Pillbox, NIH's Physician’s Desk Reference on Steroids

I spent the first part of this week in Toronto, Canada (light years away from the staid, dull town I remember visiting as a kid----with rush hours that easily rival New York’s.  I almost missed my flight home!) to attend USP’s annual science meeting.

A key theme was protecting the pharmaceutical supply chain.  A number of scientists discussed the analytical tools that are being developed to help law enforcement specialists identify fakes.  Quite a few of these presentations focused on handheld Raman, but more on that, and the conference, later.

Alongside all the spectroscopy, one much humbler tool was also discussed:  photography (albeit of the super high resolution type).

During the first day of the conference, David Hale of the NIH’s National Library of Medicine gave the audience an update on Pillbox, a multidisciplinary project (described here) that has been underway for the past four years involving partners that include NIH and NLM as well as the Department of Veterans Affairs, the nation’s Poison Control Centers, and Lister Hill Library. 

Within the past two years, FDA has become a major stakeholder, realizing the project’s potential for providing a reference standard to help protect patient safety. A pilot program involving CDER  will kick off this fall, as part of FDA's SPL project (Click here for recent meeting notes). The Agency has  donated some vacant labs in Rockville to the Pillbox team. 

Pillbox, which went online today in "public beta" mode (click here to test drive),
is like a Physician’s Desk Reference on steroids. Once completed, it will store high resolution photographs of every solid dosage form sold in the United States, allowing users to search using five criteria: color, shape, size, imprint and scoring.

Pillbox will connect directly with FDA’s structured product label (SPL) database, as well as clinical trials databases, chemical databases, drug information sites and Medline, offering a potentially powerful resource for the public at large, but also for healthcare professionals, law enforcement and the industry. 

If, for example, your three-year-old samples some of grandma's colorful blue heart medication (as mine, heart-stoppingly, did a few years ago), you'll be able to run to your handheld or laptop, look it up and figure out what the identical candy-like tablet on the floor is before you rush to the ER.  If suspected counterfeit capsules show up anywhere, local police could use Pillbox to call up high resolution photographs of all the capsules of that shape, size and color and print. (As a next step, perhaps in another decade or so--- after industry has supplied such data and vendors have submitted normalized spectral libraries, they could then compare the suspect capsule’s spectrum vs references and make an immediate diagnosis).

There’s a video tour of the Pillbox web site featured on the home page.

But,for a more personal touch, David Hale was good-natured enough to submit to my taping a demo and interview (which must have required an infinite amount of self-restraint…since David, who studied geology and physics, launched his career as a professional videographer.

And, no, he didn’t videotape weddings, but, rather, skydiving videos (no samples, but I'll bet they were along the lines of this one)

He says his background has had a great impact on the way he approached the Pillbox project, which has also, presumably, drawn from the classifying and painstaking detail he learned to deal with in geology class.

David describes himself as one of NLM’s Web 2.0 missionaries, and he makes a point of participating in Health Camp and healthcare-related “unconferences.”  While he has discussed Pillbox at some of these conferences in one recent program, he and colleagues analyzed H1N1 tweets using a prototype system based on Medline to monitor the unfolding pandemic.

All of which is living proof that, in its final stages, there is real value to be derived from Web 2.0, far beyond the Tripit  “here’s where  I’m traveling” and “there’s what I’m having for  dinner” that I love to lampoon. 

David, whose twitter feed is whimsically called "lostonroute66," says that crowdsourcing and other Web 2.0 tactics have driven the Pillbox project, and should continue to move it forward.   We’d love to hear of other important Web 2.0-driven work like this.

Key will be making sure the data meet a real need----which depends on feedback and criticism from all potential users ---doctors and healthcare professionals, regulators, industry, first responders and law enforcement.  “Transparency and access aren’t everything. Data must be useful too,” Hale says.

It must also be convenient to retrieve. (Reminds me of the consultant who used to run an online database that stored FDA enforcement records ---- for a fee, you could retrieve 483’s, Warning letters and the like online.  Sure, all of this is on FDA’s web site.  But guess who his biggest customer was?  F.D.A.)

For a rough cut video just posted to YouTube, click here. An edited interview and demo clip will be on our website soon.