Traditionally one of the most underserved and underfunded areas of healthcare, behavioral health has recently become one of the fastest-growing sectors for industry innovation. The reason? The potential to impact the lives of millions of patients and the growing understanding that behavioral health conditions are a key driver for many other chronic health conditions. Additionally, as reimbursement models shift toward fee-for-value, providers are now on the hook financially, more acutely feeling the sting of the high cost of care for behavioral health. They are also being held more accountable for clinical outcomes.
Many providers are finding that the best path to managing a population’s behavioral health needs is to leverage new technologies. And there is no shortage of new market entrants raising their hands to partner with providers to fill the service gaps in today’s healthcare system. Here we share insight on three major categories of behavioral health technology solutions.
Digital Assessment Tools
Accurate and timely diagnosis is central to managing and treating behavioral health conditions, yet under the traditional care delivery model many patients are not effectively assessed. Left untreated, their conditions can worsen, increasing the future cost of care.
Multiple digital health platforms have sprung to life to help address this issue by focusing on streamlining the assessment process and bringing it outside the traditional delivery space. Digital diagnostic tests can be deployed by primary care physicians, employers, or even public government agencies to screen populations and identify patients in need of behavioral health services. They have strong appeal for commercial payers seeking to stratify patient populations, identifying high-risk individuals early to proactively apply crucial interventions. Digitizing the screening process offers patients the flexibility to complete questionnaires on their own time and in whatever location is most comfortable, resulting in greater follow-through. In the future, behavioral health assessments will likely become part of the fabric of routine care, similar to annual wellness exams or blood work.
Remote Care and Monitoring
The advent and now rapid adoption of telehealth—defined as the use of remote healthcare technology to deliver clinical services outside of traditional brick-and-mortar settings—has changed the way care is delivered, greatly improving access to behavioral health services by bringing care directly to patients instead of asking them to come to providers.
Several of the largest national telehealth providers have recently launched psychiatry- and psychology-specific services focused solely on behavioral health. These telehealth platforms allow patients to connect with a psychiatrist or psychologist for a virtual visit in the comfort of their own homes, either to triage an acute episode or for routine therapy. And they are also attractive to providers, who have the flexibility to practice from any location, as well as the opportunity to enhance their in-person practices with the addition of a part-time remote practice. Telehealth can lower the cost of care for many low- to moderate-acuity conditions, as well as prevent high-cost emergency room encounters. The average savings for a telehealth visit is estimated to be well over $100.4
Another area of focus in remote care is transforming cognitive behavioral therapy (CBT)—a traditionally hands-on, short-term approach used by psychotherapists to modify patients’ thinking or behavior—into digital formats. Early innovators are deploying consumer-focused applications that use CBT principles to address conditions such as anxiety, depression, and substance abuse without a clinician. These apps guide users through a variety of activities, from self-monitoring and documenting emotions, to identifying and altering thought patterns, to breathing and mindfulness exercises. These solutions capitalize on the high user engagement rates for smartphones, using them as the care delivery vehicle for app-based, in-the-moment behavioral health support.
Medication Management Services
Medication noncompliance contributes to an estimated $290 billion in avoidable medical spending each year.5 Providers have historically had little to no ability to track their patient’s adherence to medication regimens, and patients themselves often lacked the necessary support to sustain compliance, with many psychiatric medications being prescribed not just for short stints but months or even years. Medication management solutions abound in today’s technology-assisted care marketplace, offering online services ranging from medication coordination, packaging, and delivery to pharmacist support.
In recent studies, Walgreens demonstrated that users who took advantage of the company’s mobile pill reminder app were 12.3% more likely to adhere to oral antidiabetics regimens, 11.3% more likely to adhere to antihypertensives regimens, and 9.1%more likely adhere to antihyperlipidemics regimens.6 Although these studies were not focused on behavioral health patients and their medications specifically, the results, which signal a huge potential impact for digital medication management services, can reasonably be extrapolated to this population.
In the Future
Continued innovation in around behavioral healthcare delivery will most certainly change the landscape for the better, helping to remove stigma and improve access for patients in need of treatment. Technology-driven tools support the proactive management of behavioral health disorders and supplement other interventions such as the continued move toward embedding behavioral health services in primary care. In the value-based era, providers who develop strategies for fitting these new digital tools into their care management plans will be in an advantageous position to capture downstream savings and improve patient outcomes.
Director’s Blog: Mental Health Awareness Month, National Institutes of Mental Health, https://www.nimh.nih.gov/about/past-directors/thom...
Projections of National Expenditures for Treatment of Mental Health and Substance Abuse Disorders, 2010-2020, Federal Substance Abuse and Mental Health Services Administration, http://store.samhsa.gov/shin/content/SMA14-4883/SM...
Assessment of the Feasibility and Cost of Replacing In-Person Care with Acute Care Telehealth Services, Alliance for Connected Care, http://www.connectwithcare.org/wp-content/uploads/...
Thinking Outside the Pill Box, New England Healthcare, Institute, http://www.nehi.net/writable/publication_files/fil...
Akinbosoye O, Jiang J, Taitel M, Orr G ‘The Association between Use of a Community Pharmacy’s Mobile Pill Reminder App and Medication Adherence’ Presented at the Society of Behavioral Medicine 37th Annual Meeting, March 30- April 2, 2016, Washington DC; Akinbosoye O, Taylor D, Jiang J, Taitel M, Orr G. The Relationship Between Digital Health Program Activity Tracking and Medication Adherence Among Members Age 50+ years. JMCP APRIL 2016 Vol. 22, No.4-a S44