Discussion on the Deployments of Digital Therapy — Starting & Categorization
Digital health emerged 10 years ago and has gone through ups and downs in recent years. With the maturation of cloud computing, mobile devices, and AI technology in recent years, there are now corresponding solutions. Here, we introduce the origin of digital therapeutics (DTx) and the classification of products.
Digital therapy trends
Disruptability Index
In his book “Post Corona: From Crisis to Opportunity,” Scott Galloway mentions the Disruptability Index, which may be related to disruptive innovation. The key signal is that the value or innovation does not increase, but the price increases significantly, leading to unearned margin.
Although the quality of healthcare has improved in some aspects, the consumer experience has not. However, the average healthcare premium for households has increased by 22% in the past 5 years and by 54% in the past 10 years, which is clearly higher than the rise in wages or inflation.
To put it simply, things that don’t make sense will eventually be overturned or reformed. Therefore, healthcare has reached a stage where it must be reformed.
In the past 10 years, there was a surge of discussions on healthcare reform sparked by Christensen’s book “The Innovator’s Prescription: A Disruptive Solution for Health Care,” which was published around 2010. Later, IBM used this as the theoretical basis for their “Smart Healthcare” initiative, as part of their “Smart Planet” program.
In Taiwan, IBM came to seek partners because of the country’s strong healthcare system and ICT technology. During that time, I respected the efforts of Dr. Fang Yongsheng, the director of the Service Science Research Center at ITRI, who organized an international digital health conference where Jason Hwang, the co-author of “The Innovator’s Prescription: A Disruptive Solution for Health Care,” was present. It was in that event that I first heard about the concept of apps being prescribed as medication.
However, I personally believe that at that time, the available technology and business models were not sufficient to solve the pain points in the entire healthcare value chain. Therefore, progress in this area also fell silent for a while.
Recent
With the recent maturity of cloud, mobile device technology, and AI technology, corresponding solutions to the problems in each segment of the healthcare service value chain have emerged. Please refer to the following discussion for more information.
The outbreak of Covid-19 in 2020 has greatly accelerated the progress of telemedicine, and the application of digital health has become more prevalent. With the maturity of cloud computing, mobile devices, and AI technology, solutions to problems in every aspect of the healthcare service value chain have emerged.
As a result, the application of digital health has become more concrete. Besides being backed by medical evidence, some have even passed government agency reviews and are recommended for use by public healthcare systems like the NHS in the UK.
Moreover, according to the IQVIA 2021 Digital Health Trends Report, the survival trend of health apps released is shown in Fig. 1. The delisting rate of health apps released since 2010 peaked in 2014 and gradually decreased until 2020 when it was only 10%. This indicates that related applications have become mature.
Discussion
Digital Therapeutics and Digital Health
Here, we reference Deloitte’s analytical report “Digital therapeutics, Catalysing the future of health”.
Their classification of Digital Health, Digital Medicine, and Digital Therapeutics is as follows:
The focus of this article is on the field of Digital Therapeutics (DTx), a subfield of Digital Medicine. As shown in Fig 2, the basic premise of entering the field of DTx is:
(1) The nature of Digital Medicine: evidence-based software and hardware can measure and intervene in human health services.
(2) The nature of DTx: providing evidence-based therapeutic interventions to prevent/manage/treat diseases.
Thus, it is evident that evidence-based software and hardware is a basic requirement for DTx.
Categorization
According to the classification in Fig 2, digital therapeutics (DTx) can be divided into monotherapy and adjunctive therapy. However, I personally prefer the classification in the IQVIA 2021 Digital Health Trends report, which considers monotherapy as a type of DTx and adjunctive therapy as digital care (DC). The original text is as follows:
Digital therapeutics are typified by their focus on addressing a narrow clinical indication, leveraging fixed content and generating high-quality evidence on clinical effectiveness.
Digital care products, including digital care platforms that typically address broadly- defined clinical conditions such as diabetes, and digital care tools — both of which are typically tailored or personalized to individual needs
Furthermore, regarding the distribution of Deloitte’s application cases for DTx, please refer to Fig 3.
In my opinion, the Treat category can be classified under DTx, while the Prevent and Manage categories can be classified under DC.
In addition, the Digital Therapeutics Alliance has launched the DTx-Value-Assessment-Guide. Fig 4 clarifies the definition of digital therapeutics and provides a clear explanation.
Further discussions will be conducted in the following articles.
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