Riley Kinman, a six-year old from Dallas was finishing her dinner of chicken nuggets at home when suddenly, noisy alarms began to beep all at once. The first reaction of her parents, Terry Kinman and Nicole White, was to rush to the kitchen to grab a large bag of pills.
Riley needs to take multiple medications on a strict schedule after having received a kidney transplant last year. She cannot afford to miss a dose of her medications which may damage the kidney she received from her dad. The alarms helps her parents stay on track.
Not taking medications as recommended is one of the main reasons why adolescents and young adults ultimately lose their transplant.
"Even if they don't lose the organ, there can be permanent loss of function that will not recover," explained Dr. Dev Desai, head of pediatric abdominal transplantation at the Children's Medical Center in Dallas. "It's a major challenge for pediatric transplant centers,” explained the transplant surgeon. He's spearheading the effort at the hospital.
Earlier this year in June, Children's Health in Dallas began testing an emerging innovation known as "digitized medicine." The digitized pill looks just like a regular pill, but the difference is that it contains no medication; instead it carries a tiny sensor about the size of a grain of sand.
In the general population, adherence to poor medication has cost the nation approximately $289 billion, and it frequently results in tests, procedures, doctor's visits and hospitalizations.
While inside the stomach, the sensor documents if the patient has taken any medication. The result is then communicated to a patch worn by the patient on the side of the body. The system can also identify increases or decreases in blood pressure or heart rate, and track physical activity and sleep patterns.
The information is transmitted from the patch to a cloud-based server and can be downloaded onto a web interface at the hospital within minutes for the clinical staff to see.
Each patient with the digitized pill is provided an iPad, so they can view their information as well. Both the patient and the medical team have access to see if a medication has (or has not) been taken at the scheduled time, or if too much (or too little) has been ingested.
So far this technology has mostly been tested in adults with chronic conditions such as uncontrolled hypertension, diabetes and tuberculosis.
Children's Health in Dallas is perhaps the first to extensively test the new technology using pediatric patients. Riley, who takes a daily combination of vitamins, steroids, blood pressure, urinary tract and immunosuppressive drugs, was the first patient to enroll in the pilot program.
The digitized drug, which is manufactured by a Redwood, California-based digital health company named Proteus, gained FDA approval in 2012, under a classification meant for "novel devices of low to moderate risk."
