Breakthroughs and setbacks for digital pills

Wearables aren’t the only tech making waves in the remote patient monitoring space. 

A different approach can be even smaller than a patch or smartwatch. Hint: it goes inside the body.

No, we’re not talking about pacemakers and implants (though, read the next piece for more on those). We’re referring to smart pills.

Startup Celero Systems’ vitals-monitoring pill is the first of its kind: it’s a ballistic monitor that measures respiration and cardiac activity.

For now, the tool is being used in sleep apnea patients. But the company has even bigger dreams for its digital pill. Eventually, they want to use their tech to fight the opioid crisis, gathering critical data on overdose patients.

Let’s unpack how this technology works. But first, let’s discuss why Celero Systems may be fighting an uphill battle with their product.

Illustration by Mary Delaney
Illustration by Mary Delaney

The challenges of digital pills

Celero’s product isn’t the first smart pill. In fact, this technology has been fairly embattled.

Medtronic recently decided to pull its pH and digestion monitoring SmartPill device after 17 years on the market. Similarly, Proteus Health’s Abilify MyCite garnered excitement for its ingestible sensor, but the company filed for bankruptcy three years after gaining the first FDA approval for a drug with an embedded biosensor. 

One of the biggest critiques of these ingestible devices? Privacy, especially when it comes to vulnerable populations.

For instance, Abilify MyCite was approved to treat schizophrenia and manic episodes associated with bipolar I disorder.

“One of the strongest mistrusts that existed towards [Abilify MyCite] was how are you going to treat a patient with a medicine that has a sensor to track and control them, when one of their main pathologies is paranoia,” said medical privacy expert and public law professor Marina Morla Gonzalez.

Will this digital pill be different?

But digital pill proponents are hopeful that more careful messaging can make these devices more impactful than mistrust-inducing.

When it comes to addressing privacy concerns, it’s all about how the pills’ use is presented to patients, providers interviewed about the devices have noted.

“You don’t want to use this to stigmatize patients or to ‘catch them lying.’ You want to use it to show what is working well, or tell ‘if you’re struggling in this situation, I want to identify the trigger,’” said Dr. Jose Castillo-Mancilla of the University of Colorado, Anschutz School of Medicine.

When framed intentionally, patients can come to see these devices as empowering them to take control of their own health.

In ingestible expert Dr. Peter Chai’s experience, participants found such a digital approach improves their connection to the medical system: “It potentially helps individuals lend some kind of concrete evidence to discussions with their healthcare provider. So, it’s not essentially a ‘he said, she said’ about adherence, but this is more like what happened … ’I’m trying to be better or I’m doing well or I’m not doing well.’”

Circling back to Celero Systems’ product, the digital pill has been found to successfully capture heart and respiratory data in a handful of sleep apnea patients. The results are early, but promising. Most importantly, they’re indicative of a simpler way to diagnose and monitor a condition like a sleep disorder. They can bring patients one step closer to relief, minimizing the need for complex testing and additional third-party interventions.

And when it comes to the startup’s opioid crisis ambitions, the idea of a speedy, minimalist intervention tool is hard to argue against.

We’re excited to see what the company does with its next study, which may in fact have to do with participants taking opioids, per STAT’s reporting. We’ll also be watching to see how they present and talk about it, perhaps giving the digital pill a new chance at success.

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