"Take two tablets and a selfie Your doctors orders may one day include a smartphone video to make sure you took your medicine. Smartphone apps that monitor pilltaking are now available and researchers are testing how well they work when medication matters. Experts praise the efficiency but some say the technology raises privacy and data security concerns. Selfie medicine works like this Open an app on your phone show your pills put them in your mouth and swallow. Dont forget to show your empty mouth to the camera to prove todays dose is on its way. Then upload the video proof to the clinic. Fans say the technology addresses a big problem About half of drugs for chronic conditions arent taken as prescribed because of cost side effects or patient forgetfulness. With treatment for opioid addiction https a skipped dose can mean a dangerous relapse. The National Institute on Drug Abuse is funding research to tailor a smartphone app for those patients and see if theyll use it. If we can keep patients engaged we can keep them in treatment longer said lead researcher Dr. Judith Tsui of the University of Washington School of Medicine in Seattle. The next phase of her research will compare a group of patients who use the monitoring app called emocha with those who dont to see if theres a difference. At one Tennessee treatment center some patients with opioid addiction are already using the app to upload selfies of their daily dose and answer questions about how theyre doing. Every time they sign on it allows us to capture data. Are they having cravings Suicidal tendencies said Scott Olson CEO of Dallasbased Pathway Healthcare which is trying the app at its Jackson Tennessee site. Maybe a phone call from a counselor might make the difference between staying clean and a relapse. Olson thinks insurers will pay for the service with more evidence. For monitoring tuberculosis patients health departments pay roughly  to  per patient each month for systems that include encrypted data storage. A small health department might pay as little as  a month. The idea of watching someone take their medicine  called directly observed therapy or DOT  has roots in tuberculosis https where one persons forgetfulness can be serious for everyone. If patients dont take all their antibiotics https their infectious TB germs can get stronger developing drug resistance and endangering the broader community. But taking a handful of pills daily for up to a year is difficult so public health departments traditionally sent workers to peoples homes and workplaces to watch them take their doses. Today many TB patients prefer remote monitoring. Nurses like it too. Nurse Peggy Cooley has used Skype for years to chat live with patients taking TB medicine. We can accomplish in a twominute phone call something that might have taken an hour to do and most of that hour was in the car said Cooley who works for the TacomaPierce County Health Department in Washington state. The new uploaded selfies dont need an appointment. They are a daily routine for many tuberculosis patients in Seattle San Francisco Los Angeles and Houston where savings on mileage and worker time amounted to  in a recent year. In Boston Albuquerque and five other cities researchers are studying whether the technology works for hepatitis C a bloodborne virus thats surging among a new generation of injection drug users. New drugs for hepatitis C https can cure but theyre expensive   for a week course of treatment  so insurers want to make sure patients take them. I think it holds a lot of promise said researcher Dr. Alain Litwin of University of South Carolina School of Medicine whos testing whether patients do better when someone watches them take their pills. Whats next An insurer in Maryland plans to use the technology in diabetes and high blood pressure https to make sure Medicare and Medicaid patients take their medicine. Startups selling the apps say they could be used by faraway adult children monitoring an elderly parents daily pilltaking. Experts worry about privacy data security and penalties for poor pilltaking. Thats the biggest ick factor said Carolyn Neuhaus a medical ethicist at the Hastings Center in New York. You can imagine a program where benefits are tied to compliance and the insurer says We wont pay for medication anymore unless youre taking it correctly. Globally the rapid spread of smartphones creates an opportunity to eradicate TB say the app developers. But eliminating TB may take simpler cheaper technologies that can be scaled for millions of cases said Dr. Daniel Chin who leads TB efforts for the Bill and Melinda Gates Foundation. The group supports research in China and India on two homegrown technologies. Chinas tool about the size of a childs shoebox reminds patients to take their pills and saves data for review. In India the government favors a blister pill pack printed with phone numbers a patient punches out a daily pill then calls the revealed number. Worldwide TB kills more than . million people annually even though most deaths are preventable with treatment. If we are going to eliminate the disease we need technology said Dr. Richard Garfein of the University of California San Diego School of Medicine who helped develop one of the smartphone apps SureAdhere."