What is a Digital Therapeutics (DTx) App?

Mansha Kapoor
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August 21, 2023

Imagine a world where Mrs.Z, comfortably seated on her couch in 2050, is excitedly discussing an innovative treatment for her knee pain. It's not a pill or a rigorous therapy session but a mobile app prescribed by her physician. This app, paired with a Bluetooth-enabled band, guides her through videos and games for targeted exercises, ensuring accurate joint movement. Not only does it guarantee optimal exercise efficiency, but it also anticipates a nearly five-year delay for potential knee surgery. No drugs, no clinic visits – just a straightforward download with a doctor's prescription.

In essence, the heart of digital therapeutics lies in leveraging technology to usher in behavioral and lifestyle alterations. Initially, these solutions were predominantly focused on cognitive and psychological disorders. However, with technological advancements, the scope has broadened considerably. Today, these therapies target an extensive range of conditions, including diabetes, heart failure, and even Alzheimer's, to name just a few.

The U.S. is at the forefront of this transformation, with the FDA actively validating and approving these innovative treatments. These fall into two primary categories: Digital Companions, which augment existing treatments, and Replacement Therapies, which offer a digital alternative to traditional pharmaceuticals. 

What is Digital Therapeutics (DTx)

Digital Therapeutics, commonly known as DTx, represents a groundbreaking shift in the healthcare paradigm. At their core, DTx is evidence-based software-driven interventions specifically tailored to prevent, manage, or treat various medical conditions. Unlike general wellness apps, which offer broad guidance on health and well-being, DTx dives deeper, offering therapeutic solutions for specific diseases like diabetes, heart disease, and high blood pressure.

One of the distinct advantages of DTx is its versatility. These treatments can function independently or seamlessly integrate with conventional therapies, providing a holistic approach. The resultant hybrid treatment could combine pharmacological treatments, in-person therapy, and specific hardware devices. Such integrations underscore the flexibility quotient of digital solutions and innovative potential in addressing health challenges.

With the inherently digital nature of DTx, data acquisition, and analysis are streamlined. This real-time data collection tracks progress and acts as an early-warning system, ensuring timely interventions and potentially averting health crises. For patients, this means more autonomy over their health, and for healthcare providers, it offers a powerful tool for remote patient monitoring, enhancing the efficiency and effectiveness of care.

Moreover, DTx has proved pivotal in addressing chronic diseases. Since patient behavior is central to managing and mitigating chronic ailments' effects, DTx provides structured programs, often amalgamated with human coaching, to ensure optimum health outcomes.

As DTx rapidly evolves, it is not merely another digital trend. It encapsulates the convergence of technology and medical expertise, offering transformative solutions that redefine patient care in the modern era. 

Benefits of Digital Therapeutics Apps

In a world where digital transformation is the keyword, digital therapeutics (DTx) apps have emerged as a groundbreaking approach to healthcare. Beyond traditional treatment methods, DTx apps employ scientifically-backed technologies to monitor treatment progression and patient behavior alterations closely.

But what sets digital therapeutics apart from general wellness apps? It's their robust foundation in clinical and scientific evidence, targeting specific diseases and disorders, ranging from metabolic and cardiovascular issues to neurological diseases. Notably, one such application, backed by rigorous clinical trials, was endorsed by the US Food and Drug Administration (FDA) for treating substance addictions, showcasing significant improvements compared to standard therapies.

Working in tandem with modern devices like smartphones and wearables, DTx harnesses adaptive algorithms that continually refine their functions based on new data. They offer valuable health insights, behavior recommendations, and even timely medication alerts, providing preventative care and acting as reliable health information sources for practitioners.

Benefits for Patients

For patients, the advantages are twofold. They receive personalized care tailored to their unique needs without the traditional hassles of commuting or waiting. The convenience of accessing top-tier healthcare right from their mobile devices is undeniably a game-changer. Meanwhile, healthcare providers can broaden their reach, providing efficient care to a more extensive patient base without geographical constraints. Even from an economic standpoint, DTx apps are beneficial, reducing healthcare expenses for patients and insurance providers by eliminating numerous in-person consultations and associated costs.

Benefits to Healthcare Providers

Digital therapeutics (DTx) is a beacon for healthcare providers, enabling them to amplify their services beyond traditional limits. Leveraging DTx, providers can efficiently cater to a broader patient base, eliminating the challenges of distance and accessibility. Instead of addressing patients individually or having them commute, DTx offers scalable solutions that revolutionize patient-provider interactions. Furthermore, the digital nature of these treatments ensures continuous care, even when unforeseen circumstances like natural disasters, including Tornadoes and Hurricanes, pose potential disruptions.

Benefits to Stakeholders

From a financial perspective, DTx serves as a boon to various stakeholders involved in the payment process, be it the government, insurance firms, or individual patients. By emphasizing components like behavioral monitoring, DTx facilitates better health outcomes and translates to tangible economic savings. Patients can minimize frequent visits to medical facilities, thereby reducing cumulative consultation fees and associated medication expenses. The result is a streamlined, cost-effective approach to patient care that benefits patients and payers.

However, as the digital health market becomes saturated with numerous apps, it's crucial to distinguish clinically-validated DTx applications from generic wellness apps. As we advance, ensuring this distinction and educating professionals and patients about the immense potential of DTx will be vital to revolutionizing modern healthcare.

What are the Disorders that Digital Therapeutic Apps Aim At? 

The global health tech order is fast changing, and traditional medical treatments are making way for more modern, tech-driven solutions, namely digital therapeutics (DTx). These software-driven tools promise to address gaps in conventional treatments across several medical conditions.

1. Mental Health:

Mental health disorders, from depression and ADHD to autism and anxiety, are increasingly being addressed using DTx apps. These innovative platforms offer personalized therapies, from simple mobile apps to intricate virtual reality systems. For instance, VR-based DTx provides exposure and aversion therapy, offering transformative experiences for patients and helping them manage or overcome their disorders.

2. Cardiovascular Ailments:

The heart of DTx's potential can be seen in its applications for cardiovascular conditions, including acute coronary syndrome and hypertension. With custom DTx products, real-time patient monitoring becomes possible, tracking critical cardiovascular indicators. Beyond monitoring, these digital tools promote heart-healthy habits by overseeing exercise, diet, and sleep patterns.

3. Gastrointestinal Disorders:

Gastrointestinal problems like GERD and irritable bowel syndrome find respite with DTx. Thanks to cutting-edge ingestible sensors combined with custom DTx software, patients and practitioners receive real-time data and feedback, optimizing treatment plans.

4. Substance Use:

The battle against substance abuse, notably opioid addiction, is fortified with DTx solutions. These software programs equip patients with tools to nurture healthier habits, encourage positive thought patterns, and maintain a consistent record of their recovery journey.

DTx also finds promising applications in other areas of healthcare. From behavioral interventions that assist in managing Type 2 diabetes through diet and exercise commitments to asthma treatments where sensors on inhalers forecast potential asthma attacks, the capabilities are vast. Furthermore, the marriage of AI with DTx in drug administration ensures precise dosages, minimizing overdose risks.

Digital therapeutics is not a fleeting trend but a transformative shift in healthcare. By merging state-of-the-art technology with medical expertise, DTx apps are redefining how we approach, manage, and treat various health conditions. 

What are the Factors Restricting a Large-Scale Adoption of Digital Therapeutics? 

Digital therapeutics, which have revolutionized healthcare delivery, face challenges in gaining widespread acceptance. A primary concern is the vast digital health market, brimming with both high-quality, clinically-proven digital therapeutics and low-quality, unverified wellness apps. The abundance of these varied applications makes it difficult for professionals and patients to differentiate evidence-based solutions from substandard ones. Consequently, the line between what's genuinely therapeutic and what's merely wellness-oriented becomes blurred. This ambiguity affects the reputation and credibility of digital therapeutics and deters their large-scale adoption. For these innovative solutions to be integrated seamlessly into mainstream healthcare, clear distinctions and rigorous validations are imperative. 

How to Evaluate Digital Therapeutic App?

The vast mobile health app market, boasting over 350K options with 200 new additions daily, presents challenges in assessing effectiveness and reliability due to minimal regulation and limited evidence generation. Although digital therapeutics (DTx) represent a subset of these apps, only 35-40, termed Prescription Digital Therapeutics (PDTx) or Software as a Medical Device (SaMD), have garnered FDA approval since 2017. A scorecard methodology is recommended to navigate this overwhelming bursting-at-the-seams app market and verify these apps' claims. This approach offers a standardized framework and visual tool that summarizes and analyzes app performance based on a specific evaluation rubric and scoring range, enabling users, providers, and payers to make informed decisions. 

The American Psychiatric Association (APA) App Advisor guides clinicians and patients in selecting mental health apps. Unlike conventional therapeutic decisions rooted in a clinician's training and experience, choosing an app is a newer challenge. Mental health professionals may not be familiar with app evaluation, making our hierarchical rating system and rubric essential. 

The APA believes in individualized care. Just as cognitive behavioral therapy isn't universal, an app's ratings shouldn't be viewed as strictly binary. An app might excel in certain areas but lack in others yet remain relevant for a specific patient's needs. The goal isn't to label an app as 'good' or 'bad.' Instead, the rating system educates users about features the APA views as critical for informed decision-making. An app might meet all criteria but only be the right fit for some situations, or vice versa.

To simplify this process, the APA offers an Evaluation Model Screener. Think of it as a primer, addressing the most pressing considerations:

1. Platform Compatibility: Which platforms or operating systems support the app? Can you access it on a desktop? 

2. Update Frequency: Has the app seen an update in the past 180 days?

3. Privacy Assurance: Does the app offer a clear, accessible privacy policy upfront?

4. Data Security: Does the app handle sensitive data? If it does, is the data management secure?

5. Evidence-Based Benefit: Are there endorsements from research, academic sources, or user feedback?
6. Clinical Foundation: Does the app's content align with its intended therapeutic or recovery use?

7. User-Friendliness: Is the app intuitive and easy to navigate?

8. Data Sharing and Interpretation: Can the app's data be shared and understood in line with its primary objectives?

This screener serves as a starting point, ensuring that psychiatrists and patients can make well-informed choices tailored to their unique needs. The above parameters can be applied to all the digital therapeutic apps ignoring that the APA has suggested them.  

Impact of Digital Therapeutics Apps

The global rise in chronic diseases, contributing to nearly 79% of deaths in 2020, underscores the pressing need for improved disease management. An added challenge is poor adherence to prescribed medications, as seen in up to 31% of type 2 diabetes patients. Comprehensive solutions that bolster medication compliance, monitor patient health, and promote lifestyle alterations are vital. 

With the vast majority of the world now connected online, digital solutions present an unprecedented opportunity to enhance patient outcomes. Pioneering studies bear testament to their potential. For instance, the Poland National Health Fund documented a 45% decline in major adverse cardiovascular events over three months after acute myocardial infarction (AMI), thanks to digital-integrated care. Likewise, the Mayo Clinic witnessed a 40% drop in rehospitalizations post-AMI, attributing success to a regimen that involved meticulous tracking of health parameters. Moreover, research from Johns Hopkins and Corrie Health has showcased a staggering 50% reduction in 30-day readmission rates post-AMI via digital interventions. And not to be overshadowed, Virta Health's digital approach enabled a commendable decrease in HbA1c levels among type 2 diabetes patients.

Digital therapeutics is dynamically revolutionizing chronic disease management, merging the power of connectivity with healthcare innovations, promising better patient outcomes while curbing associated costs. 

Final Thoughts

Investments in U.S. digital therapeutics companies have surged, reaching over $1 billion in 2018, showing a yearly growth of 40% in the last seven years. Two trends spur this momentum. Firstly, technological advancements provide vast amounts of data, facilitating the rise of personalized hardware like smartphones and wearables. Secondly, mounting evidence indicates the efficacy of digital interventions across various medical conditions such as cancer, ADHD, and insomnia.

This upward trend is amplifying the role of digital therapeutics in healthcare. Patients desire digital convenience, physicians want to manage digitally, and stakeholders see the potential for cost-effective care. Furthermore, pharmaceuticals aim to enhance therapies with digital tools, while the FDA adopts regulations to foster digital innovation.

Emerging startups offer diverse digital solutions, from video games addressing mental health to AI-powered platforms for neurological recovery. Major tech giants, like Amazon, Google, and Apple, are leveraging their analytical prowess and scale to redefine healthcare infrastructure. Voice-command diagnoses and AI-driven medical applications hint at a digitally-dominated healthcare landscape within the next decade.

Mahalo Digital Health Platform is transforming healthcare by facilitating the rapid deployment of patient-centric digital health apps and clinical trials. Organizations can use Mahalo's prebuilt modules to release white-label apps in weeks instead of years. Given that 96% of digital health apps fail, Mahalo lets professionals focus on tailoring content for improved patient outcomes rather than lengthy app development. Contact us for demo today! 

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