Oct 2, 2020

Monitoring mental health symptoms at home

By Jessica Kim Cohen

AT TEXAS CHILDREN’S HOSPITAL, some patients are trying new web-based tools to stay connected with physicians between psychology appointments—a program that’s taken on newfound importance while providers care for patients amid the COVID-19 pandemic.

Typically, providers give pen-and-paper questionnaires to patients during appointments to assess and track symptoms related to mental health over time. But the Houston hospital earlier this year began rolling out a software program from Owl Insights to screen and monitor patients remotely.

Texas Children’s psychology service treats kids with such mental health concerns as anxiety, obsessive compulsive disorder and, more recently, distress related to COVID-19.

By implementing a program that lets children and their parents respond to questionnaires online, Texas Children’s not only aimed to provide more touch points between appointments, but also to make the process more efficient for physicians, cutting down the time they spend documenting that information as well as automatically graphing symptoms over time.

The program has been particularly helpful as telehealth usage has spiked during the pandemic. That’s by chance, said Karin Price, chief of psychology at Texas Children’s, since the hospital had already been planning to go live on the program. 

Tracking a patient’s symptoms is key to noting their progress and informing treatment options; for example, flagging if a patient’s depression isn’t improving as expected, Price said. But she stressed “more information is not always better;” it’s important for physicians to select appropriate questions based on a patient’s specific concerns. 

Just a handful of providers have been tasked with using the platform to figure out the best way to integrate it into workflows. 

Mental health is a growing segment within digital health, capturing significant attention from investors. While overall funding into wellness startups dipped 24% in the first half of 2020—dropping from $6.1 billion in the first half of last year to $4.6 billion this year—mental health startups raised more than $1 billion, up 43% year-over-year, according to a report from CB Insights, a firm that analyzes data on venture capital and startups. Earlier this month, Owl Insights said it raised $15 million in an investment co-led by Ascension Ventures, the investment arm of hospital giant Ascension. While other areas of medicine frequently use metrics like blood pressure, blood sugar levels and weight when treating diseases, using standard measures to track patients is newer in psychology, said Nancy Ruddy, a professor of clinical psychology at Antioch University New England and a consultant who works with organizations on integrating behavioral health and primary-care programs. She hasn’t used similar software with her patients, but said she thinks they have potential to support a broader push to add more “measurement-based care” to behavioral health programs. 

“Whether we’re using a paper-and-pencil kind of thing or something via an app, it’s just a way of having a sense of is the treatment working and is this person improving, or do we need to change course,” Ruddy said. Jefferson Health in Philadelphia began rolling out a program to help monitor patients’ behavioral health symptoms between appointments from another company, NeuroFlow, about two years ago. Since then the system has created the app, which lets providers assign surveys and set care reminders for patients, available for behavioral health, primary care and OB-GYN treatment.

To really help patients, it’s important that the programs are “anchored with clinicians” and integrated into patient care, said Dr. Michael Vergare, chair emeritus of Jefferson’s psychiatry and human behavior department.

One of the areas where the program’s had strong uptake, even before the pandemic, is screening and monitoring new mothers for postpartum depression. Providers can offer patients the option to enroll in the program to receive reminders about wellness and mental health between visits, as well as to track symptoms related to depression and anxiety.

If a patient’s symptoms unexpectedly change between appointments, providers can use the information to intervene more quickly and to adjust their care plan, Vergare said.

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