There's no shortage of apps and other online programs that promise to make you healthier, but ones backed up by clinical evidence are rarer.
That's changing. This week, the Centers for Disease Control and Prevention acknowledged for the first time that digital tools can help patients change their lifestyles to prevent type 2 diabetes. The public health agency identified tech companies that met its standards: Omada Health, which coaches online groups on healthy behaviors, weight-loss software company DPS Health, and Noom, whose apps offer exercise and diet advice, along with phone-based services.
Health care is traditionally administered face-to-face, in few places besides doctors' offices and clinics. But by recognizing that remote and online services can also be therapies, the CDC is helping usher in a new set of health care tools that are cheaper, more widely accessible, and, most important, equally effective as traditional mechanisms.
"It provides another tool in the armamentarium that we need as diabetes clinicians to help our patients," said Dr. Suneil Koliwad, a diabetes expert at the University of California, San Francisco and president of the American Diabetes Association's Community Leadership Board.
"Given the way society works these days, where people get and give a lot of information to one another using online tools and on social-networking tools and electronic devices, these [programs'] data are very interesting and encouraging," Koliwad told BuzzFeed News.
One of the United States' major health crises is prediabetes — that is, blood-sugar levels that are higher than normal, but not high enough to be diagnosed as type 2 diabetes. More than one out of three American adults have the condition, but nine out of ten do not know it. Prediabetes increases risk of not just type 2 diabetes, but also heart disease and stroke. And lifestyle improvements — namely, eating better and exercising more — have been shown to significantly reduce one's chances of developing diabetes.
That's where digital coaching tools come in. San Francisco startup Omada Health tackles prediabetes through Prevent, in which users join online communities of people with similar weight-loss goals, talk to a coach, and measure their progress on digital scales. In a clinical trial testing the program, 220 participants lost, on average, clinically significant amounts of weight. Omada, which also has the endorsement of the National Association of Chronic Disease Directors, has raised nearly $30 million in venture capital.
"CDC recognition is a defining step for Omada Health," CEO Sean Duffy said in a statement Thursday. "This will expand dearly needed programs to a much wider audience, and signals that 2015 is the year that digital therapeutics are embraced by the diabetes prevention community."
Founded in 2007 and backed by $27 million, Noom makes smartphone apps that give personalized feedback on eating better, exercising more, and losing weight. The New York startup says it has 28 million users worldwide. And DPS Health in Los Angeles also motivates users to be active through Web and mobile programs.
Because online programs allow clinicians to treat dozens or hundreds of patients remotely, they keep costs down, which appeals to providers, employers, and insurers. "There's going to be a never-ending push to get those programs to be as cheap as possible as long as they show equivalent benefit," Koliwad said.
Digital tools can also be easily tailored to reach patients in different languages and cultures, compared to the effort required to hire and train in-person staff.
But these programs have potential drawbacks too. For one thing, they've only recently arrived on the scene, so there isn't data yet to prove their patients' lifestyle changes stick. And non-tech-savvy patients may not benefit as much, Koliwad pointed out, which could lead to a "digital divide" between different ages, educational backgrounds, and socioeconomic classes.
Finally, there's the question of whether patients will be motivated to stick with an online program outside the imposed structure of a clinical trial. Will they be on their best behavior without face-to-face peer pressure?
"It could be these electronic programs are going to be more attractive than group programs in person, or one-on-one programs in person," Koliwad said. "If that's the case, we've found a real gem for patient care. But we're going to have to see how that unfolds over time."