ATU579 – Dose Health with Alaina Gallagher

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Alaina Gallagher:
Hi, this is Alaina Gallagher, and I’m the CRO of Dose Health. And this is your Assistive Technology Update.

Josh Anderson:
Hello, and welcome to your Assistive Technology Update, a weekly dose of information that keeps you up to date on the latest developments in the field of technology designed to assist individuals with disabilities and special needs. I’m your host, Josh Anderson, with the NDATA Project at Easterseals Crossroads in beautiful Indianapolis, Indiana. Welcome to Episode 579 of Assistive Technology Update. It’s scheduled to be released on July 1, 2022. On today’s show, we’re super excited to welcome Alaina Gallagher from Dose Health. So let’s go ahead and get on with the show. Listeners, our guest today is Alaina Gallagher, and she’s the CRO for Dose Health. She’s been nice enough to come on the show and tell us all about some of the solutions that they have available for dispensing medications, medical alerts, and some other great things to help folks out. Alaina, welcome to the show.

Alaina Gallagher:
Thank you. I’m very excited to be here.

Josh Anderson:
I’m excited to have you on. I’m excited to learn all about Dose Health. But before we do that, could you tell our listeners a little bit about yourself?

Alaina Gallagher:
Yeah, absolutely. So as you said, my name is Alaina Gallagher. I have been working in the assisted technology space since I started with Dose back in 2016. I have, in that timeframe, developed quite the passion and love for assistive technology, just seeing how much it can truly impact individuals’ lives and all of the amazing outcomes that come along with that. And actually, outside of Dose Health, I am involved in networking and education in an assistive technology group in Minnesota called Minnesota-NEAT, Wisconsin Tech First Coalition, and other fun things, just really pushing the word out there about assisted technology as a whole and getting people as excited about it as I am.

Josh Anderson:
Well, awesome. I love that we definitely share that passion. And I know when I started in assistive technology, I couldn’t get enough information either, just had to learn more and more and more and more.

Alaina Gallagher:
Gobble it all up.

Josh Anderson:
Exactly. And there’s so much of it, and it’s continuous and constantly changing too. The real reason we had you on the show is, let’s start off by just kind of an overview of what is Dose Health?

Alaina Gallagher:
Excellent question. So Dose Health, we are obviously an assistive technology provider, and initially, we were founded to focus on medication management. As I’m sure a lot of you all are familiar with, it’s kind of called a hidden epidemic of medication mismanagement resulting in unnecessary hospitalizations and unnecessary deaths, along with re-homing people, people having to move to more assisted care or higher staffing needs and all of that. So when we started the company, it was really with the goal to help give people tools to be able to stay on track with their medication, but not just in the normal sense of here is an alarmed pill box, good luck.

Alaina Gallagher:
It also was something we wanted to fit into their lives, something that could allow them to live as normal of a life as possible. One of the things that we always hear from people is, “Remembering to take medications is hard because we’re living life. We’re getting distracted, we’re doing things, we’re going out to eat, we’re talking with friends, and just that takes over our brains, or whatever it is.” So something that was small, portable, people can bring it with them so they can go out in the community. They can go to work. It’s not something that they feel stuck at home waiting around to take medications because it’s like a big machine or something along those lines.

Alaina Gallagher:
So that was really the big focus, but then also in the background, the ability to tie in caregivers and loved ones, to be able to be part of that kind of care with medication management. And that stemmed from some personal experiences with our CEO, watching his grandmother, unfortunately, near the end of her life, go through that with her medications, and then ultimately having to be moved into the senior living center, which she was really not happy about, but then also the impact that that had on his aunt as her caregiver. And the regrets that she expressed afterwards about the role really changes. You’re no longer just the daughter. You’re the person who’s harassing them to take their medication, and they’re getting angry at you. You’re getting angry at them. So we wanted to be able to also offer something to caregivers that said, “Hey look, you can be involved. You can be informed about what’s going on, but you don’t have to be the bad guy.” And as I always like to put it, you don’t have to be driving the car. You can be sitting in the back seat, still observing.

Alaina Gallagher:
So that’s kind of where we came from and what grew out this beautiful company, really focused on individual care and getting the best support for med management that we possibly can. So yeah, that’s my overview, I guess.

Josh Anderson:
Perfect, perfect, perfect. No, and you brought up some really great points. And you led me straight into my next question, because I know you do have some different kind of solutions available. Start us off by telling us about your smart pill box, the Dose Flip.

Alaina Gallagher:
Yeah, so the Dose Flip is that prime product that we developed. And so it is invented and processed and all of that by Dose Health. What it is, it’s just basically an automated medication dispenser that people can use. It’s about the size of a bagel, I think. That’s a much better description than the one I used to give, which was a squished grapefruit, and people just did not know what I was talking about, but the idea really is that it’s set to an individual’s medication schedule. So at their scheduled med time, when they’re supposed to be taking their meds, the device itself is not only reminding them by it can sound alarms, it can flash light, it can also call or text them.

Alaina Gallagher:
So it’s really fitting into the way somebody wants to be reminded to take their meds, but it’s also ensuring that it’s only opening up to the compartment for the medications for that specific med time and that day of the week, so that there isn’t that potential confusion that can sometimes come about from those standard plastic pill boxes, where “Hey, it’s really great my meds are organized, but I might get confused and not know if I took them already today,” or “Is today Tuesday or Wednesday. Because I’ve been so busy and overwhelmed, I don’t actually know what day it is and which meds I should be taking,” things like that. So it’s ensuring they’re taking the right meds at the right time, essentially.

Alaina Gallagher:
Then what it does in the background is it can generate out those live notifications and alerts to family members or caregivers, or the individual themselves, we do that all the time, to inform them about what’s happening, things like “Hey, it’s been 30, 60 or 90 minutes and you haven’t taken your pills yet,” or medications were missed, or even down to potential tampering with the meds, things for safety and security, along those routes, to make sure if there are risks, that person should not have access to their pills. It can be locked. But kind of that secondary check to say, “Hey, somebody got past the lock. Now you need to know that they’re getting into the device.” And that’s just because we’ve worked with enough people to know that if there is that concern for medication abuse, it’s really, really good to have safety nets.

Josh Anderson:
Oh, definitely. Definitely. Well, and I know that safety’s not just for the individual, but it could be someone else living in the home or all other kinds of things. I love that you kind of mentioned… My next question was going to be can it alert family and friends, but it sounds like it can definitely do that. Is it customizable for folks? I know some folks have to take a lot of pills in the morning, some in the afternoon. Can it do more than once a day? Is it pretty customizable for different kinds of needs?

Alaina Gallagher:
Yeah. I’m really happy that you asked that. So one of our focuses at Dose is we just truly don’t believe there’s any such thing as a one size fits all service. So as the service provider, it’s our job to fit to the individual’s needs rather than the other way around. So we do try to really kind of talk and figure out what the setups should look like. If we’ve got adaptive equipment things, like if picking up and flipping the pill box over is not going to work for an individual, we’ve got an adaptive flipping device that can dump it out into a med cup.We’ve got extra trays and filling discs that help them set up and fill medications for if they’re self-filling their meds or family members or nurses or pharmacies even want to be able to fill the medications in a cleaner way. So we do try to kind of personalize it down to that individual level.

Alaina Gallagher:
Like I mentioned, things like the alarms or the flashing light, they can be adjusted. The flashing light can be turned off if there are seizure concerns, for example, or alarm volumes can be turned up, down or completely off. And then we can supplement in with those phone calls or those text message reminders, really, again, trying to meet the individual. Now, to your question about if somebody takes a lot of medications, you kind of mentioned that, we do have different tray sizes. We’ve got our standard tray, is 14 compartments, so it holds medications for one or two times per day for a week or two weeks at a time. But since we work with a lot of folks that do meds three or four times per day, we actually do two device setups. And our policy is that we do not charge if somebody needs a second device to accommodate that. So that way they can still be filled for that weekly refilling schedule and get into that… Like, on Fridays at 2:00 PM is when I fill my meds.

Alaina Gallagher:
So we do the two device setup. And along those lines with the 14 compartment trays, I always like to say, for a little guy, they pack a punch, because they can hold quite a few pills. A good example would be if you think of a standard ibuprofen size tab, it holds about 22 of those, or if you think about the biggest fish oils we could find on the market, it holds four of those. But I always tell people, gel caps, they can get sticky, so I recommend three at maximum for those, and then throw some other pills in there. But we do have seven compartment trays too, that then double that capacity even. So for people who do take a lot of medications, we do have other options to be able to accommodate that need.

Josh Anderson:
And that’s awesome, because I know that’s an issue a lot of folks run into is, I have the Sunday through Saturday thing, or whatever the old school one is, but I just keep one pill in S and one in M, and I just remember what I do because they’re so big or so small, or they don’t fit right, or kind of other things, so I’m glad that you gave all that different customization. And tell us just a little bit more, because you kind of glazed over it, but I want to make sure we talk about it, about the adaptive flipper, just because, in doing some research for it, I thought that was something really cool that you guys thought of. So just talk just a little bit more about that, if you could.

Alaina Gallagher:
Absolutely, and I actually have a pretty fun story for how that was developed. So you might hear me say today that we’ve got a lot of mottoes, because we do at Dose, and one of our biggest ones is, “We don’t know what we don’t know, so tell us.” And the idea behind that is, and it actually stems from this adaptive flipper, we are a team of people that, we think what we think and we know what we know. And so if somebody doesn’t think, oh, picking up and flipping the device on your own can be hard, then we’re not going to just generate that idea on our own. So it was really, really incredible. We were working with a team in Minnesota for an individual who was living in a four-bed adult foster home setting, and he really wanted to be able to manage his own medications. That was his goal. They looked into it.

Alaina Gallagher:
They kind of landed on Dose Health for the solution for him, and he got set up with our device. A couple weeks later I got a call from his caregiving team, and she was the supervisor of the home, she said, “Hey Alaina, so we’re kind of running into an issue. Essentially, this individual can focus on one arm at a time. And he’s very focused on flipping his device over to dump his pills out, but then not necessarily focused on his hands to cup it and catch the pills, so we’re…” Understandably, staff were a little nervous about the pills rolling on the floor, things like that. So she said, “I have a really funny question to ask you. Do you have something like a Bingo cage or something else that we can put the device in so you can crank it over and dump those pills out?” And so while we call that the adaptive flipper, I still refer to it as the Bingo cage, because I just absolutely love that story, and it developed this adaptive flipper.

Alaina Gallagher:
Basically, the device can sit in, or that conversation led to us developing the adaptive flipper, where it sits the device in this kind of swivel point where it can be pushed over. It doesn’t have to be done with a hand. We have some people who use their elbows, or even their heads or shoulders if they don’t have that limb functioning or control. And so the idea is to be able to knock the device over, and then that swivel actually has a med cup underneath it. That med cup is in place and ready to catch those pills if needed. The other cool thing is we can even adapt our adaptive equipment. Like I said, we like to meet individuals where they’re at and work with them. So we’ve made adapted med cups with handles and [inaudible 00:13:03] and weighting all of that to just make it easier and more flexible to meet the individual’s needs, even after those pills are dispensed from the machine. So yeah, that’s the story of the adaptive flipper.

Alaina Gallagher:
And I think the most incredible thing from that is, while initially that change was made for one person, what I always encourage people and teams when I’m talking with them is don’t be afraid to give us feedback. Don’t hesitate, because even if it seems like we’re making a change for this one person, or for you, if you’re the person talking to me and saying this is what I need, oftentimes, it’s something that we didn’t realize we were even missing, right? And now, it opens up accessibility to so many more people. And that’s our big goal. Accessibility is so, so, so incredibly important, and we never want to unintentionally prevent somebody access to our services who can really benefit from it, because we didn’t think about the solution that would help them already. So that’s where that feedback is so crucial for us to be able to support everybody that we want to.

Josh Anderson:
Oh, yeah. And you brought up some great things. Anyone that we ever work with, if it’s a company and organization, something that they’re using, and they’re like, “I wish I could do this,” I’m always like, let them know. They don’t know.

Alaina Gallagher:
Yeah.

Josh Anderson:
Like you said, you don’t know what you don’t know. And unless you really talk about that accessibility and that issue that you have accessing their device, their service, whatever it is, they’re not going to know any different. We all kind of live in the world of disability and accommodations and things, so maybe these things are front of mind. But for other companies, they don’t know if they’ve never encountered somebody with that need. So that’s great that it actually came out of that. And also, thank you for this mental picture I have of a bingo cage of pills, of just what sounds like the worst handing out of medication, just “Who gets this pill? Who gets this pill?”

Alaina Gallagher:
Which one are you going to get?

Josh Anderson:
But no, Thank you so much for that mental picture I definitely have. And we kind of talked about individuals and using the Dose Flip and everything, but I could see where this could probably be really beneficial to the facilities and things, and really kind of medication management. Do you guys have kind of a system for them, or is it just kind of the same kind of process of getting the Dose Flip? How does it work for kind of facilities, and I guess managed care kind of places?

Alaina Gallagher:
Yeah. Excellent question. We do work with facilities and kind of that managed care type setting. And it is a little different, because we’re now looking at supporting individuals, and multiple of them at the same time, right? So you have to make sure that there’s differentiation between devices, differentiation between if they’re filling multiple trays at a time, to do a couple of weeks worth of meds, all of that. So we actually have a team specifically dedicated to residential services, to be able to support and provide ongoing training. Another thing with that is you’ve got more people interacting with the device than you do when you’re just looking at an individual using the service on their own. So also with, unfortunately, the caregiving crisis and staff turnover being high, having some availability in a team to do continued education with new team members and being available to make sure every single person is comfortable, who’s going to be interacting with that device, and know how to use it.

Alaina Gallagher:
So while the device is still kind of the same, it’s just the processes around using the device and training the teams and working with the individual with goals and all of that and how to meet those goals. But it’s been… I think probably one of my favorite things with Dose is actually when we moved into doing more of that kind of residential supported living space, because I think unfortunately, sometimes people get set up with staff, and then it becomes that staff do everything for them. And so, yeah. And so that sense of autonomy, that sense of control and independence, it kind of gets slowly washed away. It’s eroding over time of like, “Well, I mean, I guess my staff will do this for me, or I guess somebody else will do this for me.” Or even in the opposite sense, sometimes it’s kind of forced on people of, “No, your staff are going to do this for you.” So one of the things that I’ve really, really loved in seeing this is building that independence back and giving that person back control in their life.

Alaina Gallagher:
And I’m sure you guys say this or hear this all the time, but once you start with one piece of technology and that person can see how much of a difference it makes in giving them that control back, it’s just so incredible to see all of the additional outcomes that are maybe unexpected. We are a med med dispensing system, right? So we’re coming in, we’re helping them with their meds. And now, suddenly we had a story of somebody problem solving, right? It turned into them… They liked that control, they liked that independence so much that when an issue came up, they wanted to sit down with their team and now figure out how to solve this issue. And that was something that was unexpected. And I just, I love that so much. It bleeds into a sense of self worth and control. There’s a dignity in risk, in saying, “I trust you to be able to do this on your own. We’ve got some safety nets in place because safety is obviously important, but I’m giving you control and trust you to do that.”

Alaina Gallagher:
And it’s just, yeah, it’s absolutely incredible. They’re also kind of the unintended, but beautiful, beautiful outcomes as well, and it benefits staff. We’re very fortunate that one of the residential providers that we worked with in Minnesota decided to do a case study actually around using our device. And so, yeah, they were comparing some key factors from before the devices was implemented into five homes versus after, and how the device had impacted it. And the key takeaways that they were looking for was reduction in medication errors, reduction in staff time spent passing meds, general staff happiness, and then obviously individual involvement. And the takeaways were incredible. They had over 50% reduction in med errors in all of their homes. They had, and this one really blew us away, a 75% reduction in staff time spent passing meds.

Josh Anderson:
Oh wow.

Alaina Gallagher:
They averaged out three to four extra hours every day that they gained back in staff time in every single one of their homes. So we were talking about having staffing issues and not having people available. Three to four hours every day in each home, that’s pretty incredible for what you can do at that time and filling gaps and everything. And then staff reported that they were happier, that they just generally felt less stressed, because med passing is one of the most stressful parts of the job. I was a direct support professional when I was younger, and I can confirm. You are doing a thousand things at one time, right? You’re focused on this incredibly crucial task of making sure that you’ve got the correct meds, the correct person, all your seven rights, right?

Alaina Gallagher:
And you’re also making sure that this person isn’t falling down, or this person might have to go to the bathroom, so you’re getting interrupted and you’re doing that. Or, you’re maybe assisting this person getting ready to go out the door to work. Whatever it is that’s coming up, it’s just a lot for staff to take on. And it’s so, so… Safety checks, all of that are so important that, of course, it’s going to cause stress. So that kind of self-reported staff happiness is one of the things that we were most excited about because really being able to do that hopefully will prevent staff turnover, and them feeling supported and happier in their jobs.

Josh Anderson:
Oh, definitely. Yeah. It takes less staff to kind of do. So if you are short staffed… But also kind of, I think you talked a little bit earlier about just kind of piling new things on and having to do more and more stuff, taking one of those things back, or at least making it a whole lot easier, as well as safer probably really helps with that staff turnover and losing the good folks.

Alaina Gallagher:
Mm-hmm. Absolutely.

Josh Anderson:
I also want to talk about… You have a few other things kind of available. And while we have a little bit of time left, I wanted to at least be able to kind of touch on them. You also have the Dose, and is it the PERS and the PERS plus.

Alaina Gallagher:
Yeah. And we call them the Dose PERS [inaudible 00:21:26]

Josh Anderson:
PERS. Thank you. I wasn’t a hundred percent sure, so I figured better spell it out for the listeners. But yeah, so what are they?

Alaina Gallagher:
So actually, it’s a good thing you spelled it out, because what it stands for is personal emergency response system.

Josh Anderson:
Nice.

Alaina Gallagher:
So if you think about… I think where most of us go, is the, “Help, I fall in and I can’t get up” button. It’s obviously the much more advanced version of those nowadays. So what they are is, it’s a button that somebody can press if they need assistance. And the cool thing with that is our devices are fully portable. They’re cellular enabled. So the idea is that somebody kind of, again, with what we did with our medication dispenser, the idea that they don’t have to stay at home. It’s not a base station that they have to be within X amount of feet around be to be able to press the button and communicate what’s going on. It’s something that has that cellular chip built into it, has the microphone and speaker directly on the device. So when they press that button, they can have a two-way conversation with the twenty four seven call center to explain what’s going on.

Alaina Gallagher:
We can also set caregivers up on their account that then the call center can reach out to first instead of sending emergency services. But then there’s also that safety net that if somebody’s not available, we can send emergency services out, right? They’re always going to talk to somebody, and then get help if needed. So it’s really that safety piece and ensuring that somebody can get assistance. And it doesn’t have to be a dire emergency. That’s one of the things that we stress to people is… I think there’s a lot of fear around that technology from what we’ve heard when we’ve talked to individuals who are considering using it, that, “I’m going to press this button, and a firetruck and ambulance and the police car are going to show up in my location.”

Alaina Gallagher:
The technology has come so far with allowing those two-way conversations so that you, as the individual who pressed the button, and that call center team who is trained, can communicate and decide what the best course of action is going to be. Maybe it’s sometimes just that people got nervous or scared, or they had a fall, and they just want to make sure somebody is on the line with them in case they can’t get up, or in case something goes wrong. And then nothing goes wrong, cool, we say goodbye, and we’re done. So that’s kind of the idea with this technology.

Josh Anderson:
Excellent. And what’s the difference between the PERS and the PERS plus?

Alaina Gallagher:
Oh, I’m glad you asked that. Yes. So the PERS is kind of the standard basic device where you press the button, have the communication, all of that. The PERS plus has additional automatic fall detection and GPS tracking.

Josh Anderson:
Oh, okay.

Alaina Gallagher:
So then obviously if somebody has a fall, they’re not able to press that button, it can get them the help that they need. And then the GPS tracking too, if there are elopement concerns or anything like that, it can track down… Although I always stress to people, with this technology, similar to any technology for elopement, the person actually has to be wearing the device in order to track them down. So if people are looking for elopement technology in and of itself, there’s probably better elopement only technology that exists out there where this has that dual functioning of being able to provide the emergency response services that are needed and that GPS tracking then as well. Plus, fall detection is always nice.

Josh Anderson:
Oh yes, yes. No, that is always really nice. Well, you guys have some great things, and there’s so much more that we could probably talk about, but I know we’ll end up running out of time. So if our listeners want to find out more about Dose Health and the solutions that you all have, what’s the best way for them to do that?

Alaina Gallagher:
Yeah. A couple of options. So you can go to our website, which is dosehealth.com. And we’re spelled like a medication, dose, not the number two in Spanish. So it’s D as in David, O, S as in Sam, E as in Edward, H, E as in Edward, A, L, T as in Tom H.com. So dosehealth.com, you can also call us directly. Our main number is (844) 300-6212. Again, that’s (844) 300 6212. And another option is by email. You can contact our main email address, which is infodosehealth.com. And then again, that’s D-O-S-E-H-E-A-L-T-H.com.

Josh Anderson:
And we will put links to all that information down in the show notes. Well, thank you so much for coming on today and telling us about all the great things that Dose Health has to offer for folks.

Alaina Gallagher:
Absolutely. Thank you so much for having me. I think it’s really incredible that you all are listening to this and engaging in these conversations. And we’re happy to provide any assistance that we can, so feel free to reach out anytime.

Josh Anderson:
Do you have a question about assistive technology? Do you have a suggestion for someone we should interview on an assistive technology update? If so, call our listener line at (317) 721-7124. Send us an email at tech at eastersealscrossroads.org, or shoot us a note on Twitter @indataproject. Our captions and transcripts for the show are sponsored by the Indiana Telephone Relay Access Corporation or InTRAC. You can find out more about in track at relayindiana.com. A special thanks to Nicole Prieto for scheduling our amazing guests and making a mess of my schedule. Today’s show was produced, edited, hosted, and fraught over by yours truly. The opinions expressed by our guests are their own and may or may not reflect those of the INDATA Project, Easterseals Crossroads, our supporting partners, or this host. This was your assistive technology update, and I’m Josh Anderson with the INDATA Project at Easterseals Crossroads in beautiful Indianapolis, Indiana. We look forward to seeing you next time.