Nurse: You forgot to take your pill this morning

This is interesting, from The Daily Mail (UK):

Microchips in pills could soon allow doctors to find out whether a patient has taken their medication.

The digestible sensors, just 1mm wide, would mean GPs and surgeons could monitor patients outside the hospital or surgery.

The ‘intelligent’ medicine works by activating a harmless electric charge when drugs are digested by the stomach.

This charge is picked up by a sensing patch on the patients’ stomach or back, which records the time and date that the pill is digested. It also measures heart rate, motion and breathing patterns.

The information is transmitted to a patient’s mobile phone and then to the internet using wireless technology, to give a complete picture of their health and the impact of their drugs.

Doctors and carers can view this information on secure web pages or have the information sent to their mobile phones.

There’s an obvious privacy discussion here.  Furious Seasons takes a shot:

On one level, this kind of technology is fascinating and interesting for all the usual dorky techie reasons (wow, telemetry has gotten that advanced and so have transmission technologies–it’s all so very sci-fi and high tech triumphant), but on another more important level it’s downright frightening. That’s because I see this “intelligent medicine” technology as a potentially massive intrusion on individual freedom and privacy.

This example is indicative of the debate territory we are beginning to enter.  The balance between life-improving-medical-innovation and privacy is becoming more difficult to strike (well, I suppose that depends on your definition of privacy).

Via Seed.

The “connection” of health care

The need for connection in health care (via Ted Eytan, MD):

In recent years, I had thought it would be nice — but not essential — to dash off an e-mail to my physician if I had a question about a minor medical condition like a sore throat.

Escalate the medical condition — whether it’s an emergency or chronic care — and you begin understand why it becomes important for the many pieces of the unconnected medical community to get better connected.

The scariness of connection in health care (via Noah Brier):

Strike two came when I was waiting for the doctor in the examination room. The nurse first came in and logged into the GE medical history software (the actual machine was already logged in, didn’t check to see if it was logged in as administrator but I bet you anything it was/is). Then she left the room. Left the room with the software that contained every medical record of probably every Beth Israel patient logged in. At this point I was a little freaked out, but was happy to see that at least it timed out after 5 minutes of inactivity and logged the nurse out. Oh that and the computer in the room was totally unlocked, I had full physical access to the machine for a good 15 minutes totally unattended. I could have done anything to that machine.

Private health information slips out easily enough when people are careful, let alone when privacy is blatantly ignored.  Connectivity is a key to health care transformation, but we need to make data secure all-of-the-time (read: every millisecond of every second) (and more HIPPA-like policies are not the answer).

Fries at the bottom of the bag: Speaking of The Barbarians, they’re responsible for the branding of Hello Health, which launched this week (check this out, talk about accomplishing a task).  Good luck to Jay and company.  Also, Likemind is Friday morning, so if you’re up early enough go check it out.

Notions of privacy are fleeting

Fast Company’s Big Idea on July 29: “CEOs of public companies should be obligated to share their health status with investors.”

The statement is inspired by investors’ concerns about the health of Apple CEO Steve Jobs.

While Fast Company poll respondents resoundingly voted no, the mere fact that the statement was made highlights our culture’s shifting notions of privacy.  Ask anyone on Facebook or MySpace what privacy means to them.

But, medical privacy is a different beast.  Depending upon your health, more important than financial privacy (where lapses can be fixed) and online behavior privacy (where lapses can be blamed on youthful naiveté).  Technological developments have increased those concerns.  While improving patient safety, electronic information also increases accessibility.

The recently passed Medicare bill that prevented fee cuts to physicians also encourages them to adopt e-prescribing. The measure has some groups, including the American Civil Liberties Union, concerned.

The Wall Street Journal Health Blog:

In an interview with USA Today, Tim Sparapani, senior legislative counsel for the American Civil Liberties Union, raised a red flag about electronic prescribing: “Any time you put something in a digital format and standardize it, it becomes much more profitable and easy to move those records.”


Electronic records and e-prescribing do raise privacy concerns.  Let us not forget the the same concerns of offline medical information, too.

Later in the day the same blog posted this:

In yet another example of the health industry mishandling private patient records, Blue Cross and Blue Shield of Georgia sent some 202,000 explanation of benefits letters to the wrong addresses last week, the Atlanta Journal-Constitution reports.

Medical information isn’t “safe” electronically, nor in hard copy form.  It seems the patient has a choice: pick your poison.