The patient arrives unconscious in the emergency room as physicians search for clues to the cause for her condition. A quick look in her purse reveals a single light orange oval tablet with ML-P17 imprinted on one side—is it related to her state or unimportant?
Thanks to a new application created by Gov 2.0 superstar David Hale and his team at the National Library of Medicine (NLM), the ER doc can access Pillbox and within moments determine that the pill in question, Doxazosin, is used to treat hypertension and cholesterol. Mystery solved, he can move forward in her treatment.
Earlier this week, we sat down with David and talked to him about how Pillbox came about, how he and his team overcame challenges in its development, and what’s next for him at the NLM.
RCSM: So where did the idea for Pillbox come from? How did you get involved?
DH: Several years ago, my division at the NLM took part in discussions with other organizations involved with medication safety, including the National Capital Poison Control Center and the Department of Veterans Affairs. What came out of those conversations was the common need for a system that would make it easier to identify solid dosage medications. The NLM’s Director, Dr. Donald Lindberg, initiated the creation of a pill image database. At that time, I was exploring connections between histology images and toxicology data, so this project was a good fit.
We knew we wanted to take the concept of pill images and build an online identification resource—but things really started coming together when we moved outside the government and learned how pharmaceutical data is integrated into the lives of individuals and communities. I met professor Michael Wesch from Kansas State University, who introduced me to the concept of digital ethnography and impressed upon me the importance of spending time with your users, learning how they utilize technology to ascribe meaning in their lives. We went from focusing on “features and functionality” to “meaning and value.”
I took that advice to heart and spent time with clinicians, patients, pharmacists, nurses, emergency medical staff, and others learning about the problems they were facing and how they were going about creating solutions. At that time, I was doing a lot of Native American health information outreach, and so I’d take time to go to an ER at a reservation hospital or a local fire station and talk with the staff about what they were doing, what problems they faced when it came to identifying drugs, and what types of tools would be helpful for them.
We also started talking to software developers who focused on health IT and mobile health, to the pharmaceutical industry, and to participants at health and government unconferences, such as Healthcamp. Our question was always the same—will you help us build this?
As a result of these conversations, what we found was that while the need for pill images was substantial, there was a greater problem facing citizens: The existing FDA Structured Product Label (drug labels) dataset wasn’t easily accessible and wasn’t in a form that could be used by those who needed the information. So while we originally set out to create a database of pill images, an engaged community taught us that we need to make federal pharmaceutical data more accessible and a tool they can use to create. We initiated conversations with members of the FDA’s SPL team to share this challenge with them.