A study in the Journal of Clinical Psychiatry.
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EMMA - Remote Medicaton Management by Pharmacy
The medication reminder world has had three tiers of product offerings -- telephone-based reminders, reminders linked to emergency response offerings, and electronic pillboxes. And medication errors, including those from incorrectly filling pillboxes, continue to be vexing.
InRange Systems, a Pennsylvania tech venture company, offers a fourth category, remote medication management. EMMA is an FDA approved device that enables the pharmacy or healthcare provider to make remote changes in dosages -- think of the blood thinner Coumadin as one example of this.
What is EMMA? EMMA stands for Electronic Medication Management, is modeled after the medication management process in a skilled nursing facility -- except delivery of dosages to the patient are in the home. A pharmacy fills a prescription into a dosage-separated blister card. But instead of delivering the cards to a nursing home, the card is sent to the patient (or an aide or attendant) who loads the card into the device.
How it works. According to Tony Pratt, VP of Sales & Marketing for InRange Systems: "The long-term care pharmacist first enters dosing instructions on a server. Then when they are filling the blister card, they scan from the original bottle so that a serial number for the blister card becomes a bar code. When this is loaded into the EMMA device, EMMA reads the barcode, understanding both regular and as-needed dosing. This 'dosage' calendar is electronically transmitted using a wireless broadband connection to the EMMA® unit located in the patient’s home."
Changing the dose. When it is time to take a medication, the unit produces an audible and visual alert in the home -- the patient then activates the device and the medication is released. Doses of already-loaded medications can be adjusted remotely by the pharmacist -- and new meds can be delivered by mail. Daily cost of EMMA is $10/12 per day or approximately $350/month, varying as to whether the device is sold, leased, or in the future, perhaps rented."
Who gets the information? EMMA produces reports about medication compliance that can then be provided to the health care provider. Tony and InRange see numerous opportunities for use of EMMA in home health -- and sees the military and VA leading the way to demonstrate cost savings and benefits of treating patients at home, rather than requiring them to be in a nursing home.
Who is most appropriate for EMMA? EMMA was designed initially for use with veterans being released to their own homes from military hospitals. The FDA-approved device is covered by the VA in those circumstances, but it is also approved for use for qualified participants in the PACE program for the elderly. As for private pay, today EMMA is included in a high end offering of luxury 'assisted living at home' program in California appropriately named LivingWell. InRange raised another $4 million in Series B funding in January, 2009, which will be used to expand sales and marketing reach.
This is not your grandmother's pillbox and the pharmacies are not your local retailers. Instead, it is for those with a demonstrated need for ongoing provider and long-term care pharmacy control of medication doses. The patients might otherwise have to remain in a hospital or live in a long-term care facility to have their medications properly controlled. But it is another tool in the arsenal of home health agencies, services, and other organizations promoting care in the patient's preferred home setting.
Thoughts are welcome.