In the 1966 film Fantastic Voyage, a crew of five, including stars Raquel Welch and Donald Pleasance, hopped into the submarine Proteus and were shrunk to microscopic size. Then they were injected into the body of the scientist who had perfected the miniaturization process. Their mission: save him from a blood clot in the brain, the result of an assassination attempt.
Heady stuff — but now part of that sci-fi fantasy has come true.
Proteus Digital Health has developed a pill that can text an alert when it enters a patient's stomach. The technology, widely tested and already available for over-the-counter sale in a pilot program in the United Kingdom, is just one of several new developments in caregiving technology designed to prevent hospital readmissions and relieve family caregivers of the persistent worry: "Is Dad taking his meds?"
The Proteus system, consisting of a pill, a sensor patch and a smart phone, combines advanced technology with a 20th-century middle-school science fair trick.
The pill's one-square-millimeter sensor has no battery or antenna. It's coated with copper and magnesium – two fully digestible metals already in our diets – in quantities far lower than those found in a standard multivitamin. The pill gets all the electrical charge it needs from a patient's stomach. Like the potato battery that illuminated a light bulb for your seventh-grade science project, it powers itself with electrolytes — in this case, from within the belly. (This video shows you how it works.)
Each pill's sensor has a unique identification. When the pill is swallowed, its sensor is activated by the body's electrolyte charge. It then transmits a signal to a small, battery-powered patch, which the patient must wear on his or her torso. The patch detects the pill's unique identification and sends a notification that it has been ingested, via Bluetooth, to a caregiver or physician's smart phone as well as a secure database accessible to anyone authorized by the patient.
The system is intended for the growing number of people aging in place and is expected to be most in demand among those recently discharged from a hospital stay who may face particular challenges adhering to a new medication regimen.
The ongoing U.K. pilot program is being offered through Lloyd's, a national pharmacy chain. When a patient or caregiver subscribes to the service, which costs about $100 a month, a pharmacist packages all of a patient's pills for the week in a tray made to accommodate up to four daily doses for seven days. The pharmacist also drops a Proteus pill into each well. (In the pilot program, the ingestible sensor is inside a small, inactive tablet that patients take with their other, prescribed medications, and is harmlessly digested.) When the patient downs the sensor pill, caregivers and doctors can assume he or she took the medications as well.
There are already an array of products available to remind those aging in place to take their medications, part of what's estimated to be a $7.7 billion home medical equipment industry — a sector rapidly ramping up its technology. One goal of the Proteus technology is to foster a more personal touch by enabling family members to call loved ones directly if they don't get an anticipated notification.
A spokeswoman for Proteus told Next Avenue the pilot program has mostly worked as hoped in Britain, with adult children reporting they have contacted parents after failing to receive an expected alert.
The most similar product to the Proteus pill is the TabSafe In-Home Medication Dispensing System. Available now, it can be loaded with a week's worth of pills and programmed with a patient's medication schedule. When it's time for the next dose, the system produces an audible alert. The patient can then push a button to dispense the drugs. Once the pills leave the sensor-enabled tray, a caregiver receives an instant alert. The system retails for about $950, plus a $20 monthly fee for the alert service.
(MORE: New Report Highlights the Stress of Long-Distance Caregiving)
The Proteus pill, TabSafe and related devices are positioned to help address what has become a major priority in U.S. health care: the broad goal of reducing costly and risky hospital readmissions. About 20 percent of Medicare recipients end up back in the hospital within 30 days of discharge, and those return visits cost the federal government an estimated $17 billion a year. The Affordable Care Act proposes to cut those numbers in half. Part of that goal may be reached through support for new post-discharge strategies, including "telehealth" systems (like Proteus, TabSafe and others) and programs designed to train and empower family caregivers to manage hospital "handoffs." The act's provisions also penalize facilities whose patients are readmitted within a month of release, by as much as 3 percent of Medicare reimbursements when the plan is fully implemented. In the program's first year, it cost hospitals $280 million in lost reimbursements, with penalties that rose only as high as 1 percent.
The American launch of the Proteus system will be part of the post-discharge pilot programs within a number of hospitals. As in the U.K. pilot, the sensor would not be inside an active medication. Instead it will be placed in an inactive, digestible pill among prescribed drugs in a patient's weekly pillbox. When the sensor indicates that the pill has been taken, it's likely the other pills have been swallowed as well.
The federal Food and Drug Administration has approved the sensor for use in an inactive pill, but not yet for placement inside active medication. Proteus is hopeful that such approval will be forthcoming and is working with pharmaceutical companies to produce medications that can be cleared for sale.
Company representatives say that, beyond the ability to provide medication alerts, its system can be a vital tool for doctors seeking to track patients' vital health data. The Proteus patch monitors its wearer's heart rate, mobility and sleep patterns, sending that information to the database and giving physicians a more complete picture of how patients are faring overall. (There are similar standalone patches already on the market that also track such physiological data, including the SecuraPatch from SecuraFone.)
After the hospital pilot program is complete, Proteus expects to launch a marketing campaign for the pill, targeting family caregivers. The company has yet to work out a cost structure for the U.S. offering, but its spokeswoman says it will probably be sold over the Internet.