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Ensure Our Tech Innovations are a Good Fit With Our Priorities
Our field has many innovators to thank for new products and services. Yet less creative people always play a role in their success. Innovations are continuously developing with many people molding them to best serve the needs and interests of the field.
We should embrace healthcare solutions due to their effectiveness, not their novelty. Leaders must challenge and press new products to meet the complexity of top priorities. The field must fully own its innovations. Clinicians set a good example for us in how they integrate new clinical techniques.
Clinicians love new therapeutic techniques but rarely change their personal approach based on them. Instead, they incorporate new techniques into how they function as a therapist. Clinicians want the repertoire of techniques they use to be a good fit for them. They also seek a good fit with each client.
Finding a good fit is a useful paradigm for assessing how innovation fits our field’s priorities. Two priorities stand out as critical to our future: care access and clinical outcomes. How are recent tech innovations addressing them, or more to the point, how can we ensure the best fit with these priorities?
Care Access
One of the most egregious failings of our field is not providing access to care for millions who need it. We are failing those with severe mental illnesses and debilitating addictions, let alone people in the early stages of a disorder or adjusting to life stressors. Solving this is a top priority, but we must ensure any solution is clinically sound. Consider how some tech solutions might not pass this test.
Many people could gain access to useful digital tools tomorrow, and we could report some success with access. Yet a standalone solution like this is blind to who needs greater clinical assistance. Digital-only or digital-first solutions are deficient until they provide linkage with clinicians to assess clinical risks. Virtual-first models will be unvalidated until well-designed studies assess initial visits in each format.
Some situations call out for both tech and service innovation. Consider our field’s consolidation into larger healthcare organizations. A shift of our clinicians to primary care is an opportunity, but our current engagement model is weak—i.e., primary care physicians referring to our clinicians for services as usual. We need an innovative system funneling many more patients for brief visits. Yet how do we screen patients?
We need systems for automated screening of primary care patients (using brief behavioral measures) to identify those in need. One day we might rely on wearable sensors or AI-based phone apps for such tasks. This technology would replace a reliance on referrals. We also need innovative clinicians to think about how to maximize brief contacts. A 50-minute hour should become the exception, not the rule.
Clinical Outcomes
Our field has failed to routinely measure its clinical outcomes. The threat long hanging over us—that payers would one day demand outcomes—has not materialized. A new threat may prove a bit more realistic—that our new healthcare owners will demand outcomes to understand the value of our services. How else will they know what services to cut or grow, as new owners tend to do?
When we finally embrace measurement-based care, some tech products will be waiting, ranging from basic to advanced. The best ones help clinicians improve outcomes, not just measure them. They include benchmark data for projecting expected change during treatment, along with procedures for flagging cases needing more clinical attention. Yet even the best are untested in large healthcare systems.
The bigger challenge is collecting data. Ideally, this should be a digital process outside of clinical visits. Such automated technology is still being refined. It must capture digital data, feed analytic engines, and generate comprehensive reporting. These automated systems should not only flag patients needing a behavioral intervention, but also monitor their clinical status before, during, and after services.
Such a monitoring system would help rationally allocate outpatient treatment resources. Who needs services, what risk factors exist, and when might care end? This would be a system designed to meet several critical needs of our field, rather than a collection of discrete products created by entrepreneurs.
Let Us Shape Technology
Technology is best developed through a reciprocal process involving innovators, technicians, and system users. Such a shared process can be seen in each technology company from early inspiration to final implementation of its products. A similar process is needed for the field itself. It is a mistake for a field to wait passively for tech companies to deliver products. Design should be broadly collaborative.
Behavioral healthcare has seen considerable investment in technology over the past decade. No one formally speaks for the field, and so it is time for everyone to participate. How would you judge the fit?
Ed Jones, PhD is currently with ERJ Consulting, LLC and previously served as President at ValueOptions and Chief Clinical Officer at PacifiCare Behavioral Health.
The views expressed in Perspectives are solely those of the author and do not necessarily reflect the views of Behavioral Healthcare Executive, the Psychiatry & Behavioral Health Learning Network, or other Network authors. Perspectives entries are not medical advice.
