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Remote monitoring of medication adherence and patient and industry responsibilities in a learning health system
  1. Junhewk Kim1,
  2. Austin Connor Kassels2,3,
  3. Nathaniel Isaac Costin2,4,
  4. Harald Schmidt2
  1. 1 Dental Education Research Center, College of Dentistry, Yonsei University, Seoul, Seodaemun-gu, Republic of Korea
  2. 2 Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
  3. 3 School of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
  4. 4 Hackensack Meridian School of Medicine, Seton Hall University, Nutley, New Jersey, USA
  1. Correspondence to Dr Harald Schmidt, Medical Ethics and Health Policy, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA; schmidth{at}


A learning health system (LHS) seeks to establish a closer connection between clinical care and research and establishes new responsibilities for healthcare providers as well as patients. A new set of technological approaches in medication adherence monitoring can potentially yield valuable data within an LHS, and raises the question of the scope and limitations of patients’ responsibilities to use them. We argue here that, in principle, it is plausible to suggest that patients have a prima facie obligation to use novel adherence monitors. However, the strength of the obligations depends considerably on the extent to which data that adherence monitors generate are, in fact, used to further the goals of LHSs. The way in which data ownership is structured in the USA poses a considerable challenge here, while the European Union framework offers a more promising alternative.

  • ethics
  • behaviour modification
  • health promotion
  • information technology

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  • Contributors HS proposed the overall angle. JK wrote the first draft of the manuscript and led all revisions of subsequent versions. ACK, NIC and HS drafted substantive subsections and critically reviewed iterations of the manuscript. All authors discussed the main line of argument and approved the final version.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement There are no data in this work.