J Med Syst (2010) 34:357–366 DOI 10.1007/s10916-008-9248-3
Dynamically Programmable Electronic Pill Dispenser System Luciano Boquete & Jose Manuel Rodriguez-Ascariz & Irene Artacho & Joaquin Cantos-Frontela & Nathalia Peixoto
Received: 3 November 2008 / Accepted: 12 December 2008 / Published online: 16 January 2009 # Springer Science + Business Media, LLC 2009
Abstract Compliance in medicine dispensation has proven critical for dosage control, diagnosis, and treatment. We have designed, manufactured, and characterized a novel dynamically programmable e-pill dispensing system. Our system is initially programmed remotely through a cell phone. After programming, the system may be reconfigured in order to adapt pill dispensation to new conditions. In this paper we describe the mechanics, electronics, control, and communication protocols implemented. Our dyn-e-pill devices can be actuated for over 350 h with two pill retrievals per hour. We challenged the charging circuit and demonstrated that the system has a lifetime longer than 6 h with a 30 min charging cycle, while it lasts for 14 h of uninterrupted use with a full charge. Keywords Medical adherence . Pill dispenser . Bluetooth . Mobile telephony . Hardware
Introduction Over 100,000 people are estimated to die each year in the United States partially due to failure to adhere to prescribed L. Boquete (*) : J. M. Rodriguez-Ascariz : I. Artacho : J. Cantos-Frontela Electronics Department, Biomedical Engineering Group, Alcala University, Alcalá de Henares, Spain e-mail: [email protected]
N. Peixoto Neural Engineering Laboratory, George Mason University, Fairfax, VA, USA
treatment . As alarming as this first number, one in every five (21%) patients never follow their prescription, and one in every twenty (6%) patients is not capable of identifying their own medicines. In extreme cases, between 12 and 20% take medicines of other patients. Non-adherence to the prescribed medication is estimated to be clinically significant in 50% of patients . Possible explanations of these facts are ignorance of how to take the medicines (oral, several times a day, before/after meals), ignorance about the importance of the treatment for health improvement, the need to take several pills at once, oversights, and mobility problems . Many of these problems worsen with age , especially in patients with several pathologies [5, 6] is a critical review about adherence to long-term therapies edited by World Health Organization. Tele-assistance represents one of the best prospects for improving the quality of life and autonomy of such patients, with the possibility of closely monitoring them in several situations without interfering with daily life. Recent technological breakthroughs in the fields of hardware, communications, and signal analysis have generated patient-aid systems, with uninterrupted data from electrocardiographic activity [7–9], blood sugar level  and blood pressure [10–12]. Mobile telephony is often a useful option to set up the communication channel [13–15]. Advantages include a universal system with well established standards; broad coverage; service quality; possibility of implementing adhoc mobile systems. We have designed and realized a dynamically reprogrammable pill dispensing system. Our objective here is to present and discuss novel tools we have integrated into this system and demonstrate the use as well as discuss the shortcomings of our “dyn-e-pill”.
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Pill dispensing systems are available commercially and have been discussed in the literature for over 20 years. Their main interest from a medical perspective relies on the measured increased adherence due to automatic reminders [16–18]. There are also several patents behind pill dispensing systems currently available. For example, Gudish  proposes a programmable and microcontrolled device, though with no possibility of implementing a communication system; Lapsker’s system’s  main features include working as an alerting device to be used by visually impaired users. The patented device  is a pill dispenser with an alarm, but it does not have any communication protocol. And finally, the “Programmable automatic pill dispenser” patent held by Lim  can send voice messages to alert the user and has an automatic dialing program for programmed telephone numbers and can playback a recorded alert voice message. SIMpill™ is a commercial device developed by Clinical Technology Advisors Inc.; when the user opens the bottle SIMpill wirelessly sends a message to a secure central computer system through the user’s cell phone indicating that a dose has been taken (out of the container). If the message is not received within the programmed time window, an outgoing text message is sent to the patient’s cell phone reminding him/her to take the medication. If the bottle is still not opened within 30 min, a text message indicating a missed dose can be sent to up to two designated caregivers’ or monitors’ cell phones. The OtCM system (Objective therapy Compliance Measurement), developed by The Compliers Group (TCG) in the Netherlands , can be attached directly to an existing, commercially available standard blister package without altering the medication blister package. A radio-frequency identification (RFID) reader reads out the data and transfers them wirelessly (GSM/GPRS) to a website. We will show here that our dyne-pill addresses most of the problems still present in these commercially available or patented devices. Our system can be dynamically reprogrammed and adjust the dose delivery
to the current status of the patient. None of the above mentioned systems proposed tackles this problem. While pill dispensing systems suit a wide range of patients, several studies have reported less than optimal results with pill-dispensing systems . Their problems were attributed to (1) withdrawal of medication from the dispensing system without subsequent intake by patient; (2) need to intervene and change dosage within less than a week due to changing medical condition; (3) lack of feedback from local pill dispensing system to a central location (hospital or doctor’s office); (4) need to refill containers manually. We hypothesized that several of these issues could be addressed with recent technologies, available off-the-shelf. We have thus designed a pill dispensing system , which can be reconfigured on-the-fly to adapt to daily or hourly changing needs of a patient [25, 26]. We show here that our dyn-e-pill solves the three first issues. We address the fourth issue in the discussion section. Here we describe the dispenser hardware, software, and control center modules and the messages exchanged between each dyn-e-pill and the control center. We have validated the system in extensive tests with loads and under repetitive use. Reliability was assessed with measurements of motor activation through the acquisition of the signal from the Hall Effect sensor.
Materials and methods System overview The dyn-e-pill system can be divided into two parts: server and clients. The server will be here forth identified as the Control Center. The Control Center communicates with the clients through a cell phone, using Short Message Service (SMS). The Control Center is composed of a database with user information, running on a server PC, and it can communicate to all dyn-e-pill clients (Fig. 1). A graphical
Fig. 1 Diagram of dynamically programmable e-pill system, dyn-e-pill DYN-E-PILL -1 BT
PATIENT-1 INFORMATION RS232 SERVER
RS232 PATIENT-N INFORMATION
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interface allows users (patients, family members) and super users (responsible physicians and nurses associated to patients) to login into the system, and verify (user), or alter (super user) personal data, medical records, medication schedule, and dyn-e-pill medicine dispensation programming. Differently from previously designed pill dispensing units, our dyn-e-pill may be also reprogrammed locally through the input of a bioinstrumentation on the patient’s body. In that case–referred to here as “dynamic reprogramming”, the Control Center receives a message and the user data file is updated. The history is kept in the database, and the super user responsible for that user is immediately notified when changes are requested by the client. Each user has access to one database entry. Due to medication scheduling and number of medicines taken, there may be one or more clients (dyn-e-pill) associated with one user. A simple example of dynamic reprogramming is the following: a heart patient takes one aspirin every 6 h. In that case every 6 h a new compartment is opened to the user, and on the display the system shows “please take your aspirin, due at 2 PM”. Because of feedback from the patient’s EKG, or from the Control Center (a doctor would be able to reprogram the dyn-e-pill too), the aspirin delivery needs to be updated to one every 4 h. In that case, instead of the next compartment being open at 8 PM, it would be open at 6 PM, adapting to the new conditions. A similar situation would be if two aspirin pills are needed: in that case the system displays “Please take two aspirins” (for example) and two compartments would be open, one after the other. Below we detail some of these variables such as pills, system for time stamping, mechanical parts of the dispenser, display, and communication with the Control Center. The clients will be identified here as the dyn-e-pill. The dyn-e-pill hardware is composed of a mechanical movable part and two custom-designed printed circuit boards
Fig. 2 Block diagram of dyn-e-pil
(PCBs). The PCBs contain the following five sub-systems (Fig. 2): mechanical interface; central processing unit; battery charger; communication module; user interface. The cost functions optimized in this design were, in descending order: simplicity (pairwise comparison chart indicated this as the most important requirement); speed (maximize); cost (minimize); number of compartments (maximize). Constraints imposed on this design were listed in the following categories: power; connectivity; size. For power we have implemented a battery driven system. The dyn-e-pill connects to a computer via a cell phone, RS-232, or wirelessly (Blueotooth), thus satisfying the connectivity constraint. The device (Fig. 3) fits inside the pill dispensing unit, and therefore meets the size constraints. It is also portable, as one of the compartments is a closed slot, thus allowing for pill transportation while in the dyn-e-pill. Further details on the dyn-e-pill are shown in Fig. 3. It has 14 compartments, which are presented to the user depending on the programming of medicines to be dispensed or loaded. Once in retrieval mode (when the medicine is presented to the patient), the dyn-e-pill will turn when programmed and allow the user to access the right medication. At the same time, an audible alarm will go off or a pre-recorded message will be heard, and a reminder text will appear on the dispenser’s display and will continue until the user withdraws the pill from the compartment; the electronic system then waits for the user to take the medication (this is detected using an optical sensor). A timer based on a real time clock measures the delay until the pills are retrieved. When a medicine is taken from the compartment a datapoint is then registered in the memory of the microcontroller. This information is then sent to the Control Center. A second alarm is programmed in so that if a predefined time is exceeded, an SMS are sent to the Control Center and a louder alarm sounds locally.
MOTOR CONTROL INCREMENTAL ENCODER
RS232 DC MOTOR
Microcontroller ATmega128L BLUETOOTH COMMUNICATIONS
USER INTERFACE: DISPLAY KEYBOARD AUDIO
Real Time Clock
360 Fig. 3 Photographs of dyn-e-pill. a Main printed circuit board, containing the microcontroller and associated circuitry. b Fully assembled dyn-e-pill
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The integration between the Control Center and the dyne-pills is such that at any time the Control Center can interrogate any of the dyn-e-pills for a status report. Conversely, the dyn-e-pills are programmed to send periodic reports, depending on pill usage and patient information (from local sources such as EKG, blood pressure, or other available physiological signals). This capability allows doctors to check on the status of their patients without any extra steps, measures, or even calls. Hardware design Figure 2 shows the block diagram of the hardware system implemented in each of the pill dispensers. The operation of the dispenser is governed by the ATmega128L microcontroller, with an 8-bit RISC core, capable of delivering up to 16 MIPS at a maximum speed of 16 MHz. Its performance features are the following: in terms of storage capacity it has 128 Kb of Flash memory (reprogrammable more than 10,000 times), 4 Kb of EEPROM and 4 Kb of SRAM. In terms of communications it features a Two-Wire Serial Interface (I2C), Serial Peripheral Interface (SPI) and 2 UARTs. Programming is done on the printed circuit board itself through a JTAG (Joint Test Action Group) interface. The system can be fed by a rechargeable lithium battery (4.2 V) or directly from a voltage power supply of 2.5–6 V; this procedure is realized by a single-cell lithium battery charger (MAX1811), which controls the battery charge (through the USB port of a desktop computer.) Since it is of extreme importance that pills be dispensed on time, a Real Time Clock (RTC) has been implemented, using an off-the-shelf low-power DS1338 circuit. This circuit transfers data through an I2C interface. It allows the dyn-e-pill to control the date and time at, which medicine is to be delivered. This integrated circuit works with a 32.768 kHz quartz crystal. A. Communications Two communication systems between the dispenser and a mobile telephone have been implemented, with the aim of
achieving a highly flexible system that can be used in a great variety of different situations: & &
RS232 port Bluetooth system
In both systems the cell phone is supervised by AT commands, making it possible to send SMSs, to receive SMSs, and to erase messages from the telephone’s memory. The main features of both systems are presented below. 1) RS232 Port By using this communication port, the microcontroller can communicate with any device working with this protocol. For example, it can be connected to a mobile telephone by cable, using the appropriate commands to build up a long-distance communications channel. This port has been implemented on the basis of the MAX3222 integrated circuit, which is designed to adapt the different voltages used in the microcontroller and the cell phone. 2) Bluetooth System The Bluetooth protocol is widely used by a great number of commercial devices such as personal computers, PDAs, and mobile telephones. The systems using the Bluetooth protocol have mainly been designed for wireless connection of Information Technology Systems, though with time its use has extended to other types of applications, such as home automation [27, 28], vehicle electronics , security systems  or telemedicine [31, 32], among others. Some Bluetooth modules work with the RS232 or similar protocols. In this case, however, we have chosen to implement this protocol using specific low-cost hardware: CSR’s BlueCore2-Ext chipset, connected to the microcontroller (transport interface) by UART. This module, based on BlueCore2-Ext, provides SPI and IIC communications, two widely used interfaces. The firmware integrated by this module meets specification 1.1 of Bluetooth, allowing, with the radio interface, asynchronous connectionless links (ACL) of up to 720 kb/s (with USB transport) and three synchronous connection-oriented (SCO) links of
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64 kb/s. It is a class 2 device (4 dBm transmission output) with a typical sensitivity of −80 dBm, with a 15 m range in an office environment (numerous obstacles) and 45 m in the open air. One of the advantages of the Bluetooth system, other than communication with the cell phone without any cables, is that the dyn-e-pill can be associated to the patient, adjusting itself as a function of the needs of that particular patient (EKG status, blood pressure, and oxygen partial pressure, as well as patients with implanted neural prosthetic devices). B. Motor Control The pill dispenser is circular in shape, so the structure has to be turned to allow access to a pill compartment. The interface with the mechanical (movable) parts of the dispenser is performed through the DC motor, actuated by the microcontroller. The motor is controlled by a precision controller LM628, a digital-to-analog converter (DAC0800), and an amplifier (LM12CL). Two modalities of sensing motor location are included for reliability: optical encoding and Hall Effect sensing. The Hall Effect sensor outputs a signal when a magnet is swapped across the sensor. We have used 2 mm diameter magnets, which were glued to each one of the compartments of the dyn-e-pill. These magnets move along with the mechanical housing, and when any one of them is aligned with the Hall Effect sensor, the microcontroller “detects” that one of the compartments moved across. C. User Interface If the system is to be used by any patients, including those with limited movements, sight problems, and a wide range of pathologies, the utilization thereof has to be made as simple as possible, including the user interface. The following user-friendly features were therefore implemented: large display (6.5×4 cm), large keys, intuitive images, audio messages, and the various functions should be implemented with minimum user intervention. The device’s user interface is made up of a small number of keys (UP, BACK, RIGHT, LEFT, ENTER), which will be mainly used when refilling the dispenser, a display (S6B0724 of 128×64 dots, connected to the microcontroller through an 8-bit parallel bus) to show suitable messages to the user and a 13-bit linear codec (MC145483), which allows voice digitization and reconstruction as well as pre and post filtering to say phrases and communicate with users. The user interface also includes the optical sensor that detects when a pill has been taken from the dispenser. The power consumption of the display is 100 mA, and the backlight about 50 mA. For most of the time, however, the backlight will be off, as it is only activated when the user presses a button or when the dispenser delivers a medicine. The display shows the mode the dyn-e-pill is on:
waiting to for the patient or care giver to load medicines; pill retrieval; messaging mode. The screen shows also date, time, and phone number the dyn-e-pill is connected to. Control Center The Control Center unit is set up on a personal computer with a cell phone connected through the RS232 port. All applications for the Control Center were programmed in LabWindows™ (ver. 7.1, National Instruments™, Austin, TX); a series of interconnected graphic modules makes it possible to centralize the information from a network of pill dispensers. Access to the application is by way of a password protected module. Once access has been granted, addition or removal of users is allowed, as well as checking or blocking the operation of each dispenser, programming the pill delivery sequence, obtaining statistical data on a user or a set of users. The Control Center software was designed with the following capabilities: data analysis, processing layer, documentation module, cell phone API, database layer, and GUI (Graphical User Interface). All these modules are interconnected and provide several indispensable functionalities to the system. The GUI facilitates the safe and controlled access to patient data by untrained users of the Control Center (Fig. 4 shows a snapshot of one of the windows). The processing layer elaborates and interprets messages with the database. The database is based on mySQL (version 2.1), and performs searches, user registration, ID and data modification, along with providing data to the GUI and report generation (part of the documentation module). The documentation layer can be accessed from the GUI, and allows for production of reports by patient, date, medicine, or responsible doctor. Formats implemented in the documentation module are pdf (portable document file) and Microsoft Excel™. Finally, the data analysis module
Fig. 4 User interface of the Control Center server
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Table 1 Pill dispenser programming message format
PATIENT No. X Y Z
TYPE 1 MEDICINE MESSAGE M
HOUR MIN. FM H H M M T C # */= ID: to show that it is an SMS from the pill dispensing system, fixed to “PAC” XYZ [000-999]: dispenser number in the network MEDICAMENT TEXT 1: text to be shown on the display $: to separate text of medicine #: to indicate the beginning of the delivery programming command DATE: following the format DD, MM, YY HOUR [00-23], MINUTE [00-59]: time of medicine delivery TYPE: type of medicine to be dispensed and number of pills to be loaded; the appropriate text will be shown on the display. COMPARTMENT [0x1-0xE]: it shows where the medicine is in the pill dispenser with hexadecimal codification FM [*-=]: *: it indicates the end of the programming command of the pill dispenser. =: it indicates that the command continues in a new SMS.
its situation in the pill dispenser. For example, if the content of the SMS is “PAC025CAPTOPRIL$ATENOLOL $#15100712301A#15A0717301B#151007123126*”, dispenser number 25 will deliver Captopril on the 15th of October of 2007 at 12.30 AM (medicine type 1 in compartment 10), and at 5.30 PM, and Atenolol the same day at 12.31 AM (medicine type 2 in compartment 6). The last character of the SMS could be ‘*’ or ‘=’. In the case of ‘*’ it shows that the programming command has finished; if this command has more than 160 characters, two messages can be written linked together, using ‘=’ at the end of the first message to separate them. ON/OFF COMMAND: it has the operation to switch the dispenser on or off. The format is “PACXYZON” and “PACXYZOFF”, respectively. When the device is OFF, a programming command is equivalent to “PACXYZON”.
runs continuously on the available data (timestamps associated with retrieval of medicine(s) by each patient. As soon as reports are made available, the data analysis compares the timestamps with the desired time for medicine intake. If they are not within a certain pre-programmed interval (tunable between 5 and 60 min) there is an SMS (alarm) sent to the responsible physician. We have developed and implemented an SMS-basedlanguage for the Control Center and dyn-e-pills to communicate. SMSs can be sent either way. The following is a list of the message types sent from the Control Center to a dispenser: PROGRAMMING COMMAND (Table 1): this command codifies the functioning of each pill dispenser. It includes the text to appear on the display with the name of the medicine to be taken and the date, hours, minutes, and
Table 2 Report message format ID
ID: to show that it is an SMS from the pill dispensing system XYZ [000-999]: dispenser number in the network T: Type of medicine C [0x1-0xE]: Medicine compartment DELAY: [000-999] delay in minutes FM: END OF MESSAGE.
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identifiers (“*” or “=”). Our intention is that several such systems would be deployed using the same server and phone. We have also implemented a local test by the dyn-e-pill of the success of sending each SMS. If the connection cannot be established to a network, the system will try every 5 min. If the dyn-e-pill cannot communicate to the control center for over 24 h, it displays locally an alarm (visual) to alert the user about the condition.
Results and discussion
Fig. 5 Cad drawings of the mechanical design
REPORT REQUEST: one specific dispenser is asked to send a report to the Control Center. The format of this text message is “PACXYZINF”. The valid messages sent from a dispenser to the Control Center are the following: SENDING REPORT (Table 2): the dispenser sends a report of its functioning to the Control Center. For example, if a pill dispenser sends the following SMS to the Control Center: “PAC2008600524000*”, this means that user 25 has taken medicine of type 1, from compartment 6, with a delay of 5 min, and that medicine type 2 contained in compartment 4 has been withdrawn from the dispenser within less than 1 min of the target time. MEDICINE HAS NOT BEEN WITHDRAWN: this message is sent when, after a certain amount of time, the user has still not removed the medicine from the dispenser. For example, if the message says “PAC025NOA10”, this means that patient 25 (of the network) has still not taken the medicine contained in compartment 10 ( 0×A) after 10 min. REFILLING MEDICINES: in order to send this message there is a key sequence that has to be dialed, which is shown on the display. An example of this kind of message is “PAC025REFILL15AD”, which means that compartments 1, 5, 10 (0×A) and 13 (0×D) have been refilled. In order to allow other medical systems to share the capabilities of the same cell phone, we designed specific IDs (in our example case above, “PAC”) and end-of-message
One of the most intricate tasks of this project was to design and manufacture the plastic model of the dyn-e-pill. A series of design requirements were met (size, weight, portability, cost) and various technical problems had to be solved: location of the user interface (display, keyboard), pill withdrawal point, selection of the motor gear, fitting the electronic circuit inside the plastic model. Figure 5 shows a view of the final design, which was successfully manufactured, and is presented here. Several designs were tested for compliance, and were adapted to meet requirements of size, power, and mechanical stability. The movable piece of the system contains 14 compartments for medicines and also gear, which is rotated by the motor. The compartment size of 8 cm3 allows for several pills to be dispensed from the same container. The model was fabricated in plastic to comply with weight requirements, and it was designed to match the printed circuit board (Fig. 4). Once both the plastic model and the printed circuit board (PCB) were fabricated, the system was put into operation; a photo is shown in Fig. 3 b. The mounted system is 13.85 cm in diameter and 4.5 cm tall; the weight is 340 g. We have manufactured a total of six prototypes, all implemented based on the same mechanical design. We have identified several problems commonly associated with pill dispensing systems, among them the lack of communication to a server and the need to adjust the dispensed medicine to a new dose when the pills are still loaded in the dispensing mechanism. We designed a system, which tackles these problems. However, we have not proposed an automated solution for the need to manually fill the dispenser. Our understanding of this issue transcends an engineering device: it is based on the fact that
Table 3 Electric consumption of dyn-e-pill Condition:
Measured in: motor Condition: Measured in:MCU, LCD, RTC
0.79 mA LCD off, MCU on, RTC on 16 mA
48 mA LCD on (without scroll) 89 mA
72 mA LCD on (with scroll) 101 mA
MCU microcontroller unit, LCD liquid crystal display, RTC real time clock
Fig. 6 Validation of charging circuit and discharge profile
J Med Syst (2010) 34:357–366 Voltage across battery (V)
364 5 4 3 2 1 0 0
Motor actuation (V)
6 4 2 0 -2 0
the medications needed by patients change and cannot be predicted too long in advance (depending on the user, new medicines are needed on a weekly basis). We therefore hypothesize that only a subset of the patients would profit from an automatic re-filler. However, this would be feasible with a mechanical arm adapted to our dyn-e-pill system. Table 3 shows the power consumption of dyn-e-pill in several situations. The analysis of power consumption can be divided into the motor and associated elements (LM12, LM628, and DAC), and electric consumption by the rest of the components (microcontroller, display, and real time clock). Since the motor and the display are only turned on sporadically in a typical situation, the dyn-e-pill has an extremely long operating time. In order to assess the discharge time, we have submitted the dyn-e-pill to several load scenarios. The most interesting result was obtained with incomplete charge cycles. Figure 6 presents a complete charge and incomplete charge of the batteries through the USB connector of a desktop computer. The full charge takes 13.5 h to discharge upon actuation of the motor and display (Fig. 6, upper graph). The estimated frequency of motor actuation is once every 5 to 10 sec. The display was lit continuously for the duration
Table 4 Dyn-e-pill features versus other pill dispensing systems commercially available and proposed in the literature
of both tests shown. In order to demonstrate motor actuation we have acquired the Hall sensor effect data simultaneously with the battery voltage. The Hall Effect sensor indicates the movement of the plastic container, and is thus a precise indicator of motor actuation. The bottom curve of Fig. 6 presents the Hall Effect sensor signal. From this signal we estimate the motor actuation to be every 5 sec. The curve with an incomplete charge cycle (red curve) follows the same pattern as the full charge (black curve). The incomplete cycle is, however, shorter by almost 50%. The charging in this particular case took 30 min, which is less than 50% of the full charge cycle (estimated to be 2 h). Other tested scenarios (data not shown) demonstrated 100% success, as per design, and are thus not discussed further here. Some of these situations are listed here: medicine dispensed after 120 and 240 h; operation with no cell phone (over Bluetooth); message malformed (dyn-e-pill requests the Control Center for a re-sending of the original message, indicating the error); cell phones provided by different networks (Siemens provided the original cell phone, but the system was later tested with other devices by adding appropriate libraries to the MCU).
Communication mode Programmable Observations on line?
Gudish  Lapsker  Baum  Lim SIMpill™ OtCM  Dyn-e-pill
None None None Automatic dialer Cell phone Cell phone Cell phone
No No No No No No Yes
Target users: visually impaired Uses voice messages. Uses bottles; patient may be alerted through SMSs Uses RFID Dynamically reprogrammable
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Conclusion While we have implemented neither a microbalance nor a camera with the dyn-e-pill, we anticipate these two features will be desirable in a system with no cost constraint and higher reliability and control. We have however shown that an optical sensor indicates the use of the device. The optical encoder, along with the Hall Effect sensor, give enough precision to the movement of the 14 containers. The observed repeatability allowed for continuous operation of the device for over 2 months with no need of reset. We had expected a mismatch between the position of the containers and the opening (see Fig. 4), and thus implemented two redundant methods (optical encoder and Hall Effect sensing) in order to reliably determine where the medicine containers were. In the case of the camera and microbalance, we intend to have a database of pills and respective weights, colors, and sizes. When a patient collects a particular medicine from a container, the system would record, which medicine, at, which time. This would allow for bigger container, in, which several doses would be present. With a simple voice synthesizer, one could implement a dyn-e-pill, which leads the patient to the pill he or she needs at any time. We present here the design of a semi-autonomous electronic system for delivering medicines to users, which expands on several previously presented automatic pill dispensing devices (Table 4). Our system can be controlled remotely by a cell phone, as well as increase or decrease medicine dispensation interval in order to adapt to the current condition of the patient. Some of the advantages of the dyn-e-pill are the immediate detection of any alteration in the medication retrieval pattern; automatic data recording; low-cost (less than $200/dyn-e-pill); portability; future application to implanted patients (DBS, epilepsy, depression, obesity) and minimal training required. Acknowledgement The project “Development of a pill dispenser controlled by cell phone”, ref. 28/05, was supported by the IMSERSO (Ministerio de Trabajo y Asuntos Sociales), Spain.
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