Research to Improve Medication Adherence among At-Risk Populations

radFrank Naeymi-Rad, PhD, MBA

CEO, Intelligent Medical Objects

rapchakBarbara Rapchak

Leap of Faith Technologies/ eMedonline

Of the ~187 million Americans who take prescription drugs, up to 50% do not take their medications as prescribed.i ii It costs over $100 billion a year in excess hospitalizations and kills more Americans than accidents, influenza, and pneumonia combined.iii At the same time, healthcare organizations are trying to optimize delivery of services. Currently, hospitals face stiff penalties if readmission rates exceed thresholds. Many readmissions are attributable to problems that would be ameliorated if we changed how we deliver healthcare. One in 5 people in the world owns a smartphone, and two-thirds of Americans own a smartphone.iv Intelligent Medical Objects (IMO) and Leap of Faith Technologies have had a unique opportunity, under a grant from the National Institutes of Health’s National Cancer Institute, to develop transformative mobile technology to address the problem of medication adherence.

eMedonline is a medication adherence platform that helps outpatients manage their therapy plans while providing clinicians with codified data on adherence and outcomes to help identify and manage high-risk populations. It is based upon theoretical models of behavior change, resulting in medication adherence levels of 96% to 99% and clinically significant improvements in self-efficacy in numerous randomized control clinical studies. It has been effective in reducing readmissions, in managing high-risk cancer and chronic disease populations, and in high-cost specialty pharmacy applications. The patient’s iPhone or Android smartphone creates a “conversation” about his or her therapy plan, driving behavior change. We implement natural language processing (NLP) to allow patients to report outcomes in their own language, capture and codify the clinical concept in the patient’s report, and send the data to the server. Clinicians manage patients through a website with a care management dashboard that allows them to follow the patient from diagnosis through treatment. We deliver a fully codified, structured data set around adherence and outcomes. A visual problem list and body map make it easy to assess the patient’s medication history.


eMedonline drives adherence to the therapy plan, resulting in better outcomes. We are currently engaged in pilot programs to reduce readmissions and manage high-risk patients. One program at Einstein Medical Center in Philadelphia serves a population with high polypharmacy, high comorbidity, and complex needs. Medication compliance is currently 99%. We are interested in other partnership opportunities to pilot the technology in order to identify and evaluate the use of codified adherence and outcomes data in managing care and understanding at-risk populations.


  1. Kaiser Family Foundation. Prescription Drug Trends, May 2010.
  2. Osterberg, L., Blaschke, T. (2005). Adherence to medica­tion. N Engl J Med, 353(5), 487-497.
  3. Sokol MC, McGuigan KA, Verbrugge RR, et al. (2005). Impact of medication adherence on hospitalization risk. Med Care, 43(6), 521-530.