Globally, over 47 million individuals are living with dementia, with new incidence of 7.7 million annually. Medication mismanagement is one of the most common and concerning risk factors in people with dementia (PwD), as it leads to under treatment of disease, emergency department visits, hospital admissions/readmissions,and serious adverse events. In the U.S. an estimated 3 million older adults are admitted to nursing homes dueto drug-related adherence problems with annual cost exceeding $14 billion. The challenge is complex medicationmanagement requires moderate executive functioning. However, as cognitive function declines, PwD can nolonger perform such Instrumental Activities of Daily Living (IADLs) safely, effectively, and independently. Whilethe goal is to keep older adults at home as long as possible, caregivers are not available 24/7 & costs of externalcare are often prohibitive. The HiDO platform will solve these market challenges by automating medication administration for PwD toeliminate mismanagement, decrease caregiver burden, reduce healthcare utilization and facilitate the ability forPwD to age in place. While still premarket, HiDO is being designed and validated as an automated, AI drivenmedication dispensing and direct observation platform to optimize adherence. The innovative device integratesmedication dispensing, dose administration time, medication synchronization, and a pair of front-facing videocameras to validate the right medications, the right route, right time, right dosage to the right patient (5R's). Thecameras record every dose using facial recognition & provide real-time medication consumption recordings formedical review if needed by monitoring the time a patient interacts with the device. Through cloud connectivity,providers & caregivers have access to video observation logs, dose administration time, adherence trends, &longitudinal adherence through the platform's dashboard. Patients & caregivers can easily setup complexmedication protocols in minutes using a smartphone app. The device then alerts patients and dispenses up to 7different types of meds simultaneously, with up to 40 doses each. The fully commercialized HiDO platform will integrate the full feature suite above. However, to demonstratefeasibility, Phase I will target an in-clinic usability study, platform enhancements & novel AI to confirm ingestion,and remote pilot study to document independent usability & adherence in PwD. An existing prototype HiDOplatform, which already integrates facial recognition AI, will be leveraged as a base technology to increaselikelihood of project success. First, using the existing prototype we will complete an in-clinic usability study tovalidate use cases and product features in the target population. The existing platform will then be enhancedwith machine vision AI to confirm medication ingestion, as well as updates to address challenges found in earlyusability. Once the enhanced platform has been technically verified, it will be deployed in a remote field usabilitystudy with PwD and caregivers.
Public Health Relevance Statement: The objective is to enhance an existing prototype platform and complete pilot field validation of HiDO, an
automated, secure, artificial intelligence (AI) driven medication delivery & observation platform to maximize
therapy compliance and health outcomes for individuals impacted with dementia. While dementia impacts many
activities of daily living, a key challenge is medication management, as this disease impacts older adults who
may have a wide array of comorbidities managed through regular prescriptions. Therefore, development of novel
technology integrated with AI to improve independent patient adherence would significantly optimize patient care
and reduce healthcare costs.
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