AI and Medication Adherence: Training Tech on Bad Behaviors

Pharmacies and providers are turning to AI to better understand why their patients aren’t following doctors’ orders on their prescriptions.

Like pretty much all of AI, ambient tools are evolving at a rapid pace. A new tool being deployed by specialty pharmacies is pushing that envelope even further – and could lay the groundwork for AI in behavioral health.

Gentry Health Services, an Ohio-based specialty pharmacy, is rolling out a technology platform designed to connect patients with peer support to ensure they follow doctors’ orders on medication management. An AI tool attached to that platform, called OLLIE, is listening to those conversations to look for clues that might help providers with medication adherence.

“With specialty medications, adherence can be very challenging,” says Katie Warmuth, PharmD, CSP, Gentry’s director of specialty pharmacy. That’s why, she says, patients need more support than the directions on the pill bottle or a paper readout.

The deployment marks an intriguing new phase for ambient AI tools, which have been rolled out at an increasingly rapid pace to capture interactions between patients and their doctors, nurses and health plans. The idea behind the technology is to capture and parse the interactions for data that should be entered into the medical record.

With medication management, that tool is being used to identify how patients are following their doctors’ orders on taking medications. This is a particular challenge for patients with complex or chronic conditions, who might be taking several different medications and at different times of the day. Studies indicate less than half of those patients, maybe even as low as 25%, aren’t taking their medications properly, leading to wasted drugs and adverse health outcomes, including hospitalization and death.

Specialty Pharmacies Gain in Value

As of 2023, there are roughly 1,750 specialty pharmacies in the U.S., accounting for just over half of the total drug spend. The specialty pharmacy market was valued at just over $68 billion in 2023 and is expected to increase as the number of people with complex and multiple chronic conditions grows.

A 2015 study by researchers at the Ohio State University Wexner Medical Center suggested that specialty pharmacies would increase in value as the nation’s healthcare landscape evolves. This and the uncertainty around the pharmacy industry are prompting hospitals and health systems to take on these services, either by partnering with existing pharmacies to support their operations or expanding in-hospital pharmacies.

[Also read: Healthcare Leaders Are Redefining the Hospital Pharmacy.]

But that growth is accompanied by a sharper focus on ROI, and that means taking a case look at medication management and adherence. That’s where resources are wasted and outcomes are reduced.

Warmuth says pharmacy executives need to work with their provider counterparts to make sure patients aren’t left to fend for themselves.

“We really have that common goal of wanting to take care of the patient,” she says. “And the prescribers can be just as frustrated as the pharmacies can be when you can't reach that patient or the patient falls off therapy.”

Partnering with the digital health company Pleio, Gentry Health has put in place the GoodStart Program, which, Warmuth says, “reaches out to the patient as soon as a new prescription is added to the database.” That conversation is designed to be more than just a reminder to take one’s medication, but also to help patients understand medication management and address any concerns about those drugs.

Warmuth says patients often have emotional concerns that they can’t easily explain to a care provider. They’re often confused or hesitant after leaving the doctor’s office, and are left to rely on written treatment plans while coming to grips with their chronic condition.

OLLIE, meanwhile, adds an extra layer to the conversation between patient and peer. According to the company’s description of the AI tool. OLLIE “addresses critical gaps in understanding patient experiences by focusing on the overall patient vibe, friction points, tipping points, and preferences — key behavioral indicators that shape prescription decisions and adherence.”

The application is like so many other AI scribes now on the market, including those designed to capture and filter the provider-patient conversation and enter relevant insights into the medical record. At the pharmacy level, these tools look for specific cues, which the company calls the patient’s “vibe,” or the “emotional state and atmosphere within patient interactions, revealing underlying attitudes, concerns, and levels of confidence in treatment.”

Moving From Facts to Feelings

Healthcare’s innovation leaders have said this is where ambient AI will evolve next. As the technology is refined to assess data, it will then be trained on emotion. A tool that can parse communication, from verbal to non-verbal to visual, could be used by mental health specialists, emergency care providers in high-stress locations like ERs, even substance abuse and suicide hotlines.

Warmuth says early results of GoodStart and OLLIE interventions are promising, with a boost in total average fills, patient volume and portion of days covered (PDC), a patient adherence measurement.

With that data, Gentry could soon expand the platform to cover other drugs, targeting medications with especially difficult adherence rates, such as injectibles. They could also launch programs that target patients with low adherence rates, or those that have “fallen off therapy,” even helping to identify better medications or treatments that might improve compliance.

“Anything that we can do to make that relationship better,” she says.