A dose observed, not reported.
Desha-Vault is a medicine cabinet that sees a dose leave the shelf and writes it down, with how sure it is. Her family gets one line. Her face stays home.
Why observed, not reported
Almost everything known about whether people take their medicines comes from asking them. Asked, people say yes more often than the bottle agrees. A cabinet that counts what left the shelf is a different kind of record.
The numbers everyone quotes and this page does not: 125,000 deaths a year, 300 billion dollars. Traced back, they rest on trade-magazine estimates from the 1980s and a think-tank range from 2009. They are left out.
Mean adherence across eleven studies, 1,684 patients, by self-report questionnaire and by an electronic monitor in the bottle cap.
- Self-reported
- 84.0%
- Electronically measured
- 74.9%
Shi et al., Health and Quality of Life Outcomes, 2010. The authors note the two measures are moderately correlated; the gap is the point here, not a verdict on questionnaires.
17%
Median overestimate of adherence by self-report compared with electronic monitoring, across 251 comparisons in 117 studies. Pill counts overestimated by 8%, clinician ratings by 6%.
El Alili et al., British Journal of Clinical Pharmacology, 2016
about half
Of 4,783 people prescribed a blood-pressure medicine and measured electronically, about half had stopped within a year; about one dose in ten was omitted; almost half took at least one break of several days.
a third to a half
NICE's estimate of medicines prescribed for long-term conditions that are not taken as recommended. NICE's own words are “it is thought”: an estimate, not a measurement.
no large gain
Reminders alone have not moved adherence in large trials: three low-cost reminder devices did no better than nothing among 53,480 people. What has shown gains is feeding measured dosing histories back to people and their clinicians.
Choudhry et al., JAMA Internal Medicine, 2017 (the REMIND trial) and Demonceau et al., Drugs, 2013
Four things it holds to
A medicine cabinet, with the person's own packs in it, that notices a dose leaving and says so. These are the rules it keeps.
- Confirmed
- Likely
- Uncertain
- Missed
It observes. It never asks her to report.
Her own packs stay on the shelf as they came from the pharmacy. The cabinet notes a dose when it sees one leave, and writes nothing it did not see.
It says how sure it is.
Every observed dose carries one of four words: Confirmed, Likely, Uncertain or Missed. An uncertain morning is shown as uncertain, never rounded up to a yes or down to a no.
Her face stays home.
Recognising who is at the cabinet happens on the cabinet, and faces are never sent anywhere. Her family receives one line: that the dose was observed, when, and how sure the cabinet is.
It works when the network doesn't.
The cabinet decides and remembers on its own. The record is kept on the box first and shared when there is a connection, so a dropped connection never loses a dose.
One morning, three people
What the cabinet changes for the person standing at it, and what the record it writes means for the people who are not.
The person
- Keeps her own packs and strips. Nothing is decanted, re-packed or locked away.
- Is greeted by name, once, when she comes to the cabinet in the morning.
- Is asked a question only when the cabinet is unsure, and can simply say no.
The family
- Sees an observed dose, not a promise: the morning strip was handled at 08:02.
- Sees an unsure one as unsure. It is never shown as missed.
- Sees nothing the cabinet did not actually observe.
The clinician
- Sees the same four words, in the same record the rest of Desha already keeps.
- Can settle an uncertain dose later, without rewriting the past.
- Gets a short summary between visits, not a feed of events.
The person's side runs on the working prototype today. The family and clinician views are designed, and are being connected to the rest of the Desha platform.
The hardware phase of a platform that is already live
Desha measures what happens to a person's health between visits, and the Health Responsibility Score is built from what they do. Today the dose at the base of that score is reported. The cabinet is how it becomes observed.
Desha.ai is raising a pre-seed round and holds SEIS and EIS advance assurance. This page is information about the company and its products. It is not an offer, and not an invitation to invest.
- 01MedNotethe patient's medicines, family and reminders, live
- 02HeartBeatthe voice that calls, listens and escalates, live
- 03Health Responsibility Score100 to 1000, from what the person actually does, live
- 04DocNotethe clinician's view between visits, live
- 05Desha-Vaultthe observed dose at the base of the score, prototype
Where the cabinet stands apart
- Every connected dispenser we could find on sale re-packs the medicine into trays, pouches, rolls or sachets. The cabinet works with the person's own packs and blister strips, on a shelf.
- Caps, lids and seal sensors log that something was opened. The cabinet observes the dose itself and says how many units left.
- No product we could find says how sure it is. Confirmed, Likely, Uncertain and Missed is the cabinet's whole posture, and an unsure dose never counts against the person.
- The connected products need a network to work. The cabinet decides and remembers on the box; the network carries one line, later.
From a review of products on sale in November 2026, listed in the data room. Nothing we found on sale for the home observes the person's own packs on a shelf.
The platform's first pilot
- patients in the live pilot
- 50
patients in the live pilot
- answered the voice calls (40 of 50)
- 80%
answered the voice calls (40 of 50)
- added a family member (32 of 50)
- 64%
added a family member (32 of 50)
- converted to a paid plan (10 of 50)
- 20%
converted to a paid plan (10 of 50)
Self-reported by the pilot, not a clinical study. The same figures, with the same labels, are on desha.ai/investors.
Talk to us
One address for everything: the deck, a pilot in a home or a care setting, a partnership on packs and pharmacies, or a question about anything on this page.