Lean in Your Life – Preventing Health Problems with Technology


Continuing this first week of the year's theme of using Lean principles to improve our lives, I'm going to write about two pieces of technology that can help prevent two different types of health problems, particularly in the elderly.

The first is suggested by a blog reader who had an elderly parent forgetting to take medications, requiring lots of reminders and phone calls from the concerned son.

My mom ened up in the ER last Aug. problem, forgetting her meds.  She forgot for two days and then took three pills.  I bought her a MEd-Q pillbox.  It flashes the individual box to be taken and has a beeping alarm.  It makes forgetting impossible.  I don;t have to call three-four times a day to remind her.  It's a real life saver.

A system like this could be considered a form of “poka yoke” or “mistake proofing” as described in the Lean methodology.

As  described  on  the company's website (this is not an endorsement, as there are similar products on the market, ranging from the simple to the complex), a user can fill the box for 7 to 14 days, programming times for pills to be taken. There are visual and audio signals given out by the box.

Now, as with many pieces of technology, something like this isn't a silver bullet. First, it has to be loaded and programmed properly (something that had better be easy to do, or the son and daughter or other caregiver would have to do it or at least ensure it's set up right). Secondly, you have to make sure the signals can't just be ignored. Are there boxes like this that will send a text message if the pill box isn't opened when scheduled?

Considering the high cost of medication errors (ranging from health problems to emergency room visits to death), it would probably be worth it to spend a little money on medication technology like this for the home.

A second bit of technology is something I read about in a magazine over the holidays. A major problem for an Alzheimer's patient is when they wander off from their home and get lost. 60% of Alzheimer's patients wander away from home, according to this  article. I imagine you don't want to make the patient a prisoner in their own home (locking them in is cruel and creates other safety problems, say, if there's a fire).

It's not true error proofing (preventing the problem from even occurring), but creating a system that tolerates errors (in this case, the wandering patient) is better than no error proofing at all.

There are now shoes made with built-in GPS sensors, as this article describes  and as pictured at left. If an Alzheimer's patient wanders off, these shoes make it easy to find them and get them back home.

But, again, with any system, we need to think about the weak points there the system could break down. What if the patient has other shoe options? Do you ensure they only have this option? Are the shoes easy to put on? What if they wander off barefoot?

I think it's a key aspect of Lean thinking to not look for easy technology solutions to solve our problems for us. As Dr. Deming said, “There is no instant pudding” and as the Toyota Way says:

 “Use only reliable, thoroughly tested  technology  that serves your people and processes.”

What do you think about these approaches? What Lean mindsets have you applied if you are a caretaker of an elderly parent or grandparent?

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Mark Graban
Mark Graban is an internationally-recognized consultant, author, and professional speaker, and podcaster with experience in healthcare, manufacturing, and startups. Mark's new book is The Mistakes That Make Us: Cultivating a Culture of Learning and Innovation. He is also the author of Measures of Success: React Less, Lead Better, Improve More, the Shingo Award-winning books Lean Hospitals and Healthcare Kaizen, and the anthology Practicing Lean. Mark is also a Senior Advisor to the technology company KaiNexus.


  1. I think they are both good. My grandparents had a pill box like that a couple decades ago that just didn’t have the alarm box portion (it could be filled for a week (or more?) and had slots for multiple times of day… I am not sure how much the alarm really adds, a bit I suppose. But just the box and a checklist is as good (maybe better – as the checklist can include lots of other things), if the alarm was really useful it could just be a regular alarm clock to look at a checklist 3 times a day or whatever…

    they had tons of pills every day. If you only had to take pills twice a week or something that would actually be harder. If you used the internet all the time (like I do) I really like using Google calendar to send reminders…

    The shoes are good. The biggest weakness seems to be taking a different pair of shoes (or maybe no shoes?). So just make sure it is something they will take with them. Photo did make it seem like it could maybe get knocked off (so just make sure that isn’t the case) – especially if they liked walking in snow (or something).

    I really like technology. But I also have the typical lean distrust of technology “miracle” solutions. Technology is cool, but consider how things can break and remember technology solutions are often not incredibly robust – failures happen due to bugs…

  2. I use rememberthemilk.com to ensure I take my medicines at the correct time of day – something I was having issue with. I set up reminders to text and email me so that I know when to take it.

    This is not a full proof solution either as I need to remember to bring my phone and have to rely on the website to be up but for now it but for now it works fine for me.

    Lean lurker – Josh


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