Should an AI be managing your meds?

Joyce Lee, a pediatrician and professor at the University of Michigan, thinks a lot about how technology and design can help people remember to take their pills.

Her inspiration? A ketchup bottle.

Pouring ketchup used to be a special skill, the domain of parents who perfected that special "pop" at the base of the bottle or savvy servers marrying half-empty ketchup bottles at the end of the night.

But then Heinz started selling ketchup in plastic squeeze bottles. Just changing the design of the bottle made it possible for anyone to create a puddle of ketchup on the plate.

Lee thinks Heinz’s redesign of the ketchup bottle can help us think about how the power of human-centered design. And she's using design to solve a problem that’s even more important than equal access to ketchup — the problem of helping people manage their medications.

Several studies show that between 25 and 50 percent of patients fail to take their prescriptions as instructed.

“As a culture we tend to blame patients,” she said, ”We say you didn't take your pills. Shame on you. But we don't say, ‘Here's a better solution that will help you remember.'”

Lee is a big fan of Pillpack, a medicine distribution company recently acquired by Amazon. Pillpack manages people’s medications and ships them prepackaged in daily doses.

It helps eliminate some barriers that keep people from taking their medications, such as standing in line at the pharmacy and sorting pills.

But these are not the only reasons why the US pharmacy system feels broken.

One of the most important reasons people why don’t take their medication is that it’s too expensive.

Pillpack says it can’t reduce prices to the consumer. However, it consistently lobbies Congress about Pharmacy Benefit Managers, the middlemen who decide what drugs the insurance plan will pay for and sets the prices people will pay on each plan.

Because so many Americans take multiple medications – four on average – there’s the potential for adverse drug interactions. One important service pharmacists can provide is to check for drug interactions and other problems with an individual’s total medication load.

At Pillpack, the job or preparing and checking medications is shared between human pharmacists and AI technology.

But the picture isn’t clear: Pillpack says humans and technology work together to fill orders and check medications. But it doesn't say how many pharmacists it employs, or even how many customers it has.

And now, Pillpack says it has added “Amazon Pharmacy” to its branding.

Pharmacy, like so much of health care, seems ripe for disruption. With Pillpack’s design solution, and Amazon’s acquisition of Pillpack, there’s been a lot of excitement that this is it.

But is it? It's hard to find evidence that Pillpack addresses enough of the underlying problems to transform the pharmacy business – much less medicine as a whole.

Design that solves problems can be transformative, but the regulation-bound world of pharmacy may prove hard to crack.

Listen to this week's episode of Primed to learn more about what Amazon's foray into the online pharmacy market might mean.

Music this episode includes Ripples on an Evaporated Lake by Raymond Scott.