The old healthcare saying “take two pills and call me in the morning” at Rush University Medical Center in Chicago is changing to “take your smart pill and in the morning I’ll call you.”
At Rush, No. 7 in the newly published Internet Health Management 2017 Digital Hospital 500, Rush is conducting a pilot project involving “small pills,” or a prescribed dose of medicine embedded with a small digestible biosensor the size of a grain of sand to help patients take pills on time.
Missing or skipping their medication at the prescribed time is a problem for patients with maladies such as hypertension. In the U.S. 34% of adults ages 20 and over have hypertension, or high blood pressure and in 2014, 30,221 deaths resulted from hypertension and hypertensive renal disease, Rush says.
Successfully treating high blood pressure involves taking medication on an ongoing and daily basis. But more than 50% of medications aren’t taken as directed or on time, says the World Health Organization. To see if smart pills if combined with data tracking via a mobile app and virtual coaching will help hypertensive patients do a better job of taking their medications as prescribed, Rush researchers are conducting a three-month pilot program with nine patients.
Over the course of the pilot, smart pills, or high blood pressure pills manufactured by Avella Specialty Pharmacy and containing a digestible biosensor developed by Proteus Digital Health Inc., were taken by the nine patients. Each pill contained the ingestible sensor made up of trace amounts of minerals found in common foods such as copper, magnesium and silicon and activated by stomach acid. The battery and antenna-free sensor is powered by energy from the body, Rush says.
Once the patient has taken the pill, the biosensor then communicates with a programmed wearable sensor patch worn on the upper left side of the patient’s abdomen.
In addition to recording the time a patient swallows each sensor-enabled pill, the patch can record personalized patient data such as average heart rate, steps and sleep time, says Rush vice president for population health and ambulatory service Dr. Anthony Perry.
The patch transmits information via the app for patients to share data with their healthcare provider and for the doctor to monitor the patient, Perry says. “Some patients take multiple medications a day, and during busy times a patient may forget to take his or her required dose that is important for managing a chronic health condition, or multiple conditions,” Perry says. “If that happens and the patient has registered for notifications, the patient will receive a text notification of the missed dose.”
If the patient takes the pill on time, the patient is rewarded with a congratulatory text but if a dose is missed the app sends out reminder messages, Rush says.
Rush, along Barton Health in Lake Tahoe, Calif., and six other health systems are the first hospitals to offer “digital medicine,” which the Food and Drug Administration classifies as a medical device that pairs medication with an ingestible sensor that works with a wearable sensor patch and mobile app to monitor if patients take their pills on time.
“Compliance, or taking medicine as prescribed, is a very important clinical issue, and sometimes a challenge in maintaining health,” Perry says.
It’s too early to have definitive results from the nine patients in the Rush smart pill project, but after three months four of the patients have their blood pressure under control, Perry says.
Results from the smart pill tracking and the related data such as blood pressure readings are incorporated in each patient’s electronic medical record. For the pilot Rush issued each patient an iPad to download the Proteus Digital Health app and communicate and be tracked by Rush medical researchers.
Insurance paid for the doses of high blood pressure medication made with the digestible sensors. Rush didn’t say what each dose costs but says some patients were responsible for co-payments.
Rush is putting and undisclosed amount of money into its smart pill pilot and Proteus Digital Health also paid for some undisclosed expenses, Rush says. The health system is taking a close look at smart pills and digital medicine as a way to better treat a wider variety of chronic conditions, Perry says.
After the first trial is complete, it’s not clear if Rush will start another smart pill project or when.
What Rush will work on next is what Perry calls the “workflow” to see if digital medicine smart pills can be successfully employed in other forms of treatment and if smart pills may one day become a mainstream way of prescribing and taking drugs. “We want to see how this can scale,” he says.
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