Cool Technology for Pharmacy – Vestigo

Vestigo is web-based Investigational Drug Service (IDS) software made by the McCreadie Group, Inc., a privately held pharmacy software company out of Ann Arbor, Michigan. The McCredie Group is a small boutique company that builds software for niche markets like IDS.

I’ve worked in pharmacies that have an IDS, and let me just say that there’s a lot of record keeping involved and attention to detail is important. One would think that the “the drug” would be the most important thing, but that’s not really the case. Records, logs, and traceability are key.

Anyway, one of the products offered by the McCreadie Group is Vestigo. I’ve come across the product in pharmacies while traveling, but never really given it much attention. Because it’s such a niche product I couldn’t even tell you who they’re competing against.

Don’t go Googling for information on Vestigo, because you’re probably not going to find much. The company has done a pretty good job of not marketing their product and keeping relevant information off the internet. Not sure how that’s possible in this day and age, but I wasn’t able to find more than some old reference articles and press releases.

I have verified with the company that they will be at the 50th ASHP Midyear Clinical Meeting and Exhibition in New Orleans in early December. I’m interested enough in the product to drop by their booth and have a look. Until then, here’s what the McCreadie Group site has to say about Vestigo:

Vestigo increases IDS safety and compliance…

  • Protocols structured in a logical and safe manner
  • Product selection limited to drugs used for the current protocol
  • Automated checks for expired products and IRB approvals
  • Patient management functions prevent dispensing to patients not enrolled
  • Accurate, electronic drug accountability records
  • High-quality, safe labels with barcodes
  • Built-in workflow for safe practices
  • Logging and audit trails required for HIPAA and 21 CFR Part 11 compliance

…and improves IDS efficiency and reduces costs

  • Electronic protocol managementFully automated protocol billing (increases revenue and reduces the cost of generating the bill
  • Electronic inventory management including tracking patient-specific items, returns and destructions
  • Reduced paperwork and handwriting
  • Integrated dispensing with automatic label generation
  • Extensive reporting to track operations, workload and financials

So if you’re in the market for an IDS solution, you might give Vestigo a look and request a demo.

Medication non-adherence, is more technology the proper response?

EMR & EHR: “Of all the things that irrationally inflate health costs, one of the top concerns is people who just don’t take their prescribed medications. Medication adherence doesn’t sound like a high-tech issue, but a lot of interesting technologies are being thrown at the problem…. At the recent Connected Health Conference I talked to several companies taking on the difficult adherence problem from different angles. Medisafe aids patients in self-monitoring, Insightfil creates convenient packaging that groups pills the ways patients take them, and Dose doles out medication at prescribed times.”  – The author goes on to describe some of the technology. The content is worth a few minutes of your time.

Here’s the thing, technology may not be the solution.


There’s no question that medication adherence is a problem. How big is the problem? Well, according to an article in The American Journal of Medicine, 28% of new prescriptions never get filled, and among patients who do fill their prescriptions,  adherence rates are less than 50%. The New England Healthcare Institute NEHI in 2009 [PDF] estimated that the cost of non-adherence was about $290 billion annually. It’s probably well over $300 billion now, but the number I see in most presentations is $290 billion. Hey, it’s a good, scary number.

Medication adherence, or non-adherence as the case may be, not only complicates things for patients but for the entire healthcare system.

The problem is well defined, i.e. people aren’t taking their medications properly, but the solution has eluded healthcare for a long time. That’s likely because the reasons for non-adherence vary widely and have been debated and discussed as long as I’ve been a pharmacist. Have we made progress? It’s hard to say. I suppose it all depends on your definition of progress. We have lots of medication adherence tools at our disposal; reminder systems, mobile applications, smart medication organizers, alert systems for medication bottles, and so on. I suppose that could be considered progress.

All these toys have a place in medication adherence, but the fundamental problem goes well beyond their scope. Medication adherence is a multi-faceted problem with roots in psychological behavior, socioeconomic background, and demographics.

However, one thing that people seem to overlook is that the contact point for most patients and their medications is a pharmacist. According to a recent report published by the National Community Pharmacy Association (NCPA), “the biggest predictor of medication adherence was patients’ personal connection (or lack thereof) with a pharmacist or pharmacy staff.”

A patient’s introduction to medication use should begin by developing a relationship with a pharmacist at the point of care, whether that’s a hospital or a community pharmacy. In hospitals, patients should speak with a pharmacist upon admission, and again upon discharge. No patient should ever leave the hospital without speaking to a pharmacist or without medications in hand.

This is an oft-overlooked opportunity within healthcare systems. For hospitals that don’t have the resources to speak with every incoming and outgoing patient, look to your local community pharmacies. Find community pharmacies in the area that are willing to partner with the healthcare system to provide bedside medication delivery and consultation, thus beginning the process of building a working relationship between patient and pharmacist. As the patient moves from the hospital back into their daily routine, the relationship with their pharmacist will continue to grow. The payoffs are huge, especially for those patients with chronic diseases like diabetes, asthma, hypertension, hypercholesterolemia, and so on.

Not all patients are willing or able to be compliant, but some are, and those are the ones we hope to reach. Using a cost for non-adherence of $300 billion annually, a conservative positive impact of 10% could add up to more than #30 billion a year in savings, not to mention the positive impact on a patient’s quality of life.

Bottom line, get a pharmacist involved early and often. Medication adherence, it’s what we do.