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  • Writer's pictureJorge Petit

Trends in Digital Transformation for Behavioral Health

Updated: Dec 8, 2023


graphic digital healthcare

In the rapidly evolving landscape of behavioral healthcare, technology has become an indispensable reality, driving significant transformation in how services are delivered, managed, and received. Tracking this journey from traditional practice to innovative, technology-enabled care solutions, we are seeing pivotal shifts towards electronic health records (EHRs), clinical decision supports, registries, dashboards, telemental health, mobile health interventions, wearables, and most recently, the looming impact of Machine Learning (ML) and Artificial Intelligence (AI).


There is growing consensus that not only supports, but encourages, the adoption of technology in healthcare as a pivotal step towards more accessible, efficient, and person-centered care. The behavioral healthcare sector is catching up, accelerated by the pandemic, to this inexorable future state, but with remaining barriers—from interoperability hurdles to privacy concerns to workforce challenges.  In the coming years, it will be imperative that we deliberatively embrace digital solutions to enhance service delivery, particularly in the public sector.  Technology-enabled care solutions will not only serve as adjuncts to therapy but will become a more fundamental aspect of how services are delivered and optimized. This future state will require innovative and progressive leadership to navigate and harness these opportunities effectively, efficiently and equitably.


The regulatory and interoperability concerns in the behavioral health sector are significant, often acting as roadblocks to more seamless integration with technology. Regulations, such as those mandated by the Health Insurance Portability and Accountability Act (HIPAA), set stringent standards for the protection and confidential handling of health information, especially behavioral health data. While these regulations are critical for privacy, they also create challenges for the development and implementation of interoperable systems that must comply with security and data-sharing requirements.


There have been ongoing efforts to address these challenges by advocating for the expansion of federal incentives to include behavioral health services in the Meaningful Use [1] program, which incentivizes the adoption of EHRs. Meaningful Use requirements are intended to ensure that EHRs are used in a way that contributes to better clinical outcomes and push for systems that can communicate across different healthcare settings. However, the unique nature of behavioral health data, which often includes notes and records that are even more sensitive than general medical information, requires additional layers of security and consent management, complicating interoperability efforts.


The Behavioral Health Information Technology (BHIT) Coordination Act promises to deliver additional funding to ensure behavioral health providers can invest in health IT for integrated, person-centered care. The Act takes privacy into consideration regarding sharing health data across behavioral, primary and specialty healthcare systems, which is critical if we are to break down the traditional silos that lead to fragmentation and poor coordination of care across the healthcare ecosystem.


In integrated care models, where behavioral health and primary care providers must coordinate to deliver holistic care and treatment, interoperability concerns are particularly problematic [2]. Health Information Exchanges (HIEs) can mitigate some of these interoperability issues by providing a framework for the secure exchange of health information across different platforms and significantly improve care coordination.  Recent policy developments, such as the 21st Century Cures Act, have begun to address some of these needs by promoting greater interoperability of health records and supporting the integration of behavioral health services with the rest of healthcare. The Act also provides funding sources for the development of electronic health record systems that are more inclusive of behavioral health data. Such legislation is critical in breaking down the barriers to technology adoption by providing the necessary resources and legal framework for advancement.

 

The integration of technology in healthcare, specifically in the behavioral health space, is a topic I’ve been passionate about and advocating loudly for over the last 10+ years. Technology transformation has garnered substantial attention and support from the medical community, with clear evidence of its transformative potential. For example, the American Psychiatric Association (APA), has been a vocal advocate for embracing digital solutions, acknowledging that they can vastly improve access to care, particularly for mental health services. The use of and expansion of telehealth services, accelerated by the COVID-19 pandemic, clearly demonstrates how technology is already reshaping the delivery of behavioral health services. Studies have shown that telemental health can reduce appointment wait times, increase follow-ups, and improve continuity of care and outcomes [3].


Also, there is the growing evidence for mobile health interventions that demonstrate significant promise in managing and monitoring chronic conditions, mental health symptoms, and promoting behavioral changes through apps and/or wearable devices.[4] Studies that have explored the impacts of digital health tools and technologies suggest that they have a positive effect, empowering individuals, giving them more control over their treatment and health data, leading to increased levels of engagement and better adherence to treatment and improved health outcomes.[5]


In this last year, we have seen artificial intelligence (AI) and machine learning (ML) at the forefront of transformation, offering novel approaches to diagnosis, treatment, and patient monitoring. The use of AI in mental health, whether utilizing electronic health records (EHRs), mood rating scales, brain imaging data, or novel monitoring systems to predict and classify mental health conditions has shown how versatile it can be. These technologies have been increasingly integrated into mobile apps, which employ AI and ML for risk prediction, classification, and decision-support.[6]  Ultimately, these systems will be able to assist behavioral health providers in creating more accurate and individualized treatment plans by leveraging large datasets that traditional methods might not be able to process effectively.


While such technologies are still in the early stages of adoption, they exemplify the innovative directions in which behavioral health care is headed, but it is imperative to call out that further research on efficacy and effectiveness is required to generate a strong evidence base for safe and effective implementation.

These digital advances underscore the transformative potential of cutting-edge technologies in behavioral health, paving the way for more proactive, personalized, and efficient care. As these tools become more sophisticated and integrated into everyday healthcare practices, they hold the promise of significantly improving the diagnosis, prognosis, and treatment of behavioral health conditions.


What will be needed in the coming years across the behavioral health sector is forward-thinking leadership that must not only embrace technology but also actively participate in shaping how it evolves within the field. This includes advocating for policies that recognize the unique needs of behavioral health services, investing in training for staff to adapt to new tools, and fostering a culture of innovation that encourages the exploration of new technological solutions.


The future of technology in behavioral health is one of immense potential and promise and we must ensure that technology ultimately serves as a bridge to better care and improved health outcomes.


 

References:

[1] Anumula N, Sanelli PC. Meaningful Use. AJNR Am J Neuroradiol. 2012 Sep;33(8):1455-7. doi: 10.3174/ajnr.A3247. Epub 2012 Jul 12. PMID: 22790244; PMCID: PMC7966550.

[2] Segal M, Giuffrida P, Possanza L, Bucciferro D. The Critical Role of Health Information Technology in the Safe Integration of Behavioral Health and Primary Care to Improve Patient Care. J Behav Health Serv Res. 2022 Apr;49(2):221-230. doi: 10.1007/s11414-021-09774-0. Epub 2021 Oct 19. PMID: 34668115; PMCID: PMC8525847.

[3] Gajarawala SN, Pelkowski JN. Telehealth Benefits and Barriers. J Nurse Pract. 2021 Feb;17(2):218-221. doi: 10.1016/j.nurpra.2020.09.013. Epub 2020 Oct 21. PMID: 33106751; PMCID: PMC7577680.

[4] Mattison G, Canfell O, Forrester D, Dobbins C, Smith D, Töyräs J, Sullivan C. The Influence of Wearables on Health Care Outcomes in Chronic Disease: Systematic Review. J Med Internet Res 2022;24(7):e36690 doi: 10.2196/36690

[5] Li, J. Digital technologies for mental health improvements in the COVID-19 pandemic: a scoping review. BMC Public Health 23, 413 (2023). https://doi.org/10.1186/s12889-023-15302-w

[6] Higgins O, Short BL, Chalup SK, Wilson RL. Artificial intelligence (AI) and machine learning (ML) based decision support systems in mental health: An integrative review. Int J Ment Health Nurs. 2023 Aug;32(4):966-978. doi: 10.1111/inm.13114. Epub 2023 Feb 6. PMID: 36744684.


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