Robots Aim to Improve Medication Management Tasks for Caregivers

Image: Black & Decker

November 05, 2019      

As a growing elder population looks for better ways to manage their medication and monitor their treatments, robotics companies are providing some solutions that can perform these tasks, as well as keep in touch with doctors, caregivers, and family members. In recent weeks, two such companies have made announcements in this space.

Black & Decker, through its Stanley Healthcare division, recently launched Pria, an automated medication management and home health care assistant device. Catalia Health, the developer of the Mabu Wellness Coach robot system, announced a 12-month pilot program with Pfizer to explore patient behaviors outside of clinical environments to test the impact of regular engagement with AI on patients’ treatment journeys.

Robotics Business Review recently spoke with officials from both companies about their systems and the goals they have for improving health care through robotics.

Pria: Dispensing medication and confirming

Stanley Healthcare, which develops medical devices for hospitals and other health care groups, created Pria as its first commercial product to be sold directly to consumers. The system is a voice-enabled tabletop robot that provides caregivers with day-to-day insights into a patient’s adherence to both prescribed and over-the-counter medication therapy. The system can schedule up to 28 medication doses, providing reminder alerts, dispensing medication at the scheduled time, and provide the user with fast access to family or caregivers through a simple voice command and built-in camera for two-way video calls.

The system is powered by Pillo Health, which manages the back-end services and hardware of the device. While Pillo uses its device to align with healthcare providers, hospitals and insurance payers, the Black & Decker / Stanley Healthcare Pria is going directly to consumers. The system will be sold directly to consumers via this website for $749.99, as well as a $9.99 monthly subscription.

The company said direct and indirect research showed a willingness of users to pay for the device, with a global population where more than 10,000 people per day are turning age 65.

Michael Abcunas, Black & Decker / Stanley Healthcare

“In the U.S., alone, where we’re coming out, there’s anywhere between 40 and 45 million unpaid caregivers out there – the sons and daughters looking for answers,” said Michael Abcunas, a product manager of the Pria system. “There’s definitely other products or other ways of getting medication compliance solved for, but there’s no holistic approach of how to do that just yet. We saw an opportunity here to introduce a product that can continue to evolve, paired with not only the user but the caregivers as well.”

Abcunas said the key focus of Pria is to manage medications so end users take the right medicines at the right time, and then communicate that with the user’s caregiver via mobile app or alerts. “Medication management is one of the major drivers when people begin to age and want to live in their own home as long as possible,” he said. “From the robotics base, that’s really our differentiator than just a standard voice assistant or other means of artificial intelligence – we found we could capitalize on this and really help the end users.”

Another differentiator is a confirmation that the dose was dispensed to the correct person at the correct time, through the use of facial recognition. “The device will actually make sure that ‘Mike’ is in front of the device, and it says, ‘OK, Mike, it’s time to take your medication, do you want me to dispense them now?’ “, said Abcunas. “Now I could decide to say yes or no, and if I say yes to the device, we’ll find that dose inside of the wheel and dispense the meds. Now the device knows that ‘Mike’ was in front of the device, and the meds were dispensed – which you don’t know when a standard pill sorter was ever opened or even touched.” The Pria device knows when the medications are dispensed, and when the cup has been picked up and returned.

The Pria system helps dispense medication correctly. Image: Black & Decker

While facial recognition is used to confirm the correct end user, the robot does not take any video of the user taking the medications, due to legal and compliance issues. But the system does know that the person was in front of the device and what time the medications were dispensed.

The second major feature of Pria is providing communication link with the caregiver and the user, not just in the mobile app giving confirmation of medications being taken, but providing a two-way communications link.

“We know that a lot of the end users have sons and daughters coming over on a Sunday evening sorting their medications,” said Abcunas. “That’s when they realize how many pills are still left from the prior week, etc. But the big part is usually they’re working full time and they’re sitting on a conference call just like we are, but in the back of their mind it’s ‘OK, I’m still worried about mom and dad.’ “

The Pria interface aims to engage users with personality. Image: Black & Decker

To address this, the system has pre-programmed questions that caregivers can send to the end user via the device, such as, ‘Good morning, Mike, have you had at least two glasses of water today? Or have you taken your blood pressure and done your exercises?’ That way, when mom responds to the device with yes or no, a caregiver is receiving that feedback on their phone.

On the voice assistant side, Pria uses natural language recognition to give Alexa-like answers to questions, such as how the weather is, or to tell the end user a joke or read a poem. However, the system can also answer questions from end users such as “When is the next time I need to take my medication?”, or “How many pills do I have left?”

“We didn’t want to just be a medication dispenser that sits on the table, where it’s only used at the time when you’re supposed to take your medication,” said Abcunas. “That obviously limits our usability and the impact on family caregiving.”

The communications link also lets caregivers conduct audio or video drop-in calls through the Pria device’s screen. “For example, if you notice that mom has missed her first two doses in the morning, the app pops up and says, ‘Yes, it’s been an hour, mom did not take her medications,’ “ said Abcunas. The system then lets a caregiver make an audio phone call to the device and to a user’s device/app, or they can allow for a video call where the device announces that the caregiver is calling, with video starting in about five seconds.

Furthermore, the design of the robot includes personality – the Pria has eyes and a face, and is friendly to the end user. “When it’s sitting on the counter, we want it to be more than an appliance,” said Abcunas. “The core competency goes back to medication compliance, but if we can help that user stay engaged and not think of it just as medication, it puts us in a better position.”

Mabu: Engaging long-term monitoring

Like the Pria device, the Mabu wellness coach is a robot that sits on a tabletop, desk, or counter, with a tablet screen that provides both a touchscreen and voice interface for interacting with end users. Unlike the Pria, the Mabu does not dispense medication, but can provide reminders and other alerts to a user’s phone, as well as monitor how the patient is feeling on a day-to-day basis.

The focus of Mabu is on providing effective patient engagement between the end user, caregiver, and the healthcare provider, including the pharmaceutical company (hence the Pfizer trial), to give insights on how their medications are performing.

Cory Kidd, Ph.D., founder of Catalia Health, said patient engagement has been tried for years through web-based systems, smartphone apps, and other interfaces, which haven’t been successful. A robot with a face, voice and expressions provides that engagement.

Cory Kidd Catalia Health medication monitoring article

Cory Kidd, Catalia Health

“It turns out that face to face is much more effective at creating engagement versus something on a [smartphone] screen,” said Kidd. “When you use a robot, a physical thing that has eyes and can make eye contact and use some other social cues, it’s much more effective at creating engagement with patients over time.”

While the Mabu has a face and eyes for engaging with patients, the design team also added interfaces such as voice response/activation, as well as a tablet to let users interact via touchscreen. “Many of our patients are older, and voice interfaces work pretty well, but they’re not perfect and it’s not necessarily easy to initially understand them,” said Kidd. In adding the screen, the question that Mabu is asking via voice can be seen on the screen, and users can respond either by speaking or touching a button on the screen. “It gives you a couple of options that let you choose how they want to interact, but it’s also a very simple way to essentially teach someone what’s going on.”

The Mabu includes expressive eyes and a tablet for interaction via touchscreen or voice. Image: Catalia Health

Another consideration for the team was the size of the device – the Catalia Health team wanted to have something that was bigger than a smartphone and that couldn’t be lost, but also not too large either. “I could have made this the size of a person,” said Kidd, “but that’s a bit intimidating and doesn’t fit well in the house.”

The Mabu isn’t sold directly to consumers – instead, Catalia Health works with specialty pharmacies to provide the program and robot for the monitoring of specific chronic disease medication and therapies. “At the core of what we do at Catalia Health is chronic disease care management, and Mabu the robot is one piece of these complex programs that we build to help engage [doctors and pharmacists] to understand what is going on with patients and help them manage their condition over time,” said Kidd.

After a new patient is subscribed a medication through a specialty pharmacy that Catalia Health is working with, the pharmacist makes the introductions, and then enrolls them into the program with Catalia Health, with no cost to the patient. If a patient then opts into the program, the pharmacy transmits the information over to Catalia Health, which then ships the robot to the patient and then provides support for the system.

Kidd said Pfizer was interested in the platform as a way to get further insights into how their medications and drugs were doing with patients – but not receive any personal information from patients. “There’s a big challenge in that once a drug goes onto the market, a drug manufacturer doesn’t know who their patients are, for legal and regulatory reasons,” said Kidd. “But if you’re trying to improve treatment programs and find a better way of understanding what’s going on with patients on a day-to-day basis – that’s one of their interests in how to help provide better outcomes for patients.”

Pfizer does not receive any personal data from any of the Mabu interactions, said Kidd – instead, they receive aggregate de-identified data so they can see what’s going on across groups of patients, to help improve treatment overall.

Kidd said Catalia Health currently focuses on three different disease states, and the goal is to provide programs for additional disease treatments and partnerships with pharmacies and pharmaceutical manufacturers, similar to the Pfizer agreement. The company is also looking at improving Mabu’s voice interface and working on the AI to improve the conversations between the robot and the patient. “Part of the team is constantly working on features like that,” said Kidd, “that will improve the experience for every single patient regardless of what condition we’re helping them with.”