Women have some special needs when it comes to behavioral health – for example, maternal mental healthcare. But they face the same challenges as men in finding mental health caregivers during a crisis situation of big demand and little supply.
Just like with access to other specialty caregivers across the spectrum, patients can find the solution to their mental healthcare challenges via virtual care.
Dr. Sipra Laddha is founder and CEO of LunaJoy, a telemedicine services company that specializes in women's mental health. We spoke with her to better understand how women can benefit from telehealth.
We spoke to her recently about why she thinks maternal mental health has been under-resourced, the keys to reducing wait times for psychiatric and behavioral health appointments, and how providers can improve their data collection and ensure they're holistically treating patients for both mental and physical health needs.
We also spoke about the ways agentic artificial intelligence can offer benefits for providers who have historically had limited bandwidth.
Q. How have you seen AI and telehealth deployed to improve access to care and reduce the training gap needed to support maternal mental health clinicians?
A. The lack of specialization continues to inhibit quality care delivery for women across the country. We have failed as an industry to deploy the apparatus needed to reach these vulnerable groups.
However, technology is finally at the point where it can be used to expand care pathways and improve the bandwidth challenges that clinicians face. One of the best use cases I've seen is with generative AI simulating real-world case examples and to provide supervision for at-risk women.
For example, not every training psychiatric professional has experience working with women who have faced trauma, like a miscarriage. No textbook can prepare you for these situations. But AI avatars – human-like personalities – can provide practice reps and build "clinical calluses" in the absence of patients.
This is a lower-risk training methodology – like a flight simulator – that can be scaled very easily in a clinic or health system.
Additionally, most providers are hesitant to prescribe medication during pregnancy due to liability and ambiguous federal and state laws around using a virtual modality. AI can help deliver real-time analytics, understanding when and how to use different medications depending on factors like stage of pregnancy and a woman's preexisting conditions.
Another patient population that is undertreated and misunderstood is opioid and SUD mothers during postpartum. It's a gap we need to fill in terms of adding clinical expertise and using technology to expand access to care.
Q. How can AI and telehealth reduce wait times for psychiatric and behavioral health appointments?
A. Phase one of using AI has been around workflow enhancements. Analog phone tag is no longer necessary, with smart scheduling platforms and intuitive online portals that identify best options for patients.
We've since evolved – as an industry – to incorporate artificial intelligence into our patient caseloads, tracking trends in patient vitals (things like mood scores, PHQ-9 and GAD-7, etc.), modeling responses and enabling clinicians with active reports on a sliding scale. We have a real-time window into who's struggling and actions doctors can take to intervene in urgent scenarios.
Of course, this is dependent on two things: patient participation and providers having the ability to afford new AI systems and training clinical staff on these tools. That's where we are heading next.
As more companies enter the field, it is democratizing technology and lowering costs to adopt. Rural FQHCs and women's clinics – which have historically been left behind from innovation – need support from the federal government to implement these technologies and drive the change we all want to see. The industry is inundated with manual workflows that need to be upgraded with AI and telehealth.
Q. How can providers improve their data collection and ensure they are holistically treating patients for both mental and physical health needs?
A. For as long as we have had healthcare, mental health has been second tier to physical health. We are learning this inequity in funding, staffing and resources has led to an unchecked crisis in our country.
Using simple digital dashboards and a universal intake system for patients will improve pattern detection. If we know that a patient has a history of trauma and depression, we should be recommending a different care pathway and treatment plan than a patient with no known history of trauma or depression.
Nearly 70% of people with mental illness do not seek care, which puts more pressure on untrained primary care doctors and OB/GYNs on identifying symptoms and assigning risk at times when there is no baseline. Technology and data analytics that go beyond checking a box can deliver a more precise level of care to patients.
Q. How do agentic AI's autonomous chat and voice bots work in the clinical arena and what are some of the benefits for providers who have historically had limited bandwidth? Further, can use of these help healthcare delivered via telehealth?
A. We are finding chatbots and autonomous voice agents have a place in healthcare. While patients should not be solely dependent on them in their care journey, studies are showing positive results and reducing severity and improving anxiety symptoms. Dartmouth's 'Therabot' is an example of how this is being done.
The best use case for these agents is during intake, as a way to log key insights about a patients' condition and to determine level of risk. These technologies are adapting and learning our behaviors faster than we can imagine. And when a crisis strikes, they can often be the first response – knowing clinical professionals cannot always be "on."
For small private practices, these tools can be a lifeline for patients and a way to decrease cognitive burden. Where it can often take 67 days to be seen in-person by a psychiatric professional, the average wait time drops to 43 days for a telehealth or virtual visit.
Still, that's not good enough. It's more important than ever to have things like the suicide hotline – known as 988 – and call centers that can route patients to immediate support. In lieu of a human staffing these facilities, we can implant agents and chatbots to pick up on keywords and assess next best steps for a caller.
Follow Bill's HIT coverage on LinkedIn: Bill Siwicki
Email him: bsiwicki@himss.org
Healthcare IT News is a HIMSS Media publication.
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