When 49-year-old former IT professional Graham Wright suffered a bout of depression a decade ago, he enrolled on an online course aimed at alleviating his symptoms.
Initially, Wright was doubtful that a digital solution would help him overcome depression. But, with nothing to lose, he gave the online course a go and found it made a difference in the end. “Often the tasks I was asked to undertake were obvious,” he says. “But it was in doing them that the recovery came.”
Since then, health technologies have significantly advanced. In particular, digital therapeutics – a new generation of web and app-based health tech that can be used to deliver a variety of treatments – have become a viable means of overcoming mental illness, with many of these solutions now offered by the NHS after rigorous testing and approvals.
Understandably, just like Wright, many people are sceptical of these technologies and how they can be more effective than traditional treatments and medications. But he says this often comes down to a lack of understanding of how digital therapeutics work and their benefits.
With that in mind, last year Wright left his 20-year corporate career and applied to join a mental health steering group, working with a software developer to aid the development of a new digital therapeutics solution to help others suffering from depression. “With this app, I felt it key that it explained to the end user why it might be helpful and to stick with it,” he says.
His experience illustrates how invaluable it can be for patients and former patients to collaborate with software developers when designing digital therapeutics, to ensure they are user friendly and address salient issues that might not otherwise be apparent.
As part of a lengthy software testing process, Wright had to review the launch website, app and marketing materials, and suggest improvements from a user perspective. The software developer worked closely with him every step of the way, providing a series of tests to elicit Wright’s feedback and taking his recommendations onboard to improve the product.
Having encountered several confusing technical terms during these tests, Wright recommended that the company make it clearer to users what the app does, how it works and how it can help them. “I wanted to understand why this new therapeutic would help me, in order to help sustain the necessary energy to continue through the process,” he says.
He adds that his involvement shows how personal experiences and skills can help the development of treatments. “While my background before was in IT, I found that my analysis and communication skills were still extremely useful in supporting the development.”
This collaborative development work also fed into the rigorous research, testing and regulatory approval processes that digital therapeutics are subject to, and which distinguish them from the plethora of wellness apps.
This is where organisations such as the Health Innovation Network can help. Comprising 15 health innovation networks across England, it collaborates with the NHS, academia and industry in finding, creating and circulating technologies that can potentially improve patient lives, health services and broader society.
Matt Williams, senior programme manager for mental health at Health Innovation Oxford & Thames Valley, says that involving end users such as Wright in the development of digital therapeutics and other health innovations is vital to ensuring they meet patient needs and expectations. This includes their therapeutic benefits, ease of use, accessibility and convenience: “After all, you may be able to deliver the most effective treatment via an app, but if patients don’t feel comfortable engaging with the app itself – for whatever reason – then you’ve wasted your time,” he says.
According to Williams, involving patients in the early stages of the development of digital therapeutics solutions can help technology companies save time, money and heartache. But he says this process must be planned based on local regulations, and performed in a careful and sensitive manner.
At Health Innovation Oxford & Thames Valley, Williams and his team work with end users and other stakeholders to assess digital therapeutics solutions based on a broad range of factors. These include the language used to describe digital therapeutics, how such solutions would work alongside or instead of medication, how they would fit into the wider health system and any obstacles to overcome.
In addition to working with patients, Williams and his colleagues partner with clinicians. “The involvement with clinicians allowed us to explore the situation – a conversation in the consulting room about the potential use of a digital therapeutic, for example – from both sides of the equation,” he says. “They have the clinical knowledge to really interrogate the evidence and the experience to identify the challenges – both clinical or logistical – that any innovation may present.”
Williams highlights the benefits of well-tested digital therapeutics for patients and health professionals, noting that such technologies give patients greater control of their treatments than traditional treatments, as they can be accessed via smartphones, tablets and laptops at any time and without the need to visit a physician in person.
Meanwhile, he says digital therapeutics can give clinicians a greater choice of treatments, allowing them to serve the needs of all patients: “I think clinicians really appreciate that, rather than always having to reach for the prescription pad, as it were.”
Nonetheless, Williams says that bringing digital therapeutics to market still has its challenges. “I think innovators need to have vast reserves of patience and to be prepared for a long journey,” he says. “I cannot think of a product that has enjoyed instant success and the regulatory framework within the NHS is quite rightly stringent.”
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In the UK, Samaritans can be contacted on 116 123 or email jo@samaritans.org. You can contact the mental health charity Mind by calling 0300 123 3393 or visiting mind.org.uk
