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Techno Health Monitors: “Just Swallow a Mini-Robot and Call Me in the Morning”

November 10, 2014
by Frank Browning

Who hasn’t had a parent or a grandparent—or yourself—lost or confused on a new trail through a dense park? Or, after a certain age, unsure if you really took that anti-cholesterol pill last night, or was it the blood pressure regulator? They kind of look the same.

Every day 10,000 Baby Boomers turn 65, with 90 percent suffering at least one chronic illness. Meeting their needs becomes more crucial as the number of professional caregivers continues to decline. Some experts say the solution lies in what they call techno-wayfinding: the idea that people can be—and almost likely will be—forced to use IT to monitor everywhere they go, nearly everything they eat or drink, and whether they’re following doctor’s orders about pill consumption.

The latest form of such medical monitoring? A pretty little pill containing a micro-robot no bigger than a grain of sand that can transmit your most intimate health data directly to a smart phone—and ultimately to your doctor and other medical authorities that might want to keep track of you. So-called “indigestibles” won FDA approval in 2012 and are now being manufactured by Proteus Digital Health, which has said it is using results gathered by test patients to refine its software. At the experimental stage, Google continues working on a swallowable pill composed of microscopic nanoparticles that it hopes will someday travel through the bloodstream, detecting malignant cells and then relaying what it finds to a remote sensor outside the body.

Soon robot pills will join other monitoring devices such as electronic pill dispensers tracing whether and when you’ve taken meds, and “dementia watches” that people wear on their wrists to call for help if they get lost.

Indeed, IT health monitoring is far from new, as UC Berkeley School of Public Health epidemiologist Bill Satariano pointed recently at a meeting of the Gerontological Society of America in Washington, D.C. For years, distance runners and gym addicts have attached pulse and blood pressure bands to their smart phones, and the newest generations of “smarts” can already send that data to clinic monitoring centers in real time—avoiding what Satariano calls the “white coat effect” of monitoring cardio-vascular performance inside a doctor’s office.

Proper use of meds, Satariano contends, is at the cutting edge of medical chip technology. Those new indigestible robots that rest in your gut for up to a week, for example, contain miniscule batteries activated by stomach acid and eventually make their way through your intestinal track before landing in the toilet. But before they plop into the toilet bowl, they record what other meds you take—or fail to take—as well as other non-prescribed chemicals you might swallow. Simultaneously, they continuously track your vital signs.  All that information is, of course, transmitted to your smart phone (or a wrist or ankle band) which in turn, with the proper app, transmits it to health authorities. Think of it as an intestinal “electronic bracelet.”

Satariano explained that this newest of health wayfinding technologies could undoubtedly improve both medication usage and effectiveness for elders aging at home, all the while reducing emergency hospital visits that result from self-medication mistakes. But it’s also possible to envision the potential perils of having such private information be accessible to the health industry, marketing firms, insurers—a prospect that alarms some privacy advocates.

Is it not the ultimate Orwellian technology?

“Without question,” Satariano answered.  “We always have to ask what is the cost to each technological advance.”

But those ready to embrace such pioneering technology cite the value of giving an aging population greater independence. Example: What happens to someone whose knee cartilage thins away or whose hip ball-and-socket joints dry out if that person lives in a home where the bath and bedrooms are all upstairs and there’s no place for a stairway chair lift? If they have money, they can move to a retirement community, but relocating can also trigger confusion.

The challenges and capacities vary by individual—depending on whether they can climb stairs, have a solid sense of direction, maintain a sharp memory and so forth. “If your capacity isn’t equal to the challenge of living in a two-story house or finding your way in a new neighborhood,” Satariano notes, “you find yourself formally disabled because you’re unable to complete the necessary tasks of every day life. That is one of the most important problems facing health care today, and it’s 100 percent sociological.”

Overwhelmingly elders across race and class say they want to grow old in their own homes.  Third-party payers, private or Medicare, agree—if for no other reason because full-time assisted living facilities cost vastly more money.  And that is where advances in coordinated info-tech, or “connected health,” may be playing a crucial role.

In a paper published this year, David Lindeman, a health technologist at Berkeley’s School of Public Health, observed: “Connected health focuses on the use of telecommunications and Internet-based technologies to broaden the provision of care to non-clinical settings, such as the home and the broader community. One dimension of these technologies is that they can be used to monitor individuals with chronic conditions to detect, and thus prevent, complications and crises that can lead to acute episodes. To maintain their health and well-being, it is just as important to provide individuals with automated health coaching, based on monitoring vital signs, activity, and behavior.”

Research for this article was supported by a Journalists in Aging Fellowship, a collaboration of New American Media and the Gerontological Society of America, sponsored by the Silver Century Foundation.

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