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Digital Therapeutics Trends And Considerations In Times Of Crises

Forbes Business Development Council
POST WRITTEN BY
Olivier Jarry

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Digital Therapeutics (DTx) are mobile software that digitally deliver clinically-proven medical interventions, unlike lifestyle and wellness apps. They undergo clinical trials, collect real-world outcomes and are based on patient-centered core principles and product development best practices, including product design, usability, data security and privacy standards.

DTx have emerged in the last few years in a broad range of interventions to prevent, detect, manage or treat diseases (mental health, cognition, obesity, diabetes, heart disease, respiratory and many others), sometimes in combination with pharmaceutical products or medical devices (e.g., blood pressure cuffs). Cognoa's pediatric behavioral health platform and Akili's platform for improving cognitive impairments are just two examples.

Importantly, in these times of social distancing, several trends have emerged in how companies are creating DTx to help people with chronic conditions to live healthier in numerous ways.

Providing Advice On Users' Phones

All DTx products provide active therapies to patients in the comfort of their own homes, and many allow their users to understand and manage their condition themselves.

Many companies provide unique services and discretion regarding mental health, sleep problems and depression. For example, Palo Alto Health Sciences' DTx product, Freespira, has demonstrated success with these patient populations. Its website says that after treatment, more than 80% of patients were panic free.

Connecting With Health Coaches

Remote or virtual coaching services are offered by many DTx solutions. These may take place at the time most relevant and through the medium most convenient to the user, including text messages, videos and chat.

For example, my company utilizes health coaching in addition to software to help users manage diabetes. And one of the first U.S. diabetes coaching services, Cecilia Health, provides coaching as well as recommendations for coping and practicing simple, at-home physical activities during the current health crisis.

Providing coaching by well-trained professionals can allow DTx companies to greatly reduce any feelings of isolation.

Connecting With Caregivers

Several digital therapies allow for an automated text or call (like Livongo) or an automated alert (like my company) to be sent to users or caregivers in case of an emergency, such as a situation involving hypoglycemia.

Automatically Replenishing Supplies

Some DTx are associated with the intake of medicines or the use of medical devices that require consumables (e.g., glucose test strips). Because software allows companies to monitor the actual consumption of these physical products, DTx companies can also identify when a person may be running short on their supplies. The application could then suggest a reorder to be shipped directly to their doorstep. Subscription or membership programs generally offer a fixed monthly price for unlimited consumables.

Home delivery of medical supplies has become a vital service for many, positioning Amazon well with its purchase of PillPack.

Connecting With Healthcare Professionals

Authorized healthcare professionals may access patient data via their DTx and provide them with their own recommendations.

Offering Telemedicine Functions

According to one article in the New England Journal of Medicine, telemedicine may be "virtually perfect" in times of pandemic by the New England Journal of Medicine. And the U.S. president spoke in support of it in March 2020. The Centers for Medicare and Medicaid Services (CMS) and the Department for Health and Human Services (DHS) also loosened rules to allow hospitals to use telemedicine.

In addition, maintaining a strong pace of clinical trials remains important for developing new treatments for a variety of conditions. Virtual clinical trials, conducted via digital tools, have been happening for some time, including those enabled by technology companies like Obvio Health and Signant Health.

The TeleDentists are also helping facilitate emergency dental consultations and virtual visits.

Triaging Patients In Hospitals

This is a different but related area of digital health. Hospitals and DTx can look at ways to connect their own systems and to use patient-reported information to help triage those concerned with situations like the COVID-19 pandemic — a need described years ago during the Ebola outbreak.

The goal should be to reduce unnecessary visits to hospitals. For example, Propeller Health says its DTx product for COPD and asthma reduces asthma-related emergency department visits by up to 57%.

Among the upcoming software and strategies in this category are Rimidi and its COVID-19 screening app, Rx.Health with COVereD, and Providence St Joseph Health's use of chatbots and nurse lines.

How Healthcare And DTx Companies Can Help

Finding ways to use and build on DTx to support chronic conditions and acute situations is important — during the current pandemic and to prepare for any possible future crisis, but also when a more normal life resumes.

Stakeholders in healthcare and DTx should seriously plan how they will use or create DTx solutions. Here are a few ideas:

• How can companies create DTx that helps patients manage their personal situations? "Hyper-personalization" and AI-based predictive analytics could become key tools in any solution.

• Physicians gather facts and data automatically that help them diagnose, treat and monitor their patient population, including remote patients. As an additional motivation, physicians should consider using the CMS's updated reimbursement codes for remote monitoring.

• Health systems can develop DTx to reduce preventable hospitalizations, improve operational efficiencies and deploy population health management.

• Some medical device companies and pharmaceutical companies have already embraced "companion diagnostics" to help physicians implement personalized medicine. Now these companies should develop "companion DTx" as they design and personalize their treatments to optimize their usage by patients.

Given these existing use cases and opportunities, it will be interesting to see how DTx continues to evolve to meet patients' needs both during the pandemic and for day-to-day care.

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