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Spies on the Inside

In a historic move by the US Food and Drug Administration (FDA), the first ever digital pill has been approved for use. The pill is designed to track if patients are taking their medication. At first techno-blush, concerns about Big Brother tapping one's body fall to the wayside; patients can voluntarily give access to the information gathered by the sensor to their doctor and designated family members or caretakers.

The pill, called Abilify MyCite, adds a tiny sensor, no larger than a grain of sand, made of silicon, copper, and magnesium inside a tablet of Abilify, a drug used to treat mental disorders like schizophrenia, bipolar disorder, and is used in conjunction with antidepressants to treat depression. The sensor is activated when it comes in contact with stomach acid and begins transmitting a signal which is picked up by a patch the patient wears on their left rib cage. The patch connects to a smartphone app via Bluetooth where people with access can read the information gathered by the sensor. The sensor is able to track when the pill was taken, the dosage, and a plethora of other metrics similar to the information a fitness tracker might gather, such as activity levels, sleep patterns, and heart rate.

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As expected with such an intrusive development, experts are gravely concerned with what this pill might mean for privacy. There is plenty of potential for such technology to be abused or used as a means to allow for punitive action against a patient who is not taking their medication properly.

Drug Tech Abuse: Big Brother 2.0

There is certainly a concern for nonadherence to medication. A report from the IMS Institute for Healthcare Informatics estimates that the cost of patients not taking their medication correctly is about $100 billion each year. Dr. William Shrank, chief medical officer of the health plan division at the University of Pittsburgh Medical Center told the New York Times, “When patients don’t adhere to lifestyle or medications that are prescribed for them, there are really substantive consequences that are bad for the patient and very costly.”

Dr. Shrank sees the potential in the new sensor technology to improve public health but also cautioned that improper usage "...could foster more mistrust instead of trust."

Psychiatrist Dr. Peter Kramer worries that the pill could be used as a "coercive tool."

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The technology is very young so there are few guidelines as to the proper usage of these monitoring pills. Privacy advocates are concerned that insurance companies or government authorities mandating their use could erode a patient's ability to make their own medical decisions. Widespread use of such technology could also make patients' sensitive medical information more prone to dissemination via hackers.

Other ingestible sensors are also waiting for approval or in development, such as a sensor being developed by MIT to monitor vital signs from inside the gastrointestinal (GI) tract. Such tech could help medical professionals diagnose illness earlier and more easily.

Monitoring health from the inside of a patient's body could open new phenomenal doors for medical treatment. However, it could also open up new avenues for misuse and abuse by nefarious actors, whether via a governmental Big Brother, or via small stochastic factions. It is imperative that security technology stays on par with these potentially game-changing innovations.

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