Matthew Panks takes five pills a day to keep his blood pressure low. But sometimes he forgets or runs out, so he listened with interest last month when his physician proposed trying a new kind of pill: one that, when swallowed, wirelessly alerts an app to its ingestion. And if Panks doesn’t take his meds? The app reminds him, and notifies his doctor — and his wife — if he misses a dose.
“I’m human,” the 58-year-old from South Lake Tahoe, California, told BuzzFeed News. Sometimes “I forget to take it and it does remind you. It’s a nice thing to have around.”
This futuristic-sounding setup was invented by Proteus Digital Health, a startup that wants to usher in an era of so-called wireless medicine — where your health is continually monitored even when you’re out of your doctor’s sight.
Though privacy advocates worry that digestible sensors might herald unparalleled new forms of surveillance, Proteus’s executives say they’re out to fix a long-standing and often fatal problem: Up to half of patients in developed countries don’t follow prescribed treatments for chronic illnesses, leading to additional health complications and costs, according to the World Health Organization. By one estimate, medication nonadherence causes 125,000 deaths annually in the United States alone.
Since 2001, Proteus has been working on a high-tech solution to that problem and in 2012 the FDA cleared it for human use. It makes a pill coated in digestible metals — copper and magnesium — which react with stomach acid to send a tiny electrical signal through your body. This charge zaps a Band-Aid-like patch on your skin, which sends a signal via Bluetooth to an iOS app that notes you’ve taken the pill. The skin patch, worn for days at a time, also transmits physiological data like step count and time spent being active versus resting.
Last month, Proteus began for the first time to give pills and patches to patients outside of clinical trials. The company teamed up with Barton Health System in the Lake Tahoe area and outfitted 100 patients with high blood pressure with its system.
Those patients include Panks, who works for the U.S. Forest Service and, until the pilot program, had never worn so much as a Fitbit. Panks takes one pill in the morning and four in the evening — he keeps them by the coffeemaker so as not to forget — and some of them contain Proteus’s ingestible sensor (Proteus has altered only a certain few medications). So far, Panks enjoys getting reminders, learning about his biometrics and, for example, pushing himself to walk more steps a day.
Barton CEO Clint Purvance said Proteus’s technology addresses one of health care’s most frustrating problems. “We look at the data: Do we need to change the medicine or is this the right dose?” he told BuzzFeed News. “Now we know they’re taking it regularly, we can make appropriate decisions on how to adjust that medicine instead of going into another medicine or changing dose.”
Right now at Barton, a compounding pharmacy combines Proteus’s sensors with eight generic medications for hypertension. Proteus says academics at University of California, San Francisco, the University of Washington, and UC San Diego are also experimenting with whether the sensors can monitor more complicated conditions like tuberculosis and hepatitis C. Big pharma is eyeing the company’s technology as well: Otsuka Pharmaceutical Co. of Japan wants to build Proteus’s sensors into its antipsychotic medicine Abilify, and the FDA agreed to consider it for review in September.
Michelle De Mooy, deputy director of the Privacy and Data Project at the Center for Democracy and Technology, worries about the privacy implications of digestible sensors like the ones Proteus has developed. She wonders, for example, what might happen if a patient’s medication-taking patterns were to be shared with employers, insurers or anyone who has a financial stake in keeping health care costs low.
“Quantifying health and electronic medical records can facilitate people really taking control of their health care,” De Mooy said. “But when it’s something that almost feels like surveillance of the body, that concerns me. ... What happens when a patient doesn’t do what they’re supposed to do?”
It may be too early to answer those questions about Proteus, but they are important to keep in mind as wireless medicine advances. Proteus isn’t the only company developing medical sensors for the body: Startup MC10 is developing a tattoo-like BioStamp that can monitor temperature, heart rate, and movement; various insulin makers are working on an “artificial pancreas” that would automatically detect glucose levels and administer insulin to diabetics without needing manual interference. Proteus has the added advantage of more than $350 million in funding and a $1.1 billion valuation.
Dr. George Savage, Proteus’s chief medical officer, said that the company values patients’ privacy; he stressed the ease of opting out of medication tracking. “This all relies on wearing a Band-Aid and pairing it with your phone and taking medicine with a digital chip inside,” he told BuzzFeed News. “If a patient doesn’t want to do this, they only have to take the Band-Aid off.” He added that patients working with Proteus typically appear “hungry for help.” “Right now, if you think about it, we’re expecting people to learn how to manage a chronic illness based on a few minutes with a doctor and a piece of paper that’s very complicated.”
Savage noted that Proteus takes several steps to protect patients’ information — it encrypts the smartphone and cloud databases in which it’s stored in accordance with federal privacy laws. Patients are also able to choose who accesses Proteus’s cloud-based app.
Panks, for his part, doesn’t mind being held accountable. “It keeps me pretty much on the level,” he said.
CORRECTION
An earlier version of this article misstated the year Proteus' technology received FDA clearance. It was 2012.