An Introduction to The Intelligent Bedside Cabinet

Kinetic-ID recently launched an intelligent bedside cabinet which has garnered a lot of attention in the press, not least the BBC which referenced Kirsty Mair, the mother of a son, Jacob, who has spent the last 16 months in hospital.

“A mother whose son has been in hospital for more than a year has praised trials of a new technology which dispenses medication and has helped her "feel like a mum again".”
Source BBC

So what is the “intelligent bedside cabinet” and why has there been so much interest in it?

In this short article, we sat down with Wayne Miller, a Solutions Consultant at Kinetic-ID, to hear first-hand what it is and why it has been gaining such attention in the UK.

The Intelligent Bedside Cabinet

The intelligent bedside cabinet is a self-contained hardware and software solution that replaces the traditional bedside cabinet, which supports patients to self-administer prescribed medications.

A patient in a hospital or at home can have a prescription loaded into the bedside cabinet, reminding them to take medication when necessary.

The intelligent bedside cabinet captures the patient actions:

When they take that medication i.e. did the patient take the medication in the right dose, on time?
Did the patient miss the medication time?
Did the patient change the dose?
Did the patient delay the time or dose?

It also records this data for clinicians to review later. All this rich data helps reposition what has historically been a dumb bedside cabinet into a smart intelligent solution with a myriad of attractive benefits.

What Problem does it Solve?

A key issue is that patients struggle to understand their medication regime, medications, times and doses.

The ability to issue a reminder is very powerful as the intelligent bedside cabinet reminds patients to take their medication at the right time and the right dose. After all, some patients may be suffering from dementia, others may be simply forgetful, and others may have had an accident and are using brand-new medications for the first time.

Another issue with the current approach is that in the absence of a smart bedside cabinet, a medical professional, often a nurse dispenses the medication for the patient. However when they are then discharged, they are usually sent away with a prescription sheet, and a leaflet that describes what they've got to take. This can be daunting for patients as they are managing their medications without supervision for the first time on discharge from hospital. As a result, there's no monitoring, there's no measurement, and there's no education in the traditional way that medications are administered. Hence, there is no surprise that post discharge problems arise specifically linked to medicine regimes.

In summary, the intelligent bedside cabinet reminds patients to take a certain tablet at a certain dose at a certain time, all of which takes place in the context of the safe surroundings of a hospital allowing that patient to medicate safely and to understand their medicine regime before they're discharged. Once they have proven they understand their medication regime, there is a high likelihood that they keep up the good regime once they get home, which greatly improves patient safety.

Supporting patient education in a safe environment before discharge is the key to better patient outcomes for medication adherence when back at home.

Bringing Intelligent Data to Light

Of course, what is underpinning all of this is that the consequences of forgetting to take medicines can be serious.

Take the example of a patient who has been prescribed an antibiotic or painkiller and is scheduled to take one every four hours. If they miss a dose at the right time, they may then be thinking about what to do:

Do they take two at the next slot or just skip it all together?
Should they call a clinician to find out?
Are there any dangers associated with a double dosage?

Similarly, if you take your medication late, you probably have to push the next dose back four hours to stay on schedule.

If you try to take them early, it might be dangerous to take painkillers early.

“We're all familiar with pressing a button at the bedside to get the attention of the nurse to come over to tell them that you need some more painkillers. Nurses are very busy people working in a stressful environment. Having the medication at bedside readily available to that patient when they want it, also frees up nursing time.”
—Wayne Miller, Kinetic-ID

In short, there can be significant downstream ramifications resulting from poor patient adherence. Part of the benefit of the Intelligent Bedside Cabinet is that the data footprint can help monitor patient activity, so a clinician at any time can go and look at the behavior of the patient.

Are they exhibiting good behavior i.e. taking the right dose at the right time?
Are they taking them late?
Are they taking them in the wrong dose?
Does the behavior indicate a need for intervention i.e. are they making poor decisions regularly like trying to access drugs early?

This data gives indication to the clinicians about patient behavior and any need for further education of the patient, and ultimately, the data from the IBC assists clinicians to judge whether they are likely to be able to self-medicate safely when they leave the hospital.

Additional Benefits

Having an intelligent bedside cabinet brings multiple benefits including:

Medication is stored securely bedside reducing the need for nursing staff to have to source it for each visit (and also reducing the risk of it being mixed up).
Nurses are very busy people operating in a stressful environment. Having the medication at bedside readily available to that patient when they want it, it also frees up nursing time enabling them to focus on areas of more pressing need.
It helps assist with good habit formation with reminders as a trigger also reducing the potential for patients to forget to take their medication.
Helps clinicians measure patients’ behavior (especially relevant for new drug regimes) and the data provided helps assess the patient's capacity to self-administer post-discharge i.e. helping them to decide whether that patient should have supervision or not for medication.
Finally, in parallel, the cabinet can also safely store valuables. By functioning as a secure cabinet, it helps provide ‘peace of mind’ for patients that items like iPhones and tablets can be stored securely while they are away from their beds. Unlike traditional pin code based lockers, the Intelligent bedside cabinet uses an electronic lock so the team never have to look for keys (there are overrides in the event of a power cut, which can only be accessed by clinicians).

Summary