The Next Generation of Digital Therapeutics

When DTx products debuted, it was commonplace to see standardized CBT content across a pipeline of products, where a common set of CBT modules were customized for each intended use. This led to linear products with a static patient experience. It also limited a physician’s ability to re-prescribe the same product again in the future in hopes of a better outcome the second time. It’s no secret that adherence suffers when patient experience is not optimized. Now, with digital biomarkers allowing for more closed loop care, it is time for leaders in research and development to think about the next generation of DTx products and how they might be smarter, more dynamic, and certainly more personalized. Since their inception, the backbone of most DTx products has been CBT. Recently, the industry has started to digitized existing mechanisms of action which were efficacious in the analog world. One example of an existing mechanism of action is the use of visual and auditory stimuli (i.e. based upon established principles of human cognition). While products that combine CBT with digitizing existing mechanisms of action are moving the DTx field forward, DTx companies and scientists alike have yet to invest in discovering and employing truly novel mechanisms of action (MOA) in the digital realm. It is these novel mechanisms of action which have the potential to add incremental, if not exponential, patient value to the status quo.

More modular experience

As the industry pivots into the next generation of DTx and investments are coming in at a dizzying pace, DTx manufacturers and partners need to design and build more forward-thinking, responsive DTx products. In addition to having novel mechanisms of action, these products must have a more modular experience pulled from a library of layered and complex content, which is displayed according to both the patient’s responses (patient reported data) and real time data collection from sensing technology (patient generated health data). DTx products on the horizon must provide custom digital experiences for patients, not only adjusting to each user’s preferences, but also considering the individual patient’s journey, any clinical testing they’ve had completed, and digital exhaust from everyday consumer devices (e.g. browsing history, GPS data, domotics, and one’s sociome on social media). The amalgamation of these multi-dimensional data points in real time through the use of machine learning can map the patient experience back to content-based breakpoints with adaptive logic. More sophisticated DTx products may even create a more autonomous biofeedback closed loop with the patient by utilizing wearable sensors, computer vision, or augmented or virtual reality (AR/VR) to capture digital biomarkers through the use of sensory experiences to feed the algorithms used to personalize the care.

Patients access to continuous care

While digitally delivered care is not a substitute for medical services received from a trained medical professional in some instances where that is necessary, it can certainly enhance the ability for patients to access continuous care when they need it. While CBT is a tried and true methodology, and it has certainly been a boon to the digital health field at large, it falls short of delivering truly differentiated patient value on it’s own. The industry needs perceptive and discerning care solutions which better engage and retain more adherent users. These new generation solutions should be designed to be deployed intra-operatively, using human factors with existing care workflows and solutions. The new generation of DTx will allow for a “blended care” paradigm where DTx products provide a digital means to improve upon and bolster current treatment paradigms by being an extension of existing care (Valerio Netto 2020).   References Fiske A, Buyx A, Prainsack B. The double-edged sword of digital self-care: Physician perspectives from Northern Germany. Soc Sci Med. 2020 Sep;260:113174. doi: 10.1016/j.socscimed.2020.113174. Epub 2020 Jul 7. PMID: 32659512. Valerio Netto A. Application of blended care as a mechanism of action in the construction of digital therapeutics. Einstein (Sao Paulo). 2020 Nov 20;18:eMD5640. doi: 10.31744/einstein_journal/2020MD5640. PMID: 33237249; PMCID: PMC7664824. About the Author ICT&health contributor Emily Kunka is a Digital Transformation Project Lead at UCB, based in San Francisco, CA. In her role, Emily leads projects that help solve some of the most interesting, innovative, and pressing issues which must be addressed to deliver the promising future of digitally transformed healthcare through high-quality digital products and solutions.