Imagine rolling over in the morning to see five, six, ten plastic bottles on your bedside table, filled with prescription pills of every shape and color. Each serves a different purpose, and each has different requirements — some must be taken with food, some without; some in the morning, some at night; some make you feel sick, but you don’t know which ones. So, you stop taking all of them.
This is a reality for countless Americans– a $300 billion reality, in fact. Medication non-adherence, or failing to take medications as prescribed, makes up close to 10% of our nation’s total healthcare spending.
Medication non-adherence is also a reality that Dr. Rajiv R. Shah, a Board-certified nephrologist and the CEO of digital health company MyMeds, is familiar with.
“As a nephrologist, it’s directly relevant,” he said. “If people took their medication correctly, they probably wouldn’t have to come see me.”
An idea worth spreading
Shah took the TEDxFargo stage in July 2015 to discuss this problem, which he believes lies in the organization of those involved in the treatment process.
The current team, he said, consists of a primary care physician, specialist, nurse, and patient. But that’s not enough.
Shah’s “dream team,” the one he employs in his world of kidneys, begins with the patient in middle, surrounded by their physician, specialist, nurse, family caregiver, health coach, and the most often overlooked person: the pharmacist.
“Who knows more about medicines than pharmacists?” he said. “I call pharmacists the doctor on the bench, and why? Because they’re doctors… and with that comes knowledge, experience, and expertise that I don’t have and never will have.”
To Shah, the key to solving the problem of medication non-adherence is putting pharmacists back in the game and back in contact with patients– and doctors and pharmacists everywhere seem to agree.
“It was sort of the beginning of a movement,” he said. “[My TEDx talk] was a springboard where the ‘ideas worth spreading’ motto really was true and has been spread across the country, everywhere I go.”
Shah’s 2015 talk has gained more than 34,000 views on Youtube and been widely shared throughout the pharmacy community. In just the last few months, he has been asked to speak around the country– for the California Pharmacists Association, the New York Health System Pharmacists, the Minnesota Health System Pharmacists, and the Tennessee Pharmacists Association. This March, he was the keynote speaker for the American Pharmacy Association’s annual meeting in Baltimore.
But to Shah, no speaking opportunity is as valuable as the opportunity to hear from the people whom his talk affects.
“It gave the message of the importance of pharmacists and patients working together with the rest of the care team,” he said. “The most meaningful part, personally, has been appreciation from the pharmacists that someone who’s an MD really values them.”
MyMeds: using technology to put healthcare in patients’ hands
Shah has been working to solve the problem of medication non-adherence since before he spoke at TEDxFargo. His company, MyMeds, began with an idea fifteen years ago.
“Medications are the one thing that patients put in their mouths, that they have control over,” he said. “I wanted to use technology in a way that patients could actually do something.”
What this idea became was a secure, cloud-based web and mobile app that helps patients manage their medications. Today, MyMeds is considered the top adherence platform in America. Shah says that MyMeds’ background technology is what really drives a good experience, seamlessly transitioning from a patient platform to a clinical platform.
“If you can help them understand what they take and how to take it…. It becomes important for them,” he said. “If something is important to you, you don’t forget about it.”
While MyMeds was in many ways the inspiration for Shah’s TEDxFargo talk, that talk has also benefited his company in turn. Shah explained that each time he does a speech, there is a surge in the number of people who sign up for MyMeds.
“From a healthcare point of view, [TEDxFargo] has given me a platform nationally to talk about the importance of patients, pharmacists, health technicians, and everyone involved,” he said. “From a business perspective, it established me as kind of a thought leader, and that lends credibility to what we are doing at MyMeds because it makes clinical sense.”
As far as actual change in the structure of the global healthcare system, Shah said, “I think that we will see some forward progress.” But for now, it is too early to tell.
Watch Dr. Rajiv Shah’s talk here: