Precision Medicine: Check! Precision Compliance? Keep Reading

Despite frequent sips of liquid and checking her blood sugar every 2 hours, Nicole’s vomiting only worsened. The usual instructions on how much insulin to use didn’t seem to be working for some reason. Her blood sugar rose, first 300 then 650, now too high to read on her home machine. By the time her mother helped her to the car, she was mumbling and her respiratory rate was 40 times a minute. In the emergency department, her pH (a measure of the acidity of the blood) was dangerously low. Despite having been a model patient since she was diagnosed with diabetes at age 8, Nicole was now experiencing Diabetic Ketoacidosis (DKA), and her life was in danger.

Although Nicole (not her real name) responded to emergency and ICU care and was out of danger in 24 hours, her situation illustrates one chapter in the emerging story of Precision Medicine, more specifically, Precision Compliance.

In many ways Nicole is the beneficiary of Precision Medicine. Unlike 30 years ago when insulin preparations were crude and home testing was absent, rarely used or inaccurate, her modern diabetes regimen kept her in good health for 10 years. She utilized specific insulin dosing to respond to changing blood sugar values. She could anticipate her insulin needs. She was very compliant with her treatment. Yet, when faced with a sudden change in the “rules” of her disease, she was not able to adapt. Precision Compliance, which brings the right instructions and the right care to the patient at the right time, might have prevented her emergency.

Precision Compliance is a new concept in medical care management that works in today’s environment. It enlists the patient as an equal partner in their healthcare management, and empowers them to be able to follow the recommendation of their healthcare provider, even in a rapidly changing or complex environment. It can optimize medical service delivery to those who need it most.

Precision Compliance leverages the ubiquitous mobile phone, couples it with patient monitoring and active interaction with a personalized treatment plan prescribed by a care giver to allow 24×7 quantitative tracking and remedial actions for the patient.


Patients need to be heard, but sometimes the patient’s description of symptoms may not be what the healthcare provider needs for an accurate diagnosis. Even an careful recital of symptoms may not be enough without quantifiable data, and time is always a critical factor.

Enter Precision Compliance, a synergistic melding of healthcare provider access and quantifiable data, merged in real-time with automatic alarm annunciation that allows both provider and patient to respond in near real-time to events as they occur using quantifiable data and self-reported symptoms as the basis for treatment and response.

In Nicole’s case, a Precision Compliance solution could have used information such as her present symptoms, their progression, her strange lack of response to her usual treatment regimen (ironically, a common feature in DKA), her blood sugar values, and perhaps a brief phone or live video interaction with her caregiver to make immediate changes to her treatment regimen, and prevent the development of DKA. For Nicole it wasn’t a lack of motivation or intelligence, she’s a model patient. But with the rapid change in her condition, she didn’t simply need a compliance tool to remind her of her treatment plan, she needed a precision compliance tool to deliver just the right care instructions to her at the right time. Personalized responses, tailored to the patient’s exact needs, are the hallmark of Precision Compliance. It not only allows responses, but proactively tracks a patient’s condition and allows markers signaling an impending problem to be identified. The positive psychological impact on the patient cannot be understated.

Precision Compliance has the potential to be a critical component of high quality health care delivery in the years to come.