INTO THE GROOVE page 43
Where can you
find a pediatrician
"after hours"
summer, fall,
winter or spring?
For instance, patient Sue Fisk,
a pseudonym, receives a message
like this on her MediTrac pager
each morning: March 4, 9:00 a.m.
Sue Fisk, Take 7 Glyburide. Call
555-5555 if blood level is greater
than 10Orng I dl (milligrams per
decaliter).
Children's Hospital of Michigan
Evening Si Weekend
Pediatric Center.
Now your children can have the special care they need
"after hours." During the evening. On weekends. Even
holidays.
Staffed by pediatricians affiliated with Children's
Hospital of Michigan, the center handles non-emergency
conditions when your child's regular physician is not
available. After a visit to the center, we'll provide your
child's physician with a follow-up report so he or she
can continue treatment, if necessary.
Our center is located on The Detroit Medical Center's
Lahser Campus at 27207 Lahser Road, Suite 201, just
north of Eleven Mile Rd. in Southfield. Call (810) 827-
7940 for more information.
Weekdays: 6-11 p.m.
Weekends/Holidays: 1-9 p.m. ,
No appointment necessary'. We accept patients up to
30 minutes before closing,
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At Springhouse, we provide Assisted Living Services
in a residential community — respecting the dignity
and independence of older adults. Our residents receive
the help they need with the activities of daily living,
allowing them to maintain as active a life style as possible.
If you, or someone you love, are looking for a warm,
caring environment where
a helping hand is always nearby, we can help.
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ASSISTED LIVING
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Where Caring Has A Special Meaning
Ms. Fisk pops the correct
dosage and measures the level of
glucose in her bloodstream. If it's
too high, she dials up MediTrac's
central office which relays the in-
formation to her health-care
provider.
A central MediTrac computer
stores data on patients like Ms.
Fisk. The intricate software reg-
isters each patient's specific reg-
imen of care. Which medications
does he or she take? When?
Why? How? How much?
The program also details pa-
tients' unique lifestyle. When
does he or she eat breakfast?
Nap? What other medications
have been prescribed? Should
these medications be taken to-
gether, or separately?
MediTrac (which operates
with a back-up system in case of
power failures) also offers basic
facts about certain drugs like
tetracycline for infections, which
shouldn't be taken with milk or
antacids, or erythromycin, an an-
tibiotic best consumed with food
and not on an empty stomach.
Richard Davidson, Eric Labe
and Melanie Schaengold are the
brains behind the quest to make
compliance a virtual no-brainer.
Wait for the MediTrac signal,
read the message, follow it, and
presto. You've complied.
But, even with a constructive
crutch, the onus is on patients to
remember to carry pagers and
medications around with them
during the day, in their pockets
or purses. And, of course, no com-
pany guarantees follow-through.
That, in the end, is the patient's
responsibility.
"This is not a life-support sys-
tem," Mr. Labe stresses. "This is
solely meant to be a tool, a re-
minder."
The trio — Davidson, Labe and
Schaengold — have combined
their specialties in law, business
and pharmacy to create MediTrac,
but each has at least one story
lending personal significance to
the entrepreneurial endeavor.
As a former retail pharmacist,
Ms. Schaengold witnessed non-
compliance firsthand. Her hus-
band, Phillip, works as CEO and
president of Sinai Hospital and
sees fallout from the problem dai-
ly.
Mr. Labe, 31, was diagnosed
with an inflammatory bowel dis-
ease when he was 18. "I followed
my prescription for probably a
solid six months, then I started
slacking off. At 18, you think you
can take on the world."
Not so. He got sick again, but
only for a while. Luckily in recent
years, Mr. Labe's condition has
gone into remission.
And Mr. Davidson, 30, saw his
father struggle to comply with
the medical care his mother,
Jean, needed when she began
suffering from Alzheimer's dis-
ease five years ago.
"It was an incredibly difficult
situation that would have been
made easier if the (MediTrac)
system had been set up then,"
the younger Davidson says.
His mother now lives in a
nursing home where she receives
around-the-clock attention. One-
fourth of all nursing home ad-
missions, in fact, result when
older people can no longer keep
track of their medications, ac-
cording to the American Health
Care Association Journal.
The cost of such admissions:
About $5 billion yearly.
But noncompliance is not just
a problem striking the geriatric
population. All ages ail, and in-
creasing numbers of younger pa-
tients are at risk for compliance
complications because more and
more health care is becoming a
service less spoon-fed. By the
year 2000, about 70 percent of
health care will be provided on
an outpatient basis.
MediTrac aims to
make compliance a
no-brainer.
Ambulatory care, which avoids
expensive hospital stays, might
be cost effective, but nonetheless
can be dicey. If hospitalized pa-
tients go home early, then stray
from their prescriptions, they'll
wind up back where they started.
Cancel all hopes of saving
money.
MediTrac and other compa-
nies have marketed their com-
pliance systems to managed care
organizations with the theme:
Pay minimal amounts now, or
pay more later. The price of Med-
iTrac, for instance, ranges from
$5 to $25 a month for individu-
als. For large companies and
HMOs, the cost is negotiable.
"I'm really kind of excited
about it," says Diana Morasch,
area manager of pharmacy ser-
vices with Kaiser Permanente of
Kansas City.
She will use MediTrac this au-
tumn for a clinical trial with
asthma patients. The HMO will
test whether the pager-alert sys-
tem does, in fact, heighten com-
pliance and save money.
"Any time you increase com-
pliance with asthma patients,
they'll have better outcomes. It
keeps them from being admitted
to the hospital. Ultimately," says
Ms. Morasch, "what we'll be test-
ing is whether the MediTrac re-
minder will prompt the patient
to follow through. Most patients
want to do what's best for them.
Sometimes they just need a tool
to help." ❑