As part of our course on innovative engineering strategies, we're going to have a conversation here with Eileen McDonald. Eileen is a faculty member, at the Johns Hopkins Bloomberg School of Public Health, where she's a core faculty member, of the Center for Injury Research and Policy. Eileen has been doing some cutting edge work around pill dispensers, and I'm really glad that she's come here to talk to us today about her work in this area. Welcome Eileen. Thank you, thanks for the opportunity to talk about our smart Pill Dispenser. Sure, tell me about the Pill Dispenser, that you have here in front of us, how did it come about, what is it? So this actually is the brainchild of our Center Director Dr. Andrea Gielen. As you may recall, our Injury Center has had a long history, with the Johns Hopkins University undergraduate senior engineering class, where senior engineers are tasked with a real-world problem, and they're asked to engineer solutions to it, and our Injury Center has worked for a number of years on a variety of injury related issues, with this group. As the Opioid Epidemic was growing, Andrea had this idea, that there should be some innovation brought to bear on these traditional pill vials, and worked with faculty and students at Homewood, to create a different version, this is actually our second prototype, but the students came up with a non-working prototype, that was enough of a proof of concept, to show that there was something there, and with the student's technology, we were able to turn that non-working prototype into resources from our own institution, from our Tech Transfer Group, to continue to work with a professional engineer, and build out, and mature the prototype to what we have here. So we're still in the early development phases of this work, but we think it's very promising. Great, and this is a bit different type of a strategy, than what we've been talking about in this course. So help us to understand why this type of pill dispenser is important to what we're seeing in this country around opioids? Sure, so many of your viewers may recognize this, a traditional medication vial, and this child resistant cap, that I just easily opened, was an innovation in the 1950ths. It was created in response to, the aspirin ingestion that were killing hundreds of kids back in the fifties, and it was created by a Pediatrician, and then adopted first around aspirin, but now it's required by the FDA on many medications, and this original technology, the child resistant cap is recognized as a public health success. It reduced aspirin ingestions by more than half, but in light of our current epidemic, it is insufficient to address the needs that we're seeing now. So one of the problems is, once I've opened this cap, I have access to all of the medications in here, so I can take as many of these as I want, I can take them for longer than indicated by the physician. Importantly, others who are not the authorized user, are not the individual for whom the prescription was written, can easily access these as well, and we know from some of the epidemiological data, and from some of our own research, that medicine cabinets in our own homes, are what are getting people into trouble. So we know from some research that upwards of 80 percent of heroin addicts, report first getting access to prescription pain medications through friends and family, so you can see why we need innovation brought to bear on this challenge. Certainly, yeah that makes a lot of sense, and it's certainly, a different but upstream intervention that we can certainly see how it would make an impact on this type of problem. We're certainly cognizant of the opioid epidemic, and we feel like this is an area almost of low-hanging fruit, if we can bring this technology to bear, we can greatly reduce misuse, and possibly addiction, pilfering by others, but it's not just opioids that are being used inappropriately or unsafely by others. So we are kind of taking advantage of the interest in the Opioid Epidemic, to secure the necessary resources, to continue to build out this device, but we really do believe that, once this is available on the market, it can help with the safe administration of a number of other drugs. Yeah, well it makes a lot of sense, and as you said this technology that is commonplace now, I'm sure it's in most viewers homes, has been around for half a century, and more than half a century. So innovation is in order I would say. Are there other types of advances, that we've seen with pill vials in recent years, sort of short of this very high Tech Approach that you're pursuing? Yeah. So as part of our, trying to get interest in our product, we are charged with kind of understanding the landscape in this area, and through that work, we've become aware of a couple of other types of innovations to the traditional child resistant cap. There is a general category of things known as locking pill vials, so they work on the same principle as this. It's the traditional amber pill vial, but has slightly more sophisticated cap, that has a combination lock integrated into it, so that only the authorized user can access that. That is an advancement to this, but it still has a weakness, once you get this open, it still has a weakness of allowing the user to access as many of these pills as he or she wants, or for longer periods of time than indicated by the prescription. So we think our device actually ticks off a few more boxes in that area that would help to reduce the challenges that we're seeing now. Makes a lot of sense, and how do you envision this coming to market, how will patients be able to access this new pill vial when it's ready? So right now, our vision is that this would be a device that is delivered through pharmacies. So only the pharmacist would have access to the key lock here, and through the complementary software that is used to program this device. So the pharmacist would take the prescription, using a proprietary software, that is in progress, would enter the personal information about their prescription. So for instance, the number of pills to be administered, no, let me say that differently. So the pharmacist would enter information from the prescription in here, and that would program in, how frequently the pills could be administered every four hours, every six hours, every eight hours, whatever it says on the prescription, but then also importantly, for what duration? Maybe eight days, 16 days, 20 days, whatever the clinician decides, that gets entered in here, along with the Bio-metric Thumbprint recognition here, so that the authorized user would have to be available, at the pharmacy to fully program this device. So once it's ready to go, and the prescription, or the pills actually loaded in here, the patient, or authorized user takes it home. The internal clock is kicking down, so let's say, the prescription called for a medication dispensing every six hours, when six hours is up, the pill doesn't automatically come out because we don't want to necessarily encourage people to take medication every six hours, but we want it available to them should they need it. When the patient decides they are ready for medication, and the authorized time has passed, they would put their thumbprint on the reader, and a pill would be dispensed here, to be taken, and then another one could not be taken again, until the authorized time has passed. If the other feature that we're programming into this, is if the person doesn't use the medication, in two or three days, that it may lock down the medication. I'm not sure that's important to say, but yeah, maybe we should just go on from there. Well there is, it certainly gives a great example of the wide ranging potential applications of this technology, I mean, I know that I have older family members, who have trouble remembering when to take their pills. So I think a lot of times with the opioid epidemic, we think about intentional pilfering, or access to opioid pills, but as you say there's broader applications of this technology that can help people, fill their prescriptions, and pursue their doctor's orders. Hopefully, address a number of other unintended consequences of medications. I just learned last week, of a young child in Baltimore who died from an unintentional ingestion of Methadone. He was able to access the medication, that was in the house from his father, and with a device like this, simply that could've been prevented. So we do have ways to go to actually get this to market, but we're very committed to seeing this through because we do think it will really solve some problems, and help save lives. Are there things that our learners can do, to help move this kind of technology, this kind of thinking along? One thing that we really want to encourage, or accomplish with this course, is to give our learners very concrete steps that they can take in order to address opioids. So if there are people in the audience who think wow, "this is a great idea, I'd like to see this come to market sooner." Are there things that people can do, sort of short of following in your footsteps, and developing a device of their own way? Well, if there are any budding entrepreneurs, so Dr. Andrea Gielen is leading this effort, and I've had the pleasure of working with her on this, and as I said we are committed to seeing this through. We're not interested in becoming business people, we are committed to our careers, as Injury Prevention Researchers. So ultimately our our idea, is to build this device out until we have solid evidence that it works, and then hopefully license the technology. So if any of your listeners are already in the pharmaceutical industry, or are interested in starting a company to help support this, and would want to license this technology, we'd love to talk to them. I think there are other roles too that individuals could play, so what's happening now is that state-by-state legislation is being considered around, how opioids are being dispensed, and so there's always an opportunity, for your viewing audience to get involved in advocacy around, advocating for evidence-based solutions to the opioid problem, and how opioids are being dispensed, or distributed at a state-by-state level, would be a great place to start. Terrific. Well, that's certainly a great recommendation moving forward, and aligns well with some of the specific recommendations that we've outlined in this report. Is there anything that we haven't discussed yet today, that you'd like to make sure our listeners know, before we close out this discussion? Not that I can think of, no, sorry. Okay no. Terrific, well thank you very much for your time. It's my pleasure. Thank you. All right.
