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The original article can be found on NeuroFlow's website here.
Many of us are now familiar with the “digital front door” concept which came out of a desire to increase access to traditional care through advancements in technology—making it easier to schedule appointments, find a doctor, or review personal medical records. The digital front door was an important first step in using technology to increase access; however, it’s just the beginning.
Today, technology can extend an organization’s ability to identify needs, triage, and even deliver care with efficacy and scale that increases access, improves outcomes, and reduces the burden on staff. Paired with the growing understanding of how closely mental and physical health are linked, technology is creating new opportunities for providers to deliver care differently to their community in ways that add more value and frequency to patient interactions.
While there is massive potential, aligning diverse technology solutions to effectively serve the needs of a population is challenging. That’s why NeuroFlow is setting a “new standard of digital care,” a high-tech, high-touch approach to behavioral health that we believe health systems should and can incorporate. This standard of digital care creates a behavioral health infrastructure across enterprise health systems, enabling care teams to serve populations with varying and evolving needs in a unified way.
In this blog, we’ll explore how each of these core functions enables comprehensive behavioral health at the population level, and support other critical population needs like identifying and addressing SDOH and managing comorbidities.
Behavioral health is inextricably linked to population health, but most health systems struggle to identify and support the behavioral health needs of their populations. Behavioral health typically remains siloed in a department that is understaffed and overloaded with demand, while scores of patients remain on lengthy wait lists, don’t follow through on referrals, or are never properly identified as needing behavioral health support at all.
Technology plays a pivotal role in scaling behavioral health measurement and support population-wide, but to date a lack of consistent, principled approach to digital care has made it difficult to know where to start. The standard of digital care aims to resolve these persistent issues that have prevented behavioral health technologies from making the greatest impact on population well-being.
Before health systems can provide behavioral health support, they need a way to identify unaddressed needs, risk stratify their population, and identify the appropriate level of care. NeuroFlow accomplishes this by delivering regular behavioral health assessments via app when an individual begins using NeuroFlow and throughout their journey. Assessments include clinically-validated questionnaires like the PHQ-9, GAD-7, and WHO-5. These initial assessments achieve a 65% completion rate on NeuroFlow, creating a much clearer picture of population health. Plus, patients’ ability to take assessments on their own time, in the comfort of their home, is believed to improve response candor.
NeuroFlow’s measurement-based care approach provides longitudinal data that alerts care teams when a patient’s wellness is trending downward and an intervention may be needed. NeuroFlow’s proprietary Severity Score takes into account assessment scores and other user-reported data to generate a unique risk baseline for each patient, which enables detection of worsening conditions and prompts action by care teams when necessary. Changes to Severity Score are monitored over time in NeuroFlow’s Manage platform, helping care teams identify and prioritize who may need support on an ongoing basis.
A critical way to meet the diverse needs of a population is to empower individuals with evidenced-based behavioral health resources that they can discover at their own pace. Built on the tenets of digital cognitive behavioral therapy (dCBT), NeuroFlow provides a wide range of dCBT curricula, known as journeys, on topics like worry and tension, substance use, healthy relationships, parenting wellness, and more. Individuals have 24/7 access to journeys, and can explore the topics that interest them most in our Journey Gallery.
The platform also assigns relevant content to individuals based on changes to Severity Score. A notable increase in severity levels would not only trigger an at-risk alert to care teams, but would also assign the patient a depression journey, for example, to receive self-guided support.
Engagement is a critical part of NeuroFlow’s standard of digital care. Using a mixture of gamification, reminders, and notifications, NeuroFlow has achieved industry-leading engagement rates. After one month, 57% of registered patients remain active on the platform, compared to the industry standard of 6%. At the six month mark, 33% of these patients are still completing at least one activity per day on average.
Access to behavioral health specialists remains a huge barrier to improved population health. 45% of the U.S. population lives in an area with a shortage of mental health professionals, and 70% of all psychiatrists are 50 and older which will result in an even greater shortage as they retire. Teletherapy and telepsychiatry can help alleviate this burden, which is why NeuroFlow is excited to partner with four of the leading behavioral health organizations in the country: Array, LifeStance Health, Marvin, and Brightside Health. With these partnerships, NeuroFlow can leverage its Severity Score-powered triage engine to guide the right individuals to the right higher level of care when appropriate, either directly through the app or through care coordination.
Referrals can also be customized by population. If post-traumatic stress, for example, is prevalent within a population, NeuroFlow can prioritize therapists who specialize in PTSD. Alternatively, the app can refer only to therapists that take an individual’s insurance. This level of versatility helps NeuroFlow adapt to the unique needs of a health system and its population.
Suicide is a leading cause of death in U.S., claiming over 49,000 lives in 2020. Tragically, 45% of individuals who took their own life had contact with primary care providers within one month of suicide. That is why suicide prevention is an essential part of a comprehensive behavioral health solution for populations. NeuroFlow offers Response Services, a network of certified mental health professionals who proactively contact individuals when they trigger an at-risk or urgent alert. These alerts could be triggered by a recent assessment or through natural language processing technology which analyzes and flags free text shared in the NeuroFlow app that indicates self harm or suicidal ideation. The combination of identification through technology and high-touch, compassionate care provided by our response services coordinators makes a significant impact on suicide prevention.
“We actually had a woman who had been treated by doctors for years for a chronic illness, but had never been able to disclose that she’d had suicidal thoughts for years,” says Faith Best, NeuroFlow’s Clinical Services Senior Manager, “So using the app gave her the opportunity to identify that, and then NeuroFlow was able to respond, and we got her connected to therapy, which was huge for her. She actually said, ‘This might be a small thing for you, but it’s a big thing for me.’”
Partnering with CAMS-Care, an organization that provides suicide prevention training and resources, NeuroFlow incorporates an industry-leading suicide prevention protocol into our platform. We provide valuable assessment tools to care teams along with population monitoring and proactive crisis outreach. In addition, NeuroFlow offers easily accessible crisis resources, including the new mental health and suicide prevention lifeline, 988, which patients can contact directly through the app. With Response Services, NeuroFlow is able to intervene before individuals reach crisis and refer them to the appropriate level of care.
A unified, holistic approach to behavioral health will make the greatest impact on population well-being. We’ve seen this time and time again at NeuroFlow. The more that health systems can engage, monitor, and proactively respond to their populations’ needs, the better they will be able to elevate and standardize quality of care across the population. A high-touch, high-tech approach can eliminate inconsistent behavioral health approaches across different sites and ensure high-quality care. According to the American Medical Association, the benefits of high-touch and high-tech behavioral health care include improved outcomes, greater access to care, lower costs, and improved provider satisfaction. To learn more about NeuroFlow’s unique approach to population behavioral health, check out our resources hub.
References:
https://www.nimh.nih.gov/health/statistics/mental-illness
https://www.aafp.org/pubs/fpm/issues/2021/0500/oa1.html
https://www.mhanational.org/research-reports/2021-state-mental-health-america
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1852925/
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