Patient Adherence Monitoring & Caregiver Automatic Alert Skill

Let's Talk About the Caregiver Alert Skill: Someone's Watching When You Can't Forget Your Meds

To be honest, when I first saw the name of this skill, the image that came to mind was the scene in a hospital where a nurse presses a call button. But after actually learning about it, I found it's much more practical than I imagined—especially for scenarios where elderly family members need to take medication long-term, or you need to manage a chronic condition yourself. Today, let's chat about this Caregiver Alert Skill, a thoughtful little tool hidden inside the MedGuard AI project.

What exactly does it do? Don't be scared by the English name

The core of this skill is just one sentence: it automatically monitors whether the patient has taken their medication, and if something goes wrong, it notifies family members or the doctor. It's not a standalone app, but a "skill module" within the open-source project MedGuard AI. Think of it as a smart alarm clock + emergency contact + health report generator—except all the logic is already written; you just need to configure it to use it.

What are the specific trigger conditions? I went through the included SKILL.md document and summarized 5 situations:

• More than 2 missed doses within 24 hours (not just forgetting once occasionally, but consecutive misses)
• Critical medication not taken at all once (e.g., warfarin, insulin—medications that are dangerous if stopped)
• Symptoms reported after taking medication (e.g., dizziness, stomach pain, rash)
• Overall weekly adherence rate drops below 80% (meaning 1 out of 5 days did not take medication properly)
• No activity for more than 4 hours during waking hours (e.g., typically 8am to 8pm, if the system receives no confirmation for 4 hours, something might be wrong)

You see, it's quite thoughtful—not just simple tracking of check-ins, but combining medication importance, frequency, and user feedback.

Alerts are divided into three levels: from "just a heads-up" to "calling in reinforcements"

What I like most about this design—it doesn't blast all notifications to everyone at once, but divides them into three levels:

🟡 Level 1: FYI (just to let you know)
Only the primary caregiver receives it, through app notification and email. For example: "Patient Zhang San forgot to take aspirin at 9am today. A reminder has been sent, we are monitoring." This level won't bother the doctor or make family too anxious.

🟠 Level 2: Action Needed
If multiple doses are missed within 24 hours, or if a critical medication is missed, the system will directly send an SMS to the primary caregiver, with a CC to email. The SMS will say something like "Your family member has missed N doses, including a critical medication. Please contact them immediately." At this point, you can't just ignore it.

🔴 Level 3: Emergency Intervention
The most severe situation—like consecutive missed critical medications, or the patient reports dangerous symptoms such as chest pain or difficulty breathing. The system will call the primary caregiver, backup caregiver (e.g., another child), and the doctor, even playing a voice message via Twilio. After the call is connected, it will ask you to press 1 to confirm receipt of the notification, ensuring someone responds.

This classification reminds me of the "Dark Forest" alert system in The Three-Body Problem, haha—but this one saves lives.

How to configure the caregiver list? Use JSON

When implementing, you just need to create a JSON file named after the patient ID in the data/caregivers/ folder. For example, P-001_caregivers.json, with the following content:

{
  "patient_id": "P-001",
  "caregivers": [
    {
      "name": "David Collins",
      "relationship": "Son",
      "priority": 1,
      "phone": "+1-555-0192",
      "email": "[email protected]",
      "notify_on": ["level1", "level2", "level3"]
    },
    {
      "name": "Dr. Priya Rao",
      "relationship": "Physician",
      "priority": 2,
      "phone": "+1-555-0847",
      "email": "[email protected]",
      "notify_on": ["level3"]
    }
  ]
}

Each caregiver can be set to only receive certain levels of notifications—for example, the son might want to know everything, while the doctor only sees Level 3. The priority determines that if the first caregiver cannot be reached, the system moves to the second one. This design is very human-centric, preventing the doctor from being bothered by irrelevant reminders.

Also a thoughtful deduplication mechanism

What I fear most is the system going haywire and sending me 100 text messages every hour for the same event. This skill sets a 4-hour cooldown period—alerts of the same level will not be repeated within 4 hours. Furthermore, if a caregiver acknowledges receipt (e.g., pressing 1), the system records alert_acknowledged: true and pauses other notifications for that event. If the issue is resolved, it records incident_resolved: true along with notes. Isn't this a complete ticketing system?

Symptom reporting process: more than just alerts

If the patient actively says "I feel dizzy after taking this medication," the skill will do the following:

• Record the symptom and the time the medication was taken, and archive it
• Display a disclaimer: "I am not a doctor, but it is worth recording. I have notified your care team."
• If the medication is critical...