Voice of the Diabetic

Voice of the Diabetic

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TALKING MEDICINE IDENTIFIERS

by Ed Bryant

Photo: portrait. Caption: Ed Bryant.

Blind people, and those losing vision, have always had difficulty

identifying their medications and telling them apart. Serious consequences can

follow, when prescriptions, oral or injectable, are mistaken, and the wrong

dose given. One of those medications is insulin.

For years I have worked to make insulin manufacturers aware of this problem,

of the need to make insulin vials distinguishable from each other by type/duration,

without sight. The drug companies have not been particularly interested. We

have been left with our homemade Braille labels, rubber bands, tape, and other

temporary "recognition systems."

A partial solution has been the Roche VoiceMate blood glucose monitor, with

its "talking insulin identifier" feature. This monitor reads the bar-codes

on Lilly insulins - but not on any others, and, while quite functional, is very

expensive. A more general solution is needed.

In September of 1999, Dr. Marc Maurer, President of the National Federation

of the Blind, asked me to attend a meeting at the National Center for the Blind,

in Baltimore, Maryland. Representatives from the ASKO Corporation discussed

and demonstrated a prototype of their ALOUD Audio Labeling System.

First of a new class of "talking prescription containers," the ALOUD

consists of three components: The recording unit (in the possession of your

pharmacist, to whom ASKO will provide it without charge), the playback unit

(cost: less than $100, and you need only one), and the Audio Label (which contains

a digital storage chip). Each medication will need its own Audio Label.

When your pharmacist prepares your medication, and creates a written label,

an "audio label" is created also. With the ASKO recording unit, the

pharmacist reads pertinent dosage information onto the Audio Label, as if into

a tape recorder. Like recorded tape, the Audio Label is reusable — when

your prescriptions change, the pharmacist can replace old information with new.

And note, there is no language barrier — whatever language your pharmacist

speaks can be easily recorded. Standard reusable "audio labels" cost

$10 each, and the smaller labels (for insulin vials) will cost $5 each.

The original ALOUD was very functional, but a bit large, not particularly convenient

for use with an insulin vial. As those of us who most need a "talking label"

on our insulin are likely users of an adaptive insulin drawing device such as

the Jordan Count-A-Dose, any "talking label" needs to not interfere

with insulin drawing. The original ALOUD made using the Count-A-Dose inconvenient,

and I conveyed this fact to the management at ASKO.

Clearly ready and willing to work with the NFB, they promised to try to shrink

the Audio Label, to make it more convenient for blind diabetics. The electronics,

and the system's capacities, will remain unchanged. As of this writing, I have

not seen the revised Audio Label, but I am told it is much smaller, about 3/4"

x 1-1/2," and extremely thin. ASKO management is scheduled to bring samples

of the smaller label to the NFB national convention in Philadelphia.

A completely different approach to the same problem, far more high-tech, has

been taken by En-Vision America, maker of the ScripTalk system. Like the Aloud

System, the ScripTalk consists of recorder, playback unit, and labels; but where

the Aloud stores and plays back the pharmacist's voice, the ScripTalk utilizes

Radio Frequency Identification (RFID) technology, and encodes a microchip with

the same information typed onto the label - detected by the user's scanner and

played back by through a voice synthesizer. As with the Aloud, the pharmacist

determines the label content; the consumer can only play back the information.

At this early stage, the ScripTalk's recorder (sold only to pharmacists) and

playback unit are fairly expensive, approximately $1500 and $250, respectively

(each label costs $1), but these prices are expected to drop. Also, within a

year, ScripTalk will have eight times the storage capacity of the present system,

so each audio label will offer far more data to the blind user.

Because the ScripTalk's special microchip is in the label, no great bulk is

added to the label or container, and an insulin vial with label attached should

easily fit into adaptive measuring devices like the Count-a-Dose. They offer

two label sizes (same chip) with the smaller label ½" x 3/4"

specifically for small vials like insulin.

En-Vision, a regular exhibitor at NFB National Convention, has worked for years

to develop products genuinely useful to blind people.

A simpler, more limited approach is offered by Millennium Compliance Corp.,

maker of the Talking RX audio label. Although the Talking RX looks like the

Aloud, and stores spoken information on a digital chip, there is no separate

"recorder" — each unit has the capacity to record. Where the

Aloud requires a different "audio label" on each prescription, but

only one playback unit, each Talking RX unit is self-contained, recorder and

playback, and no separate "audio label" is required. You attach pillbox

or insulin vial to the unit, and leave it there until you've finished that course

of medication. They're inexpensive ($19.95 each, suggested retail); but if you

take a lot of meds, you may need to buy a lot of Talking RX devices.

Your pharmacist programs the Aloud (your playback unit can't alter the message)

but you load information into the Talking RX, and you, the consumer, can alter

it. You will need a different Talking RX for each of your medications.

All the systems have their pluses, and their problems. Although both the ALOUD

and the Talking RX are "lifetime" products, endlessly reprogrammable,

and both are simple and relatively inexpensive, neither is particularly convenient

for use with an insulin vial, as both are really too big to work well with adaptive

measuring equipment, unlike the ScripTalk. (Note: I haven't seen the newest

ALOUD label, but its smaller size should go a good way toward answering some

of my misgivings.}

To conclude, my primary interest has always been the ability to distinguish

one insulin vial from another. Designed for pill bottles, the ALOUD and Talking

RX systems are only partial answers for insulin identification. Both require

sighted intervention — and until there is some way a blind person can reliably

and independently tell insulins apart, without such aid, the job is not completed.

The ScripTalk, while a larger initial investment, appears to better fit for

the needs of blind persons at this time.

Stay tuned for further improvement!

ASKO Corporation

c/o Audiosears Corp.

2 South St.

Stamford, NY 12167

1-800-533-7863

En-Vision America

1013 Porter Lane

Normal, IL 61761

1-800-890-1180

(309) 452-3008

Millennium Compliance Corp.

PO Box 649

Southington, CT 06489

860-681-9277

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