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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.


As usual, I enjoy reading your blog. I think EMMA has elements of a good medmgmt device but it also has elements that keep it from broad distribution. First, cost: who/ which plan can really afford this? It would seem like the most appropriate candidates could not. Also, what if a senior decides to leave the home for a few hours...can they take pills "to go"? A large home device seems to bind a patient to the home. These first generation of devices seem to be intended for frail and very ill patients. But what about the average senior who is taking multiple pills a day and needs help managing them?

I would like to see a company design a portable, light and discreet solution, maybe in a pouch or handbag. Or perhaps a home bound station but a snap-off section if a senior wants to travel for a day. It could use technology to record when pills are taken then transmit the information to a database when plugged in at home. These devices need to allow seniors to get out of there home so they can remain social. I think the technology exists but nobody has cracked the code yet. I'm optimistic that the second or third generation of devices will be lower cost yet more flexible and easy to use.

Medsignals -- I think this description matches what you have noted.



In response to your questions regarding EMMA. The patients can take their pills to go. There is an option for a next drop which will deliver the medications in a sealed blister with all of the important information listed on the back of the pack. EMMA will then call the patient's cell phone when it is time to take their medications, allowing the patient to travel for a day or even go on vacation while still getting the all important reminder to take their medications. A patient can't afford not to have EMMA. The percentage of Seniors that do not properly adhere to their medication regiment is astonishing, resulting in hospitalization and other medical costs.

Hey there my name is Anne and I work at the Mayo PHarmacy. I have been a CPhT for almost 6 years. I enjoy doing what I do. I want to further my knowledge and advance in anyway I can in the Tech world. I was talking with Samantha last weekend, and she was telling me about this. I think this is one of the coolest things ever. I told her I would travel around the world to diffrent nursing homes and explain the device and how it works.I would try to help sell this device. It is such a awesome idea to help patients keep up with their medications, and a great way to remind them. I am here to help in anyway I can. Thanks for letting me share my thoughts and comments. I am really proud of what has started, what will become, and what will be in later down the road. Good LUck and Take care!! I am rooting for you and one of your biggest fans!!


Anne Miley CPhT at Mayo Clinic Jacksonville Florida

Real Time Touch platform optionally includes caregiver video engagement seniors, vets, patients. Therefore, allowing verification of who is taking the pills and watching/recording consumption, vital signs etc. When the risk of nonadherence is lower, the RTT system can be reset to automatic, manual, etc.  Great for enabling seniors to stay connected and independent longer.  And good for reducing hospital readmission rates, reducing new prescribed opioid dependencies, and for decentralizing clinical trails globally. We are seeking partners.


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