Have you seen the science fiction movie in which the mad scientist invents a chip to implant in patients’ bodies and then controls it with a wireless device?
Wait a minute. That’s not a movie. It’s real.
Massachusetts Institute of Technology professors Robert Langer and Michael Cima just published the results of their chip-implantation trial conducted with 7 Danish women who have osteoporosis. Patients did not receive the medication—teriparatide, a growth hormone—by injection; rather, each dose was sealed inside a chip. Doctors implanted the chips in each woman’s abdomen. When a remote control was triggered, a tiny foil seal on the chip would melt, releasing a dose of hormone into the patient's bloodstream.
And we all thought FDA social media guidance was a big deal.
In truth, remote-control medicine and the use of so-called smart objects raise questions that may not have answers for a long time. Some are technical: Could the wireless chip controls be hacked? Some are privacy related: What if the government tries to mandate implants for certain diseases or populations?
Meantime, healthcare innovators have been making much progress with a different kind of chip implantation: not in people but in things. All of these smart objects share a goal: helping patients change behaviors in support of better health outcomes.
The smart objects are like health educators. Only smaller.
Some background: Behavior models have long informed health educators about the power of feedback to drive behavior change. The Health Belief Model, for example, suggests that for change to last, patients must know the consequences of their actions (that is, have feedback). The importance of feedback is why HealthEd recommends that clients provide medication tracking tools to patients. You can’t control what you don’t know.
So, why do people keep missing doses of medicine? For one thing, it takes work to track your behavior. Often, the patients and care partners we talk with ask for tools to help manage their conditions, but they don’t always use the tools. For another, it turns out there is value in having someone else—or something else—there for motivation.
Enter smart objects. Thomas Goetz, author of The Decision Tree, wrote a great summary in “The Feedback Loop,” an article in Wired. Goetz explained that as the price of simple sensors drops—a motion-sensing accelerometer costs under $1, he wrote—the door opens to embed these tiny feedback generators into everyday objects.
One example you may already know about: GlowCaps, those plastic tops for medicine bottles that light up when it’s time for a dose. A tiny chip in the plastic “knows” when you haven’t taken your medicine and, like a personal nurse, gently reminds you to follow your doctor’s orders. This virtual nurse can get progressively more assertive: GlowCaps play a reminder tune until a dose is taken. Then, if you’re still not compliant, GlowCaps can call you and send e-mail progress reports to your physician.
(Kind of makes an abdominal implant sound less invasive, doesn’t it?)
The manufacturer, Vitality Inc., raised eyebrows when a GlowCaps study resulted in a 98 percent adherence rate. But, as Goetz pointed out, here the technology plays second fiddle to the patient experience. A GlowCap is a humble piece of plastic fitted with the heart of a health educator. Get the user experience right, says Vitality CEO David Rose, and smart objects begin to feel “enchanted.”
There are many other examples of smart objects in healthcare, particularly in prevention and monitoring:
- The Humana Horsepower Challenge lets kids advance in a video game by using sensors attached to their sneakers. The game is meant to encourage physical play and exercise
- French-based Withings has won design awards for its connected products, including a blood pressure cuff that plugs into an iPhone, as well as a scale that can tweet your weight for motivation
- A stateside competitor, Fitbit, closed on a $12 million round of private equity funding in January. Its Fitbit Ultra, a clip-on health-tracking device, contains chips and sensors that analyze its wearer’s sleep patterns and exercise habits, which it reports back over the Web
All to say, while social media innovation gets most of the press, I think pharma and healthcare organizations should spend more time exploring behavior innovation. Learn about behavior models and how they can predict personal health decisions. Ensure that flesh-and-blood health educators are integrated with marketing teams. And explore the many ways that “nanoeducators”—tiny chips programmed with the brain of a behaviorist—can help you improve patient outcomes.