Digital Therapeutics are the future of healthcare. But how do you predict the future of a healthcare revolution that has just begun? Tracking the latest trends and innovations in wearable technology and computer science could be the answer.
‘Wear the right kind of smartwatch and you might be able to prevent the onset of diabetes.’ Just 10 years back, this statement would have been met with ridicule. But now, smartwatches that track physical activity and use that data to predict whether you are at risk of diabetes, and voice assistants that can distinguish between an allergic cough or something even more serious, are all part of everyday life.
This easy adoption of technology by people, healthcare providers and payers is great news for anyone interested in Digital Therapeutics (DTx) and their future. A quick study of the innovations in smart consumer products like wearable devices, and advances in specific areas of technology is a good way to gain insights into the future of DTx technology.
Wearables – wearing your health on your sleeve
DTx relies on data to be effective and efficient. And wearable technology like smartwatches, fitness bands and smart earbuds are great sources of granular data. When placed on your body, such smart devices can help measure health data like temperature and blood pressure; physical data like elevation and movement; and even the specific electrical activity of the heart, muscles, brain, and skin. As such, innovations in wearable technology will indicate what developments will follow in DTx.
Smaller, lighter, and thinner wearables
Rapid advances in the miniaturisation of electronic components has made it possible to compress high processing capacity into smaller and lighter devices. It has enabled manufacturers to integrate wafer-thin sensors into wearables, making them practically invisible to the end user. This will lead to greater access to better health data and more product innovation in the field of DTx.
For instance, if the news coming out of the University of California, Berkeley is any indicator, wearable skin sensors will soon replace needle pricks for tracking some conditions. A team of scientists at Berkeley is developing a sensor design that essentially prints sensors onto a sheet of plastic, like words on a newspaper. These tiny sensors can be worn by users all day, detect what is in their sweat, and provide real-time updates on health problems such as dehydration or fatigue.
Wearables made by traditional medical technology companies like Philips and Siemens will get certification from the USFDA and similar organisations as being medical grade devices. Data from these devices will be considered clinically reliable by HCPs making these devices more popular than their generic counterparts. This in turn will drive more traditional medtech companies towards developing DTx solutions.
The wearable blood pressure monitor, HeartGuide from Omron is one such medical-grade smart device. It takes the form of a wristwatch and is registered with the FDA as a medical device. The HeartGuide takes clinically accurate blood pressure readings using an inflatable cuff within the watch band, and claims to be the first clinically-accurate, wearable blood pressure monitor to do so.
One wearable to measure them all
Manufacturers of wearables are moving further and further away from specialisation, and are focusing on developing multi-parameter devices. A good smartwatch, for instance, can measure and analyse multiple sets of data related to health, location and movement at the same time. This capability will be especially useful as the ability to constantly observe different vital signs is essential in remote monitoring of patients with chronic medical conditions.
Current Health, an Edinburgh based start-up, provides real-time insights into a patient’s health using a wearable armband. Algorithms continuously and passively analyse vital signs - pulse rate, oxygen saturation, respiration rate, temperature and movement - of the patient with the same accuracy as an ICU monitor.
Small steps for information technology, a giant leap for healthcare
The biggest change in the field will come from the rapid advances occurring in the world of information technology and computer science itself. Artificial Intelligence, Machine Learning and Blockchain are just some of the technologies that have found real-world applications in sectors as diverse as automotive, banking, e-commerce and, of course, healthcare. Many healthcare innovators and providers are currently using these cutting-edge technologies as part of their DTx offerings to provide better outcomes for patients, smarter tools for clinicians and cost-effective solutions for payers.
Artificial Intelligence – crunching data to save lives
Artificial Intelligence (AI) and Machine Learning (ML) are already playing a significant role in improving healthcare. They are being used to analyse large quantities of medical data in order to spot diseases like cancer earlier, develop new ways to diagnose diseases from basic tests, and even personalise treatment plans based on the medical and personal histories of individual patients.
As more and more healthcare applications use the power of AI/ML to improve outcomes, increase efficiency and reduce costs, we will see data analytics being used to support public health initiatives, improve patient engagement, customise healthcare plans and more.
The smartphone app Streams, the result of a collaboration between Royal Free Hospital in London and DeepMind, a British AI research firm owned by Google, is a good example of using data analytics to make doctors more efficient and help them save more lives.
The application, carried around by doctors and nurses at the hospital, streams and analyses live health data and test results of patients. It alerts clinical teams as soon as test results show that a patient is at risk, and provides them with the information needed to help them recommend treatment before the patient’s condition deteriorates.
Voice Recognition Technology – all ears and ready to help
The ability of digital devices to recognise human voice has put us in direct communication with our smart devices, and made the interaction smoother and much more efficient. In the context of DTx, voice-enabled applications will help healthcare providers receive and respond to critical situations at the point of care, without having to use their hands. Another use case for voice-activated devices will be in the field of remote patient monitoring.
Wellbox provides Chronic Care Management services and solutions to healthcare providers in the USA. One of the ways they increase a patient’s engagement with their treatment plan is by providing a cellular-enabled, 2-way voice hub that permits direct communication with their care team at the touch of a button. This device makes sure that even the most technologically averse patient can easily access healthcare when they need it.
Blockchain – keeping sensitive data private
Personal information and data is the currency that runs the digital universe. Securing it and making sure private information remains private is essential for making people feel comfortable about sharing details about themselves, especially medical information.
This is where blockchain technology comes into play. The simplest way to explain it would be to consider it as a shared, trusted, public ledger that uses cryptography to convert information into a code that cannot be tampered with.
Obviously, blockchain has an important role to play in DTx, because a patient’s healthcare records have to be shared with multiple sources, and stored at multiple locations, all the while making sure they are kept private and secure.
Unalterable blockchain-based record-keeping system provider, Factom, for example, has developed a portable medical wallet that records a patient’s medical information using blockchain. This ensures that the information it contains cannot be compromised, can be transported securely between different clinics, and will be safe forever.
Internet of Things- connected care to improve health
The Internet of Things (IoT) helps devices share data with each other, and work in tandem using the internet to make the end user’s life easier. By integrating IoT functions into medical devices, manufacturers will be able to create healthcare products that share critical data about patients with providers in real time. This will mean better management of chronic diseases, improved quality of healthcare, and shorter response times.
ABILIFY MYCITE® is an aripiprazole tablet used to treat certain kinds of schizophrenia, bipolar disorder and depression. Unlike regular aripiprazole tablets, this comes with an Ingestible Event Marker (IEM) sensor inside it. The sensor is the size of a grain of sand and sends a tiny signal to a wearable Bluetooth patch that is connected to the patient’s smartphone. The app maintains an accurate and up-to-date log of physical activity levels, dosages and much more for the patient and healthcare provider.
VR/AR – the new reality of healthcare
Augmented Reality (AR) and Virtual Reality (VR) do away with the need for a mobile or computer screen to display information. This helps the user immerse themselves into a virtual environment that feels real yet can be manipulated easily and filled with relevant information. This feature makes AR and VR invaluable tools for DTx.
Doctors are using these technologies to practice important surgical procedures in virtual environments created using data inputs from actual CT scans of their patients. Therapists are using VR to help patients suffering from post-traumatic stress disorders, by exposing them virtually to their triggers in a controlled manner, helping them face their fears gradually.
As VR headsets become smaller and more powerful, and AR glasses become more ubiquitous, the day is not far when virtual doctors from one corner of the world can treat real patients, at the other end of the world.
XRHealth for instance, is a virtual clinic that uses VR to connect licensed therapists with their patients. The therapist and the patient enter the same virtual room and take part in personalised treatment regimens that are tweaked in real-time based on the patient’s performance.
Move fast, but don’t break trust
The next few years will witness many advances in technologies that will be adopted for use in Digital Therapeutics. But in the rush to revolutionise healthcare, innovators and providers should not break one of the sacred principles of healthcare: trust. Firstly, the data captured by their devices and analysed by their algorithms should be clinically accurate and medically trustworthy. Secondly, the data should always remain private. The trust between a doctor and their patient is sacrosanct; the data exchanged between them should be treated the same way.