Connecting Through Your Medicine with emocha Health
Updated: Apr 10, 2021
Welcome to Molecular Ideas and thank you for sharing your time with us. Today, we explore how emocha Health is changing how payers, providers, and patients address one of healthcare’s most critical challenges: medication adherence.
In 1985, former Surgeon General C. Everett Koop announced, “Drugs don’t work in patients who don’t take them.”
At some point, we’ve all heard the phrase “Take your medicine.”
Parents, friends, and healthcare providers need to remind us that we rely on our medication as a way to safeguard our health. Yet, many patients treat life-saving medications as secondary given the events of the day, other commitments, or concerns about their medication regimens.
While medication non-adherence seems like a simple problem, its root causes are as wide-ranging and varied as we are. We may not like how drugs make us feel, or the side effects they produce. We face high barriers to obtaining medication and managing our disease in the form of social determinants of health. Unfortunately, medication – particularly for chronic diseases – is rarely optional. Failure to meet target health outcomes forces us to reconcile the fact that treatments increase longevity and quality of life.
Medication adherence is one of healthcare’s most formidable problems. Research indicates that upwards of 50% of patients with chronic diseases do not regularly adhere to their medication. This translates into billions of dollars lost each year, in addition to increased human suffering and mortality. Simply put, word of mouth isn’t cutting it.
Until recently, the market has not had a holistic and effective solution to this challenge. While there are many stakeholders with the mutual goal of improved patient outcomes, there are seemingly dichotomous ways of achieving this. Further, the field of digital health tech is still in its infancy. Despite COVID-19 driving the space into an early adolescence through increased funding, interest, and usage, aligning these stakeholder interests while overcoming operational obstacles remains a challenge.
emocha offers a platform to provide asynchronous, personalized engagement with patients to build positive medication adherence habits. In order to ensure dose-by-dose adherence, emocha has patients video record themselves taking their medication via a proprietary, HIPPA-compliant application. The videos are then reviewed by qualified nurse practitioners and other healthcare professionals on staff to verify adherence, assist in proper technique, and provide motivational support.
What sets emocha apart – technically and strategically – is the follow-up and engagement. These healthcare workers send tailored follow-ups to build a relationship with their patients, thereby ensuring compliance. If the medication was taken successfully, these reviewers push positive reinforcement messages; if not, they work with the patient and their provider to uncover why. This approach adds immense value to doctors, who can subsequently tailor their treatment regimens and expectations.
While at first blush this may seem intrusive, most patients come to love it. “The videos aren’t just ‘Oh here, I’m taking my meds.’ We have people introducing their pets, taking us on apartment tours, and even singing Christmas carols to the radio,” says Morad. “They enjoy building that bond, and knowing that there is another person who will see them.”
I asked if his team could keep an ear out for any patients singing sea shanties.
Morad also pointed out just how difficult it can be to build positive adherence habits in light of three categories that factor into non-adherence:
a) Behavioral Challenges: Did the patient remember to take their medication? What other confounding lifestyle factors stand in the way of adherence?
b) Social Determinants: Can the patient afford their medication? Is it accessible? Does the patient lack transportation?
c) Medication Challenges: What are the side effects that may cause noncompliance?
Unfortunately, payer systems are not built to accommodate these questions. Morad mentions that “the current KPI most payers use for medication adherence is refill rate. That means you can pick up your meds, flush them down the toilet, and do it again the next month without any [direct] reaction from the payer. But that doesn’t lead to good outcomes.”
emocha inverts this paradigm by providing payers with adherence data to create more accurate models of patient behavior. By bringing these three stakeholders - patients, practitioners, and payers - into alignment, they can keep patients on their medications – increasing the number of patients reaching positive clinical outcomes, while requiring fewer healthcare dollars over time.
Relationships are critical to the world of healthcare, but inevitably tricky to manage. Despite the power of big data, cutting-edge science, and statistically-validated clinical trial results, we still look to our doctors for a compassionate relationship and mutual trust.
The beauty of emocha’s platform is that it creates these one-on-one patient-physician relationships at scale. The idea of personalizing digital health isn’t new; amidst COVID-19, its importance has only become amplified as patients rely on at-home care and fewer in-person interactions.
Prior solutions designed to ensure patient adherence lack at least one of three elements that typically prevent effective and widescale adoption. Plenty of ‘smart’ pill dispensers exist, but are largely impersonal and can easily be ignored. The same can be said for setting up reminders on a smartphone or downloading a calendar app: they lack the external validation to keep patients accountable.
Telemedicine, or remote diagnosis and consultation via real-time video conferencing, has become a popular alternative to in-person visits. These visits aren’t solely for check-ups or surgical procedures – before emocha, they were a daily occurrence in the lives of patients battling serious infectious or chronic diseases, all of whom needed to receive their medication and validate proper administration.
Regardless of the restrictions imposed as a result of COVID-19, this model of ensuring adherence is inherently constrained by one key factor: time. There simply aren’t enough hours in the day for practitioners to manage their clinics and provide personalized medication adherence support to patients. Moreover, patient time is constrained by having to build both personal and professional schedules around appointments. When transportation or other social determinants are already a challenge, these constraints can create seemingly insurmountable barriers that give rise to noncompliance.
The past of digital health tech was based on automation, while the present is based on real-time reactions. But emocha Health is carving out a future frontier in which stakeholder time, personalization, and the necessity of adherence are holistically balanced in service of better outcomes. As of this writing, emocha Health has successfully launched with 400 clients and serviced over 65,000 users since its inception.
It may seem too good to be true. After all, emocha’s offering begins with a patient-facing smartphone application, of which there are thousands. With that in mind, I asked Morad about the role of mobile devices in medicine and the future of digital health.
“For each stakeholder in the healthcare equation, you have a different set of need and different targets for ROI. But nearly everyone has a cellphone, regardless of their healthcare needs. While hardware evolves to address some of the major unsolved problems in medicine, a phone allows you to see your doctor whenever you want, wherever you are. That access allows you to maintain a relationship between visits. [emocha] has the flexibility to address concerns without having to buy a specialized piece of hardware. Since almost everyone has a cellphone, it’s a matter of how we use it.”
The versatility and near-ubiquity of mobile devices is essential to fully realizing the promise of digital health tech. Yet no matter how they evolve, it’s critical to remember their original purpose: personal communication. While various social media sites continue to entertain, inform, and educate us through our phones, emocha has demonstrated how to see both the forest and the trees in order to build lasting, healthy habits.
You can learn more about emocha Health here.
emocha Health was founded by two Johns Hopkins Carey Business School students and launched in partnership with Johns Hopkins Technology Ventures – a world-class technology transfer office dedicated to maximizing the impact of Johns Hopkins University's research excellence by facilitating the translation and commercialization of discoveries into accessible technologies, products and services that benefit society.
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