Senior citizens typically fail to follow their prescribed medication regimens. Separate studies report that adherence to long-term therapy for chronic illness is less than 50 percent. Failure to take medicines as prescribed significantly increases the likelihood of negative health outcomes. For example, studies suggest that 11 percent of elderly hospital admissions and 24 percent of nursing home admissions are due to medication non-adherence. Our application is to develop an image enabled intervention system whereby a remote informal caregiver (e.g., a family member) can collaborate with a senior citizen living at home to improve medication adherence. A significant innovation is changing the self-medication process model into a real time collaborative one. Today's solutions require physical presence for objective verification and do not encourage dialog related to the root causes of non adherence. Starting with the information on the labels of the patient's Rx bottles, the proposed approach allows a remote participant to literally see that the prescribed medications are properly organized and that they have been removed from the organizer according to the desired schedule. There are a plethora of pill organizers and reminder systems on the market today. The proposed Collaborative Medication Adherence System builds upon perhaps their simplest form (i.e. the $5.00, 7 day compartmented pill box) and adds the dimension of collaboration. A key component of the system are "MediCam" devices that apply existing low cost video conferencing technology in a novel and highly constrained manner to address privacy and ease- of-use concerns. The associated software captures an image history and presents reports that encourage the collaborators to discuss how to improve adherence. T I Works Inc. will collaborate with Oregon Health and Science University (OHSU)'s Oregon Roybal Center for Aging and Technology (ORACTECH) to accelerate the work. This will build upon their expertise, processes, Health Coaching Platform infrastructure, and patient population. To verify feasibility, experiments will be conducted with a small number of home- resident senior citizens that are already participants in ORCATECH's health coaching project. This new dimension of intervention is likely to have both adherence and socialization benefits. Further, the approach has the potential to delay the senior from being institutionalized, saving up to $70,000 annually;because there is high confidence in their medication adherence. These benefits would be compelling motivators for commercial products and services. PUBLIC HEALTH RELEVANCE: Poor adherence to medication regimens by senior citizens is wide spread, costly, and increases the likelihood of negative health outcomes ( e.g. worsening of condition, relapse etc.). The research proposed is relevant to public health because it has the potential to improve the wellness and delay institutionalization of senior citizens. The approach can be implemented at low cost because it uses existing technology and engages a previously untapped resource, namely remote relatives and friends. The vision is that "aging in place" elders can extend their ability to live independently and safely at home, because there is high confidence in their medication adherence.