With the phenomenon known as ‘selfies,’ it doesn’t seem too surprising that ‘selfie medicine’ apps are being integrated into the medical world. Today, some doctors require patients to record a video of themselves taking medicine to prove they are following instructions. These new ways of monitoring medications and healthcare come with various challenges, such as monitoring security issues and receiving long-term adherence from patients using the app.Telehealth requires experience in finding the right balance of personalization and technology, but Shital Mars, CEO of Progressive Care, a personalized healthcare services and technology company, has seen what can work and what usually doesn’t work when it comes to creating a digital pharmacy model.The first hurdle with selfie medicine apps is data security and ensuring that a patient’s sensitive information about their disease isn’t exposed.“Right now, selfie medicine is being used to monitor patients with disease states that require perfect adherence to a medication regimen. Medications for diseases like Tuberculosis and Hepatitis C require the patient to never miss a dose in order for the medication to be successful,” said Shital. “It is imperative that patients with these types of illnesses are protected from data breaches because of the sensitive nature of the information, especially since each patient’s face is now linked to a disease state.”In order for these apps to work successfully with a diverse group of users, the interface between the provider and the patient also needs to be seamless.“The more cumbersome the app, the more difficult to log in, and the more steps needed to accomplish a goal or access data. This will all yield diminishing use of the app,” said Shital. “It also has to work for a wide demographic set.”Another hurdle is creating enough value for a person to continuously use the app and reap daily benefits. We have all started fitness or finance tracking apps that slowly becomes less prominent in our day-to-day lives. Although we start with the intention to stay on track with an app, it can become cumbersome and tedious to do every day. According to Shital, voluntary compliance apps are only effective, on average, for about six months, which includes fitness apps, weight loss apps, etc.Reward complianceIn order to motivate patients, health apps should consider providing a reward for compliance, but this can be difficult to measure what level of compliance is needed to gain said incentive.“Personally, I even grouse at the idea of taking a picture or video of myself taking my medication, and I believe wholeheartedly in adherence,” said Shital. “I can’t imagine the average person wanting to do this at all, let alone for a long period of time. Even if there was some kind of meaningful consequence, it wouldn’t take long for people to begin faking taking their medicine just to avoid being hassled or harassed about it.”Selfie medicine could work for patients with short-term medication regimens, but it isn’t practical for someone taking several medications at different times throughout the day. Additionally, doctors are already short of time, so taking the time to watch their patients take medications would be quite time-consuming.“I do leave a little room for success if a monetary incentive program were implemented. If it’s not a discount, but in the form of real dollars to patients this could be enticing because who wouldn’t want some extra money in their pocket for being adherent,” said Shital. “There are insurance companies that do provide money for preventative screenings and wellness programs like gym memberships, but the vast majority of insurance companies don’t provide those benefits because of the costs involved. Even if there were a broad scale monetary adherence incentive program in the near future, it certainly wouldn’t be big enough to be effective on a large scale.”Online pharmacyAnother idea that follows the selfie trend, but in a much broader scope is the Tele-PharmCo app, aimed at encouraging patient engagement by acting as a digital pharmacy window with live stream video and audio.“The app allows patients to interact with their pharmacy in a way that facilitates medication consultation, coaching, and reconciliation. Interactions are initiated by the patient to discuss issues, concerns and questions they may have about their treatment plan,” said Shital. “The app can also be utilized on our kiosk platform in a hospital setting, allowing patients to submit prescriptions and insurance information.”Patients can also use the kiosk to talk with a pharmacist about potential allergies, side effects and other medication concerns.“We have found that personal communication about these topics greatly improves adherence and health outcomes,” said Shital. “The point of our tech usage is to engage without being intrusive, coach and educate without pestering, and monitor without hovering so that we can improve the wellbeing of the patients we serve. Building mutual trust with patients will lead them to be more open about their situation and allow us to tailor a plan that works best for them.”