This interview was originally featured on HIStalk.
Josh Stein is founder and CEO of AdhereTech of New York, NY.
Tell me about yourself and the company.
I graduated from Washington University in St. Louis in 2006 with degrees in economics and finance. Long story short, instead of going into finance, I decided to enter into the world of startups. I worked for various early-stage consumer and tech companies for four years, then in 2010 I began my MBA studies at Wharton. I graduated from Wharton in 2012. AdhereTech is a company that I founded while I while I was an MBA student.
What were the other startups? Were they related to AdhereTech?
The other relatively well-known companies that I worked for were FreshDirect, PlaceVine, and Lot18. None of these startups were healthcare related. This is my first time in healthcare.
How did you get into the medication adherence business?
Both of my parents are in healthcare. My dad is a doctor and my mom is an occupational therapist. Years ago I asked them about the biggest problems in healthcare. That’s when they opened my eyes to issues of medication non-adherence.
In response, I came up with the idea of a pill bottle with a timer on top – very simple. That sat in my list of business ideas for about a year until I started business school. In business school we did these activities called innovation tournaments, where everyone in a class submits an idea into a big list. The ideas on said list are then voted on in a crowd-sourced, bracket-style tournament. Thankfully, my idea for the timer cap did pretty well.
Then I thought, let me do a deep dive and see if this is a viable idea. I saw that other smart pill bottles, so I basically designed AdhereTech around the perceived downfalls of existing products. I wrote a business plan and worked with the University of Alabama – Huntsville to build a working prototype. By the time I graduated in 2012, we had all that in place, and I recruited an incredible team.
Then I joined Blueprint Health, a healthcare accelerator program in New York, which is absolutely fantastic. After many months of hard work, we built a working prototype, won some competitions, lined up some trials, and put the pieces in place for potential partnerships. We have a really solid team, great advisors, and promising opportunities lined up in the coming months.
What does AdhereTech’s pill bottle do that the rest don’t?
There are three main differences between AdhereTech’s bottle and most similar products in the space. First is usability. AdhereTech has a wireless chip that automatically connects to the cloud and allows the product to be used anywhere, whereas most others use a hub model that requires user setup and restricts usage to a certain radius around the hub. Second is accuracy. AdhereTech measures the open and close of the cap plus the contents, whereas some others only measure whether a device was used. Third is access. AdhereTech is using a HIPAA-compliant open API, whereas some others utilize a closed system.
During the optimal dosage time, the bottle pulses blue. That’s the time the patient should take the pill. If a dose is missed, the bottle flashes red and beeps. At the same time, the patient will get a phone call or text message.
What happens if you don’t pick up the phone?
We’re still designing that system, but it will call you every X minutes. That would vary based on the disease and the patient’s preferences. This is fully configurable.
More of the diseases that we’re targeting, such as HIV/AIDS or cancer, demand immediate notifications to ensure adherence, especially when compared to something like hypertension. However, we have to make sure not to upset the patient. We don’t want this to be something that annoys people, so we’re very cognizant of that issue.
There are different pill shapes and sizes and some are square, some are rectangle, some are capsules. How does your technology work?
The bottle transmits two pieces of data to the cloud and this data is sent whenever the bottle is opened or closed. First, it sends a timestamp of the open and close of the cap. Secondly, the bottle also has a patented capacitance sensor built inside which sends a capacitance measurement of the contents. This allows AdhereTech to track the number of remaining pills at any given time and determine how many pills were removed.
Our server then compares this information – how many pills a patient took and when he/she took them – to the patient’s recommended dosage schedule. If a discrepancy is identified, such as missing a dosage or incorrect dosage consumption, our automated system will then intervene via a phone call or text message.
What’s your distribution model going to look like?
We haven’t finalized our distribution model, but we have a few options, and these vary depending on the exact business model that we pursue. Our ideal business and distribution model is to integrate with drug manufacturers and pharmacies so they can do all of the setup for the patient. Additionally, we could also send the bottle straight to the patient, but this would require the user to set up the bottle. We want to avoid that because it requires the patient to do something even if it’s as simple as pouring the pills in. Bottles could also be given to patients as they are discharged from the hospital.
How about FDA approval?
We need 510(k) approval. We will be a Class I medical device. We’ve already begun the process of engaging with FDA consultants to help us realize what we have to do. There are already reminder devices out there, so we are confident that there is a pathway paved for us.
When will you sell it to the general public?
We’ll be starting trials in the fall with a variety of clinics and hospitals. We’re hoping to start a major trial with a big pharma in early 2014 and release to the general public by late 2014 or early 2015.
Who else is involved in the company? I see two other pictures on the site.
Those are my two co-founders, both of whom are brilliant and great at what they do. John is AdhereTech’s CTO. He has dual degrees from Yale and joined the team after graduating with his masters in computer science. Mike joined the team a little later, but is undoubtedly a co-founder. He has an undergrad from Bucknell and a master’s from Ohio State, both in mechanical engineering. Mike spent the past three years designing jet engine parts at GE and overseeing certain aspects in manufacturing process. I couldn’t have found two smarter, harder-working professionals to work with.
Where are you located?
We work at the Blueprint Health offices in Soho in New York City. The Blueprint Accelerator program was incredible. I can’t say enough fantastic things about it. Now we’re also part of a new accelerator called Startup Health.