1. What future do you see for implantable and ingestible devices? Is healthcare going to be the main driver or do you see other applications as well?
Implantable and ingestible devices have an exciting future ahead. People want easy ways to solve problems. We know that pills are popular because of that reason. Taking a pill is one of the easiest ways for people to address medical problems and it has revolutionized health behavior and the healthcare business. Ingestible devices will have a similar path, especially as sensors for tracking getting better and people get more comfortable using them. I think one of the most exciting potential advances in this area will be in medication adherence. Only about 50% of people adhere to their prescribed medication regimens, and this leads to huge health care consequences in deaths and billions of dollars spent that could be used if people were more adherent. Researchers currently struggle with knowing whether people are taking their medications. For example, large clinical trials test whether new medications are effective in reducing disease. Those studies assume that people are taking their medications. They assume that if the drug doesn't prevent and reduce disease that it's because the drug didn't work. But often, it's because people didn't take the medication. This means that a lot of money is being spent on testing drugs and that these drugs appear to not be working, but not because they aren't helpful, but because people aren't taking them.
There are already devices being tested that could monitor whether people are taking medications. There are sensors that can detect when a drug has been ingested. These devices can be used to notify doctors and other people making healthcare decisions with the patient. There are a lot of potential ethical issues with these devices. For example, if lack of adherence to medication causes so many deaths and costs so much money, and if we had the ability to track who was adhering to their medication, then might their be penalties for people who didn't adhere to their prescribed medication? These types of questions need to be studied and make ingestible devices an exciting area in the future where we need to understand the costs and benefits of these technologies.
Your question also asked about whether these devices would only be used in healthcare. Yes, healthcare is the main driver for these devices right now in order to diagnose and treat disease. But other application areas exist too and are growing. For example, the ingestible pills I mentioned are also being used in areas of cybersecurity.
2. You recently tweeted a meeting to discuss ingestibles with Intel. What contributions are they making in this field?
Intel is a sponsor for the University of California, Institute for Prediction Technology (UCIPT). We met to discuss our current collaborations, like our Freshman200 study where we attempt to predict student health and well being, and a study we are doing to test how Intel/Basis bands compare to standard tools for measuring fitness and sleep. We also discussed future ideas within wearables, but I unfortunately can not go into the details of those discussions right now.
3. Do you think ingestibles are going to be more accurate at detection human bodily functions and behavior than external devices? Or are they designed for people who are to lazy to wear wearables?
Ingestibles can add another data point. They can supplement, not replace, existing ways that we detect human behavior and disease. We currently have health care providers talk to patients, have patients complete surveys and answer questions, and have devices like pill counts to measure behavior. But valid, objective measures of behavior are really important to help people make decisions. When doctors ask their patients if they are taking their medications, patients often don't give an accurate response. This is not necessarily because they are lying, but there are a lot of other reasons like they can't remember or there is stigma associated with taking the medicine. By having sensors that can accurately and objectively know whether or not a person took medication, exercised, or stuck to their nutrition routine, we can learn a lot about how to help people. These tools provide another layer of data that can be used to guide decisions about people's health care and other behaviors. And yes, although they're not designed for people who are too lazy, by making something easier to use will make everyone more likely to use it. Cars weren't designed for people who don't want to walk, but they make it much easier for us to get around to place quickly.
4. How would you personally feel about an electronic device traveling in your body? As a psychologist, can you imagine follow up counseling that would be needed to ensure the success or acceptance of medical applications of such devices?
This gets back to the interesting ethical questions that come with these devices. I discussed the ethical questions associated with technologies in the New York Times piece that was published earlier this month. We've done a lot of research on people's ethical views about technologies. If people think the benefits outweigh the risks, if the technology and people recommending it are intending it will do good, and if people are aware of the risks, then it is generally considered ethical to use. Personally, I wouldn't want a device like that traveling through my body until I had read studies about the long-term effects of us or unless I was told it was necessary for my health and well being.
5. Do you perceive technology as an enabler of public health or as a menace? Certainly your research proves we can easily collect huge amounts of health data. On the other hand, one could argue that all this convenience leaves a chasm - less urgency in changing ourselves or our environments.
I try to avoid the question of whether or not technology is beneficial for public health, because it's unavoidable. People will continue to build technologies and if these are helpful to people then they'll use them. I see good technologies as tools that can help make things easier for people to do things. These tools can be used for good or bad means, these can be enablers of public health or they can be used as a barriers to public health and well being. When the telephone first came out, as with almost any big technology, people were scared that it would negatively impact our society. Maybe it did, maybe it didn't. But it definitely made it easier for people to communicate. Technologies aren't going away but they are making it easier for people to do things. As a psychologist I see my role is to see how I can help people use them for things that will improve their lives and work and make the world a better place.
6. If you could design any implantable device to treat the conditions of digital behavior highlighted in your research, what would it be?
I'd like to not have to sit at a computer and type. I like to walk while I think. I've tried audio and transcription software to talk while I walk, but this doesn't work as transcription software makes mistakes when detecting language. If something could read from my brain and transcribe that would be a lot more accurate...