How this Dutch start-up improved medicine management with IoT
How this Dutch start-up improved medicine management with IoT
How this Dutch start-up improved medicine management with IoT

    How this Dutch start-up improved medicine management with IoT

    Dutch supply chain start-up AntTail tells us how IoT apps are helping its pharma clients to deliver better – and safer – products.

    ‘Track and trace’ logistics may not sound exciting – but it is growing in importance in a pharmaceutical market where the margin for error is razor-thin.

    How so? Well, medications become increasingly less effective as they go ‘out of range’ in terms of temperature. Industry figures from American Health Ministry suggest that 35 per cent of distributed vaccines and medicines become exposed to temperatures outside of the proper range at some point in the supply chain, reducing their effectiveness, while AntTail’s own research reveals that 90 percent or more of patients are failing to store their medications properly.

    This is serious both for the patient and provider; there are numerous examples of vaccines being spoiled, forcing patients – including young children – to have another round of vaccinations to safeguard them from disease. It’s also hitting pharma pockets, with pharma companies said to be losing a whopping $637 billion in revenue per year from non-adherence to medication.

    “For insurers, employers, and patients, non-adherence significantly increases healthcare costs as a result of disease-related complications,” wrote authors of the above research report, carried out by adherence company HealthPrize Technologies and consulting company Capgemini.

    “For pharmaceutical companies, pharmacies, and pharmacy benefits managers, non-adherence significantly erodes profit due to prescriptions never filled and medications not taken often enough … non-adherence is also to blame for immense personal and societal costs beyond the financial, in the form of poor health outcomes, untimely death, lost productivity, and compromised quality of life.”

    This is where AntTail, along with its technology partner Mendix, aims to step in and solve the problem.

    AntTail provides small hardware sensors and SaaS solutions so that pharmaceutical products can be tracked from dispatch to pharmacy and even to the customer. The sensors, built by partners in China, can continuously check the package’s location and temperature, as well as see if it has been opened or not.

    AntTail sensors – which have batteries that last near 18 months – are placed on boxes, pallets, packaging or even in warehouses and they transmit data on their situation to Amazon’s AWS cloud in real-time. The ‘built-on-Mendix’ AntTail application (provided to AntTail customers as a software-as-a-service offering) interprets that data and interconnects with users’ existing processes and procedures to derive intelligence from the local hardware. If anything isn’t as it should be, automated actions can be triggered, alerting staff to put things right.anttail-an-intelligent-sensor-low-res-002

    Technically, AntTail uses a central router as a hub for the sensors, collecting the data when there is a connection and storing the data when there is not so to ensure no data is lost.  The Router uses Vodafone’s Managed IoT Connectivity Platform to connect to AWS, and has a Java service running which puts the data into a Hadoop database. The sensors, interestingly, use a proprietary network to communicate, eliminating the need for ZigBee, Wi-Fi or Bluetooth standards which can be a power hog.

    Co-founder and CEO Mark Roemers gives IoB the lowdown on the benefits the firm has seen so far.

    Related: Smart fridge revolutionizing vaccine care

    The benefits – adherence

    “We place sensors in the packaging of medicines,” said Roemers. “These monitor temperatures and also the times when the package is opened/the patient likely taking their medicine.

    “We connect the patients’ medicine fridge and the sensors in the packaging to our back-office. The hospitals get exception reports and an overview of their patients and whether they appear to be taking medicines at the times and frequencies prescribed.

    “The pharmacist gets alarms when the storage temperature of sensitive medicines looks like it will exceed set guidelines.  The patient has an app on his/her smart phone to support prescription adherence and check the temperature of their medications.”

    Roemers – who lists a “pharma giant on the New York Stock Exchange’ and hospitals in Netherlands, Belgium and England as being customers – says that monitoring the quality of medication has typically been an onerous task. Equipment can be expensive and inaccurate, whilst there are concerns over temperature control and criminality (stolen or forfeited packages are a continuous worry for the industry.)

    AntTail claims to have, in one case, helped one pharma client reduce out-of-range exposures for medicines to just 1 percent – case studies Roemers thinks will become more commonplace as data analytics becomes more affordable.

    “Certainly the cost of gathering data has gone down,” said Roemers. “The new economics of data gathering, processing and analysis makes it affordable for businesses and individuals to make use of ever-more granular and timely data to manage processes more effectively and make better decisions.

    “At AntTail, the IoT allows us to support the pharmaceutical industry, pharmacies and patients and ensure medicine quality. Our service monitors medicine origin, location and temperature throughout the supply chain, particularly the ‘last mile’ from the pharmacy to the patient’s home. It also helps patients adhere to their prescriptions and can help doctors monitor that adherence.”

    App development

    AntTail has long been collecting the data, but the IoT application is key as it provides an interface of what’s happening.

    Mark Roemers
    Mark Roemers

    Critically, Roemers built the app himself, armed with his expertise in pharmaceutical supply chains, his business idea and Mendix’s ‘rapid application’ development tool.

    Roemers says he last coded over a decade ago but, with Mendix, he can draw a workflow chart and drop into it various pre-built components from a Mendix library, test and adapt until he had what he and his users needed. As well as making it easier to build apps quickly, the solution allows AntTail to speedily add and adapt services to meet users’ evolving needs.

    Roemers says it’s been quick to develop apps, and a major change from the traditional Waterfall IT development model. It is now “sensor to service”.

    “[The] time-to-delivery of applications is shorted from months to days. Adapting applications based on user-feedback is fast and consistent,” says Roemers, who further stresses the importance of users being able to see the prototype of the app.

    “We can develop apps iteratively and in close collaboration with AntTail service users – from a foggy notion of what’s needed towards a precise solution that solves a need.”

    App development could further be simplified too; a newer AntTail service built into the Smartt App allow authorized users (such as a patient’s doctor) to track when a patient has opened and thus likely taken their medication. If a patient appears to have missed a dose, they can be reminded through another new service now built into the app.

    In an interview with IoB earlier this year, Mendix CTO Johan den Haan said he foresees a time that these ‘smart’ apps can make the change, rather than the users themselves.

    “They are context aware, intelligent, process all the data and do something meaningful with that – they’re proactive. So instead of the user going to the app for information, the app can go to the user with push notifications or maybe even chat bots,” he told us in June, further indicating that how such apps are being used by other companies like airline KLM to drive business efficiency.

    So, is IoT pharma adoption growing?

    For all of this, Roemers admit that IoT, while big in the supply chain world, is still in its infancy with most pharmaceutical companies, even if there are examples of useful smart fridges emerging for vaccine care.

    “IoT adoption is not yet widespread in the pharma world, though some firms are running trial projects. The pharmaceutical industry relies heavily on trusted but big centralized legacy systems. It’s often very old school.”

    Related: IBM using Internet of Things, cloud and AI to fight the Zika virus

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