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Mobile Health in Behavioral Care

Helping to better connect with patients in the digital age.

More than 57 million Americans have a behavioral health condition, making it the third costliest condition in the U.S. (and equivalent in costs to cancer treatments). The Kaiser Family Foundation estimates that more than one-third of Medicaid beneficiaries have a mental illness - and of those, 61% have a comorbid condition.1 85% of healthcare "superutilizers" - those whose care costs $25,000 or more annually - have a behavioral health condition.

Unfortunately, behavioral and medical health data records are often maintained separately and very little behavioral health data finds its way into hospitals' electronic health records (EHRs).

Mobile health technologies are helping to bridge this chasm, producing better outcomes and greater savings. There are now about three million Android and Apple (iOS) apps on the market and one research firm estimates that more than 100,000 of them are mHealth apps.

Mobile technology makes engaging with patients - especially those who go directly to the emergency department - much easier and a recent Pew Research Center study found that more than 90% of Americans own a cell phone and 64% own smartphones.

The Benefits of Passive Monitoring

Smartphones and tablets capture a wealth of "passive" data that gives providers a continuous picture of how an individual is doing. When passive data is analyzed, providers can detect patterns and take action before crises emerge, helping to dramatically lower the number of unnecessary ED visits and hospitalizations.

SEE ALSO: Mobile Device Use in Hospitals

We recently conducted a pilot program called coactionHealth, a clinical model that integrates mobile healthcare technologies with data analytics into a care management platform. It's designed to reduce superutilizers' healthcare costs and improve their quality of care.

The 94 participants received a Verizon smartphone featuring HipaaBridge's secure texting, email and video chat capabilities. The phones also used an app created by Ginger.io that captured passive data 24/7 to look for behavioral patterns. Any disturbing patterns automatically triggered an alert to a caregiver or health coach. The app also captured active data, including weekly questionnaire responses.

Here are some of the benefits produced by the program:
  • Improved Patient Engagement - Participants could contact clinicians any time, securely and easily, which reduces the likelihood of them winding up in the ED.
  • Automated Reminders and Care Tips - Superutilizers preferred to get these on a smart device, not on a desktop computer or in a mailed flyer.
  • Reduced Need for Self-Reporting - Clinicians got the data they needed with minimal input from the patient.
  • Better Outcomes and Lower Costs - In just 90 days, coactionHealth saved more than half a million dollars by reducing unnecessary ED and hospitalization costs. The program helped lower hospitalization days by 61% and ED visits by 32%.
Apps: Our Best Engagement Tool

Mobile technology offers the most effective way to engage those who either overuse the healthcare system or fail to use it at all. Providers know that there are individuals who won't visit a doctor until there's a serious emergency, whether it's major depression or an untreated heart condition. Those individuals are much more likely to respond to a text than a letter.

What we've learned from coactionHealth can be replicated anywhere in the U.S. and on a much larger scale. Mobile health technology is the key to lowering superutilizer costs while improving outcomes - and it can engage patients before their current behavioral health issues turn into costly crises.

Tom Doub, PhD, is CEO of Centerstone Research Institute in Nashville, Tennessee, a subsidiary of Centerstone, a nonprofit provider of community-based behavioral healthcare.

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