Tracking behavioral health outcomes and therapist performance has been notoriously difficult in the past.
New telehealth capabilities could hold the key to measurement-based care in the future, according to panelists at the Future of Mental Health event. Digital tools could also provide more insight into clinician performance and help behavioral health organizations deliver appropriate interventions.
“Psychiatry has a lot of very good, very well-validated tools that are associated with results,” said Dr. Seth D. Feuerstein, a Yale School of Medicine professor and serial entrepreneur. “We just don’t use them.”
ieso, a UK-based digital mental health company, records patients’ PHQ-9 and Gad-7 scores as behavioral health measures. The startup then uses these metrics as a tool to track patient outcomes and give therapists feedback along the way.
This shifts care from reactive to proactive, according to Andrew Welchman, executive vice president of impact at ieso.
“We make a prediction of the expected outcome for a given patient and then look at the therapist’s performance against that set of predictions,” Welchman said during the panel. “So, because each case is unique, everyone presents the data and the profile. You can’t just compare simple cases.
The company uses data to help identify which care trends are working and which are not. It can also be used as a tool to help therapists plan future appointments.
“One of the really interesting things to come out of this work is that the therapist’s expressed empathy doesn’t correlate very well [to improvement]”, Welchman said. “It’s one of the worst predictors. The key point, however, is not that you shouldn’t be empathetic, but in fact, spending too much time being empathetic doesn’t make progress. the conversation.
Digital health startup NOCD, which focuses on providing virtual care for people living with obsessive-compulsive disorder, has created its own electronic medical record (EMR) system. Providers are able to review measures for reducing symptoms of OCD, as well as anxiety, stress, and other comorbidities.
Data tracking can be used not only to review a patient’s progress, but also to identify clinicians who may be underperforming.
“We can actually identify providers who might need immediate intervention in terms of training and supervision,” Stephen Smith, co-founder and CEO of NOCD, said during the panel. “Each of our clinicians goes through a clinician training program. Then they are actively supervised. If anyone sees no change in [outcomes] hopefully, our system makes it easy for our clinical team to identify this provider and provide oversight. … We only use data to inform our decision-making and better allocate our time.
Data from virtual providers can not only be used to help clinicians make decisions, but also payers.
However, Feuerstein said providers have historically been wary of sharing data with insurers.
“I think we’re afraid, actually as a field, of getting too much quantified data because we know that’s going to push us either to treat sicker patients or more complex patients or to do more intensive things. or exhausting,” Feuerstein said. “For us, that will require a redesign.”
Although the data can provide information to providers about the impact of care, many clinicians have expressed concerns about confidentiality and the “performative pressure” that supervisors’ analysis of sessions could cause.