Telemedicine and Digital Therapies
In 2017, the US Food and Drug Administration approved the first prescribable digital therapies to treat disease, in this case, substance abuse. In early 2021, a health intelligence platform offered to manage pharmacy benefits for these digital therapies. This move meant that physicians could now prescribe a cellphone application to their patients, and insurance companies could pay for the prescription.
The Tip of the Iceberg
The COVID-19 pandemic accelerated the roll-out of virtual office visits and consultations. There is only a short step between virtual patient-physician encounters and the prescription of digital therapies.
Behavioral health, including mental health and substance abuse, was a perfect match for the first prescribable digital therapies. Traditionally, delivery of mental health and substance abuse therapies involved so-called ‘talking therapies’ that can occur more efficiently by electronic means than in person. There are already thousands of cellphone applications designed to manage behavioral health issues. It is only a matter of time before the appearance of more sophisticated applications prescribed by physicians and reimbursed by insurance companies.
But behavioral health is only the tip of the iceberg. Hundreds of thousands of Americans currently suffer from chronic medical diseases, many of which can be managed, at least in part, with digital therapies.
There is a substantial body of evidence to suggest that a patient’s environment and behavior contribute to most preventable diseases. An emerging body of evidence suggests that digital therapies improve environments and behaviors.
The financial realities of medicine today demand the move to digital therapies. According to the Department of Health and Human Services, 86 cents of every healthcare dollar is spent on chronic diseases. Admissions to hospitals, many of which are preventable, account for a large proportion of this spending.
Whereas most chronic diseases like diabetes and congestive heart failure cannot be cured, these diseases can be managed, and in many cases, prevented. Cellphone-based applications are positioned ideally to help manage chronic conditions and prevent unnecessary hospitalizations.
Experts agree that daily behaviors substantially affect many chronic diseases, ranging from hypertension to sleep apnea. Digital therapies are practical tools for implementing small lifestyle changes that, over time, develop into long-term health benefits. These applications, combined with virtual office visits with specialists, are already revolutionizing the world of behavioral health. Over the next several years, we are likely to see the revolution spread to treat other chronic diseases.