Prescription for Change: Care & Therapy Enter Digital Era

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    Over the last few decades we saw exponential progress in our knowledge, including in areas such as medical sciences. New molecules and novel approaches to things like diagnostics or immunization have gone to scale while tech in general/ AI in particular have been force multipliers for healthcare.

    One thing that has NOT changed much is that some of the most effective medical interventions we know, continue to involve things like movement, diet and sleep. 

    A Dose of Solutionism

    Yet, we kind of continue to ignore all of that. Instead, modern healthcare continues to be optimized for old school medication prescription.

    “Take one of these after every meal and call me next week”.  

    Part of this has to do with misaligned incentives and special interest, but part of it is simply because it is much easier for everyone involved: the Dr. can quickly prescribe a pill and the patient doesn’t have to change their behavior in any way. It’s kind of easy to keep track of things like dosage and duration and adherence, and there aren’t too many variables to worry about.   

    This is normalized to the point that that providers and patients cannot really do anything else even if they would want to: a provider won’t get paid for working with the patient to address behavioral issues and insurers simply won’t cover non-molecule therapy.   

    I believe this has started to change

    And my hot take is that even while advances in science will lead to better and better molecules, I believe we are in the early days of a global trend that will lead to an overall decreased use of medication in therapy. 

    A.I. as a shot in the arm

    This is driven by several variables, including the increasing accuracy of AI in detecting patterns and recommending customized, optimized therapies even while continuously sampling datastreams from patients. Additionally, we are getting better at building behavioral change tools, which can help patients make positive lifestyle changes and reduce their reliance on medication.

    I for one am very excited about the emergence of digital therapy products that combine AI with longitudinal data and immersive experiences. These will provide patients with a higher impact from behavioral interventions and reduce the need for prescription medication. Here are a few ways in which this is happening:

    1. AI is getting very good at detecting patterns and helping not only with better dosage but also with identifying factors that aggravate or mitigate therapy. Things about how environmental factors – humidity, temperature, air quality – impact the management of asthma, for example. 
    2. By consuming longitudinal data – sleep, HR, diet, activity – AI-powered tools can identify patterns that were previously difficult to detect. For instance, these tools can help identify early warning signs of an impending disease or detect optimal dosage/ dosage window. 
    3. Behavioral change tools such as cognitive-behavioral therapy (CBT) and mindfulness-based stress reduction (MBSR) are already used extensively in healthcare. There is copious evidence that these help patients develop positive coping mechanisms, reduce stress, and improve overall mental health. With the emergence of digital tools, as well as immersive technology – such as AR/ VR, these interventions are increasingly delivered digitally, leading to better outcomes and reduced reliance on medication.

    Pills, Thrills, and Digital Chills – a new era in Care and Therapy

    By using tactics tried and tested in engagement-driven application (tik-tok?) digital therapy products engage people in their own health care in ways that traditional healthcare simply could not. They combine AI with virtual and augmented reality, and are delivered through smart devices – or even game consoles – to create engaging and interactive experiences that make it easier for patients to make positive lifestyle changes.

    This can help patients adopt healthier habits and reduce the need for molecule based medication.

    The decreased use of medication in therapy has many potential benefits, including reduced healthcare costs, improved patient outcomes and greater access to care.

    This is not to say Digital will eat pharma. In fact, as AI help us reduce the shotgun approach to treatment, we will probably reach a balance between highly advanced molecules, combined with digital elements that amplify impact and allow patients to follow highly customized, dynamically adjusting regimes of care or therapy.

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