Technologized Talk: Wearable Technologies, Patient Agency, and Medical Communication in Healthcare Settings

Introduction

In November 2017, the U.S. Food and Drug Administration (FDA) announced its approval of Abilify MyCite, the first human-ingested digitally trackable pill. Within the pill, a sensor records that the medication has entered the patient’s body. Abilify MyCite is designed for use with patients in the treatment of schizophrenia, bipolar I disorder, and, possibly, as a supplement to depression management. Once ingested, the pill communicates from the pill sensor to a wearable patch, which then transmits information to a smartphone. Patients and approved caregivers and physicians can access the medication ingestion information through a web portal. In its press release about Abilify MyCite, the FDA noted that “Abilify MyCite’s prescribing information (labeling) notes that the ability of the product to improve patient compliance with their treatment regimen has not been shown” (FDA, 2017).

The approval of Abilify MyCite brings up important questions of patient compliance, patient-physician communication, and patient privacy. While the ability to track medication ingestion is promising for many cases, patients may find a wearable so “all knowing” and invasive to be problematic. Although medication is prescribed in the interest of the patient, concerns about surveillance at this level are real and unprecedented. In the instance of Abilify MyCite, we are faced with an example of a wearable technology and associated tool that can potentially help bridge gaps in medication compliance. However, the question remains: will patients be willing to comply with such tracking? And how might this particular type of wearable technology complicate—rather than facilitate—communication between patients and their doctors?

Abilify MyCite may seem an extreme example of the potential invasiveness of wearable technologies, but, at all levels, wearable technologies continue to redefine what it means to be human and what it means to “know” about one’s body through the collected (and possibly shared) data. Through wearables, embodied computers, smart jewelry, and other devices, we can track, analyze, and modify behaviors impacting our physical and mental health, productivity, communication, and daily routines like never before. As such, we are moving towards a truly technologized state of being and identity.

In the realm of health communication, particularly when we consider the data we can now gather about our bodies and health through wearable technologies, the impact of wearables on the patient/medical practitioner relationship is shifting in unprecedented ways. Abilify MyCite is just one example. Mobile health applications, health and fitness trackers, and even telemedicine is all shifting how and when we make health decisions, as well as who we consult (or do not consult) and when. As users, many of these technologies collect and provide us with data for which we may have had to consult a medical professional to gain access in the past, increasing the level of control many of us feel we have with regards to our bodies. Wearables are thus shifting our sense of agency about our own health. For those of us with a stake in the current and future development of the next generation of medical practitioners, considering the ways wearable technologies have changed the rhetorical relationships among patients and medical practitioners is particularly important.