Adherence in CertiScan
On their own, smart packages are just a source of unit dose timestamps. Accurate, objective timestamps, but unprocessed nevertheless. It is up to software to interpret these timestamps in order to provide insights.
CertiScan analyzes every dose from a smart package. It will automatically classify each dose into one of several possible categories, and will also produce an overall score and trend information per patient.
Classifying Doses
Patient Has a Corresponding Regimen
If the regimen specifies that a dose should be taken "as needed", CertiScan will classify it as PRN and it will be represented throughout the web portal using a blue color.
When the regimen specifies that a dose should be taken at scheduled times, CertiScan will classify the dose as Adherent if it was taken on time, Early or Late if the dose was taken before or after the scheduled time, or Extra if the dose exceeded the assigned quantity.
Regimen schedules are not single points in time, but rather spans of time or "windows" that provide some tolerance. For example:
Take one "AM dose" between 5:00 am and 12:00 pm, and take one "PM dose" between 12:00 pm and 7:00 pm."
Adherent doses will be represented throughout CertiScan using a green color, Early or Late doses will be represented throughout CertiScan using an amber color, and Extra doses will be represented throughout CertiScan using a red color.
If a patient's scheduled dose time has passed but CertiScan could not find any dose records, it will mark the dose as Missed. Missed doses will be represented throughout CertiScan using a grey color.
Patient DOES NOT Have a Corresponding Regimen
CertiScan will NOT attempt to determine a dose's adherence status if there is no corresponding regimen set up, or if a dose was taken before the regimen start date or after the regimen stop date. Such doses will be classified as Unscheduled and will be represented throughout the web portal using a blue color.
If a smart package was somehow set up with a medication that does not match any corresponding regimen, CertiScan will classify it as an Unrecognized dose and it will be represented thorughout the web potal using a black color.
Patient Scores and Trends
Score-to-Date
CertiScan calculates a score per patient, from the first day of the first regimen until the final day of the final regimen, OR until today (whatever comes first). This score is usually presented alongside a ring graphic.
The score increases when patients take adherent doses, decreases when patients take extra doses, and is unmoved when patients take any other type of dose.
The ring is a graphical representation of the patient's progress-to-date. It is made up of adherent doses, early doses, late doses, and missed doses. CertiScan uses a ring because it is a good visualization of a patient's progress towards taking a certain number of doses.
Extra doses are not included in the ring because these are not necessarily targets that the patient should be aiming to achieve, and are therefore not suitable to include as part of the the patient's proress.
Unscheduled and Unrecognized doses are also not included in the ring because CertiScan does not know if these doses should or should not count towards a patients progress. However if you go on to set up a regimen that encompasses these doses and allows CertiScan to computer their adherence, they will become part of the ring.
Furthermore, the ring does not appear at all for patients on pure PRN regimens for a similar reason: there is not a target number of doses to achieve in a PRN reigmen, and therefore a ring is not a suitable measure of progress.
Trend
A patient's trend will be up if their adherence improved over the course of their treatment period, down if the patient adherence decreased over the course of their treatment period, or unchanged if adherence was relatively steady over the course of their treatment period.
Alerts for Aberrant Use
Certain patterns of aberrant dosing will trigger alerts. Typically this only applies to Med-ic, and the most common aberrant use pattern is a Deblistering, where a patient removes all of their doses at once (typically to transfer them into a ziplock bag for portability).
If there are any alerts for a patient, this will be reprsented prominentlly beside the score using bell icon. Click on this icon to read the alerts.
The patient themself will also receive these alerts on their mobile phone if they are using the app Full Mode.
If patients are using the app in GO Mode, they will not receive any alerts, because GO Mode only presents a simple scan and upload user interface.