Looking back on the Going Digital: Behavioral Health Tech Conference in June 2022, we highlight a few conversations we had throughout the event. We spoke with Jennifer Gentile, PsyD, the Senior Vice President of Clinical Innovation at Ieso; Trina Histon, Ph.D., a Senior Principal Consultant in Prevention, Wellness, and Digital Health at Kaiser Permanente; Reena Pande, MD, Chief Medical Officer at AbleTo; and Stephen Schueller, Ph.D., the Executive Director of One Mind Psyberguide, about responsible innovation in digital mental health. We explore what it means to build and deploy responsible digital products.
The FDA has created a Digital Health Center of Excellence to “empower stakeholders to advance health care by fostering responsible and high-quality digital health innovation.” Responsible innovation must include the importance of values such as trust, safety, and privacy, having checks and balances like oversight bodies, and processes of innovation and collaboration. Additionally, equal access and patient autonomy are critical pieces of responsible innovation. But what does responsible innovation in behavioral health look like today, and how can we improve in the future?
Because healthcare providers must abide by ethical principles to protect the rights and safety of their patients, digital health tools should abide by similar principles. Dr. Schueller echoed this idea when he explained, “I think responsible innovation really builds off a lot of the core ethical principles we have of medicine generally, do no harm and make sure that we bring value and benefits to patients.” He continues to explain that digital solutions should build upon the current standard of care to add value to the patient care experience.
Beyond the baseline of not harming patients, innovative digital behavioral health companies must deliver good clinical outcomes. As Dr. Gentile explains, “patients deserve high-quality mental health care, and more importantly, they deserve good clinical outcomes. Because we know as a society, everyone benefits if we have healthier, happier people.” An essential part of delivering good clinical outcomes is being able to perform research and measure patient outcomes using a specific digital health intervention. Dr. Scheuller comments, “if you want to be serious about outcomes…you need to measure it, and you need to measure it responsibly.”
Improving access to care has been an integral part of creating digital behavioral health technologies. However, Dr. Pande explains that “so much of the conversation these days feels like it’s around access, access, access, which is necessary, but not sufficient.” Dr. Schuller adds, “let’s get people connected to care, but what are we offering them when they get there?” A responsible digital health product can not only expand access to services but must also consider the quality of services they offer.
Discussing responsible innovation in digital behavioral health leads us to consider the role of digital health and when and why it should be used. One example is the ability to move beyond episodic data, typically seen in healthcare. Dr. Histon explains, “the value for me of adding a digital layer is you now have sort of continuous data that could and should deliver insights, even beyond, are we moving the clinical benchmark? So I’m excited by that.” Digital tools allow providers to connect with their patients more frequently and gather more information about how they’re doing on a day-to-day basis.
Additionally, digital health can be used to redistribute some of the administrative workloads off of clinicians so they can focus on helpful interventions. Dr. Gentile explains, “as a clinician, I don’t want to be in the business of taking clinician jobs, but rather, how do we help psychologists do what they’re really good at doing, versus having them spend time…scheduling appointments, or practicing breathing interventions.” Thoughtfully considering how digital interventions can be used in conjunction with mental health providers will create the best experience for both patients and providers.
An important part of responsible innovation in digital behavioral health is a genuine acknowledgment of what certain products can and cannot do. As Dr. Pande explains, “one thing that I’ve seen, which worries me, is the lack of humility and transparency about what your solution does well and what it doesn’t do. And part of being responsible is being very honest about when this intervention, digital tool, or therapeutic approach is right and when it’s not right.” Patients are best served when leaders are honest about when their product is a good fit for a specific population and are clear about its limitations.
Dr. Histon comments, “I feel that there is no one app to do everything…and people are complicated. And if you mismatch a solution…time one or time two, you’re reducing the likelihood someone sees the value later on.” There is always a danger that patients may start to feel hopeless if they are accessing an intervention that isn’t a good fit for their specific needs. The goal of digital behavioral health should be to help more people gain access to quality behavioral health services, not to turn them away.
As we think about responsible innovation, we wonder if responsible innovators can meet the needs of all stakeholders. Dr. Pande believes “you can do good and do well.” The key is ensuring all stakeholders have the same goals and mission. Dr. Pande continues, “I’ve been thinking a lot about a North Star, a True North. You have to be clear about what your True North is, and you have to stick to it, and you have to make sure that all stakeholders are aligned to that TrueNorth.”
Responsible innovation in behavioral health will take a conscious effort from all stakeholders to ensure that patient’s needs are the first priority, digital health is used as an informative and helpful tool, and there is transparency around where digital health is or is not appropriate.
These are just a few insights from our conversation with Dr. Gentile, Dr. Histon, Dr. Pande, and Dr. Schueller. To hear our full conversation, visit our video library.