This author has been writing about digital health technologies for a while. Regular readers know that it is rare for individual companies or products to be highlighted or even mentioned in my posts. However, the Proteus Digital Health (formerly Proteus Biomedical) ingestible biosensor has ramifications that transcend earnings for the company or a few patents. It was recently approved by the FDA after having been approved a while ago by the CE of the EU. In summary, this technology is a physiologic sensor incorporated into a medication pill. Stomach juices activate an energy source which is similar to a potato starch battery. The sensor then sends signals to a skin patch electrode which then wirelessly transmits information such as vital signs, body position, and verification of medication ingestion. The information is obtainable to designated persons (caregiver, clinician) via an app. It is, essentially, the quintessential digital technology.
1. This technology is the ultimate medication adherence tool. Medication adherence has been a target of digital health technology development for many years, as it is estimated that up to $750 is spent on care and other expenses on non-adherent patients. From text messaging to digital pill bottle caps, technologies have been trying to come as close to an eyewitness of a person ingesting a medication as possible. This technology leaves no doubt about adherence.
2. This technology represents the crossroads of sensors, wireless, remote monitoring, and mobile. Physiologic sensors, wireless technologies, and mobile apps are the focus of dramatic developments recently. The Proteus ingestible sensor combines all of these features, demonstrating unique elegance and ingenuity.
3. This technology is clinical enough to put it on the radar for physicians. Most medical apps and digital technologies have not been taken seriously by clinicians because they are too simplistic and unproven. The ingestible sensor appeals to the scientific mind as well as addressing real clinical problems. If it is shown to decrease hospital readmissions, perhaps improve workflow, improve outcomes, and have no long-term adverse effects, it will no doubt be welcomed by healthcare providers worldwide.
4. This technology provides a firm foundation for development of offshoot technologies. Like the development of NASA technologies and the ‘Star Wars’ initiative in the 80’s, this is a technology which will spawn ideas and developments in a few diverse directions resulting in the development of perhaps unrelated products and services. Examining all the ‘moving parts’ of this technology offers to me that kind of exciting promise.
5. It is a technology with market appeal to clinicians first, consumers second. Most mobile apps to date have been targeted at consumers for various reasons. They do not require regulatory approval, they can be mass marketed, and they are not currently beholden to any standards. This technology has gone through vigorous approval processes by multiple agencies, addresses real clinical concerns, and may have a major impact on patient outcomes. So far only a few technologies have gone through this process. These are the technologies which will, by virtue of their potential impact on patients, be the ones to break barriers of adoption of digital health technologies.
One might see why a champion of digital health technologies like me is excited about this product. I look forward to many other digital health developments (Tricorder X Prize contestants, personalized genomic medicine, and others) having the same impact on the healthcare system. It should be noted that I have no financial interest or relationship with Proteus Digital Health.
In spirit I agree with your thoughts. Please allow me to point out that monitoring of adherence is not the same as improved adherence. The art of personalized feedback based on sensor inputs and clinical trials will eventually address the latter and that still leaves several years before doctors will be convinced of efficacy if for no other reason than well designed translational clinical trials take a long time to complete. Promising for sure but the road is still longer than most would assume especially if not familiar with the protracted path of translational medicine. I would also not dismiss ‘simple’ as a key ingredient to medical breakthroughs including pay for adherence. It’s amazing what people will do when a few bucks or a gift card is offered as an incentive.
Thanks for your thoughtful comments, Kevin. I agree that simple technologies like text messaging have been shown to increase adherence, especially in developing countries. I also agree that this technology doesn’t inherently increase adherence but monitoring of adherence. Your efforts in this area are important and appreciated.
There are plenty of studies that show ‘text messaging’ is not efficacious. The key is the detailed design and specifically how is text messaging utilized. More along the lines of the pill based sensor, the trials and tribulations of continuous glucose monitoring should be a cautionary tale for all exciting new patient ‘worn’ technology. I believe this technology is a huge leap forward for those who would use it. Great technology. Extra work. Poor adoption. Poor reimbursement. Lack of efficacy in children and teens. You can read a comparison of cgm vs. a simple approach, both studies published in Diabetes Care earlier this year: http://type1techventures.com
Really interesting post. I do believe that one should not under estimate patients worrying about an invasive tracking of their health. I have friends complaining to me about the fact that their cell phone’s location can be tracked and that the SunPass tracks the movement of their cars. Now we are going to ask them to swallow pills with sensors. I have to add that I would not object to this treatment for myself.
As I understand it, Susan, the ‘tracking’ will be directed to any third parties by the patient. Thanks for your interest and stay tuned.
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