We live in a world where drugs dominate healthcare. So ingrained are pharmaceuticals into the fabric of our everyday life that it's almost impossible to imagine a world without them.
But why? Put simply, for the past 100 years no other form of healthcare has been able to match their most compelling qualities. Drugs alone are scalable, standardized, affordable and evidence-based. So only the pharma industry has been able to grow to a size where it can exert influence over every aspect of the health ecosystem - from regulation to medical training to procurement.
Of course drugs are essential to the health of many millions of people across the world. The problem comes when drugs remain the default solution in the face of overwhelming evidence in support of much more effective non-drug alternatives. We now have decades of clinical evidence that problems affecting billions of people, from insomnia to anxiety and depression, are most effectively addressed with behavioural interventions such as Cognitive Behavioral Therapy (CBT). Yet despite this only a tiny fraction of sufferers of these conditions have access to anything other than pills.
It may be difficult to imagine how things could be any other way. But for the first time in human history, thanks to technology, drugs have a credible challenger: digital medicine.
Web and mobile technologies (including increasingly ubiquitous smartphones) give us a platform upon which to deliver proven behavioral interventions in a manner that is automated and algorithmically-driven. By using best practice from consumer technology we can make these interventions compelling for people to use. As a result, properly delivered, software-based therapeutics (such as our own Sleepio sleep improvement program) have the potential to display the same qualities of drugs that made them so successful - scalable, standardized, affordable and evidence-based.
But this is just the beginning. As sensors of all kinds become standard in our phones and other devices, the constant tracking of health data will become a normal part of everyday life, supported by frameworks such as Apple's HealthKit. And what these tracked data afford us is the opportunity to create interventions of a kind never before possible, that react not only to differences between people ('trait' characteristics) but that respond to moment-by-moment changes in need ('state' characteristics). This is a level of insight and contact with the patient that traditional healthcare practitioners could only dream of. So if face-to-face therapy is already able to deliver clinical effects many times greater than drugs in many chronic conditions, with this new, hyper-reactive model we should by rights be able to smash existing standards of adherence and outcomes, and challenge even the results possible with the 'gold standard' of in-person therapy.
Of course for this vision to become reality a few things need to be true. The tracked data collected need to be reasonably reliable, reported in close to realtime, and near continuous. But these are surmountable problems, and when they're solved I believe the door will be opened to a bright new era of digital medicine.
Peter Hames is Co-Founder and CEO of Big Health. Big Health's first product, Sleepio, is a digital sleep improvement program featuring proven cognitive and behavioural techniques, available now on web and for iPhone.