Birmingham Medical News

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New Pill Mapping Index Becomes iPhone App for Clinicians
By: Jane Ehrhardt

Birmingham-based MedSnap will soon make it easy for clinicians to almost instantaneously and accurately identify most pills presented by patients. “This will allow the ER or physician or home healthcare worker to quickly assess the brown bag full of pills the patients bring with them,” says Patrick Hymel, MD, chief executive officer and co-founder.

To use the pill-mapping program, the clinician places the pills or capsules on a special tray about the size of a smartphone, and then snaps a photo with their iPhone. Within seconds, a screen pops up listing the pills by name and strength, their usages and interactions, plus any disease interactions. Any missing meds or any creams, lotions or injected medications, like insulin, can be added manually.

“What the patient assembles on their own is much more likely to be the truth than what they write down,” says Hymel, who comes from an emergency medicine background.

MedSnap can help ERs avoid unnecessary admissions. “If you can establish the source of a patient’s problem as medication-related, it’s a call to their physician rather than an admission,” Hymel says, adding that adverse drug events and non-adherence are the number one cause of preventable readmissions.

A mammoth goal, MedSnap’s pill mapping index (PMIX) aims to cover the most popular 2,000 pills. “The top ten prescribed pills represent a very, very large percentage of all pills prescribed. So if we get even the top 1,000, the program’s going to know most of the pills out there,” Hymel says.

Currently MedSnap’s PMIX has tapped into the volunteer services of more than 500 healthcare providers to submit images of pills from all sorts of angles and lighting situations. Samford’s pharmacy school is an avid supporter.

“Those students come from a mindset of crowd-sourcing and like to tackle a mission,” Hymel says. “We were so impressed with their enthusiasm, we thought why not open it to everyone.” So far, no one with the right iPhone has turned down their invitation to participate. Any interested clinicians with the right phone can sign up at medsnap.com.

Hymel says a pill’s color, shape and size “gets you 80 percent of the way in pill mapping, and the rest is the imprint and other proprietary things.” But color presents the prime challenge.

“What is a white pill in yellow light? it’s yellow,” he says. “You need white balance to understand what the exact color is you’re looking at. It’s a surprisingly complicated problem.”

Before MedSnap, the FDA had the best pill-mapping database, but it differentiates between only nine color categories. “What if you look at an orange pill that’s between yellow and orange? The FDA didn’t have a color for that. We differentiate between over 900 types of color,” Hymel says.

The solution for the color problem and to allow multiple pills to be identified at once lies with the special tray. “The tray surface keeps the pills within the camera frame and forms a grid to let us assign which pixels to which pill,” Hymel says.

With the tray, the MedSnap app holds a 96 percent accuracy in identifying the right pill. “That takes enormous technological achievement,” Hymel says. With the right data, they will be able to push that to 99 percent. “Especially with the white rounds, which are incredibly dangerously similar to one another.”

Currently thirteen full-timers and eight part-timers work six days a week on testing the program. With the steady growth of their PMIX database, MedSnap plans to launch the subscription-based app this March.

Individuals will pay $69.99 per year per phone, plus $20 to $30 for the tray with no usage limit. A licensing fee can be arranged for large practices and hospitals based on volume.

Initially, the app will work only on iPhone 4S and 5. “Eventually we’ll have it on Droids, but that’s a lot more difficult, because the vision system is very precise and requires consistency in the operating system and the hardware,” Hymel says. “With iPhones, you know the OS doesn’t need to interact with a different camera system when you move it from a Motorola to a Samsung.”

Ultimately, MedSnap will be tweaked to also help individuals identify and keep their medications straight. “If I can’t tell the difference between two white rounds at forearm’s length,” Hymel says, “think how hard that can be for a 70-year-old.”

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