The booming segment of behavioral health technologies is still defining its limits.
The lack of clarity calls for cross-industry collaboration and a complete focus on patient needs. The behavioral health technology industry is expected to quickly coalesce around industry norms and standards, according to stakeholders.
“I think the innovation is great,” said Dr. Yusra Benhalim, Senior National Medical Director at Optum, during a panel discussion at HLTH. “I think we get carried away, which is exciting. But we lack a collective agreement to hold us accountable for making sure this happens in a safe way.
It will likely be difficult to establish industry norms and standards in the area of behavioral health technologies. This has certainly been the case for traditional behavioral health, as there aren’t many well-known industry standards for care delivery, process and process measures, and care outcomes.
This is particularly painful in the shift to values-based care, which assumes a standardized set of care outcomes and processes.
Yet the tech industry‘s norm-crushing approach has entered behavioral health more than ever. COVID has driven this in at least two ways. First, the pandemic has revealed the potential of telehealth and other technological tools for behavioral health. Second, it drove a wave of capital into space. Yet funding has declined somewhat over the past year.
However, the two industries have different and often opposing ethics. This can be problematic given the relative immaturity of behavioral health. Behavioral health suffers from gaps in scientific knowledge, small-scale systems and data, and systemic isolation from the rest of health, according to a 2021 Deloitte report.
Still, behavioral health technology shows promise for solving several general problems, panelists said.
More and more health care stakeholders are pointing to non-clinical staff as a way to address staffing shortages. These roles include peer support specialists and coaches. Payer-provider conglomerates Aetna and Cigna each include coaches and peers in their behavioral health strategies.
“In the context of the evolution of behavioral health over the past two years, it’s kind of become a Wild West,” Benhalim said. “We have to be intentional about defining the words we use. A coach can mean many different things.
“As an industry, I think we want to learn together, but we want to make sure we do it in a very safe way.”
Varun Choudhary, chief medical officer of New York-based virtual mental health provider Talkspace Inc. (Nasdaq: TALK), said coaches could be used to help patients navigate an organization’s systems and services.
Talkspace itself only provides services from licensed clinicians, such as psychiatrists and therapists, he said.
Patients can, however, send text, audio or video messages to their providers and obtain asynchronous services. This system increases the patient’s access to care and increases the reach of therapists. Choudhary maintains live sessions and asynchronous messaging is an efficient mode of processing, citing company studies.
Panel moderator Nikhil Krishnan posited that asynchronous telemedicine lends credence to the idea of automated mental chatbot services, by removing a human from the provider side of the interaction. Choudhary disagreed.
“There’s no replacement for licensed therapists… That human touch, that therapeutic alliance that you get from a licensed clinician — I’m not sure you can get that from a chatbot,” Choudhary said. .
Dr. David Stark, chief medical officer at investment bank Morgan Stanley (NYSE:MS), said he sees behavioral health technologies like chatbots and artificial intelligence services as having the biggest impact on people. administrative and customer service processes.
“In the short term, it’s about replacing the clipboard,” Stark said.
This could include patient admission and triage, symptom screening, treatment response monitoring with standardized assessments, better patient-provider matching, and remote patient monitoring.
Technological tools that communicate or collect patient information present a notable gray area for behavioral health technologies, panelists said.
AI and other data tools could shift the care paradigm from reactive to proactive, Stark said. He pointed to the potential impact of “nudges” or messages sent to people to remind them of ways to take care of themselves.
Stark said remote patient monitoring and the use of personal device data raise several troubling questions.
“The risk of talking about this stuff is that it can be very scary,” Stark said. “As we embark on this project, we need to stay very, very focused on these issues and not let technological excitement take precedence over need.”
Krishnan suggested that exploring social media offers an opportunity to create new measures of behavioral health, risk screening and progress.
While additional data can be helpful, it can also raise privacy concerns.
“Where do you draw a line and say, ‘This is an invasion of privacy; it is not net beneficial, etc. said Krishnan.
Not knowing where to draw the line comes from the lack of industry-wide standardized outcome measures, Choudhary said.
“That’s the biggest challenge; we are at least five to 10 years behind medicine in how we conceptualize these measures and how we use them for value-based care,” Choudhary said. “And that’s gonna be the real thing we need to [address] over the next few years because, as we know, our fee-for-service system really does not respond well to the mental health field.
Behavioral health technology is ultimately limited by issues in the behavioral health industry, particularly around data and outcomes, Benhalim said.
“It’s time for us to be inspired, to be really creative, to say [that] we may not know what the measures should be, but let’s start putting new ones,” Benhalim said. “Let’s test and learn together. And let’s start to infuse more of that human experience, which is hard to measure, but is possible. »