TMC PULSE

t m c » p u l s e | m a r c h 2 0 1 9 31 companion apps for veterans suffering from post-traumatic stress disorder (PTSD), substance abuse, anger management and concussions, to use in conjunction with a health care professional. The VA's PE Coach app uses prolonged exposure to teach veterans how to confront PTSD-related memories, fears and situations. Using the app, patients can record their PE therapy sessions, track PTSD symptoms and access homework and exercises to decrease anxiety. But can software code replace pharmaceuticals? One digital therapeutic that replaces a drug is Akili Interactive's video game to treat children with autism spectrum disorder (ASD) and attention deficit-hyperactivity disorder (ADHD). While antipsy- chotic drugs and stimulants are used to treat ASD and ADHD, respectively, Akili's video game uses software as a primary treatment. The game targets specific cogni- tive neural systems in the brain to deliver sensory and motor stimuli. As the child plays the game, the program trains the brain to filter out distractions, focus on multitasking and improve memory. "We're always looking for drug alternatives—things that will reduce the risk of adverse effects or long- term effects that medications are having on patients that we still don't necessarily know a lot about, partic- ularly in the mental health space," said Lance Black, M.D., associate director of the TMC Innovation Institute. "There are mechanisms of action that we don't quite under- stand how these drugs are working, quite frankly, when it comes down to the biochemical processes. We just know that they have positive effects on some patient populations. But it's always concerning when there are questions around what else the drug is doing—not just immediate adverse effects, but long-term. Is it changing the neurochemistry? Is it causing things that we won't recog- nize until five, 10, 15 years later?" Not to be confused with health and wellness apps Digital therapeutics shouldn't be confused with apps like FitBit or Calm, the meditation and relaxation tool. Unlike the 320,000-plus health and wellness apps flooding the marketplace, such as sleep trackers and fitness guides, digital therapeu- tics sets itself apart by conducting pre-market randomized clinical trials to demonstrate a very real and measurable clinical value. "Health and wellness products are fantastic," Coder said. "But digi- tal therapeutics are assumed to be in that health and wellness space only, so they may not be given the recog- nition they need. … This is not just an app. This is a health care delivery tool that is as clinically validated as should be expected." Education is one of the biggest issues facing digital therapeutics. "Trying to convey to patients, providers and payers and regulatory agencies what these are and what these are not is really important," Coder said. "It's going to be a shock for providers and patients when these are prescribed." In addition, technology advances faster than regulators can keep up. "Historically, health care has been slow to implement disruptive technology tools that have trans- formed other areas of commerce and daily life, such as ride-sharing apps and virtual home assistants," said Bakul Patel, associate director for digital health at the U.S. Food and Drug Administration's (FDA) Center for Devices and Radiological Health. "These digital health prod- ucts are creating an opportunity for medicine and health care to reach patients outside the clinic and deliver therapies that can be personalized to the individuals. One factor that can allow this poten- tial to be realized, among many, is the regulation that accompanies medical products." ➟ Honoring our volunteer dental and medical providers, represented by James Lloyd, D.D.S. and Mary Neal, M.D., with the Portrait of Compassion Award. For sponsorships and tickets, visit sanjoseclinic.org/artwithheart or contact Cristina Herrera at cristinaherrera@sanjoseclinic.org or 713.490.2620. SAVE THE DATE Thursday, May 2, 2019 • 6:00 p.m. to 10:00 p.m. Join His Eminence Daniel Cardinal DiNardo, STL and Event Chair Madonna Barfoot for a night of art, jewelry, generosity, and compassion at Art with Heart 2019. The Ballroom at Bayou Place • 560 Texas Ave. Houston, TX 77002 San Jose Clinic is a 501 (c) (3) non-profit organization, a ministry of the Archdiocese of Galveston-Houston, a Texas Medical Center member institution, and a United Way agency. From $250,000 Garden Homes • East of Main • Just South of 610 Near Stella Link and Willow Bend • Below market 100% financing with no PMI available • Featuring 3 Bedrooms, 2.5 baths and 2-car garages • Gated community with low HOA fees close to the Medical Center • Ample green space for pets • OPEN HOUSES Thurs & Fri 3-5:30 PM, Sat & Sun, 11 AM- 5:30 PM C O N T E M P O R A R Y G A R D E N H O M E S C a l l G e o r g e B a l l a a t 8 3 2 - 4 5 5 - 6 4 1 1 c o n t e m p o ra r y g a rd e n h o m e s . c o m Why rent when you can own?

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