Digital therapeutics is bridging the gaps in India’s chronic disease management

Digital therapies include monitoring, incentives, and design thinking to enhance patient engagement and enable them to manage their health and stay on course.

Digital therapeutics is bridging the gaps in India’s chronic disease management
Perhaps the scope of technology can be best measured in the transformation of care delivery models. (File)

By Dr. Suhas Patil

Chronic diseases are becoming more prevalent in India, putting increasing strain on the healthcare system. Hypertension affects 24% of the population, while diabetes affects 9-10% of the population. Noncommunicable diseases accounted for 63% of all mortality in India, with cardiovascular diseases (CVDs) accounting for 27%, according to the WHO and recently documented by Redseer. CVDs alone are also responsible for 45% of mortality in the 40-69 age range. Approximately 75 million people in our nation suffer from diabetes, which places India in second position for diabetic patients, only behind China, (As per Redseer report). Consider your family instead of statistics: at least one member has high blood pressure, diabetes, or cardiovascular disease.

As India ascends the economic and social development curve, the prevalence of chronic illnesses was bound to rise. Worrisome, however, is the rate of chronic disease expansion. Even younger folks in their 30s are currently experiencing health issues relating to stress and sedentary lifestyles. Nearly every home has concerns relating to obesity and spending more time and money on health is becoming increasingly common.

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The healthcare journey of a patient with chronic disease frequently entails several healthcare activities including, doctor consultations, regular vital sign monitoring, medicine purchases, lab tests, dietary alterations, and monitoring and tracking all developments. Lack of appropriate healthcare infrastructure or knowledge, living with the chronic disease and its conditions makes day-to-day life of a chronic disease patient worrisome. In addition to these, the financial burden of managing a chronic disease is added to a household’s overheads. Overall, living with chronic disease can become burdensome not just for the patient but for their family as well.

Over the last few years, our country has seen a rise in not just consumer adoption of digital players for e-commerce but also an emergence of e-players across sectors. Digital Therapeutic Apps are helping address issues of chronic disease patients in a holistic manner. In the last five years, there have been many start-ups focusing on apps that provide full-stack solutions to chronic disease patients making them rely on technology rather than human interface to tackle their chronic diseases more effectively. They are making use of widespread availability of smartphones, wearable technology, and rising internet usage, to help patients manage their disease for better outcomes. These start-ups are seeking to fill the gap left by both public and private healthcare providers. These apps and their IoT technology also help Doctors in monitoring patient’s health conditions on a near-real time basis. Doctors can easily give appointments to patients using their smartphone and the readily available patient history on these apps helps them manage patient follow-up more efficiently.

What are digital therapeutics?

Digital therapeutics refers to the application of digital technology to facilitate disease management. It connects doctors and patients using a smartphone application. This approach uses the data provided by wearables, health monitoring devices & self-reporting to enable patients for independetly manage and monitor their chronic diseases. In the feedback, often a team of specialists in food, fitness, and mental health advise patients on how to make comprehensive lifestyle adjustments. Digital therapies include monitoring, incentives, and design thinking to enhance patient engagement and enable them to manage their health and stay on course. The therapies aim to improve patient-reported outcomes and disease indicators such blood glucose, blood pressure, and pain. Broadly, Digital therapeutics adds treatment adherence and lifestyle behavior change to conventional medicine-based therapy for chronic diseases.

Issues that are addressed by digital therapeutics (DTx)

Care continuum
Normally, care should continue even beyond the hospital. However, while the doctor is limited by physical boundaries of the hospital to extend care support, the patient is limited by lack of continuous access to doctor, costs, and knowledge. A doctor does not have easy & credible means of ensuring treatment compliance by the patients. They do not know how the patient is doing between two hospital visits. Whether patients are responding to medications, whether the drugs have adverse effects, whether the patient follows their recommendations, etc. Since there is no real time feedback sharing, patients often get subpar clinical outcomes. The patient too must make hundreds of decisions every day. There are so many risks of mismanagement of health.

All these concerns can be solved with connected care. Remote monitoring devices and smartphone applications enable recording of vitals, symptoms, treatment response, etc on a regular basis. Alerts denoting deviation of vital parameters can be shared real time with the doctor who can then intervene immediately. Reminders for medication, self-monitoring, lab tests, and follow-up visits can be set up, which makes it easier for the patients. Patients can tele consult or book appointments. With digital technology, Care Continuum overcomes home care difficulties, and helps reduce a clinical consequence or cost.

Preventive management of chronic diseases
While DTx improves curative treatment response, it is also used extensively in the prevention of chronic disorders. In fact, preventive health management is deeply integrated into the DTx. Patients are educated about harmful lifestyles through knowledge assistance from health specialists and information. Regular health monitoring itself acts as an intervention, educating a patient about his body’s response to different stimuli. Patients are constantly enabled to evolve to healthier lifestyle via reminders, incentives & communication.

Access to healthcare services at home
To be able to provide integrated care, certain digital therapeutic startups are bringing together a variety of services on a single platform. As a result, patients get access to different healthcare experts from the convenience of their home. Some of the platforms provide medicine delivery, lab tests, devices, etc. which eases the lives of the patients. Healthcare e-commerce has significant utility in making available the long-tail services and products to people in tier 2,3,4 cities and rural areas.

Patient education
It is critical to keep a patient updated not just about their health but also the evolution in chronic disease world. It enables them in making informed decisions which will influence their overall health. The information is delivered in a variety of channels and forms and enables patient education at scale at minimum cost.

Making effective use of healthcare data
Thus far there was a lot of data generation via healthcare stakeholders, however, it remained unutilized to a large extent. For the first time, all this fragmented data is bundled together and proceed via DTx, and the data analysis is benefitting each and every individual patient. The information is being used to assist in decision-making, alter lifestyle and health behavior, and enhance patient clinical results.

Paradigm changes in outlook
Until recently, it was believed that once diagnosed with a chronic lifestyle condition, a patient had to live with it for life. However, with advancements in medical care systems and certain lifestyle modifications can now help in controlling certain diseases which consumers are less aware about.
But with DTx, the mindset is slowly changing.

Patients are seeing firsthand how a change in diet and exercise routine is controlling vitals like blood glucose under control. In a sustained effort, medicine dosages are being curtailed, and the medical community is talking about reversing disease progression. In an effort to provide value-based care in a cost-effective manner, hospitals and payers are exploring options. In fact, even companies are investing in the development of wearables and self-monitoring devices to bring healthcare to individuals rather than asking them to visit healthcare facilities.

DTx players in the industry today are recognizing the value of remote patient monitoring systems. At Phable, we understand the importance of DTx and have developed a dual response platform that takes care of the problems faced by patients as well as physicians and bring the two closer through DTx. Phable has also developed an integrated platform for patients’ convenience, allowing them to order medications, devices, health and wellness products, schedule lab tests, purchase health insurance, and more from the comfort of their homes. This comprehensive solution enables patients to better manage their health journeys.

Apart from providing CDM solutions that brings CDM patients and Doctor community closer, Phable is pushing the envelope via health data analysis. Phable is studying vitals of many patients on the app, is reading the data from several patient lifecycles, including the patient’s hospital visit, self-care at home, and self-reported outcomes, and making it available to the doctor for improved disease management.

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As a result of decades of relying on medicines and hospital-based management, we are experiencing a shift in mindset. Digital therapeutics are helping shift gears in management of chronic diseases as well as to overall healthcare delivery, resulting in a paradigm shift in the healthcare industry. The digital therapeutics sector is still in its nascent stages, but this is just the beginning.

(The author is Director-Medical Strategy, Phable. Views expressed are personal and do not reflect the official position or policy of

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