Intelligent Medicine: Proteus' Very Smart Pills
"Being digital" is about to take on a whole new meaning. The phrase was popularized by a prescient book of the same name written by computer guru Nicholas Negroponte, which said that humanity was headed for a future where everything that could be would be digitalized. Next up is humans. Say hello to in-body networks.
Technologies are being developed that enable tiny computing devices inside pills to report when they have been swallowed, record information about the body's response to the drug, and transmit the information to mobile phones and the Internet so doctors can track a treatment's impact and a patient's health in real time.
"This is the most personal computing that has ever been conceived," says Andrew Thompson, chief executive of Proteus Biomedical, a Redwood City (Calif.) company specializing in so-called intelligent medicine. The field involves installing distributed networks of computers and sensors within and on the body, and connecting them to existing medical devices and pharmaceuticals. Proteus is one of 34 companies named by the World Economic Forum on Dec. 4 as a tech pioneer offering new technologies or business models that could advance the global economy and have a positive impact on peoples' lives.
Proteus is already conducting human clinical trials. Its system, called Raisin, enables an "ingestible event marker," a tiny microchip with a nontoxic battery activated upon ingestion, to be added to any kind of pill during manufacturing. Once swallowed, the pill sends a high-frequency electrical current through the body's tissue. The electrical current is picked up by a receiver on a patch placed on the patient's skin. The patch—which Thompson describes as "a kind of Band-Aid with electronics" placed on the tummy or back—periodically downloads the information it is recording to the patient's mobile phone, which then sends it to the Internet.
From there, the data are processed and forwarded to whatever person the patient has authorized, such as a doctor or a family member. There is no chance of transmitting data to another human's body by accident or for unwanted snooping from outsiders, says Thompson. The technology doesn't rely on any kind of radio signal, instead using the conductivity of tissue to relay signals, which are thus confined within the body. The device eventually disintegrates and passes safely through the digestive system.
Still, Raisin may generate fears about Big Brother. Thompson argues the benefits outweigh such risks because the technology offers the potential to transform the way heart patients and those with infectious diseases or mental problems are managed. For drug therapy to be effective, patients have to adhere to a prescribed regimen, taking required doses at appropriate intervals. But clinical studies show that more than 50% of heart patients do not receive guideline-recommended therapy, and of those who do, only 40% to 60% adhere to the regime.
The initial application of the Raisin system is for the treatment of patients with heart failure. The system senses and records the precise time a patient takes one or more microchip-enabled drugs, providing feedback on its bodily impact. The information is sent to caregivers and clinicians so that decisions can be made about any necessary adjustments. Proteus is also developing "intelligent leads," or wires connected to defibrillators and pacemakers, which, when used in conjunction with Raisin, will allow doctors to make long-distance adjustments to both the device and a heart patient's medications.
One of the significant challenges that have prevented widespread use of in-body computing to date is the disintegration of active electronics as they are exposed to bodily fluids. Proteus has developed so-called ChipSkin technology that eliminates this issue with an extremely thin and durable wrapper to protect the leads and preserve performance of the active electronics.
The adoption of Proteus' technology could mean that people will make fewer trips to doctors' offices. While that's potentially an advantage, it also poses management challenges, such as figuring out how to bill patients for constant monitoring when they don't make office visits, says Hardwin Mead, a member of Proteus' scientific advisory board and a cardiologist at Sequoia Hospital in Redwood City. Those kinds of issues will solve themselves, he predicts. "The upside is that doctors will be more efficient," says Mead. "We will be able to provide much better care."
Proteus is betting that its technology will resonate with consumers. That is why it decided to name its system after a fruit, says Thompson. If the company gets its way, its Raisin system could become as integral a part of people's lives as their BlackBerrys and Apple gizmos.