Copyright, iHope Network, Inc 2016 1 Telemental Health For Whom, What and When? Steven E. Locke, MD Chief Medical Officer iHope Network Clinical Associate Professor of Psychiatry Harvard Medical School Telemental Health: Expanding the Digital Fron6er William James College September 23, 2016
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Copyright,iHopeNetwork,Inc2016 1
TelementalHealthForWhom,WhatandWhen?
StevenE.Locke,MDChiefMedicalOfficer
iHopeNetworkClinicalAssociateProfessorofPsychiatry
HarvardMedicalSchool
TelementalHealth:ExpandingtheDigitalFron6er
WilliamJamesCollege September23,2016
Copyright,iHopeNetwork,Inc2016 2
AnotherQuesRon…
WhyTelementalHealth?
Copyright,iHopeNetwork,Inc2016 3
Amotherwhosechildissick,requiringhertocancelherappointmentwithmebecauseshecan'tleavehome.
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Afrail,elderlyphysicianlivesalone,reRred,andstruggleswithgriefanddepression.HehasParkinson'sDiseaseandcannolongerdrivetomyoffice.HisMedicareAdvantageplanwillnotpayfortelecare.
Copyright,iHopeNetwork,Inc2016 5
Ahospital-basedphysicianwholeYworkforapsychiatryappointment15milesawayledhisservicechieftothreatenhisjob.
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Achildwhosemotherhastoleaveworktopickherchildupatschoolanddrivehertohertherapist’soffice.Themotherlosesincome,thechildlosesclassroominstrucRonandmissesaYerschoolacRviRes.
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Ayoungwomanwithpersistentdepressionunsuccessfullyusesaself-guidedprogramfordepressionshefoundontheInternettoself-managehercondiRonbecauseshecannotfindatherapistwhocouldprovideCBT,thetreatmentrecommendedbyherPCPwhoprescribesheranRdepressant.
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Ahighschoolsenior,apopularathlete,screensposiRvefordepressionatthepediatricianandisreferredtoatherapist.HerefusestogobecauseheisworriedhewillrunintoclassmatesinthewaiRngroom.
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Why?WhataretheDrivers?
• Epidemiology• Quality• Outcomes• Costs• Access• Payers• Integratedcare
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ForWhom?
o TargetpopulaRons• Military/VA• Isolatedenvironments• Prisons• Primarycare• Homebound• Employers
o Providers:careeropportuniReso Payers(commercial,public,ACOs)
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What?
• Typesofapproaches• Technologies• IntervenRons• Mobilehealth(mHealth)• Guidedself-care• GamesandgamificaRon• Clinicians• Training
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TypesofApproaches
• Guidedself-care• Listservs• Chatroomsandsupportgroups• Onlinecoaching• Referralsites• TeleconsultaRon:clinicians• Telemedicineservices:consumers• Integrated,collaboraRvecare
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What?
• Typesofapproaches• Technologies• IntervenRons• Mobilehealth(mHealth)• Guidedself-care• GamesandgamificaRon• Clinicians• Training
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When?
o Newtechnologies!opportuniReso Barrierstocare• Access• SRgma• Reimbursement• Licensing• Regulatory(Boards,CMS,FDA)• LegislaRon(state,federal)• Liability(statutoryvs.caselaw)
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When?
o Telementalhealthacrossthelifespan• Children• Adolescents• Students• Adults• Seniors• Endoflife
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When?
o TheFuture:MovingtheBall• Avatars• VirtualReality(VR)• Virtualworlds(SecondLife,Whyville)• IntegraRonwithwearables• SpeechandvoiceanalyRcs• SimulaRons,seriousgames• AnalyRcsandmachinelearning• Psychogenomics
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MentalHealthinSecondLife
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MentalHealthinWhyville
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What’sNext?
o LegislaRon• State• Federal
o Regulatorychanges• EliminateoriginaRonsiterestricRons
o Licensure• Interstatecompacts
o Lobbyingeffortso Moreresearchtoproveclinicalandcost
effecRveness
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