Security Review: Smart pillboxes, maybe too smart?

By dschen at 11:02 am on February 10, 2008 | 2 Comments

Recently an MIT research team has developed a smart pillbox to help combat the problem of patients failing to take their medication at prescribed intervals. This problem of over/underdosing of the drug by the patient accounts for ~10% of hospital visits every year. To combat this problem the MIT research team has developed a smart pillbox, the “uBox” which stores and dispenses two weeks worth of medication and alerts the user to take the medication with an alarm. In addition the box records the exact time that the pills are taken and prewvents over dosing by only dispensing medication once per day. The smart pillbox then also communicates with a second component, dubbed the “uPhone” which can download the patients dosing information and configure the pillbox. The uPhone also records patient data collected by special software including temperature, weight, symptoms and answers to diagnostic questions. This information is then forwarded to a centralized location over the air so doctors can analyze the dosage patterns and overall health of a patient to determine effectiveness of a treatment.


  • Health of the patient, the primary goal of this pillbox is to help increase effectiveness of drug treatments.
  • Patient information, the uBox collects timing data while the uPhone collects other medical information that should be kept private.
  • Medication in the uBox, certain medications are quite expensive.
  • Patient’s privacy, a patient may not want to follow the treatment for some reason.

Potential Adversaries/Threats:

  • Drug companies might want to gain access to this information directly for purposes of increasing sales of a drug.
  • Insurance companies might want to gain access to the information to determine whether or not to insure a particular patient.
  • An enemy might want to harm the patient by over/under dosing the patient.
  • The patient might desire more or less drugs than prescribed.


  • The data collected by the uPhone is transmitted over the cell phone to some server, if this information isn’t encrypted before transmission then it could be easily accessed.
  • The programming of the uBox occurs via cell phone, what happens if say the communication protocol were discovered and the uBox could be programmed to do whatever an attacker wanted to do.
  • Collecting data on a cell phone, a very small device puts a large amount of information at risk, if the phone were lost/stolen an attacker could fabricate false information or access the data stored on the phone.
  • While the uBox dispenses the drugs a day at a time, it really doesn’t look like it provides that big of a defense against a physical attack (i.e. screwdriver, hammer, etc)

Potential Defenses:

  • Encryption of all the communications between the uBox, uPhone and server should all be encrypted. By encrypting these communications the data transmitted will be protected as well as the configuration of the uBox since only authorized users could program the uBox.
  • Have the uPhone only forward information to the server, ensure that no data is actually stored on the phone.
  • Strengthen the physical structure of the uBox, although a balance must be achieved between size and strength.


The uBox/uPhone together look like a promising tool for dealing with drug delivery and effectiveness monitoring for doctors. However many measures must be taken to ensure the integrity and privacy of the data being transmitted between all the components of the system. As medical devices become increasingly connected with one another, the transmission of the data securely becomes the largest security issue being faced today.

Original article here

Filed under: Current Events,Security Reviews2 Comments »


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    Comment by Jessica

    February 10, 2008 @ 11:17 pm

    Another potential adversary of this system is a street drug dealer or drug addict. Many prescription drugs (especially narcotics, pain killers and anti-depressants) can fetch an extremely high price on the street. In particular, hydromorphone can cost more than $75 for one 4-mg pill ( This medication can be taken every 1 ½ to 4 hours continuously throughout the day meaning that up to 480 pills are in a one-month supply( This means a one-month supply of this could get $36,000 on the street.

    The FDA advises that people do not throw out pills in their pharmacy containers as these are easily recognizable and stolen from trash and abused ( Some pills are so desirable that the FDA recommends that they be flushed down the toilet instead of thrown out. Among these are morphine and oxycodone.

    Having a system that broadcasts (particularly if communications are unencrypted) who takes which drugs only helps a potential adversary more easily locate desirable pills. If an adversary knew the exact location of desirable prescription drugs, it would be possible for them to target specific homes with the drugs (and it is sure a lot cleaner to listen to signals over the air than go dumpster diving). Though not as profitable as breaking into a pharmacy, it is probably easier as there is less surveillance on a private home.

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    Comment by Wintermute

    March 22, 2008 @ 1:06 pm

    Another problem here is if the box is used to get information on symptoms ect. is the lack of human contact. Many symptoms can only be diagnosed live, and might not correspond to pre-defiined symptoms. The box should not be used to replace patient/doctor or patient/nurse interactions for this reason.

    Also, if the phone line goes down of there is a power failure, will the person be able to access thier medication? Missing a day (or in a large power failure) a week of medication can have very severe consequences.

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