In the past several decades we have witnessed a tremendous leap forward in both the number and efficacy of prescription medications. The population is also aging, and when you combine the increased availability of new wonder drugs with more and more people who need them, in one sense that can be a prescription for real trouble.
The more medications we take, the more opportunities we have to get confused and make potentially life-threatening mistakes.
According to the AFB Access to Drug Labels Survey Report, the print impaired community is particularly at risk for at-home medication errors, such as swallowing the wrong pill, missing a refill date, or ingesting expired medications. Prescription labels contain vital information about our medications, including how much to take and when to take them, and yet they are among the most inaccessible of documents.
Many individuals with visual impairments create and use their own braille labels, but if they bring home more than one prescription from the pharmacy, sighted help is required to create the labels. Since space is at a premium on those small medicine bottles, the information is usually abridged and incomplete. Nearly 90 percent of the visually impaired population does not use braille regularly and so those individuals must develop other strategies to distinguish their medications from one another. Some use rubber bands or other markers to help tell the bottles apart (one rubber band means blood pressure medicine and a stick-on raised dot means stomach medication). Others might store one prescription bottle on a lower medicine cabinet shelf and another on the top shelf.
But what about those who are taking six, seven, even eight or more medications a day? How do you keep them straight in your head? Particularly if you are elderly and your memory isn't as snappy as it once was, it can be very difficult to remember how much of which medication to take, and when.
If you don't believe this is a serious accessibility issue, just try to imagine a sighted individual telling his or her pharmacist, "No thank you. I don't need labels on my prescription bottles. I will remember the instructions precisely, and I'll be able to figure out which medicine is which by feeling the size and shape of the pills."
Happily, technology has provided at least one solution to this serious problem. The ScripTalk Station from En-Vision America voices prescription label information at the press of a button. In this article we'll take an in-depth look at this useful device, and we'll also tell you how you can join En-Vision America's Pharmacy Freedom program and get a ScripTalk Station on permanent loan to read specially tagged prescriptions labeled by a participating pharmacy.
ScripTalk Station: What It Is and How It Works
ScripTalk Station is an accessible prescription reading device that allows print impaired individuals to manage their own medications without guesswork or sighted assistance. Special "talking labels" incorporate radio-frequency identification (RFID) chips smaller than a grain of rice to store prescription data encoded by a participating pharmacist and affixed to the prescription bottle or package. The ScripTalk Reader scans the label and then uses voice synthesis to announce the medication name, dosage, refill date, and other essential information.
What's in the Box
The ScripTalk Station package includes the ScripTalk Station itself along with a 5-Volt AC/DC Power Adapter and two AA batteries. There is also a mini-USB cable for connecting the unit to a PC for use with the optional downloadable software, which allows you to review the prescription information on your computer using speech, screen magnification, or a braille display. Additionally, the package includes a sample pill bottle, so you can practice using the unit's controls before you receive your first RFID-tagged prescription. The ScripTalk Station documentation is available in braille, large print, and audio CD. A fully accessible PDF copy of the manual can also be downloaded from the company's website. The documentation was clear and concise and covered the device's operation in an easy-to-follow, step-by-step manner. The page also includes an audio demonstration, so you can hear the device in action.
The ScripTalk Station is a semi-circular half-moon-shaped device that measures 6.5 inches by 4.75 inches by 1 inch at its widest points, and it weighs 8 ounces. The housing is made of sturdy plastic, and there are five rubber feet on the bottom that provide a solid non-skid grip. The device is designed to be used lying flat with the curved semicircular edge toward you, but there are also two notched screw holes on the back to accommodate wall mounting.
With the back edge of the device facing forward, from left to right you will find a mini USB jack, a 3.5 millimeter headphone jack, and the unit's power adapter jack. The battery compartment is located on the bottom surface. A spring-release clip made it easy to find and open the compartment, and the batteries were equally easy to install.
The device's curved front edge contains a single control: a thumbwheel that turns the unit on and off and controls the volume. On the top surface just above the thumbwheel, there is a grouping of three buttons. The largest, which is the center button, is an oval-shaped "Read" button with a tactile dot that makes it easy to locate. The smaller triangular button at the right is the "Previous" button and the similarly-sized triangular button on the left is the "Next" button. Also on the top of the device is a horseshoe shaped semi-circle of tactile dots that surround the speaker grill and provide an easy-to-locate space to position a prescription bottle for scanning.
The ScripTalk Label
The included sample medicine bottle is a typical 1 inch by 2.5 inch plastic cylinder with a push-and-twist type safety cap. Along with the standard prescription label, there is a much smaller blank label affixed to the bottom of the bottle. A tiny bump no larger than a single braille dot covers the RFID chip, which has been encoded by a participating pharmacist to hold all of the label data that is printed on the prescription bottle.
After installing the included batteries or connecting the power adapter, turn the thumbwheel to the left, and the unit switches on with a palpable click. ScripTalk responds with three initialization beeps, a brief pause, and then a longer beep. This is followed by the voice announcement, "ScripTalk Station ready," followed by two more beeps. The unit is now ready to scan and voice an RFID tagged prescription bottle.
At this or any other point, you can choose to listen to the documentation by pressing and holding the "Read" button for three seconds. Unfortunately, the unit does not save your place or offer any section navigation or bookmarks, so every time you consult the onboard documentation, you must start again from the beginning.
To scan a prescription label, position the tagged container on top of the unit inside the semicircle of tactile dots. Press the oval "Read" button. ScripTalk beeps to indicate a scan is in progress, and almost instantly the unit begins speaking the label information.
You can also choose to press the "Read" button before positioning the labeled bottle. ScripTalk beeps steadily until it detects a talking label, and if no label is found after 15 seconds, it responds with a "labeled prescription not found" error message.
The information ScripTalk voiced after scanning the sample prescription bottle included the following field names and data: patient name, the medication name and strength, dosage instructions, the prescription date, the number of refills remaining, the prescriber's name, the phone number to use to call in a refill, the prescription number, warnings and additional instructions, quantity, and the medication's expiration date.
The information is voiced from beginning to end, but the reading can be interrupted at any time by pressing the "Read" button a second time. After that you can move down the list item by item up using the "Previous" and "Next" buttons located to either side of the "Read" button.
RFID chip transmissions only travel a few inches. Indeed, placing the bottle upside down caused ScripTalk not to be able to read the tag. For my evaluation the company sent along a few extra sample prescription bottles, and when I placed one beside the unit and a second on top, ScripTalk only read the proper bottle. I also tried setting two prescription bottles on top of the unit. ScripTalk continued to beep until I removed one of the bottles and, then, scanned and voiced the information from the remaining bottle properly.
ScripTalk uses the ScanSoft Heather voice. The company also produces a Spanish version of ScripTalk, which was not tested for this review. This unit does not perform any translation, however. Rather, it is programmed to speak a prescription label printed in Spanish with the ScanSoft Paulina voice.
ScripTalk is programmed with five voice speeds. To change among them, press and hold either the "Previous" or "Next" button for three seconds. The different speeds have no numbers or names, such as fastest or slowest. Instead, ScripTalk repeats these instructions: "Voice speed adjustment using the increasing or decreasing speed." Press the "Previous" or "Next" button repeatedly until you reach the desired setting, then press the "Read" button to save your changes.
One step below the slowest voice setting is the unit's spell mode. Selecting this option causes ScripTalk to continue to voice the various heading names (Name, Medication, etc.) word by word, but the field data itself will be voiced slowly and letter by letter. The sample bottle is tagged to contain the popular antibiotic amoxicillin, and each letter voiced clearly. At the highest volume levels, ScripTalk's built-in voice began to grow a bit scratchy, but it was still quite understandable.
It would be handy to be able to change the Spell Mode and Voice Speed settings on the fly, but when I tried pressing the "Read," "Previous," or "Next" buttons after confirming a speed or spell change, ScripTalk announced, "No prescription information is available. Please scan medication," and I was forced to repeat the scan before I could hear the data letter by letter or using a different voice speed setting.
ScripTalk only retains medication data for 30 seconds after you finish your review, so it's easy to prevent others from coming along behind you and obtaining personal information. There is also a headphone jack, so you can listen to the information privately. I tried this feature with my Apple EarPods and was disappointed to discover the information only played through one ear because the headphones are stereo, and the ScripTalk sound jack is mono.
If ScripTalk is left on battery power for more than five minutes without being used, an audio reminder alarm will sound and repeat every 1.5 minutes. The alert sounds through the unit's speakers even if you have headphones attached. It also plays at full volume no matter how the volume level is set, which is a useful feature because during my testing I neglected several times to power down the unit and only realized this when I heard the alert from a different room.
If you take medications just before bedtime and tend to be a bit forgetful, you may want to use the power adapter, so you don't have to get back out of bed if you neglect to turn it off. If you take your medications just before you leave for work, you may also be at risk of forgetting to turn the device off and running down your batteries. A more elegant solution the company might consider for an updated version would be a programmable control circuit that could power the unit down automatically, much like the Victor Stream turns itself off after a period of inactivity or when the sleep timer runs out.
The ScripTalk Station Carrying Case
My review unit also included the optional ($19.99) logoed ScripTalk carrying case. This black fabric bag is approximately 8 inches by 10 inches by 4 inches with a carrying handle and detachable shoulder strap. A zippered outer compartment is designed to hold the ScripTalk unit. Inside the zippered lunchbox-style insulated bag, there is also a mesh inner pocket for a freezer pack, and there's enough room for plenty of medications and other personal care items.
The ScripTalk Software
Recently, the company introduced the ability to connect the ScripTalk Station to a Windows PC via the included mini-USB cable. The software is available upon request, and it works on PCs running Windows versions 8 through XP Service Pack 3. (A Mac version is currently in development along with apps to run on smartphones equipped with near field communication capabilities.)
The ScripTalk User software uses a standard Windows installer, so it is easy to get up and running. Connect ScripTalk to your PC via the supplied USB cable, turn ScripTalk on, and you are ready to run the application software.
At startup you are presented with a Settings menu with three option controls. The first is the "Port Settings" field with a default button that, when pressed, automatically makes the connection between ScripTalk and the software. The second setting is a checkbox you can use to decide if the ScripTalk User software should start when Windows starts or if you would prefer to start the software manually. The third control, a combo box, determines how long the prescription information will remain on your computer display before the built-in privacy controls remove it. The choices are 15, 30, 45, or 60 seconds. You can also choose the "No Time Out" option, in which case prescription data is displayed until you close your browser tab or window.
The ScripTalk User software uses your default browser to display the prescription label information on a standard webpage created on your local system. Your information is not shared or transmitted over the Internet. I tested the software using a Windows 7 64-bit Dell PC running Window-Eyes version 8.2 and both Internet Explorer version 10 and Firefox version 20. Happily, the webpages are created using basic HTML, so no matter what screen reader, screen magnifier, or braille display you use, if you can read a standard webpage, you should have no trouble reviewing prescription information.
With the ScripTalk User software running, scan a prescription bottle as described previously. ScripTalk will voice the information as before, but after three or four seconds, your browser will pop up and display the exact same information. I found it slightly annoying that even when connected to the PC the ScripTalk Station continued to voice the information, causing a bit of auditory confusion as both the unit and my screen reader began voicing the same information at different starting times, but I was able to silence the ScripTalk with a second press of the "Read" button.
The ScripTalk User software is a must-have for deaf-blind individuals and others who wish to access their prescription data via a braille display or screen magnification. However, even if you are perfectly satisfied having your prescription label voiced by the ScripTalk Station, there is still a good reason to install and run the software.
The prescription data webpage created by the ScripTalk User software includes a hyperlink to the medication's Patient Information Monograph. This fully-accessible text version of the same booklet or insert pharmacists include with most medications is chock full of additional information about the medication, how it works, how to take it, and what side effects may result.
Receiving a ScripTalk Station on Permanent Loan
For several years the Veterans Administration has been providing its sight impaired clients with free ScripTalk Stations, and they recently broadened their program to include soldiers who return from combat with traumatic brain injuries that impair their ability to comprehend printed materials.
More recently, En-Vision America itself has begun providing units free of charge on a long-term loan as part of their Pharmacy Freedom Program. To qualify, all you need to do is arrange to have your prescriptions filled by a participating pharmacy. A complete list of participating pharmacies can be found on the company's website, which can be searched by state or zip code. I tried my own small town zip code, and the nearest brick and mortar pharmacy was a Sam's Club nearly 25 miles away. However, the list also included five mail order services, including CVS Caremark, Kohl's Pharmacy & Homecare, and Wal-Mart's mail order prescription service.
The Bottom Line
The ScripTalk Station does one job, and it does it well. Any quibbles I have with the design and feature set are minor and do not affect the device's usability.
The ScripTalk Station would be a valuable resource for many visually impaired and deaf-blind individuals. The free long-term loan broadens the device's appeal significantly, but not everyone can benefit from it. My own health coverage, for instance, will soon involve a requirement that I use Express Scripts for my prescriptions. Currently, they do not participate in the Pharmacy Freedom program, but hopefully, they and many other pharmacies will join soon and make universal prescription label access a true reality.
Product: ScripTalk Station
Available from: En-Vision America, Inc