Health apps are revolutionizing the healthcare industry by making it easier for people to track their health, access their medical records, and find doctors and health services. They are also making it possible for people to manage their health care costs and get the care they need when and where they need it. But that’s not all they are doing.
“I think your back may be a little tight today. Let’s change how you exercise.” These instructions were delivered in a soothing yet authoritative voice with the typical physiotherapist cadence. However, it was robotic. The smartphone’s speakers are where the AI physio issued her orders from. She only requires a phone with a camera to complete her job, which entails choosing the exercises based on the patient’s injury, guiding him through each session, and ordering modifications when he is not performing an exercise correctly (bending a knee at the wrong angle, for example). His body is marked up by an AI algorithm studying his movements, which is how it can detect when a joint hurts or the back is stiffer than usual.
By many standards, the digital therapist created by the German business Kaia Health is just as effective as a real therapist. In a study involving 552 exercises performed by osteoarthritis patients, it was discovered that human therapists cooperated with Kaia’s app’s adjustments to exercises just as frequently as they concurred with the corrections proposed by other human therapists. Patients with back discomfort who used the app in clinical studies fared better than those who received in-person physiotherapy. There are various risks involved when you ask injured persons to bend and twist. Kaia’s app is comparable to human specialists in that regard as well. In surveys, less than 0.1 percent of the app’s almost 140,000 users reported negative experiences.
The Food and Drug Administration (FDA) of America and the European Union both have the app listed as a medical device. More than 40 other health applications have received FDA approval since 2017 for issues like diabetes, back pain, opioid addiction, anxiety, ADHD, and asthma. They are evaluated per the regulations for medical devices, typically within the moderate-risk category (which covers things such as pregnancy tests and electric wheelchairs).
Some European nations are creating unique approval processes that also specify how health app purchases will be made through their healthcare systems. Health apps are required to be paid for by health insurance in Germany since they can only receive provisional approval for a year based on preliminary proof of benefits. Applications that offer strong support from clinical trials acquire permanent approval. Another 19 are on the tentative list, and twelve have already been permanently approved. The German model has imitations in France and Belgium.
These “digital therapeutics” applications show enormous potential for common and unusual ailments. Some are standalone gadgets that only require a smartphone to use. Others work with wearables and other gadgets such as continuous glucose monitors that transmit data from users’ bodies. Some of them need a prescription or a referral from a doctor.
There have been three waves in the development of digital therapies, according to Brent Vaughan, a seasoned digital health entrepreneur, and current chief executive of Boston-based firm Cognito Therapeutics. The first mainly consisted of what he refers to as “nagware”—apps that assist people with diabetes and other chronic illnesses in managing menial activities like taking their medications, getting more exercise, eating healthy food, or checking their blood sugar. As described by Mr. Vaughan, the second wave of therapeutic interventions that had almost no safety risk were digitalized. Examples include cognitive behavioral therapy for various mental health issues, including insomnia (“Repackaging things that we’ve done before face-to-face, and moving them to face-to-screen”).
He claims that they are recent developments in digital treatments. By modifying the underlying molecular mechanisms, such as by rewiring neuronal connections in the brain, these treatments may slow the progression of a disease.
Most heart attack survivors who were prescribed cholesterol medications stop using them after a year.
Although nagware apps for chronic diseases may seem uninteresting, they can significantly affect population health. Steven Driver, a cardiologist and medical director of digital therapeutics at Advocate Aurora Health, a significant hospital network in America, asserts that this is what it will take to change behavior. “I won’t be back in the office 30 days from now to tell them to eat healthier and exercise more. On Tuesday, somebody will say, ‘It’s 5 o’clock, you’re presumably home from work, and you only have 3,500 steps. You can achieve your objective if you get up and walk for 30 minutes.”
Another major issue is poor medication adherence. No one, according to Dr. Driver, is more willing to take their medications than someone who has just suffered a heart attack. But most treatment plans see a decline in adherence after just three weeks. Most heart attack survivors who were prescribed cholesterol medications stop using them after a year. And because other health issues are frequently accompanied by chronic disorders like diabetes and heart disease, even diligent patients find it difficult to remember everything they need to do.
AI coaches offer assistance with all of that, similar to a typical well-organized, devoted, or even tyrannical spouse. Blue Star, a diabetic app, automatically pulls information from the clinics and pharmacies the patient visits to integrate information on a patient’s food, exercise level, sleep patterns, social interactions, and mental condition with information on meds and testing. It can be connected to a variety of equipment, including smart scales, continuous glucose monitors, activity trackers, and blood pressure cuffs. They receive daily information about how certain meals, bedtimes, and exercise affect their blood sugar levels, along with suggestions on how to make changes.
AI coaches offer assistance with all of that, similar to a typical well-organized, devoted, or even tyrannical spouse. Blue Star, a diabetic app, automatically pulls information from the clinics and pharmacies the patient visits to integrate information on a patient’s food, exercise level, sleep patterns, social interactions, and mental condition with information on meds and testing. It can be connected to a variety of equipment, including smart scales, continuous glucose monitors, activity trackers, and blood pressure cuffs. They receive daily information about how certain meals, bedtimes, and exercise affect their blood sugar levels, along with suggestions on how to make changes.
According to clinical studies, when BlueStar is combined with patients’ regular care, hemoglobin A1C (a biomarker of long-term blood sugar level) is decreased by two to four times more than it is by the most popular diabetes medications alone.
These apps may also be beneficial for chronic diseases, for whom current therapies don’t always work. A customized dietary component is part of an AI-based migraine app being tested by the German startup Perfood. According to some research, a low-glycemic diet may be as effective in relieving some migraines’ symptoms as some of the more often prescribed painkillers.
Though chronic-care applications are predicted to overtake all other digital treatments as the most popular category, some of the most intriguing innovation is focused on less prevalent health issues, including some crippling conditions for which present therapies are ineffective. Freespira, a digital therapy for panic attacks and post-traumatic stress disorder, serves as one illustration. Patients utilize a pill twice daily for four weeks with a respiratory sensor attached to it that is inserted in the nose. How people with panic disorders breathe generates a buildup of carbon dioxide, which is thought to trigger the physiological chain that results in panic.
They learn to breathe normally with the help of Freespira. Acacia Parks is a user who developed panic attacks when her spouse was admitted to the hospital following a car accident. She is a licensed psychologist. She claims that the existing panic disorder therapies are terrible. To purposefully trigger a panic attack and then learn to deal with it, you are effectively pushing yourself toward the cause of your anxiety. No one desires to do that. Though limited, several clinical research indicates that after six months or more, the majority of users report fewer symptoms or are in remission. Ms. Parks claims that the software has been very helpful.
Certainly, health applications are quickly moving beyond diagnosis and toward treatment. It is thanks to the increasing accuracy of sensors and the ability to collect more data. With more data, algorithms can be trained to better identify and predict health problems. This shift will allow for earlier intervention and better management of chronic conditions. In the future, most of us will be ‘cyborgs’ with a small sensor attached that detect diseases and injuries and informs us of the best paths to recovery.