Providence's Todd Czartoski spoke about helping doctors stay safe both physically and mentallyRead more...
As coronavirus ravages the nation, it is spurring innovation and adoption of mental health tools
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Right now, the US has passed one million confirmed COVID-19 cases, with roughly 30,000 new cases and 2,000 deaths per day, which could soon hit 60,000. Obviously, this is an incredibly serious situation with huge ramifications.
At the same time, we have to try and find that silver lining in there. Something good has to come out of this, even if it's that we take diseases like this more seriously going forward.
On Wednesday, Vator, along with HP and UCSF Health Hub, held its second virtual salon of the year, centered around mental and behavioral health in which our panelists broached this topic. They included Dr. Clare Purvis (Director, Behavioral Science, Headspace), Billy Deicht (Investor, Oak HC/FT), Dr. Todd Czartoski (Chief Medical Technology Officer, Providence Telehealth) and Eva Borden (Managing Director, Behavioral and Medical Solutions, Cigna)
Co-moderators Bambi Francisco Roizen (Founder and CEO, Vator), and Dr. Archana Dubey (Global Medical Director, HP Health Centers, HP), asked the panels how they are helping to bring something positive out of this situation.
Francisco referred to her post, "In the new normal, who will we become?," when she raised the point that the downtime has taken away what "we want but given us the time to pursue what we need" and that has created new meaning and purpose in our lives that is good. So how do we take the better versions of ourselves forward?
"How do we avoid what this article talked about [a silent mental health pandemic]? Once this is all over and we get to this new normal, we might actually see this silent pandemic if people don’t like the new normal. How do we bring the positive thoughts we learned forward to avoid this? Is there a specific program that you’re focused on to develop these positive aspects and bring them forward?" Francisco asked.
Dubey added: "The new normal that nobody likes is going to be rubbing against each one of us in a negative way. So what are you doing to make things positive for folks?" asked Dubey.
Borden answered by mentioning how COVID has ramped up adoption of virtual care by behavioral health professionals.
"There’s a lot of very large corporations that can get mired down and things move slowly. and there's hesitation, ‘Will people adopt it? Will they not? What will it look like?’ We’ve seen a tremendous acceleration within our behavioral network on a few fronts. Number one, we had at the end of February about 20,000 providers who were willing to do virtual care, who said, ‘Yes, I want to do virtual care, put it in your directory.’ In one week in March, we had 45,000, so an increase of 25,000 providers who volunteered to the point that we said, ‘No more, we will assume if you’ll do it, we’ll reimburse it. Check done. Nothing else.’ Because it was such a great need," she said.
COVID has also forced Cigna to be more innovative she said, especially in terms of how it thinks about its digital partners, meaning they are going from telling their employer groups that they have another partner to add, to embedded those partners directly into its behavioral health network.
"There’s four different partners I would say over the course of the next 45 days we’ll be announcing that are directly embedded into our network, so that way employers don’t have to choose, ‘Do I want it? Do I not want it?’ Instead, if that’s your preference for seeking behavioral healthcare, we’ll make it happen. Those are some of the positives, and if COVID-19 hadn’t happened, instead of 45 days it would have taken six months."
While she couldn't give specifics, Borden did mention that one of those partners was in the text therapy space.
"In the moment you’re feeling it, which is actually to some of the things we often struggle with, I’m feeling something, I want to talk to someone, I may not be able to talk to someone, even if I can get an appointment in three hours, I may not be feeling the same way, but from an asynchronous text therapy perspective, I can text it in the moment I’m feeling it."
Dubey turned the question to Czartoski, asking how Providence is approaching with positive psychology in its virtual care solution. She also asked specifically how the company is helping its providers with grief counseling.
"As people are losing family members, they get grief counseling, but also their friends and extended network is getting impacted with loss. That is another hidden pandemic, and that’s causing a lot of grief and pain. How are you addressing that, especially with healthcare workers who are seeing not such positive outcomes for some of their patients?" she asked.
He responded that virtual tools can be used to connect people who are grieving but who can't be together right now.
"I have a caregiver on my team who’s family is from the east coast and had a close relative pass away completely unrelated to COVID but they couldn’t travel, couldn’t be there, so they used some virtual tools to be with family and loved ones," he said.
"That sense of not being able to say goodbye and be there, it’s such a sacred moment for people that that’s maybe one of the biggest impacts we’ve had is to be able to at least give people the ability, and most people have their own device, and we can set up connectivity, not just with healthcare workers but their family. But if they don’t, making sure that they have an iPad or a tablet. That’s been a huge part of it."
The other way Providence is trying to spread positivity, Czartoski noted, is by "being very proactive about telling the story and celebrating our caregivers."
"In addition to giving them tools to be able to deal with the stress and deal with the PTSD and deal with the hours and the fear of exposure and lack of PPE, putting together montages and videos and celebrating. So, if you go by many of our hospitals, you’ll see homemade signs that say, ‘Heroes work here.’ Just some things that are not digital, some tools to really call out and celebrate the positive," he saod.
"It’s interesting because I work in my office all day on video calls, it even resonates with my kids who are used to seeing me go to the hospital and see patients and be gone for long hours. Now I’m cooped up in my office but it resonates with my 8, 10 and 12 year old that papa’s in there helping people. Even if he’s not seeing patients himself, he’s setting up tools so that other doctors can see and help people."
Purvis also answered the question, noting that "Headspace has shown clinical efficacy for the alleviation of a variety of symptoms of mental and physical health."
The company has 75 active collaborations with university-based researchers looking at the "clinical efficacy, feasibility, acceptability of Headspace as either an adjunctive to traditional care or, in some cases, a standalone intervention, particularly folks in that sub-clinical range, with common mental health conditions," she said.
Purvis also noted that Headspace is increasingly looking at how the company can treat physical and chronic health conditions with a new digital therapeutics subsidiary within Headspace called Headspace Health, where it is developing digitally enabled services to support adults managing stress related chronic, physical conditions.
"As we know, certainly mental health comorbidities are the rule, not the exception, with chronic physical health conditions. So, as we move towards going to market with that product our first step will be a clinical pilot trial and then a larger clinical randomized control trial, looking at that new service," she said.
"All of that being said, one reason, frankly, as a clinician and scientist that I decided to join Headspace is that they don’t take a traditional clinical or medical model approach to the alleviation of those symptoms. It’s a mindfulness meditation as a solution, an approach, an intervention, it is inherently whole person oriented."
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