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A prescription bottle with the Pillsy cap (left) and Pillsy’s own bottle designed for vitamins and supplements (left). The Pillsy devices connect to iOS and Android tracking apps through Bluetooth. (Pillsy Photo)

Taking a pill isn’t very hard for most people. But remembering you need to take a pill? That’s a bit harder. Remembering to take several pills at different times every day? That’s a nightmare.

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Studies have shown that up to 75 percent of people struggle to take their medication as prescribed, a problem called medication non-adherence. In the United States, that problem costs 125,000 lives and up to $300 billion every year. And it’s a problem that Jeff LeBrun has spent a lot of time thinking about.

“It really makes no sense. It’s just an inefficient drag on the healthcare system and on our country, honestly,” he says.

LeBrun is the CEO of Pillsy, a startup founded by three Seattle entrepreneurs who are aiming to take on this giant problem. Their solution? A connected pill-bottle cap, a gadget that can fit in the palm of the hand.

LeBrun and fellow Pillsy co-founder Chuks Onwuneme join us on this episode of GeekWire’s Health Tech podcast to talk about Pillsy and the challenges that startups face in the healthcare industry.

LeBrun first started thinking about medication non-adherence when he was having trouble taking allergy medication. He quickly realized that the problem was much bigger than himself and started asking why so many people struggled with it.

“There’s a whole field of research on this. Typically, the number-one reason is actually just forgetfulness,” LeBrun said. He thought there must be a way to solve the problem with technology.

When LeBrun moved to Seattle, he ran into Onwuneme, who happened to also be thinking about a similar idea. Onwuneme has a background in Bluetooth and other connected devices technology, and he was thinking about how to make sure patients in clinical trials were taking the correct doses.

LeBrun and Onwuneme teamed with former Microsoft engineer Otto Sipe to create Pillsy, a connected pill bottle.

From left to right: Pillsy co-founders Chuks Onwuneme, Jeff LeBrun and Otto Sipe. (Pillsy Photo)

Actually, it’s mostly a connected pill bottle cap. LeBrun realized early on that pharmacies wouldn’t use bottles that they didn’t manufacture, but a cap is much easier to work into the system. The startup also provides a larger bottle designed for vitamins and supplements that uses the same technology.

“It’s pretty simple,” LeBrun said, explaining that there’s a small switch inside the cap that’s depressed when the it is taken on or off.  “It just tracks when it’s opened and closed. It stores the medication schedule, and then it beeps and blinks to remind if you miss a dose,” he said.

That’s on the hardware end: the device’s software is much more complicated. The cap’s firmware is connected to Pillsy’s backend through Bluetooth and the cloud and also connects to the company’s Android and iOS apps for consumers and a web application for pharmacies.

That web of connections tracks both the schedule users should be sticking to and when they actually take their medication.

If they don’t take a scheduled dose, there’s a variety of notifications they can set up to remind them, including increasingly loud alarms from Pillsy itself, push notifications to their phone or automated phone calls. The data can also be shared with loved ones, family members or their healthcare team.

“We’re working with some specialty pharmacies that are interested in giving the product to people that take medications for things like cancer, HIV, hepatitis — typically more expensive drugs where there’s often side effects or just other issues with the person taking them as they’re prescribed,” LeBrun said.

But it hasn’t exactly been a walk in the park for the company, particularly as such a small startup entering an industry that runs on giant corporations and entrenched systems. Unlike the tech world, healthcare can be a struggle for startups.

“I think the reality is, as a startup, it’s kind of a difficult endeavor. We just spent over two years developing this. In order to do it, you really need to find investors that are willing to fund that and then after you’re done, potentially wait for two years for insurers and hospitals to pay you,” Le Brun said. “The reality is most investors aren’t interested in waiting that long.”

Pillsy raised its initial funds from taking part in accelerators and from angel investors in Seattle, plus many hours of sweat equity, LeBrun said.

Pillsys mobile apps monitor when patients take doses and keep them on schedule with reminders. (Pillsy Photo)

The healthcare world is also different than the tech world when it comes to pace: while tech embraces lightning-fast change and disruption, healthcare’s day-to-day focus of caring for patients means the industry opts for stability and slower change.

“It’s trying to make changes, but they’re not used to working with startups or adopting new technology,” LeBrun said. “They’re just getting off of paper, honestly. You think like where the rest of the world was 15 years ago, that’s where healthcare is today.”

Onwuneme, who has a history of working with large tech companies, has a brighter outlook on the prospectives for health tech startups.

“[The industry is] just now getting to the point where they can start looking at technologies,” he said. “I think I look at it more as an opportunity for healthcare tech startups to come in.”

Onwuneme’s sense of opportunity isn’t unique — there are more and more startups entering the healthcare space, particularly in Seattle.

Several are spinouts of the University of Washington, like predictive analytics startup KenSci. Xealth, a company that provides a digital platform for hospitals, publicly launched on Wednesday after being the first startup to spin out of Providence Health and Services.

But these companies and many more face another unique challenge: the uncertainty of health insurance regulation. The majority of health services in the U.S. are paid not by patients but by insurance, whether that’s private companies or public insurance like Medicare and Medicaid.

Changes to how insurance is regulated and who insurance covers has a huge ripple effect throughout the healthcare industry, and LeBrun said the current plan to repeal and replace the Affordable Care Act is leaving many healthcare companies unsure on how to act.

“Our customers won’t be as likely to invest in new technologies or innovation if they don’t know that the laws that would make those make financial sense will be around in a while,” LeBrun said. “I’ve had several large hospitals tell me that if they have to deal with having 20 million new uninsured people showing up in their emergency rooms, then their innovation budget goes to zero. It may not affect us directly, but it affects our customers.”

Despite the challenges, LeBrun and Onwuneme remain optimistic that Pillsy and other health-focused startups can make change in the industry. While they can’t change how things are run or what the government does about insurance, they say they’re happy just to be starting with a connected pill bottle.

Find more Health Tech podcasts at GeekWire.com/healthtech, and subscribe on iTunes, Soundcloud or wherever you listen.

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