1. Smartphone Applications
The smartphone is still the mainstay of delivering DTx solutions. Many DTx solutions that use multiple technologies still use a smartphone to interact with the patient. Smartphone applications can be highly innovative, engaging, and offer therapeutic value.
- Woebot is a smartphone-enabled mental health chatbot. It uses conversational AI software to form therapeutic bonds with users as they discuss mental health issues.
- Mindset Health recently launched a DTx app for smoking cessation, relying on self-hypnosis.
- Sidekick Health recently launched a DTx app for atopic dermatitis. Patients have access to a variety of educational content, videos, and a coach to support them.
2. Video Games
Delivering behavioral change or cognitive training via video games is an emerging medium. Done well, it has the potential to activate reward centers in the brain and engage participants over the longer term.
- EndeavorRx from Akili uses video games to treat children with ADHD. Akili are expanding to other indications including autism, major depressive disorder, and lupus.
- MindMotion Go from MindMaze was an early DTx entrant employing a ‘gamified’ solution. It uses 3D motion capture games to engage patients undergoing neuro-rehabilitation exercises.
3. Virtual Reality
Virtual Reality has the power to immerse participants in a 3D environment that can facilitate the treatment of a range of conditions, from chronic pain to mental health issues.
- AppliedVR uses virtual reality to reduce Chronic Pain intensity long term compared with a placebo app. The 8-week immersive program uses body awareness, pain distraction, relaxation, and behavior modification to counter the pain.
- OxfordVR employs virtual reality to treat people with serious mental illnesses. The technology helped people who had previously been too anxious to visit a store, ride a bus, or even leave home. It did this by offering simulated experiences of these activities using the VR headset, gradually reducing their fear.
- A virtual reality digital therapeutic for amblyopia – sometimes known as lazy eye – has been shown to improve vision correction. The DTx – called Luminopia One – treats amblyopia by getting people with the condition to watch specially modified TV shows and movies using a virtual reality headset designed to promote use of the weaker eye.
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4. Smart Headbands
These are being explored as potential DTx solutions. The headbands could offer direct therapeutic intervention, e.g. using vibrations, or they could provide neurofeedback based on EEG measurements in the brain.
- Otolith Labs aims to treat chronic vertigo with a headband that emits vibrations that interact with the motion sensors in the inner ear, which could lessen vertigo symptoms.
- Myndlift, offers digital mental health programs using the Muse® EEG headset. They recently completed a study of remote neuro-feedback therapy (NFT) showing improved mental health outcomes among participants.
5. Smart Pills & Devices
Medicines embedded with microchips and medical devices with integrated sensors can form part of a DTx solution. The technology can detect if the medicine has been taken correctly, at the right frequency, and also if it has been effective.
- etectRx makes wireless sensors embedded in medications. They are partnering with Pear Therapeutics to develop two products that will combine etectRx’s medication adherence sensors with Pear’s DTx products. The goal is to help patients see when their medication is working.
- Propeller Health’s smart inhaler system for asthma and chronic obstructive pulmonary disease (COPD) tracks when and how often patients use their inhaled medications, and has shown to improve patient outcomes.
Wearable devices, such as smart watches, can be used to track health metrics and provide advice and interventions based on data collected as well as the patient's personal health profile. Other wearable devices can have a therapeutic effect, for example, by delivering energy pulses.
- The FDA approved a digital therapeutic for the Apple Watch to quell PTSD-related nightmares. The device monitors heart rate and motion during sleep in patients, using AI to detect when a nightmare is happening. It then delivers gentle vibrations designed to reduce the sleep disturbances.
- Natural Cycles partners with Oura Ring to monitor temperature for their birth control app. Instead of taking their temperatures manually, users can sync data from the Oura Ring to help determine fertility.
- Theranica is developing a migraine DTx. The Nerivio device is worn on the arm for 45 minutes at the onset of a migraine and delivers low energy electrical pulses. It aims to trigger a conditioned pain modulation response to alleviate symptoms.
7. Connected Devices
Various devices including medical grade monitoring systems can ‘plug into’ a DTx solution. For example, sensors for measuring blood pressure or blood sugar levels.
- CureApp is a DTx app for managing hypertension. Data from a blood pressure cuff is wirelessly transmitted to the digital platform.
- Sidekick Health recently partnered with Ypsomed to reduce patients’ anxiety when self-injecting medication. The goal is to integrate the DTx platform with the device to provide a seamless experience.
8. Contactless Sensors
This is an area that is developing fast and is very exciting. Imagine a world where, without doing anything, sensors around you can help you track and manage your health. Your vital signs could be tracked without touching you and the results inputted into a DTx solution.
- Researchers at MIT have developed a sensor that can track Parkinson's patients' breathing while they sleep. The contact-free sensor can alert caregivers to any progression of the condition and could also be used to diagnose the condition.
- Binah.ai has rolled out a new contactless blood-pressure-monitoring system. Users can tap into the system to measure their blood pressure, heart rate, heart variability rate, and more.
DTx development should never be about the technology, but rather the patient (and provider and payer!). However various types of technology can integrate in a meaningful and coordinated way to seamlessly support these stakeholders. As these technologies become more advanced and integrated, the DTx solutions constructed from them will become even more powerful and effective.
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About the author
Digital health thought leader, writer, and speaker.