Biophilic design, neuroarchitecture and therapeutic home environments: harnessing medicinal properties of intentionally-designed spaces to enhance digital health outcomes

Abstract

Digital health technologies (DHT) support patient-centered care by delivering behavioral, educational, self-efficacy and self-management interventions. Yet, multifactorial chronic diseases are shaped by complex interactions between genetics, environment and behavior, embodied in social and commercial determinants of health. Given that people in the United States spend on average 18 h per day at home, the impact of home environment on a person's health is underutilized in medicine. Herein, we discuss opportunities to improve therapy outcomes through bridging digital interventions with intentionally-designed restorative and multisensory environments that simultaneously foster physiological and emotional homeostasis. Harnessing positive effects of biophilic design, neuroarchitecture and therapeutic home environments can enhance the effectiveness of digital interventions, including digital therapeutics (DTx), wearables and drug + digital combination therapies that utilize "prescription drug use-related software" (PDURS) framework. Real-world barriers to advance these solutions include a lack of public awareness about connections between the built environment, health and wellbeing, the knowledge gap in long-term clinical outcomes of biophilic interventions, and a limited funding for advancing "biophilic design as an adjunctive therapy" applications. In conclusion, creating digital health ecosystems that favor symbiosis between digital health interventions and enriched environments can promote sustained behavior change, elevate precision care and improve value-based healthcare outcomes.

Keywords: biophilia; built environment; household; housing; mobile medical app; prescription digital therapeutics; salutogenic; virtual reality.

Figure 1

The applicability of the Kurt Lewin's field theory to integrating health behavior, digital health interventions and the built environment. The original theory, B = f (P,E), states that behavior (B) is a function of a person (P) and environment (E). The Lewin's Force Field approach to health behavior change shows competition between the health-harming exposome and therapeutic interventions that encompass a patient and the environment.

Figure 2

Integration of digital health interventions with a patient's home environment. (A) Evolving health technologies from prescription drugs (Rx) to digital therapeutics (DTx) and their integration with the therapeutic home environment (THE). (B) One of the roles of the therapeutic home environment in a long-term management of chronic conditions. Optimizing a patient home environment for accelerated healing, prevention of disease symptoms and a relapse illustrates the ability of the therapeutic home environment to improve digital health intervention outcomes beyond remission. (C) A hypothetical example of a drug + digital combination therapy for a chronic condition where a patient's home environment is optimized using biophilic design, offering multisensory engagement through natural light and other biophilic elements such as indoor plants, natural materials and patterns. Through biophilic features and optimized spatial arrangement, this redesigned living room fosters stress reduction, relaxation and self-efficacy.