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Leaders See Technology as Altering, Not Replacing, Clinicians' Work

August 17, 2019

Technology is highly unlikely to replace the human interaction that characterizes addiction and mental health treatment, but it will alter care providers' roles in ways that still haven't been clearly defined, panelists said at the NCAD East conference on Saturday.

In order to maximize technology tools' potential, panelists said, the behavioral health field must grapple with many challenges that need to be navigated, from integration to personalization to privacy. Each of the three leaders on the morning plenary panel identified numerous tasks that the provider community faces. For example:

  • Among technology developers, “The race to win is pervasive,” said Angela Joerin, director of psychology at X2, which develops artificial intelligence (AI) programs for numerous target populations. Collaboration that could be highly productive is therefore in short supply, Joerin said.

  • “Physicians are pulling telehealth into their lives. … The growth in EHR [for behavioral health] has not been as fast,” said Steve Millette, director of recovery ecosystems at Gloo, developer of a data solutions platform for personal growth. Millette attributed the difference to the market-driven nature of telehealth's growth in medicine versus the mandated aspect of electronic health record implementation for addiction and mental health treatment providers.

  • “I'm very concerned about privacy, for all of us,” said Kimberly Johnson, PhD, research associate professor at the University of South Florida and former director of the federal Center for Substance Abuse Treatment (CSAT). “We've pretty much given up our privacy,” and the field still needs to answer basic questions about who ultimately owns sensitive behavioral health data, Johnson said.

Opportunity to engage

Panelists assured a provider audience that is historically skeptical of how technology will change the landscape that the tools being developed are enhancing prospects for the human interaction in which they specialize.

Millette said fear of the “rise of the robots” is essentially a fiction. He sees mobile apps and other technology tools as being particularly beneficial for individuals who otherwise might not reach out for help until their issues become full-blown crises.

Joerin, whose organization is developing an AI system embedded with empathy and memory for being able to deliver components of therapy, said the company's research has shown that four weeks of interaction with the “chatbot” actually leads to an increase in the number of people the user will choose to interact with face-to-face.

“This is not meant to replace the quality of care delivered by a person,” Joerin said. However, an individual might be more likely to share sensitive information such as suicidal thoughts first with a non-human entity, which then can help to connect the person with a care provider for the necessary follow-up, she said.

Contrary to expectations about this type of technology being most attractive to the youngest individuals, women ages 30 to 60 make up X2's biggest user group, Joerin said.

Future applications

Johnson, who at CSAT was immersed in the process of updating the federal 42 CFR Part 2 regulations that offer an added layer of confidentiality protection for substance use information, said she is most excited about opportunities to incorporate data to do predictive analytics. “Technology hasn't gotten very far in the ability to predict relapse,” she said.

Johnson suggested that payers likely will drive advances in technology for addiction treatment because “they're looking at cost savings.”

Joerin's organization has to have careful discussions about reimbursement because its AI services fall under wellness/coaching rather than therapy, though they technically qualify under a billing code for remote patient monitoring.

Millette added that ultimately consumers, providers and payers will all have to drive change. He also sees the greater integration of behavioral health into general medicine as accelerating the move toward more advanced technology solutions.

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