Nathan Sigworth was a freshman in college when he spent a month visiting a small hospital in India, and made a simple discovery: economics there dictated a very different delivery of health care than he was used to seeing. In time, he discovered that while the first stop for a sick person here might be a doctor, clinic, or emergency room, the first stop for patients there frequently was the neighborhood pharmacy.
In effect, he said, “pharmacists are often the general practitioners.”
While it is a health care answer to the obstacles of long distances to clinics or doctors, it is a solution with its own costs, of accurate information and communication, as well as control over the quality of the medicine that is disbursed. While what he saw led him to research the problem of counterfeit drugs, it also led him to recognize an opportunity to communicate with patients at “their moment of need,” an opportunity he felt was not being grasped.
“We’ve gotten very good at distributing medicine,” he told Science Speaks, “but not very good at distributing healthcare and information about medicine.”
Using cell phone technology to link patients with health care information was not a new idea. But, as Sigworth puts it, “Using the infrastructure of the pharmacy, the place people go when they sick,” seemed to offer unique promise.
At the same time, efforts to track and trace medicines in developing countries to ensure their authenticity also was not new — but it was challenging and expensive.
Bringing the two efforts together was a natural solution, that met good timing, the way Sigworth tells it. While printing manufacturers in India were developing capacities that allowed them to add unique identifiers to pharmaceutical packaging more economically, cell phone use was proliferating there.
He started PharmaSecure in 2007 with a Dartmouth classmate, and returned to India where he persuaded the first drug maker to sign on. The basic idea was straightforward: put a unique identifier on a package of medicine that the customer could then validate over a cell phone or landline — by texting the code, speaking it, even by making a “missed call” that would then be returned, allowing the customer to economize phone fees or “talk time.”
“You have to go to the lowest common denominator in technology,” he said.
The possibilities that even the lowest common denominator in technology offers, to hear him tell it, is vast. After customers call to verify medicines, he said, they can be given the option of speaking to a healthcare professional.
Currently, 6 percent of patients given that choice have opted to speak with a health care advisor, he said. They also can opt to receive reminders to take the medicines they have called to validate.
In addition, the company can follow up in two months to find out if patients are continuing treatment, and if not, why, and when they stopped. Tuberculosis medicines would be among those for which that information would be critical.
“The potential for longitudinal studies is significant,” Sigworth said. Organizations that provide care can use the system to follow up to help identify obstacles to completing treatment.
“It can really add to what’s already being done and identifying where the real needs are.”
Operating as a for profit business allows demand to drive its product, he says.
“I’m in this because I want to change the way healthcare is delivered,” Sigworth said. “If you can do something as a business, that’s the best way to do it.”
The demand from consumers, once they verify their medicine, will help direct and support other mobile health care responses, he said. “It’s a platform we hope can change the system.”