1. Why don’t people comply…..
Oral
medication
Regular
appointments
with physician
Attending
screening visits
Following a
special diet
Weight loss
Increased
physical
activity
Smoking
cessation
Blood glucose
monitoring
Insulin
Injections

2. Can new technologies assist?
(1)
• Remote monitoring
• Reminders
• Coaching
• Online support
• Competition
• Decision support

3. The Neglected Gods of Public
Health Are Angry
Preventable deaths
• Injury by firearms 28,839
• Influenza 36,000
• Motor Vehicle Accidents 46,378
• Tobacco Related 430,000
• Preventable Breast Cancer Death 20,000
• Preventable Colon Cancer Death 40,000
Non-adherence affects many aspects of medicine, as seen in failure of
patients to take their medications, missed appointments for cancer
screening, hypertension control, diabetes control, immunization, …[fill in
for yourself!]

4. Laboratory of Quantitative Medicine
Massachusetts General Hospital
Health Communication
Technology Group
The Health Communication Technology Group uses modern computer speech,
telephony, and web-programming to build systems that can help recruit, remind,
schedule, and track patients, so as to keep them in good health.
Cancer Math Group
The CancerMath.net Group uses mathematics to answer practical questions
about cancer, such as he creation of Web-calculators for medical professionals
and their patients, and the use of mathematics to learn how best to time cancer
screening visits.
James S. Michaelson Ph.D.
Scientific Director
Liyang Leon Chen
Research Assistant
CancerMath.net Web Calculators
University of Washington & MIT
Electrical and Nuclear Engineering
Andrew Sellergren
Research Assistant
Manager of the Breast Cancer Database
Harvard University
Biology
Raymond Alexander Jean
Research Assistant
Manager of the
Head and Neck Cancer Database
Harvard University
Biomedical Engineering
Megan Cohen
Analysis of Cancer Outcome
Brown University
Biology
Manju Deivasigamani
Technical Support Specialist
Mammography Reminder System
Madurai Kamaraj University
Computer Science
Joseph Lust
Research Assistant
VXML programmer
University of Rochester
Engineering
Eric Wei
Research Assistant
Survivorship
Case Management Software
Columbia University
Engineering
Mitalee Patil
Research Assistant
Lawrence Health Center Project
Dartmouth College 2008
Biology & Economics
Roopa Das
Research Assistant
Mammography Reminder
System, Tracking Add-In
MIT
Math and Computer Science
Matthew Pappas
Research Assistant
PreventiveMath.net Calculator
University of Michigan
(Engineering and Medicine)
Boston University
(Public Health)
Blake Cady, MD
Mass General Hospital
Christiana Toomey
Research Specialist HemOnc
Manager of the
Hematological Malignancy Database
Dartmouth
Electrical Engineering

5. Ambient Reminders

7. The Neglected Gods of
Public Health Are Angry
Preventable deaths
• Injury by firearms 28,839
• Influenza 36,000
• Motor Vehicle Accidents 46,378
• Tobacco Related 430,000
• Preventable Breast Cancer Death 20,000
• Preventable Colon Cancer Death 40,000
non-adherence affects many aspects of medicine, as seen in failure of patients
to take their medications, missed appointments for cancer screening,
hypertension control, diabetes control, immunization, …[fill in for yourself!]

8. Laboratory of Quantitative Medicine
Massachusetts General Hospital
James S. Michaelson Ph.D.
Scientific Director
Liyang Leon Chen
Research Assistant
CancerMath.net Web Calculators
University of Washington & MIT
Electrical and Nuclear Engineering
Andrew Sellergren
Research Assistant
Manager of the Breast Cancer Database
Harvard University
Biology
Raymond Alexander Jean
Research Assistant
Manager of the
Head and Neck Cancer Database
Harvard University
Biomedical Engineering
Megan Cohen
Analysis of Cancer Outcome
Brown University
Biology
Health Communication
Technology Group
The Health Communication Technology Group uses modern computer speech,
telephony, and web-programming to build systems that can help recruit, remind,
schedule, and track patients, so as to keep them in good health.
Manju Deivasigamani
Technical Support Specialist
Mammography Reminder System
Madurai Kamaraj University
Computer Science
Joseph Lust
Research Assistant
VXML programmer
University of Rochester
Engineering
Eric Wei
Research Assistant
Survivorship
Case Management Software
Columbia University
Engineering
Mitalee Patil
Research Assistant
Lawrence Health Center Project
Dartmouth College 2008
Biology & Economics
Roopa Das
Research Assistant
Mammography Reminder
System, Tracking Add-In
MIT
Math and Computer Science
Matthew Pappas
Research Assistant
PreventiveMath.net Calculator
University of Michigan
(Engineering and Medicine)
Boston University
(Public Health)
Blake Cady, MD
Mass General Hospital
Cancer Math Group
The CancerMath.net Group uses mathematics to answer practical questions
about cancer, such as he creation of Web-calculators for medical professionals
and their patients, and the use of mathematics to learn how best to time cancer
screening visits.
Christiana Toomey
Research Specialist HemOnc
Manager of the
Hematological Malignancy Database
Dartmouth
Electrical Engineering

9. Ambient Umbrella

10. Ambient Orb

11. ambient
Weather Wizard

12. ambient
Bus Stop

13. 40% or greater non-adherence for hypertension and
high cholesterol effect over 35m people.

14. GlowCaps

16. Monthly printed report:
*historical trending
*doctor is in the loop
*progress against agreed-
upon goal
*incentives for exceeding

17. V I T A L I T Y confidential
Vitality’s multi-faceted approach is effective across populations who
are motivated by different factors.
Doctor-Patient Accountability GlowCaps report compliance via printed report card
shared with a doctor every month.
Social Support Integrated reminder light reflects compliance in the
home for friends and family. Weekly email summarizes
progress.
Coordination of Refills Vitality Network sends refill requests to pharmacy,
reminds patient to pick up script.
Patient Forgetfulness GlowCap pulses for an hour, then play a melody for
another hour, then dial the home phone.
Adherence Issue Vitality’s Approach