling assays would be a fun experiment, but again, as with SleepTrak, I do not see why these applications make a strong point for NFC transforming healthcare.
At the end there was a panel discussion, with the keynote speaker Prof. Akiyama, the three previous speakers and four panelists: Nick Holland representing the Yankee Group, Gagan Puranik from Verizon Wireless, Charles Walton from INSIDE Secure and Joseph Ternullo of Partners Healthcare. The main impression I got from this discussion was that everybody was excited, excited about future prospects, about what an NFC-future may bring, but they are yet waiting for the big breakthrough. If NFC was as popular as Bluetooth, then their time would come, so to say. There was consensus that the big players – Apple and an NFC-enabled iPhone 5 as the “key event” was mentioned a couple times – first have to bring NFC to the masses. As the panelists were mostly representing companies whose products interact with smartphones, everybody seemed to agree that the smart phone is the gateway for NFC. One should note that some other big players, most notably Qualcomm, think otherwise. Qualcomm wants to see NFC in small, standalone devices, without the need for a smartphone. Obviously, these opinions are strongly biased by each company’s business interests.
The panel discussion at the end made another important point, not directly tied to NFC, a point that seemingly everybody is making these days: healthcare needs to change. We do not only need to find better medications, we also need to find ways for people to improve their medication adherence. Especially Qolpac’s Haja Janse was putting some weight behind this statement. It was also argued that big pharma will have to and will want to get more involved with helping people improve their adherence. Technically, NFC has the potential to improve medication adherence, but first NFC has to make its mainstream breakthrough. It’s unreasonable to think people would be willing to purchase a different phone in order to monitor their medication adherence. According to the conference organizers “over 100 million NFC smartphones expected in service by 2012 and over 500 million by 2015”. It will be interesting to see how quickly this hoped-for mass adoption of NFC technologies on smartphones will change healthcare technology. Again.
[Pascal Pfiffner is working on mobile and cloud based implementations of Indivo, an open platform for personal health records, and SMART, an API layer for substitutable medical applications, and will be sharing more about this exciting project in the future with iMedicalApps.]