From Mosaics to Medicine: Insightfil Founder Tackles Medication Adherence

Over 70 million Americans struggle to manage their medication regimens. Medication adherence, a major issue in healthcare, costs billions of dollars annually in avoidable medical costs, and can be fatal to patients who are not taking their medications properly. Ted Acworth, founder and CEO of Insightfil, saw an opportunity to apply expertise and technology from his first company, Artaic, known for the development of innovative robotics software for manufacturing large-scale mosaics, to address the problem of medication adherence. Insightfil, which participated in the National Science Foundation (NSF) Innovations Corps (I-Corps) Teams program through a pilot for startups called the Upstate New York (UNY) I-Corps Small Business Innovation Research (SBIR) Phase 0, was recently granted a $225,000 SBIR award from the National Institute of Health (NIH). The UNY I-Corps Node sat down with Acworth to discuss Insightfil’s growth and I-Corps journey.

What inspired you to move into the healthcare space with Insightfil?

I had already started the company, Artaic, which is a mass customization/personalization concept focused on the area of mosaic tile artwork. Creating custom mosaics is time consuming and labor intensive, which means that mosaics are very expensive to create, especially in developed countries, like the United States, where labor is costly. We engineered design and logistics software and robotics to greatly facilitate the design cycle and to make the manufacturing faster and more cost-effective.

During this time, I received a phone call from my mother, who lives in New York. She informed me that my stepfather was in the emergency room, but that he was okay. It turned out that he made a mistake taking his medications. This incident opened my eyes to the issue of medication adherence, which is a huge problem in healthcare. Insightfil’s co-founder, Mike Trachtman, also has a personal connection to the issue of medication adherence in caring for his parents and experiencing firsthand the challenges of preparing and administering multiple medications.

I did some basic research and discovered that 70 million Americans—typically individuals who are taking five or more medications, and/or individuals who may be older or dealing with serious illnesses—struggle with medication adherence. I learned that one person dies every 17 minutes in the United States due to medication adherence errors and it costs the system about 300 billion dollars each year. I thought about these findings and realized that the software and robotics we were using at Artaic to place tile into customized mosaics, could also be used to place medications into customized arrangements within packaging to make it easier for patients to take the right medications at the right times. That was the spark of the idea.

What makes Insightfil unique from similar startups addressing the problem of medication adherence?

One “holy grail” of healthcare is to boost medication adherence, which is presently only 50% in the United States; almost everyone agrees it should be much higher. It’s a very complicated issue with a lot of variables, such as culture, economics, psychological barriers, and simple forgetfulness—there are a lot of reasons people don’t take their pills on time. Accordingly, there are many proposed solutions on the market. It’s a very crowded field with many startups claiming “We’ve got a wonderful solution for medication adherence.”

What really differentiates Insightfil from other startups addressing this problem, is that at the core, we have a low-cost, practical, unobtrusive technology for instrumenting the new emerging pill pouch format medication package, so that through the patient’s mobile phone—without any effort or required interaction on their part—the smartphone app can measure if the patient has opened their medication in real-time. The cost is very low—ultimately under 10 cents per pouch. It’s uniquely low-cost and non-intrusive and is able to gather impressive real-time data from the medication package itself through a low-cost chip on the pouch that communicates with the smartphone. It’s a passive chip, so it doesn’t need power or a battery, and it’s disposable.

In this way, we are able to generate incredible amounts of data about medication adherence. This is considerably better than the industry’s gold standard, which is the 30-day refill. Typically, when you have a reoccurring medication, one that you refill every 30 days, the system—this includes the pharmacy and the insurance company—measures your adherence by whether or not you pick up your refill every 30 days. We are able to gather real-time data on patients taking their medication multiple times per day. Instead of getting one data point every 30 days, we can get 120 data points every 30 days. The difference is in the quantity and quality of the data.

How do you plan to utilize Insightfil’s most recent SBIR award from NIH?

There are two parts to our proposal. The first part is to develop a prototype and the second part is to test that prototype with a small 30-person pilot group of patients. We plan to measure the technical performance of the product, as well as the engagement by the patients—whether they use it or not—over a multi-week period. We also plan to measure how satisfied patients are with using it.

We received the grant in August, so we are well underway with the first part, which is product development, technical research, and the prototype. For the second part, we are already exploring which patient group to pilot the prototype. We plan to conduct patient recruitment around the end of October and begin the pilot in November. We are currently seeking, and need help finding, a good patient group for our pilot.

How did participation in the I-Corps program benefit Insightfil?

I-Corps is typically geared toward university-based researchers. While I have an affiliation with the Massachusetts Institute of Technology (MIT), I’m not a professor or graduate student there, so we were selected for the Phase 0 pilot, which is open to the broader startup community. It’s the same seven-week curriculum as that of the I-Corps Teams program, which the university-based researchers undergo. During that time, we interviewed over 100 people as part of the customer discovery process, and actually extended that process beyond the allotted seven-weeks for a full year of customer discovery. We just wrapped that up in July.  

The I-Corps program gave us $25,000 to cover our expenses for approaching and interviewing anyone we could possibly get our hands on who could give us knowledge about being a potential user of our products. As a startup, you don’t really have any cash on hand—even taking a flight to another city to interview someone can be very expensive, so the program gave us the ability to interview anyone that we felt was worthwhile, no matter where they were.

In addition to funding, we benefited from participating in a structured system, where we learned about the business model canvas method, and in particular, the customer product fit methodology, which focused on looking at the customer universe and then ultimately homing in on a customer segment that could see tangible economic benefits from our potential products. We want to build a product that people care about.

What surprised you most about the customer discovery process?

Having to complete 100 interviews in seven weeks sets a very challenging pace. Each week, we were required to conduct at least 15 interviews. That’s not easy, especially if you have other things going on in life, another company to run, three young kids at home, and all the other responsibilities of life—it’s difficult to dedicate a full-time effort to customer discovery. It’s a big commitment.

I thought the program was hugely valuable, especially for scientists and engineers who tend to get enamored with the science or technology, and often place secondary importance on the potential customers, who may or may not care about their ideas. There is a saying: “Don’t go inventing a monochrome television, when there is already a color television.” The program’s customer discovery process really helps focus efforts toward innovation and development that people, other than the inventor, will care about. It’s not just inventing for the sake of inventing, but it’s inventing for the sake of benefiting real customers.  

Was there anything that came to light during the customer development process that made you take another path?

The process really challenges your assumptions. I think every team in our cohort had a lot of assumptions at the beginning of the program about the direction they were headed. Most of us, if not all of us, were brutally woken up about certain aspects of our ideas that didn’t jive with reality. There are definitely some low moments during the customer discovery process when a lot of your assumptions are stripped away. The optimism and enthusiasm of participants tends to start out high and then steadily declines in the first few weeks of the program until it hits rock bottom. Eventually you find a spark—a customer segment who sees clear value in your product and would pay for it—so you focus on exploring that customer segment in the following weeks until you identify and evaluate a genuine customer for your product. More often than not—and this is what happened to us—it’s a different group of customers than you began with.  

What advice would you give to teams about to begin the I-Corps experience?

Fasten your safety belts, clear the decks, and prepare to commit some serious time. If you have a family, make sure to spend some time with them, because you’re not going to see them for a little while. If you have a job, make sure your big projects are completed and out of the way before you begin. It’s a huge effort, but you get a huge benefit out of it, especially if you’re an engineer or scientist type with little customer experience. It’s game changing for that type of person. My number one strategy for how to survive I-Corps is to find a target-rich environment to conduct your interviews. We started out with a strategy to find interviewees, but it failed, so we were behind for the first few weeks. Then we found a trade show to attend, and it was like shooting fish in a barrel. We would go to one trade show and get a week’s worth of interviews in one day. If I were to do the I-Corps experience over again, I would plan my cohort dates around two or three trade shows during that time that I could attend, so I could hit the ground running, and easily achieve the number of interviews required. Anything extra is gravy.

Is there anything else you would like readers to know about Insightfil?

It’s still a journey; we haven’t nailed it yet. We are exploring another segment of the customer group we originally discovered during I-Corps that might be more economically viable and we are looking for help. If anyone can make introductions for us to care provider organizations for people who take medications, such as home care organizations, or assisted or long-term care facilities, let us know. We would love to talk to more customers and continue the journey.