‘Automated hovering’ aims to keep patients on track after hospitalization

Behavior health researchers at the University of Pennsylvania will test a new approach in caring for people after a heart attack.

Dr. Kevin Volpp said adherence rates for crucial medicines are “shockingly bad” and the health-care system needs to help patients stay on track after a heart attack.

With new money from the Centers for Medicare and Medicaid Services, Penn will test out an approach called “automated hovering.” It brings together the power of social media, insights about behavioral economics and advances in wireless technology.

“In this case it uses, wireless pill caps, but in other studies we are using pedometers, CPAP [continuous positive airway pressure] machines,”Volpp said. “We are using different types of scales, we are using different devices that measure people’s blood sugar, blood pressure.”

You might think people would be powerfully motivated to take their medicine after a life-threatening experience such as a heart attack, but Volpp says a recent Harvard Medical School study found just 39 percent of patients do so in the year after hospitalization. And, he said, offering patients free medication didn’t improve compliance much.

Many efforts to help people manage their disease rely on expensive personnel. Volpp, a health economist, says his team’s approach will be less labor intensive and include a lottery that dangles small, daily financial prizes.

“You can’t really have a person checking every day, or twice a day if a person took their medicines,” Volpp said.

You’ve heard of helicopter parenting? Well, “automated hovering” sounds a lot like “helicopter doctoring.”

“Nobody wants to be overly paternalistic, but, of course, we want to be helpful in whatever ways we can,” Volpp said. “There are a lot of factors competing with the efforts providers are making towards healthy behavior.”