Are digital therapeutics the future of healthcare?

Consumer healthcare is going digital. And it’s going fast.

From glucose monitors to prescription renewals and virtual doctor’s visits, digital health is touching every step of the consumer health journey. In just a few years, a wide range of digital health products entered the market at a rapid pace. The most common and widely used are fitness and weight loss apps, virtual doctor’s visits (telemedicine), and wireless tracking devices and wearables. Although these products and services are helping people get and stay healthy, digital therapeutics are a lesser-known but incredibly exciting category of digital health.

What are digital therapeutics?

Software and healthcare have converged on an even deeper level and created this new category of digital health. According to the Personal Connected Health Alliance and Digital Therapeutics Alliance, “digital therapeutics (DTx) deliver evidence-based therapeutic interventions to patients that are driven by high-quality software programmes to prevent, manage, or treat a medical disorder or disease. They are used independently or in concert with medications, devices, or other therapies to optimise patient care and health outcomes.”

What sets digital therapeutics apart from their fitness tracking counterparts is that they’re held to the same standard as medication or other therapies. This means that they can be prescribed along with other treatments and even billed to a patient’s insurance. Closing gaps in care and improving patient outcomes through scalable, evidence-based technology is what makes this category of digital health so exciting — for patients and healthcare providers alike.

How are digital therapeutics used?

From diabetes to depression, digital therapeutics may enhance, and in some cases, replace medications and other behavioural interventions. For example, a patient who is experiencing back pain may be prescribed physical therapy and a digital therapeutic with programmes specifically designed for musculoskeletal health, like Kaia Health, to help them adhere to an exercise plan and monitor their pain.

In most cases, digital therapeutics can lead to an improvement in health outcomes and a reduction in healthcare costs. But, in some extreme situations, the information delivered could help save a life. For example, it’s vitally important for certain individuals with a chronic health condition to monitor their biometric health indicators in real-time, like blood pressure and glucose levels. Say someone has an abnormal reading and it’s outside of their doctor’s business hours. Depending on their numbers, they may be directed to information about their reading and what it means, be prompted to speak to a health coach who can provide guidance, or even be directed to an emergency room for immediate care. Having critical health information at your fingertips not only means people can get answers faster, but it also boosts confidence levels and improves patient advocacy.

For other conditions and health issues, digital therapeutics may be used to support medication compliance and lifestyle changes through targeted programmes. This could include reminders to take prescribed medication or attend virtual therapy sessions. In either case, digital therapeutics solve a problem that is all too common in healthcare — they help patients access care when and where they need it. They also provide necessary preventive and follow-up care that the majority of healthcare professionals are unable to provide in between appointments.

The growth of digital therapeutics

The ability to help individuals take control of their health and improve clinical outcomes are two of the driving forces behind the rapid growth and adoption of digital therapeutics. As of May 2018, over $600 million had already been invested in digital therapeutics. As digital therapeutics become more widely adopted and new use cases are proven out, these numbers will only continue to grow.

Data shows that more than 50% of consumers are interested in having new digital therapies and connected health devices as treatment options. In addition, an increasing number of physicians are beginning to support the use of digital therapies and devices in their patient interactions. While this doesn’t mean the end of the doctor-patient relationship, it does suggest that the office visits of today may look very different in this digital landscape.

Digital therapeutics in the workplace

Patients and doctors aren’t the only ones quickly taking to digital therapeutics. Employers are recognising the opportunity to help prevent and treat some of the costliest chronic conditions in their workforce, like diabetes prevention and management, musculoskeletal disorders, obesity and mental health disorders. In fact, 68% of employers worldwide are planning to invest in digital health in the next five years.

Digital therapeutics are an attractive option for employers because they easily integrate with existing wellbeing programmes, are low cost compared to traditional treatment options (like hospital visits and expensive medications). For example, CVS Caremark clients are able to cover the cost of Sleepio, a behavioural therapy app that helps treat sleep disorders, just as they would cover the cost of medical therapies. Employees are also more willing to use digital health tools than you might think. A recent report by Mercer found that two-thirds of workers would feel more confident using a digital health tool if it’s provided by their employer.

Employers are just starting to dip their toes in the water, but as more digital therapeutic companies amass data and are able to prove that their solutions work, regulations are put in place to ensure the quality of their products and more insurers get on board, we can expect to see a surge of digital offerings for employees.

Engagement and attrition in digital therapeutics

Digital therapeutics hold great promise for delivering scalable, cost-effective and clinically significant results. One meta-analysis of 22 studies found evidence that digital therapeutic interventions in the workplace have a positive impact on health-related outcomes. The analysis, however, pointed to an ongoing challenge: the lack of sustainable engagement as evidenced by high attrition rates.

This is a key struggle for digital therapeutic companies. No matter how great your solution is, it doesn’t work if no one is using it.

So, what’s the secret to improving engagement and reducing attrition? Well, it’s actually a complicated question to answer. One study on the usage of digital health interventions for the treatment of depression points out that first, we need to define what meaningful engagement is, and that in some cases attrition was actually a good thing. Some participants only needed the initial levels of intervention and felt that they had progressed enough to not complete the full prescribed treatment course — so in those cases, attrition is actually a positive outcome. For others, where attrition was a negative outcome, their condition made it more difficult for them to engage, the software wasn’t user-friendly enough, they lacked guidance from their provider or they needed more flexibility than the programme provided.

As more data emerges on engagement in digital therapeutics, there is one strategy that’s proving to effectively drive usage and better outcomes: don’t stick to digital tools alone. While digital tools may produce better outcomes than traditional methods, taking a multi-pronged approach and giving people options ensures greater success.

Integrating digital therapeutics with a centralised wellbeing platform provides a shortcut to better outcomes. Users get access to social support and incentives. Not only that, digital programmes are served up alongside their health benefits and relevant information — reducing another barrier to entry.

Improving the future of health

To many employers and healthcare professionals, the promise of improving patient advocacy, increasing access to care and reducing or eliminating an individual’s reliance on expensive and ineffective treatments is incredibly exciting. Digital therapeutics may prove to be the silver bullet the healthcare industry has been yearning for to improve health outcomes, reduce costs and give individuals the tools and resources they need to manage and improve their health.