Chronic pain is a huge health crisis. In the United States and Europe, approximately 20% of adults experience chronic pain, defined as pain that lasts for more than 3 months. The incidence is expected to increase in the coming decades, partly due to the aging of the population.
In recent years, there has been an explosion in the number of digital tools that promise to help people living with pain, some of which leverage machine learning and big data. Digital therapy companies such as Hinge Health in San Francisco, California, offer remote physical therapy monitored with computer vision to correct posture. In 2022, Woburn, Massachusetts device company Neurometrics will launch Quell, a wearable smart device for nerve stimulation, as the first non-drug treatment for fibromyalgia, a disease characterized by widespread body pain. Approval for marketing has been obtained from the US Food and Drug Administration. And fatigue. Virtual reality (VR) platforms for neurofeedback therapy help train the brain to better cope with pain over time, and are expected to provide relief similar to opioid drugs.
Chronic pain can be treated, so why do millions of people still suffer from it?
In my sociological research, I have spoken with dozens of entrepreneurs, doctors, and people living with chronic pain about the potential of digital technologies in pain management. Our conversation is full of examples of how data-driven alternatives to addictive drugs can help fight chronic pain. In fact, companies at the forefront of this trend have shown good evidence that their tools work, such as Hinge Health's longitudinal cohort study (JF Bailey). Such Al. J. med. internet resolution. twenty twoe18250; 2020).
However, there are some caveats. His 2022 review of research from 12 countries, including the United States, found that digital health technologies can create health disparities or exacerbate existing disparities (R. Yao other. J.Med. Internet resolution twenty four, e34144; 2022). For example, broadband internet access is often not available in rural areas, and older adults may lack digital literacy. People with disabilities can be left behind if digital tools are not designed to be accessible. If digital health equity concerns are not taken into account, these technologies will be insufficient to address the pain crisis.
Digital therapies that use a single approach, such as online physical therapy, may benefit some people, but they promote the view that pain can be easily solved and co-occurring conditions require other solutions. may be ignored. Chronic pain is complex and often involves a combination of several pain conditions, depression, anxiety, sleep disorders, and social factors. That's why the International Association for the Study of Pain states that the gold standard for chronic pain treatment focuses on the needs of the individual, requires collaboration between pain specialists and other medical professionals, and can combine several treatments. We are adamant that this is integrated care. This approach requires time, resources, and infrastructure that allows for seamless real-time coordination between professionals and with patients.
Digital technology has great potential to improve access to integrated care, but it is not being realized. The competitive spirit of Silicon Valley does not mesh with the continuity of care, interprofessional communication, and organization needed to manage this condition. When simply added to existing systems rather than thoughtfully integrated, digital technologies can lead to suboptimal care, lead to provider burnout, and require providers to use electronic health records more frequently. of time and even have to coordinate the use of different tools.
Treat pain as a priority rather than an afterthought
One solution is to focus on strategic partnerships between digital health companies with the technological know-how and hospitals and health systems that provide quality pain care. For example, New York City-based Fern Health is co-developing and expanding a multidisciplinary education and lifestyle intervention program with MetroHealth System, a nonprofit public health system based in Cleveland, Ohio. Fern has also merged with his VR company BehaVR, which is based in Nashville, Tennessee and provides neurofeedback therapy at home. New digital health solutions should be designed as add-ons or plug-ins to broader collaboration platforms, rather than as standalone solutions.
Other examples of digital technologies addressing disparities and making healthcare more accessible to more people can be seen in several startups, including US company Override Health and New York City-based Upside Health. It will be done. These platforms do not promote any particular treatment. Rather, it digitally connects multiple healthcare providers to discuss an individual's progress in a coordinated way and provides patients with access to a network of people with similar conditions.
Therefore, access remains an issue. Beyond broader societal issues such as broadband access, digital technologies need to be understood as two-way media, not only between healthcare providers and patients, but also between platform designers and users. Digital transformation of chronic pain care will not be successful without design input from the people who should benefit from these tools.
When digital technology is seen only as an upgrade to existing single solutions rather than as an innovative connector, everyone suffering from the pain is missing out on a huge opportunity.
Technical solutions to medical problems require careful consideration. However, if digital health technologies are used to integrate care and focus on equitable access, they have the potential to change the course of the current pain crisis.
competing interests
The authors declare no competing interests.
