Of the many topics that AccessWorld has reported on, few are of more importance than technology that provides independent access to medically necessary information. While workplace accessibility is of economic and professional importance and lifestyle technology allows equal enjoyment of the digital age, maintaining health and physical independence may be the most important.
AFB TECH has reported in the past about vitally important access to equipment for monitoring blood sugar. In this article, we bring you information about a new class of medically related technology. Unlike talking blood-glucose meters, which provide equal access to medical technology through speech output, prescription medication devices provide independent access to print information that sighted individuals rely on for identifying and using prescription medications.
This article discusses a relatively new product from En-Vision America and provides some background on the technology that is used to support this important device. A future article will share the thoughts and observations of some individuals who use the technology and pharmacists who provide accessible medication labeling to their customers.
RFID: The Technology Behind ScripTalk
Radio frequency identification (RFID) is the name of a special class of computer memory chips. If most of us have heard of these ultrasmall storage devices, about the size of a small grain of rice, it is probably in the context of the technology that large retailers use to track inventory. For the purpose of providing independent access to prescription medication containers, En-Vision America has moved RFID from the warehouse to your house.
RFID chips share some important characteristics with the computer chips that are more common. They can receive and store data, they do not require power to have their data read, and they are able to store any type of file. Unlike more familiar memory formats, RFID chips do not need to be physically connected to a computer or other device to communicate their data. This "hands-free" connection is possible because radio waves, or RF, excite the chip, causing it to resonate. Once the resonating chip is placed near a receiver, a sensitive and specialized radio-like device can read the data that are stored on the chip.
In comparison to more familiar computer storage devices, the amount of data that can be saved on an RFID chip is limited. Despite this limitation, sufficient amounts of data can be held on RFID chips to represent a small file, similar to an ultrasmall word-processing file.
RFID technology falls into the category of technology that is occupied by highly specialized hardware devices doing specific tasks. If the specialized RFID reading device is designed with text-to-speech technology, it is easy to understand how data that are captured on the RFID chip can be read by the device and announced in the same manner as a text file is read on a traditional computer by a screen reader.
This is a quick explanation of how individual RFID chips can each contain the information on the label for a single medication. When the medication container is placed on the special ScripTalk Station, the RFID technology inside the unit can read the data that are associated with the medication package.
How Are Medications Labeled?
As with most transactions in the modern era, picking up a prescription at the pharmacy involves the generous application of computer technology. Of particular interest to us is the behind-the-scenes system that modern pharmacies use to track medications for customers. When preparing each prescription, the pharmacist usually consults a database of all medications. In addition to providing specific information of interest to the pharmacist, the computer system is used to enter the text information that will appear on the printed label that is placed on the medication container. Once the package information is ready, the pharmacist uses a computer printer to create the physical label.
Like traditional computer chips, RFID chips can receive files. An encoding unit in a participating pharmacy is connected to the computer system that the pharmacist uses to print the label and other print information for each prescription. In addition to the printed version of the medication information, a copy of the same information is sent from the computer to a ScripTalk Encoder and stored, as a file, on the RFID chip. This file is a duplicate of the print information that is associated with the prescription.
Each chip is contained in a quarter-size adhesive label. Typically, these round labels are placed on the bottom of pill bottles containing the medication. For packages of other sizes and dimensions, the label can be placed on the side or bottom of the package. After the RFID label is encoded, it is attached to the medication container and given to the customer for use on the ScripTalk Station.
ScripTalk Station
En-Vision America developed a special-purpose piece of hardware to take advantage of RFID technology in order to allow independent, nonvisual identification of prescription medication information. The system uses synthetic speech technology to announce the prescription information to individuals who are not able to read the conventional printed information that is associated with a prescription. In addition, the information can be reviewed, much as a word-processing file can be reread on a computer.
AFB TECH evaluated the ScripTalk Station in October 2008. All observations and measurements were made by AFB TECH staff who are familiar with a wide variety of products that use text-to-speech technology.
In the Box
The ScripTalk Station is packaged in a custom soft, zippered pouch. Resembling an insulated lunch bag, the rectangular carrier includes a large central compartment that is filled by the ScripTalk Station in its original box, as well as a side pouch. A shoulder strap is also included.
Opening the main compartment reveals a sturdy box with ScripTalk Station and the En-Vision America toll-free phone number in braille in the upper right-hand corner. This is the only braille labeling included in the package. Inside the box is a plastic tray that contains the ScripTalk unit. Beneath the tray is a second tray in which the documentation, in conventional print and on CD; power supply; and two AA batteries and power adapter are shipped. A sample prescription container is also included for demonstration and learning purposes.
Documentation
The documentation for ScripTalk can be accessed in three ways. The included CD contains an audio file of the documentation. A print version is also included in the package. By pressing and holding the oval Read key on the ScripTalk device, the documentation can be read directly from the Station. The audio recording of the documentation provided on the CD is a recording of a synthesized computer voice reading the material. The voice is of a high quality, in our opinion. The same voice appears to be used by the device, and when you listen to the instructions after holding the Read key, the same audio file is read. The print documentation is printed in regular type. Unfortunately, no large-print information is included with the unit.
We found the documentation to be easy to follow. It describes ScripTalk in a logical order. This is a simple device, and the documentation is well written and easy to follow.
Getting Started
After ScripTalk was removed from its plastic packaging, it was easy to locate the connector for the included power adapter on the back of the unit. It was also easy to locate the battery compartment on the underside of the unit and to install the batteries. The battery compartment includes the conventional spring-loading design, making it easy to orient the two AA batteries correctly. Note that regular, disposable batteries are used. ScripTalk does not use a rechargeable system.
The device is between one and two inches thick. Its footprint is semicircular, and it is about the size of half a salad plate. The top of the unit contains three easy-to-feel controls, near the front edge. In addition to the Read key, which can be identified by a prominent nib, the Next and Previous keys are arrow shaped. They point down and up and are to the left and right of the Read key, respectively. The bulk of the top surface is flat and contains the speaker, which is surrounded by two rings of nibs or bumps. These nibs are used to orient the medication container above the speaker, which also contains the electronic sensor that reads the ScripTalk data.
Moving from the top of the unit, the front edge has a single control. An On/Off/Volume control can be located by moving from the Read key downward across the front surface. Sliding this control to the left turns the unit on. After the unit is on, the same control adjusts the volume.
The back of the ScripTalk Station has two round openings through which the power cord and an earphone can be attached. The power cord uses the larger of these connection points. An earphone is not included in the package with the Station, but any standard 3.5-millimeter earphone will work.
First Impressions
Within a few minutes of unpacking ScripTalk, the device was reading prescription information in a clear, easy-to-understand female voice. Sliding the On/Off/Volume control activated the unit with three short beeps and a longer beep. The synthesized voice announced "ScripTalk Station ready," and a final tone sounded. Placing the medication container within the circle of nibs directly above the speaker and pressing the Read key caused the unit immediately to beep three times and for the voice to announce "Patient, David Raystrick."
Following the patient's name, all the information associated with the sample prescription was read in sequence by ScripTalk. The voice was well modulated and provided information at a pleasant pace. Note that the rate of speech can be changed.
After reciting all the information associated with the sample medication, a sequence of beeps signaled that the system had finished with that particular medication. Pressing the Read key again caused the information to be repeated. Note that after 15 seconds, the system reset, removing the last information from memory.
Navigation and Repeating Information
Since the information that ScripTalk presents is contained in a particular format, the sequence of information is standardized for all prescriptions. The Next and Back keys allow you to navigate the information, not unlike reviewing a computer file with a screen reader.
The order of information that is included is "Patient," "Medication," "Instructions," "Prescription Date," "Refills Remaining," "Prescriber," "To Reorder This Prescription," "Prescription Number," and "Other Information." In addition to navigating through the information, the Read key can be used to start and stop speech. Note that after 15 seconds, information is removed from memory, requiring a rescan of the container.
In our experience, navigation was smooth and well controlled. The Up and Down arrows were easy to locate and use, with a solid feel to the control as it was pressed. The speech was responsive and did not repeat or lose position while navigating the information. When the system required a rescan, the voice announced the status as having no prescription and prompted me to rescan the prescription.
Scanning Prescriptions
The prescription can be scanned in one of two ways. By placing a container within the circular ring of dots and pressing and releasing the Read key, identification of the prescription is immediate. Alternatively, the Read key can be pressed with no prescription on the unit. A series of short beeps indicates that you can place the prescription container on the top of the unit. As long as the container is placed in the appropriate location before the beeps end, the system will read the information. This may be of particular importance to those who are not able to use both hands to orient the container in the correct location and to press the Read key at the same time.
Availability
The issues and circumstances surrounding the adoption of ScripTalk are something of a "chicken-and-egg" scenario. Before the technology is useful, a reasonable number of pharmacies must have the encoding units in operation. No one will want home stations until the pharmacies have decoders and so forth. At this time, one large group of individuals has immediate access to ScripTalk Station technology—any person who is blind or has low vision who receives medication services from the Veterans Administration may request a ScripTalk Station immediately. The Veterans Administration pharmacies that supply prescriptions will encode all future prescriptions for use with ScripTalk. In addition, Michigan-based J and B Medical announced that it would provide ScripTalk tagging for its nationwide customers. The announcement was made in July, and at press time, J and B Medical is implementing the process.
Some independent and regional pharmacies have installed the necessary equipment. Wallgreens is conducting a pilot program in northwest Indiana. For information about participating ScripTalk pharmacies in your area, contact En-Vision America. Consumer organizations of blind people, including the American Counsel of the Blind and the National Federation of the Blind, are aggressively reaching out to pharmacies in many communities to place ScripTalk technology in the communities.
Additional Observations
Despite a high level of sophistication, ScripTalk keeps a simple task—identifying prescriptions and reading their associated information—a simple matter. The fit and finish of the device are solid. The current generation of ScripTalk uses a relatively natural female voice. Earlier versions included a male voice which, while familiar to users of screen readers, was not especially natural for some who were not accustomed to synthetic speech.
ScripTalk can be placed on a flat surface, such as a table or counter top. It remains in place while in use, thanks to four small rubber feet. An alternative placement is on a wall using two keyhole slots on the ScripTalk Station and the included mounting template and screws.
AFB TECH staff had an opportunity to demonstrate the ScripTalk Station to five persons who are blind or have low vision in the Huntington, West Virginia, community. These persons are typical of the bulk of users who have moderate experience with high-tech devices. Each of them was able to use the device easily. They also found that listening to the ScripTalk's voice was easy and that navigating the prescription information was straightforward.
The Bottom Line
The ScripTalk Station was designed to do a single job, and it does it very well, indeed. The design of the device indicates a great deal of forethought and insight by En-Vision America. The speech in current units is of the highest quality available. All controls are solid and contribute to an overall quality that is often lacking in special-purpose devices.
The documentation, read by synthetic speech, may not be as desirable as listening to a human reader. At the same time, having the documentation onboard is helpful, especially since CDs and print documents can be lost after time.
As the first of its kind of technology, ScripTalk has set a high standard for all future devices that intend to offer comprehensive, independent access to prescription information. We encourage pharmacies to recognize the critical need for customers who are blind or have low vision to have full and independent access to medication information and to embrace technology that provides such access.
Product Ratings
Packaging: 4.
Documentation: 3.
Fit and finish: 4.
Speech quality: 4.
Navigation and controls: 5.
Accuracy: 5.
Product Information
Product: ScripTalk.
Manufacturer: En-Vision America, 1845 West Hovey Avenue, Normal, IL 61761; phone: 800-890-1180 or 309-452-3088; web site: www.envisionamerica.com.
Price: $195.
If you would like to comment on this article, e-mail us at accessworld@afb.net.
