The idea of using digital health tools in a disciplined, trackable manner (e.g. as digital therapeutics) has been in the air for quite some time. However, I’ve seen very few concrete examples of such deployments so far. This week, though, brings the news that Kaiser Permanente has made it possible for its psychiatrists and mental health therapists to refer patients to health and wellness apps through its Epic EHR.
While the Kaiser news release doesn’t say so specifically, It’s possible Epic Is delivering this capability for Kaiser using digital health management platform Xealth. As we’ve noted previously, both Epic and Cerner are working with Xealth to manage and deploy digital health tools to patients. If there not using Xealth it would be interesting to know what they’re using.
In its release on the subject, Kaiser notes that recent research supports the value of having clinicians involved in guiding patients to mental health and wellness apps, as their involvement makes it more likely that patients will use the apps than if they’d found them on their own.
The Kaiser list of mental health and wellness apps available for referral include tools for mindfulness, meditation and cognitive behavioral therapy that can support patients with mild to moderate anxiety, depression, and other mental health problems.
The apps selected by Kaiser include Calm, Headspace and Whil, which are mindfulness and meditation apps focused on reducing stress and anxiety and improving sleep. Others include myStrength, SilverCloud and Thrive, which are cognitive behavioral therapy apps offering guided support through coaching and interactive activities. Kaiser members can access Calm and myStrength on their own but need a referral from the mental health clinician to work with the others.
Clearly, Kaiser’s intent is to move from haphazard experimentation with mental health apps to a structured approach to their deployment and use. The idea here seems to be to make these apps a direct extension of care rather than options patients seek out on their own. The shift seems to be comparable to putting patients on prescription medication rather than having them rely on over-the-counter options.
“What we’re tapping into is the existing relationship people have with their Kaiser Permanente therapist,” said Don Mordecai, MD, national leader for mental health and wellness at Kaiser Permanente in a prepared statement. “Digital therapeutics such as mental health apps have a clear place in a care plan.”
For what it’s worth, my feeling is that this is a nice gesture, but one without a whole lot of substance to back it up as of yet. While it’s all well and good to prescribe apps to patients, if the apps don’t generate data flows to the back into the EHR, there’s a limit to how much value this initiative can offer.
That being said, there’s no harm in moving this direction, as ultimately, I believe, harvesting and analyzing data generated by patient-managed digital tools will prove important for managing both population and individual health.