The Doctor Prescribes Video Games and Virtual Reality Rehab

These digital diagnostics are also making their way into people’s homes. AliveCor developed a $99, smartphone-enabled EKG device that uses AI to detect an abnormal heart rhythm known as atrial fibrillation. Aural Analytics uses an iPhone app to analyze speech for motor and cognition changes, which can be a sign of neurodegeneration. Amazon is working on a similar project, which uses an Alexa voice recording of the patient to detect subtle changes in brain health.

An algorithm may also forecast the likely outcome of an event, which creates an opportunity for intervention. Facebook, for instance, has rolled out an AI tool to detect suicidal posts before they’re posted. Another project, the Open Artificial Pancreas System, uses a digital device connected to an insulin pump to continuously monitor blood sugar, providing a faster and better calibrated response to changes in levels.

Apps and algorithms that treat disease

Software can measure and diagnose, but can it treat disease? Judging by recent FDA decisions, the answer is yes.

Sleep.io and SHUTi are two scientifically-backed platforms designed to improve sleep and reduce reliance on sleeping pills. The MindSciences team, led by psychiatrist Dr. Judson Brewer, has created therapeutic apps for smoking cessation, overeating, and anxiety.

Beyond behavior management, a growing number of companies are building products in which the software itself is “therapeutically-active,” meaning that use of the product directly impacts the condition (much like taking a drug has a direct impact on the body). In May, MindMaze received FDA clearance to bring a virtual reality rehabilitation platform to market for stroke and traumatic injury patients. Meanwhile, MedRhythms uses music, sensors, and software to improve mobility in stroke patients and other neurological disorders such as Parkinson’s Disease or multiple sclerosis.

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Recognizing such advances in medical technology, last year the FDA outlined a more streamlined path to clearance for digital health devices. This year, the FDA is deep into building a pre-certification program, paving the way for software products—including AI and adaptive algorithms—to come to market faster.

We’re hitting an inflection point in digital medicine. A number of consumer-focused tech companies are making big commercial bets on Apple’s Watch, Amazon’s stealth 1492 project, and Verily, formerly Google Life Sciences.

Thus, the time is now to make sure regulations are in place to effectively bring these AI and machine learning products to market. The medical industry builds a body of evidence on the safety and efficacy of drugs through peer-reviewed research and clinical trials—digital medicine should be no different.

Our healthcare system has strong protections for patients’ biospecimens, like blood or genomic data, but what about our digital specimens? Due to an increase in biometric surveillance from digital tools—which can recognize our face, gait, speech, and behavioral patterns—data rights and governance become critical. Terms of service that gain user consent one time, upon sign-up, are no longer sufficient. We need better social contracts that have informed consent baked into the products themselves and can be adjusted as user preferences change over time.

We need to ensure that the industry has strong ethical underpinning as it brings these monitoring and surveillance tools into the mainstream. Inspired by the Hippocratic Oath—a symbolic promise to provide care in the best interest of patients—a number of security researchers have drafted a new version for Connected Medical Devices.

With more effective regulations, increased commercial activity, and strong governance, software-driven medical products are poised to change healthcare delivery. At this rate, apps and algorithms have the opportunity to augment doctors and complement—or even replace—drugs sooner than we think.

WIRED Opinion publishes pieces written by outside contributors and represents a wide range of viewpoints. Read more opinions here. Submit an op-ed to WIRED Opinion at [email protected]


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