Jeans don’t always fit right, even though you’ve grabbed your size off the rack. The same can be said of medicinal dosages.
They may seem right for your symptoms, height, weight, age and other health specifics. But tweaks are often still needed, especially with a progressive disease like Parkinson’s, where one day’s symptoms can differ from the next.
Enter Project Blue Sky, a collaboration between Pfizer and IBM designed to harness the Internet of Things to track the exact details of a drug’s effectiveness by monitoring interaction with an individual’s system. Even more, it aims to continuously devise and revise a plan to make treatment even better, minute-by-minute.
Today, doctors can listen to their patients and adjust dosages accordingly, but they can only go so far in personalizing treatment. They can’t monitor a patient’s every movement and track the minutiae of their day-to-day lives. But the Internet of Things may be able to do just that.
By pairing up treatment and technology, Blue Sky’s goal is to merge medicines and machines to work together toward abating symptoms – like tremors, dyskinesia, dementia and sleep troubles – and improving the everyday lives of those individuals with Parkinson’s and other motion-manifested disorders.
Opening the Door
It starts with taking observations in real time, in the real world.
“I like to say we’ll be measuring data that's in the wild. Did the patient open the refrigerator door? Did they take the milk bottle out of the refrigerator? You'll know what the patient is doing. You'll be able to measure their activities of daily living and their quality of life. Those measurements may provide information that could improve the patient’s therapy,” said Peter Bergethon, Vice President and Head of Quantitative Medicine at Pfizer's Kendall Square site in Cambridge.
That kind of tracking takes many forms. It might be sensors on wrappers in your refrigerators to record what you’re eating. It might be motion detectors on the floor that track your path so objects that might trip you up can be moved out of the way. It might even be alarms set to go off when you need to take your medicine that keep ringing until you do.
“If we ask, ‘How fast can I turn my hands over?’ – which is one of the things that we might measure in Parkinson's disease – that's nice. That says your drug works. But, really, what matters is: ‘How fast can I make a sandwich?’ ‘How quickly can I get out of bed?’ ” added Bergethon. “That's the Blue Sky idea. That information could be used to help an individual with the things they're having trouble with.”
Blue Sky’s big benefit is the potential to have absolute accuracy. Scanners and motion sensors, wristbands and monitors could enhance anecdotal information received from patients. A patient’s statement that he opened the refrigerator today just as easily as last week can be colored by embarrassment, bravado or simple human forgetfulness.
Technology, on the other hand, could monitor and record a patient’s actual movements in the kitchen. For example, if he grasped a door handle differently or took longer to swing the refrigerator wide open to rummage inside. And the program never needs down time. It would have the potential to deliver information 24 hours a day, seven days a week, including the potential to provide data on sleep patterns.
At the same time, the idea is that the technology will be non-invasive and non-disruptive.
"The ideal scenario would be, an individual doesn't have to mess with any of the technology... they just go about living their life. They don't have to push any buttons, they don't have to learn a new interface of any kind,” said Ajay Royyuru, director of Healthcare and Life Sciences at IBM Research. Though the exact devices haven’t been finalized yet, the idea is for a patient to simply wear a sensor on a wrist or elbow – and go about his or her day.
The researchers identified Parkinson’s as the starting point for the project because the disease largely manifests as a motor disorder, and technology is already savvy enough to capture minute movements.
But they don’t intend to stop there.
"What we're trying to do is build a model that we can replicate for other neurological diseases," said Bergethon. "And we're already talking about the next possible applications."