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Utilizing Next-Generation Digital Health Technolog ...
Presentation and Q&A
Presentation and Q&A
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Hello and welcome. I'm Dr. John Torres, the Director of Digital Psychiatry at Beth Israel Deaconess Medical Center and a member of the SMI Advisor Clinical Expert Team. I'm pleased that you're joining us for today's SMI Advisor webinar, Utilizing Next Generation Digital Health Technology to Improve Care for People with Serious Mental Illness. Next slide, please. SMI Advisor, also known as the Clinical Support System for Serious Mental Illness, is an APA and SAMHSA initiative devoted to helping clinicians implement evidence-based care for those living with serious mental illness. Working with experts from across the SMI clinician community, our interdisciplinary effort has been designed to help you get answers that you need to care for your patients. Next slide, please. Today's webinar has been designated for several types of credit. There's one AMA PRA Category 1 credit for physician, one Continuing Education credit for psychologist, one Continuing Education credit for social workers, and one nursing continuing professional development contact hour. Credit for participating in today's webinar will be available until May 30th of this year. Next slide, please. Questions from the presentation are available in the handout area, which is found in the lower portion of your control panel. You can select the link to download the PDF. Next slide, please. Feel free at any time to submit questions throughout the presentation. You just simply have to type them into the question area, which is also found in the lower portion of your control panel. We'll reserve about 10 minutes at the end for question and answer, which I'll be moderating. And next slide, please. So now it's my terrific pleasure to introduce you to the faculty for today's webinar, Dr. Timothy Angst. So Timothy is an Associate Professor of Pharmacy Practice at the Massachusetts College of Pharmacy and Health Sciences. He's conducted research on digital health technologies in the pharmacy space and published multiple peer-reviewed journals and spoken at probably countless venues on the topic, I would say. He hopes to inspire the pharmacy profession to further integrate digital health into patient care and raise awareness on the possible futures that are coming tomorrow, in the next week, next decade. And I'll say on a personal note, this is someone who if you just wanted to know about pharmacy and technology and what's happening, I think we are lucky to have the world expert here. So Dr. Angst, thank you so much for joining us and leading today's webinar. It's a pleasure. Thanks, John. I really appreciate it. It was a great introduction. I mean, you hyped me up here, so I'm going to have to deliver on that. I'm going to go for it. So some disclosures I'm going to get out of the way, then, is that I serve as consultant for GoodRx, Level X, Equally Interactive Pharmaceuticals, Otsuka Eli Lilly. I work heavily in the digital health space and been called upon in many advisory boards to help drive a lot of background changes that are going on in the industry. Our learning objectives today is that apocalyptic activity participants will be able to, what I hope you can do is define and explain basically what is digital health, like what is going on, what are digital biomarkers, what are digital therapeutics, and what does that actually mean for serious mental illness? And I'm going to just say SMI going forward now. Identify digital health tools that are available for treatment of psychiatric conditions, and look at what are the risks, what are the benefits for use? Like, should I care about this now, or is this something that's coming downstream that I need to at least be aware of? So that's going to be a large part of this presentation. And lastly, evaluate, what's the current clinical evidence for this? Is this all hogwash? Is this a real deal? You know, what are things that are barriers, and how do we overcome them? And I think we can really all right now that's listening can really, you know, identify with us. I mean, mobile devices have changed the world that we live in. I want you to reflect on the past just 24 months, how much of it has turned into, you know, were you shopping online? Were you looking at your smartphone for just engagement? How much did you turn to entertainment on a smartphone? How many of you are going to look at that thing and get an email, get a text message, idly check social media while you listen to me? And I think that's because it's the real reality of the world that we live in. And I think that's fine, because it's definitely a society that is tied together. But even though we can shop, date, look up information on the go, we can, we have to identify, you know, how has this impacted us as healthcare professionals? And how has this actually impacted our patients? And I think technology has been a focus for how patients engage in care for decades. I, you know, I'm here to talk about digital health, but that's not necessarily a brand new thing, I would say. We've had multiple itinerations of just the idea and concept of technology and healthcare that have been floating around for a long time. You can call it the e-health movement late in the rise of the internet of the 1990s. And then we have the mobile health, which still is around, but has a big focus on mHealth for short, with the early integration of internet of things technology, especially with the smartphone arising in the mid last decade, or two decades now. And then we got to the 2010s. And I would say by 2015 and onwards, we saw a huge push for digital health. And right now, this is the era of digital health. And it's been really accelerating due to the pandemic. We saw a lot of people want to identify, you know, how can we use technology to engage our patients that we no longer can traditionally see in person? And this identification is, you know, what is the new normal? But there's been an underlying kind of process in terms of why we want to go down this pathway. It's not necessarily just thinking, how do we digitalize our interactions with our patients? I think that's the first step. How do you take this interaction? How do you digitize it? That's fine. But there's also something beyond that. I want you to reflect on this. If you have a motor vehicle, if it starts saying it needs an oil change, if it says your tire needs air, or that there's something going on with the engine, do you just keep driving it? Or do you say and look at it and say, you know, I need a handle at least soon, because if I don't, I know something bad's going to happen. What is that bad thing that happens? It means that the car may not move. That could be the worst. You don't get from point A to point B, or it could break down and just not and cease its function. And then you think about your head like, man, I'm glad car insurance or I'm hoping I can pay for this, right? But you know, we live in a world where we see a lot of stuff. We see a lot of also our household goods and things also being tied together. We have like smart fridges to tell you when to get new milk, for instance, or coming to the field. How do we apply that to health? How does that kind of concept change the patient journey? How do we go to a point where we can identify as a patient what is going on internally? And most of us don't walk around thinking, you know, my blood pressure is high, my cholesterol is high, my, you know, my blood glucose levels are high. But do we also walk around thinking to ourselves like, you know, I'm at risk of being and becoming depressed or having anxiety or my sleep's not normal. And I think that's why this whole push for digital, the digital medicine now is coming to a forefront is that we have the ability to passively measure. I think that's the thing is measure like what is an acceptable goal? What is acceptable medium that you want to establish? And for human behavior, then how do you reward that? Like, hey, you're doing a great job. You're active. You're living a great life. Your vitals are good. You're in the last time you had last year were good. Keep doing, you know, you know, giving that nudge in the right healthy behavior, I think is what we're really pushing for because we can passively monitor and we can take that on. But then can we also move to a point where we can intervene when we know something's going wrong? Instead of like waking for a patient to show up in the ER, do you need to be hospitalized instead of waiting for a patient to schedule that appointment? Can we be proactive? Can we help the patient? I think this is where we're really trying to go for a lot of chronic conditions, but of course this big conversation today is about SMI. That's what I'm going to focus on. But even some of the technology we have available could work into that. We know that stress can do many different things. It can alter blood pressure. It can alter heart rate and such. Can we passively monitor sleep? Can we monitor other vitals and activities for people and say these serve as different markers for your health, even for your mental health? And I think that's where we're trying to go because these devices are getting more and more prevalent in society. I would not be surprised if at least by the next decade we see like almost an all-in-one device that can collect most of the vitals and metrics that we really are trying to care about on a day-to-day basis. And while they may not be medical grade, they at least are a passive tool that can serve as a medium to say, hey, you need to actually engage with your health more often, or we need to do something or go to a higher tier. Also, we're seeing things in our households come to a point where there are actually people making smart toilets, for instance, that while you hypothetically go and have a bowel movement on it, detect your heart rate, blood pressure, everything else like that. What if also you have a toilet that can detect electrolytes in different labs from there? Maybe you can detect concentration in certain byproducts of medications you may be taking or other products too. What is the value of that? How do we adopt that into our healthcare providing? Because I think this is where we're two things we see are growing is this whole idea around virtual care engagement. The idea like, you know, can we use an app to work with you? Could an app or a digital therapeutic service, a medium to actually help out with your care? How do we put together telehealth management? Do we build in remote patient monitoring or RPM into getting data? And then how do we do that data? And then how do we engage with a patient? Do we go through a portal? Do we text them? Do we call them? Do we have a teleconsult with them? What is the proper medium? These, I think, are all perfectly fine questions to ask because I think that's a transition we're going through. At least that's what we will be facing heavily for the next five years. Because post-pandemic, we're not going back to the way things were. Some models are coming up. I don't know if you've seen it. One is the hospital-to-home model. Why do we need some patients to come into the hospital and occupy a bed? Can they be treated at home? Are there certain conditions that we can take on that we can actually treat at home? And that focus on the homeless-centered care and rethinking that model is, you know, engaging people where they're at, engaging patients in their own lives as they go about their day, not on our schedule but on their schedule. And I think that's where we're all seeing movement towards what I would say is our current health monitoring, which is very much, you know, hurry up and go. Patients may receive treatment, responsible then for carrying out said treatment, taking their medications, being their own coach at the end of the day to actually push themselves to really want to improve. Ultimately, gathering data, going for testing, writing down their own patient-reported outcomes, and then following up with a provider and transitioning any subjective or objective information that is then meaningful in a way that can then lead to a further process of clinical care. I mean, that's, you know, that's a pretty broad statement, but I mean, overall, I think for many health conditions, that is the thing. And then how do we go to a point where you go to this digital health integration where you do have this passive assessment and monitoring? And then acting on that, what if you were on a therapy that you start a person on and you could have a way to track and say, you know, we just started, we just increased your dose of your antidepressant. And we see from your movement that, you know, you're actually much more engaged, you're much more active. This is a good sign that maybe the therapy is working. Instead of waiting for a patient to follow up from doing it yourself. Patient may not be actively having to do all the reporting on their own, but there is a passive tool to do it that leads to you having an assessment that, hey, things are going good. Or conversely, maybe things are not going good. And I think that's the key thing there is, you know, what extra level of data can we wrap into this to help us? And that's going to be the question, you know, when do you want to intervene? You know, if you have a way to monitor a patient that is, let's say, have schizophrenia and you can monitor medication utilization, and you see like from a device that they're not using a medication, do you wait one day? Do you wait two days? Do you wait three days? When do you want to intervene? In the past, you may not have known this. You may have had to wait until something happened for the patient. But now you have a really marker that, hey, you know, we know that non-adherence is a sign that, you know, something else could be going on. Should we intervene now? And then when do you want to do these things? You know, can they be done remotely? Do you, do we send text messages to the patient? Do we have some kind of medium that we know what is the best way to then engage with the patients on their own terms to, you know, maybe it's a phone call. Maybe it's, you know, let's have a tele-chat or maybe it's like, you know, do we need to send someone to some, someone to see you? Or do you want to come in and see us? You know, and I think that's the, that's the thing is that it's allowing us to have these types of interventions. Now speaking broadly for digital health, if you're, if this is a really brand new term for you, I think, you know, I'm hoping I'm building up this idea constantly like, hey, this is a really changing dynamic of care. The world in the way that healthcare is going to function in the next decade is going to be drastically different than likely, you know, you've been educated or how you've been gone through training or that you maybe you're seeing the end roads, maybe you've seen some adoption, tele, some adoption of other technology. So it could be all over, you know, we're speaking to a very diverse audience. And I think that's a key thing is that, you know, let's take a step back and be, what is all this different types of technology available then, you know, Tim, like, you know, you're talking about all this stuff, but, you know, really, what are we dealing with? Like, how would we classify this? So there are for digital health, if I had to say anything, I would say it's an umbrella term. It's a very much like a very broad term. And under that is different stems. One, you can argue that, you know, an enterprise system using EHRs classify themselves as a digital health tool. If you have a clinical decision support system, any HIT or anything like that, that would also fall under digital health. And then you get to the point where it's also wellness and support for a patient like activity and fitness trackers, apps that maybe help out with these, you know, mindfulness or stuff like that, lifestyle. Those would be digital health technologies. But then you get, and as you can see, as we go for each thing, they're getting more and more specific. What about devices that you can use for diagnostics? And this can be remote diagnostics in the home and such. A good example would be like the Apple watch that currently at this time, you know, is FDA cleared that can detect age for fibrillation. So that classifies as a digital health tool. We are getting to the point where we're seeing even voice, this concept that people are exploring, if you had like a home voice assistant, you know, Amazon Alexa, Google home, et cetera, and you came into your house and you start coughing, you know, we look at the sound of that cough and we say to ourselves, Hey, that sounds like it could be COVID. And then you could have something engaged and be like, Hey, you know, what the voice assistant says back to you, you may have COVID. Would you like to have a, would you like to go to a testing center now? Would you like us to mail you a testing kit? Would you like to set up an appointment with your provider? That's it. That's the, that's the going from that passive to intervention as an example, but you have these diagnostics, these wearable devices that at least have clinical evidence of how they work. And that's going to be where the expectation lies as we go from just wellness and support towards evidence that it actually can do X, Y, Z. And then finally we get what's now a very novel area of digital therapeutics. This idea that, you know, we, we deal with medications and other interventions that can lead to an expected outcome for a disease such as treating or managing or preventing a condition. But what if we had an app that could do the same thing? What if you didn't have to prescribe a pharmacological agent, but instead you could prescribe some kind of app or device that can actually modulate and treat and manage sick condition. So this is the spectrum. This is probably also why I feel like digital health is not a one size fits all definition, because we honestly don't know what's coming downstream. We are now dealing with topics of the metaverse, mixed reality. Yes, the FDA is actually watching us pretty closely. They want to know that they don't want to box in this whole area right now, because with the rampant rise of different technology out there, it's kind of that they want to see what people are capable of to actually encourage innovation. Going with that further, I think at this current time, the best way to quantify then digital health is probably three things. There's a broad digital health stuff that goes on. Then there's digital medicines. Digital medicines are basically diagnostic tools at this point in time that can measure or intervene to a certain extent with human health. And then you get to the point where it's digital therapeutics. It is definitely an evidence-based therapeutic that can prevent, treat, or manage a disease or condition. Some examples of digital medicines. I think this is quite fascinating for me. It's the idea, concept of how do we utilize a digital health product to track and measure a person's health. And as I mentioned before, we're probably right now focused on very much digitalization of a lot of what we do. So the example would be like we talked about with patients that maybe post-stroke, people that maybe have multiple sclerosis, for instance, Parkinson's and such, and we see a neurological issue with gait. Let's say that, what do we do? We can do a yardstick. We can do a stopwatch test. We can do a six-minute walk test, 25-foot timed walk. But when you do these types of tests, the thing that comes up for me is always having a patient come into a very semi-steroidal environment, very much into a clinic, and it's a snapshot on their life. Is that moment really representative of my patient's daily activities? There's 365 days in the year. They may see a health provider 20 days or less, and during those 20 days, each of those visits could be anywhere between 30 minutes to an hour, possibly. Is that representative of that patient? And I think that's a question that we're really building upon because can we just visualize that? Instead of just having a person being assessed at that moment in time, what if we could just monitor them all the time? Monitor them in their homes. Monitor as they're out at work. Monitor them while they're going shopping and living their daily activities. Can we see a digitalized process in terms of real-world data and not just having someone under our guise and actually say, hey, that actually looks like it's good or bad. It's not just a snapshot into a patient's health. And I think this is where we even go beyond digitalization. Then we have novel measurements. If we're talking about using a wearable device, now we have the GPS built in. We can see where and what situations maybe it's not as good. But we can also see things besides skate speed. In this case, based on the internal accelerometer gyroscope, we can actually probably measure postural sway along with that. It's not just speed, how fast, but it's also how your body's movement is and such. And I think that's the really cool stuff. We never really would have been passively able to do this very well in a clinic even, but now with these devices, we get new data. The question ultimately for us then clinically is that while this may, from a scientific process, be very cool, be very interesting, get this stuff. And for me as an academic as well, I mean, this might be good for research. This theoretical data doesn't have actual practical capabilities. And I think that's where we are right now. We have a lot of actually clinical studies that are ongoing integrating these so-called now digital biomarkers, trying to assess whether or not if we collect this data, is it actually useful then to quantify a therapy's intervention? Can we actually get data to actually then affiliate the success of therapy, the intervention? So here's some, I'm going to keep this just for your reference. These are like examples that are coming up. The Food and Drug Administration is very keen about, they are actually really in focus on digital biomarkers as a new means to actually validate and ensure medication safety and also outcomes associated with different interventions. Along with that, there is a question amongst the payers or insurers about these new types of measurements. Do they mean something? Is it worth then providing coverage for certain therapies beyond just a typical associated outcome, whether it's an emergency room visit or a hospitalization, for instance? Is there other things that we can actually look at that we have to measure, like such quality of life in a way we never had before? If you're very fascinated around this, one thing I would recommend is read the playbook from the Digital Medicine Society. It's called Digital Clinical Measures. It's about 200 slides, I would say. It gives a very good case scenarios about that. But if you're very interested to see what are people trying to experiment with, what's going on in terms of clinical research, clinical care, and just trying to how we can even use this for public health, I would highly recommend just paging through this because it is an area that is steadily getting bigger. I would say in visual health, this is one that we'll probably see impacted slowly because we'll start seeing clinical research being published. We'll see it in CEs. We will see this in research. We'll be like, hey, a new thing just completed a phase three trial. And not only was it a primary outcome associated with our traditional things, but maybe another primary outcome or secondary outcome was they were looking at how this person would just live their life. Not just self-reported, but we actually could measure this, these different things that we never really thought about. What does it do for like never needed a treat and therapy and such like that? I really don't know. This is why I'm still wrapping my head around truly. But this is, I think, very important for us to just know that this is what is coming downstream. Going beyond that then, talking about this next level of digital therapy is this idea like, what if we have technology that actually could treat and manage a condition or health function? Maybe you look at that like, that sounds crazy. You're like, yeah, I could see that. Maybe a patient's already used certain apps or anything else to help out with certain levels of anxiety, sleep or such like that. And you say, they've actually had benefit from it. Maybe you yourself have used them. But what if we have evidence that's just what they use? What if you get to the point where you prescribe these types of things to actually want to achieve an outcome associated with them? As overall, what we've seen for a lot of wellness products is they fly under the FDA guidance because they don't get, they're not really, the FDA's not responsible for looking at a lot of wellness products on the market. They don't have to look at a product that just helps out with sleep. They will look at a product that helps out with insomnia, which is a medical diagnosis. So as you start implying your product or service can do more medically related things, then it needs more evidence to support its claim and needs clearance or approval from the FDA to actually allow it to make those set statements. Otherwise it's kind of like, you know, OTC vitamins and say, oh, like it does this, but it really doesn't. And this is a current battleground going out between regulation and innovation, I would say. A lot of digital therapy has become this kind of, some kind of software, which could be on a computer or these days like we see mostly on mobile devices. It could be also with hardware itself. A good example of this that we'll probably see very soon is a closed loop insulin system that uses continuous glucose monitoring that can track blood glucose and then have a pump that actually then is a amount of insulin based on internal hardware and software, which will be the digital therapeutic that actually calculates how much insulin then to mimic. That's a good example of what's going on there. The other ones I've seen is also, we have like a neurostimulation devices that you put on your arm, for instance, that sends like a shockwave up the nerve that helps out with migraines, even to prevent migraine from forming. And it's at least an app that actually protects and then tells you, hey, put this on, do this charge and do that. And then we're also seeing digital therapies with medications, whether it's to track adherence or encourage some kind of systemic outcome associated with that. We've seen a lot of that in pulmonary, for instance, with smart inhalers and that associated stuff coming to market. So right now, if we go beyond just looking at this umbrella, you know, we have digital health, digital medicines, digital therapeutics and software evidence. And then we're getting to this point where we're called prescribed digital therapies is a new term in the past 12 months that's really popped up, which is prescribable digital therapeutics. So this is an environment, this is where we're at. You know, what's the implication for serious mental illness and digital health then? You know, what does the current market look like? What are we going towards then? You know, a question I hear people ask all the time is, is the days of in-person care numbered? And some people will probably scoff at that and other people, this may be a serious question. You know, how much can we truly go to remote? We've seen companies that truly are providing management for depression and some other serious mental illness fully remote to different levels of success and failure, I would say at this current time. And, you know, this is still the nascent phase as this other technology comes on board. Is it feasible that we could go more remote because we have better data to back up this stuff? Moving away just from thinking about telehealth and subjective patient-oriented information, but also towards all this other stuff that can be in the background. And, you know, right now I think the current focus from a realistic standpoint is going to be, you know, telehealth and telepsychiatry and teletherapy. Like that is highly feasible. Question obviously is going to be about reimbursement models that encourage one way or another, and I'll leave that to regulators and others to figure out. But I think as we will see from the pandemic that this stuff does work, at least calls into question if the services work and are feasible, do the payers want to then engage in that more? I think that's what we're going to see driving outcomes. Medication optimization I think is going to be another one. You know, if we can monitor different biomarkers about how digital biomarkers, about how patients are behaving in terms of their health, I think that's going to be a big thing. We'll have digital therapies for serious mental illness. We will have prescribable agents for that. We'll establish new digital biomarkers around serious mental health and serious mental illness. You know, whether it's activity, physical activity, sleep and such, we'll also use that with remote patient monitoring to collect data, not just like traditional information, but like tying in as well. I think self-care management is going to be pushed further using apps and different platforms. And I think we're on the cusp of that too, whether it's being through traditional EHR portals, but other technologies. Care coordination I think is going to be really escalated with this and then screening and triage of care. So one thing that we're seeing across the board is this whole focus on a digital front door. You know, in my pharmacy world, what we're also hearing this whole idea is they call it click and mortar, not just brick and mortar. You go to a business and a place to go to, but it's click. You have a digital front door for services that you can establish appointments, do your reminders, doing all your billing and stuff. Like why do that in the mail? Why go see someone to do that? Why can't I just do it through an app? But then also communication. Chatbots are also coming into play. Is that something that can be done? Different portals for communication. I think this is really focused on meeting patients where they're at in this demand for a digitalized way of communication. I think we'll see many businesses, companies, and health systems just gravitate towards this because from a consumer mentality post-pandemic, that's going to be the expectation. Truly. And I think that's where you'll see a lot of it. That's going to be the first part and then disseminate from that is, you know, these different services. So impact I think of telehealth. I mean, we've seen benefit. We've seen massive adoption of telehealth services billable under CMS and payers. Whether as we continue further, but we also saw a lot of tele-therapy and tele-psychiatry services across state lines. Like that was always a huge limitation. And that, you know, really, I think that's going to be something I'm excited to see some research come out of, what that meant. You know, talking to, you know, instead of having a student come home to go talk to someone, you know, they could actually talk on campus with the person they know and trust, for instance. And I think because we have the scalable solutions, it really escalates across different lines that maybe we didn't have enough practitioners in certain regions due to, you know, different socioeconomic background issues or costs and such. Getting people even not in person, at least virtually services. And I think this is where we found in some research, we've seen some improvement and some benefits too. I think no matter what though, what I would probably say is telehealth doesn't necessarily replace everything for care. Rather what we'll probably see is a hybrid based approach. You will have that basically click and mortar, the option to do virtual and the expectation you still have a physical presence if needed, at least somewhere in the continuum of care for that patient. You know, wearable devices. Oh man, this is where we're going to get into remote patient monitoring and such. I think it's the question for us is, you know, what do we need to track and what has value associated with tracking? How do we put together for care? I have seen and talked to different practitioners in a psych field that will look at this and say, hey, you know, I look at the physical activity. You know, I want to see if they're more active. They told me before they used to, you know, run or anything like that, you know, are they getting back into it? Are they sleeping better and such? You know, also GPS, you know, do we build that into different digital therapies where you can track movement and how do we use that? Even your tone of sound and voice. There are several wearables on the market from companies that are now tracking, trying to determine, you know, just from your tonal and your voice, you know, can we collect metrics? Not even just by like, you know, give an example of COVID infection, but like, you know, do you sound not yourself? Do you sound like something's wrong? Do you sound stressed? You know, are you yelling a lot? Are you just speaking in a very monotonal kind of a passive way? You know, how does that, based on your own internal metrics, how does that measure? And other things, you know, is VR mixed reality, this concept of augmented reality in wearable devices. You know, what comes after a smartphone is always a question. Do we actually move to the point where not being too futuristic, but we live in a world that has mixed reality and we have wearable devices that are our mainstream of communication? These are serious questions that are being raised. I still think that's probably next decade, but maybe it'll be proven wrong would be quicker than I thought. You know, and also why get engaged in this remote patient monitoring? Well, the other thing is for serious mental illness is because there's money now too. Quite frankly, in the past it'd be like, well, you know, we could use these devices and such, but we're not gonna get paid for our time to do that. Well, that's changing. Now there is actually remote patient monitoring for monitoring of different things and different health parameters. That is now being encouraged also by reimbursement for the time and effort being put into it. So I think it's another level that people are looking at, like, hey, you know what? It's not just something to do for the hell of it, but it's also because it's something that, you know, there is a business, health business model around this too. And if I get data around this meaningful in such a way, then maybe this will help, maybe wanna encourage this. Good example I always come up with, sleep. Sleep, I think is one that I think is probably really a great example of like, in terms of like looking at like patients that says trouble with sleep could be multifactorial. You meet with a patient, do you just do sleep hygiene? Do you do education around that? Tell a patient to go do it, have them attempt to do it. You don't know if they're doing good or bad, right? But it's fascinating. You can actually look at screen time on a smartphone now. You can actually pull up the data like, you know, we talked about sleep hygiene, but you're still using your smartphone like, you know, one o'clock in the morning. We actually have data around that. Your smartphone could possibly assess it. You know, can we use that? We're like, okay, let's go back and retry sleep hygiene before you wanna actually try, you know, prescription agent, for instance, or maybe some other kind of therapy. And, you know, it's going and showing up, showing up and stopping and gain treatment recommendations based on what you collect from the patient. What if you could though passively monitor a patient? Like, again, you can see like, when we tried sleep hygiene and you did, and you saw no improvement. And you have a wearable device, we can see like you actually have trouble falling asleep or you have trouble staying asleep or you just wake up too early. You know, how can we analyze that data and how can you tie together with the other comorbidities the patient may have and pull it back and say, hey, you know, this is maybe the treatment you need. Maybe we can do CBT, maybe we use medications, but, you know, how do we wanna provide that intervention? I think it's because the data can help drive you better to actually illustrate what's going on with the patient. I would say, you know, where I see some feedback here is that people be like, well, I don't wanna sit down and look through all that data itself. What I would probably throw out to you is that you won't have to. What will end up happening is that instead people just build platforms for probably data analytics systems around this at Quantify. And we'll just spit it back to you as almost like a helpful decision-making support tool saying, hey, you know, based on what's going on with the patient, consider the X, Y, Z. And if you want to, you can dig back further and see why that algorithm maybe came to a conclusion. But this is, I think, where we're trying to build things out to do. Other areas, especially for me as a pharmacist, I think, you know, we face the fact that medication optimization is not very well done in the United States. We look at almost like it's a $500 billion problem. You may have heard like, you know, medication adherence is a $300 billion problem. It's not, it's not adherence itself. That's the issue, it's a drug-related problem that comes actually back to optimization of therapy. Optimization could be reducing the side effects associated with adherence. Titration of therapy, you know, is it actually maxed out towards an appropriate goal or does one just initiate therapy and actually didn't follow up with it? Are they actually on the best evidence-based therapy correctly for them? Reduction of drug duplications, et cetera, et cetera. I think new technology is coming, definitely that's helping out with this medication management process that we can actually use for optimization. And, you know, it could be going one way where you can actually track how people are using medications, but also the platform itself. Like we had devices like with injectables and wearable devices that can actually work together. We have inhalers that have sensors on them, but we also have like smart pill dispensers too. We have things that look like you took the Amazon Alexa and the pill dispenser had a baby with it and it actually will sit in your home and will talk to you like, hey, it's time to take your medication, dispense it out to you. Oh, you know, you have a question, just, you know, ask me a question or touch a button and I'll put you in contact with your provider or your pharmacist and they can talk to you through me. And if something's not going on, I'm gonna send you a reminder and say, hey, you know, you haven't taken your medication today, what's going on? We also like virtually observed therapy or VOT, which is you watch someone through a camera ticket. Now, these things all have different benefits. I love the concept of even just short messaging services or SMS, you can text people to help them remember, pick up their medications and such, that's like the low hanging fruit and scalable, but you can go further depending on their devices. If they have, you know, if you wanna recommend an app, I always say, you know, there's a, you need to know like, you know, what does a patient have access to the internet and LTE or whatever, or the iOS or the Android, that's always like the bare minimum to start with there. And then what's their literacy with the stuff, but then maybe it's that, that they wanna put on. A lot of them are cheap, could be an easy start, but maybe some medications they wanna focus on, you know, could we use like a smart pill tray, smart pill bottles. Some of these are now covered by insurance. Most of them are still paid out of pocket. So is it on a patient and do they wanna afford it? Virtually observed therapy. This has always been more of a public health when I've seen right now, especially when we're like tuberculosis and such, it's been mainframe, but some people are also using it for clinical research. Are they taking the intervention or the treatment? We're gonna need to do that throughout the trial. Smart pill dispensers. We even have bios, smart bio-adjustable medications out there. We have many different ways that we're trying to get into this. The question ultimately, you know, what works best? I don't know if one works best than the other. I would say what's nice is we have many different tools that can help us identify what we can use for these patients to help them. And it's really what I would look back at is that it's not like everyone gets solution A and that's it. I think it's, we have ABCDEF, et cetera, and some will work better for patients versus others. I think that's a beauty, especially if you come across that. And again, you can also track, you know, when patients are taking their therapies, then we can tie it back with other data. You know, you're taking your medications actually not regularly. And on these days, if you don't take the medications, we actually see if you have more symptoms. You know, let's talk about this because can this help you encourage to take your medications? Or can we actually see that, you know, you're taking your medications all the time, but you're still symptomatic? Does this mean that the therapy works best for you? Maybe not, or do we need to increase the dose? Or does this look like you're, when you're having this, taking this medication, we're actually seeing side effects associated with this relatively early? Like, oh, there's, you're really sedated. Like your movement just starts dying off. Or you basically start sleeping more when we see you take this medication. Maybe we need to change to a shorter acting or something else like that. This is the kind of things that I'm really excited about, that how we can think about that we never really had in the past. Along with that, then we come back to this digital therapeutics. You know, what types of, besides medication, that can we prescribe apps? And areas of focus right now is really chronic health conditions. Cardiometabolic is a big one. Diabetes, high blood pressure, et cetera. But mental health and substance use is another big one. That's actually really, really started out, is a lot of them are focused actually on kind of behavioral therapy or CBT being provided through a medium of an app. And we're seeing other areas, oncology, ophthalmology, women's health also being targeted with digital therapeutics. Some examples is Endeavor Rx was the first FDA cleared game that was approved last year. And it's actually a prescription digital therapy for ADHD between ages of eight to 12 with or without medications. You basically play this game. And if you want, you can actually download the demo and try it out if you wanted to. But it's something that you as a prescriber would basically prescribe for a patient and like set them up and like monitor how well they're doing it. It's supposed to lead out to better outcomes with social with that. There's a number of digital therapies for sleep, sleep pills. Another example, provide CBT interventions, but basically helps trains people on techniques to alleviate common issues around insomnia. It's quite interesting how much CBT has been combined with a lot of these different types of things. We also see that also for another one was Endeavor Rx, which is actually about lower back pain. You actually wore a VR headset and actually walks you through different scenarios through CBT, but also patient education also plays games that you can do on it for soothing environments to help out with lower back pain to reduce the need for certain analgesics, for instance. So the one that's probably the original digital therapy you can now PDT on the market was Reset and Reset Out, which is focused around substance use disorder. It can be also used with buprenorphine, for instance, and also opioid use disorder. And this one, the whole concept is, we'll go see a therapist, but how long does it take you to see a therapist? How long can you set up an appointment? What's the followup and such? How did the patient doing that? If nothing else, and this is where the payers are looking at, if meeting a therapist is not feasible, you do different things, what's the next best thing? What's the next kind of technology we can provide for these patients? And I think that's really where we're seeing digital therapies come into it, is that we would like, and we have a theorized idea of what would probably be best all the time, but if we can't, from a scalable impact, we cannot provide said service, what can we do to at least get more patients at least something versus nothing? And I think that's really where we're seeing a lot of this in common place, is the concept of care management around digital health, that you seek to unbundle the provider from doing a lot of tasks. If you look at a PCP office, think about how much they're doing billing, how much are they doing like remote monitoring, organizing testing, doing on-demand consultations, you have a patient calling an ECU, well, do they really need to see me or can we do something else or can I just figure out some of the specialists right off the bat? Patient advocacy and stuff like that. So instead of having the physicians or the provider's office handling a lot of the stuff, you can just outsource it. There's many different companies out there that are proponent to do this, and I think that's where we're seeing that. And SMI in mental health, yeah, that's another area. There are people that are looking at, can you actually have tied into the patient self-care portal or an app that they can actually use? Instead, care coordination actually directed towards mental health and SMI, network management, billing, teletherapy. Do you actually need to provide the therapy or can you actually outsource it to someone else, for instance? You make that decision, but that option is there for you, and especially if you know who you want to intervene or spend more time on. Ultimately, what is the evidence and validation for a lot of stuff? What are we looking at? First off, digital biomarkers, do they work? We're working on it, quite frank. We're trying to figure this out. In some therapeutic areas, we think we're learning more. We know that some of the stuff is meaning, but the question ultimately is, what is the best device? Just because you can measure sleep, what is the sensitivity specificity around that device? Is there a gold standard device you're supposed to use or does any of them matter? Even around sleep, do you want a wearable device that works on your wrist, which is a lot of them? There are also a smartphone you can put on your bed that can actually detect movement. Does that count? Or if you sleep with someone else, would it detect their movement? There are things that you put under the bed that can detect that. You know, what is the right thing to use? I think this is where we will see more expansion. So I wouldn't negate this, but I would say this is something you will see much more attention this decade focused on tying together. Like not just like our judicial markers and judicial tests, but also these types of digital biomarkers. Other people will say, what's the patient perceptions of digital health? You know, do you actually want to do this? Yeah, there's a lot of acceptability. We see especially younger patients that are really agreeable to self-monitoring with an app, especially if you're like psychotic symptoms and such. They don't have an issue around self-inputting this information. A lot of people actually like a digital front door that an app medium to actually track themselves. The question though is adherence again with doing these devices, can they continue using or they, you know, especially if they're doing well, they just stop importing stuff, but then if they start not doing well, you never had any pre-data to actually establish that you were going to that point. Again, how much of this relies on patient self-activation actually doing X, Y, Z outcome versus passively monitoring. And I think that goes back to the digital biomarker takes a lot off the patient. Ultimately though, having a digital medium engaging with SMI has an uptake. So I would expect we'll see a big focus on that. You know, and I think for a lot of us in healthcare, we have questions about, you know, okay, so you're telling us that all these technologies are coming downstream, that this will probably be a default medium of how we engage in care at some point. Well, how do I know what's going to back? You know, what's my responsibility? Well, the big thing is that we have a lot of things we have to take into account. You know, what is the value of a lot of this stuff will vary across payers, patients, and providers. Most of you in this audience are providers, but payers are gonna look at different outcomes, patients are gonna look at different outcomes. So we spent some time looking at this. Validation of an app, of service will take time. We've done multiple attempts of that over the past 12 years, I would say. And we've seen many people fail. One of the biggest ones I remember seeing back in the last decade was NHS trying to launch an app store and actually getting in trouble because a lot of their diabetes apps were just failing. But I think different organizations trying to pay attention to this more. Even, you know, American Psychiatric Association though, you have an initiative, the app advisor work that's undergoing. I applaud that. I think there are some sectors that we've seen a lot more work and that will lead it for other health specialties over time. This is one thing that I think internally has to be done as a transition period, as we try to figure out, you know, what works and what doesn't work, ultimately. What is good at this point is highly subjective, but we're trying to make it objective in terms of measurement outcomes associated with it. Anyway, if you're really curious about just apps in general, I highly recommend looking into this. FDA has been passive for a while, but now they are actually getting much more active. They launched what's called now the Digital Health Center of Excellence. They're releasing guidance. They're releasing statements about what should you consider. They recently put out guidance on digital biomarkers. They had one on AI. Like, what is AI mean in healthcare? What would you actually quantify for that? Why would you monitor that? We saw, due to the pandemic, they actually released a guidance enforcement policy for digital health devices for treating psychiatric disorders during the coronavirus. They actually want to basically encourage more technology being available for people to use because if they could not seek treatment in person, what was the next best thing? Can we reach them where they're at? And this is my own self-interpretation. You can pull up this document and see what they were doing, but I think what they really focused on there, they were looking at, you know, technology that provides a computerized therapy device or software intended to provide a digitalized evidence-based therapies of condition-specific interventions as a standalone or objective tool to clinician treatment that uses a passively collected patient data device and active intervention to address a specific disease or condition and allows for novel approaches and complementary mechanisms in the treatment of chronic conditions. This is, to me, like what the FDA is really trying to lock down is that it's still relatively broad, but this is really what they're looking for. This is what they're trying to track and this is what they're really gonna regulate. That if you have something that you say is gonna do X, Y, Z, you need to have the evidence to support it. I think we're gonna see people come with really different things in these types of digital therapies. Is it VR? Is it metaverse? Is it expanded? Who knows, but they're aware of it and they're gonna monitor it and that's where you hear a lot more approvals come downstream. And for you in healthcare, especially with dealing with SMI, like we'll have products that, like, man, I've attended CEs in the past dealing with medications, but now we have a CE on VR? What is this? Like, what does that mean? I think there'll be quite interesting times. Other things that have to become into consideration is, you know, what is the evidence? Is it useful? Is it usable? What's the engagement with this? Are our patients gonna be adherent to this? I think this is other stuff we'll have to take into consideration. We have a lot of different stakeholders that are going to look at this in different ways. You know, cost is gonna be one. Is it like bringing your own device or are we gonna pay for it? If you take a VR service, do I mail you the VR service and you mail it back to me, for instance, or do you have to buy one out of your own pocket, for instance, will your insurance cover it? Oh, I don't know. That's gonna vary, I bet. You know, and that's where I think that we really have to take that consideration. Even if you were to have a medication or some kind of therapy that's tied with an SMI, let's suppose you have some of this bipolar disorder and they are starting a therapy and that therapy now has, it was medication or digital therapy or whatever, is tied to an app. Are you responsible for setting up that app? Am I, the pharmacist, when they come get the medication, as a nurse, is it gonna be remote? If the app or product doesn't work on the weekends, who's responsible for getting that and taking over it? Do I wanna be paid about that? Like, oh man, this is the next level of stuff that comes up. You know, and then payment. You know, there are many companies exploring, you know, what to put out. There's a lot of people actually going after employer benefit programs. That's actually a big one right now, is going after employer benefits, especially around muscle, skeletal, depression, sleep, anxiety, we're seeing that actually being really prevalent. Even some digital therapies are being just provided out of pocket. Like, it's actually for some, like you can make a recommendation around a service and say, this is an option. Patient says, I don't wanna go on medication. You got something else? You know, let's look at the cost and, you know, can I actually buy that? You know, that might be an option. And then the other thing is CMS. Are they gonna adopt this stuff? And there is talks about CMS much more engaged in digital health tools. Telehealth is one, but also digital therapies and using digital biomarkers to actually prove effectiveness. So when we see mass coverage on digital health products in the next few years, I don't think so. I think we'll see it trickle down to certain therapeutic areas. Cardio-metabolic is probably one that we see a lot diabetes, but mental health, I do think is one area, especially with SMI, we will see a lot of attention placed onto because there's already a lot of people playing this field, but the evidence we're still trying to figure out and who we're gonna partner with and who we're gonna use, I think is where we're gonna see things really come together. You know, I talk about these different barriers. You know, one that I get concerned about from evidence is what I call, you know, the trickle-down data. We have a lot of people that are on digital health tools that tend to be white, higher socioeconomic class. Taking that data from that and say, well, I show success, I show success for all patients, doesn't make sense, especially when we know there's a digital health divide, you know, social determinants of health. If I take evidence from a platform that has a higher amount of just, you know, my user base is 99% white and college educated, and then coming out to a payer and saying, hey, you know, I show benefit and say, well, you know, 50% of ours are actually, you know, Medicaid patients, and you never study in there. How would you actually say it showed the same benefit? This is where I think there's a big divide about even though there could be evidence and could be enough evidence to get it cleared by the FDA, doesn't necessarily mean it's evidence for clinical use. And it's gonna be on us to figure out. You know, how many times do you want pilots? How much do you wanna pilot new software, new app, new thing? Like, does everything need a pilot? I think there's gonna be a lot of us talking to each other in terms of like, you know, you tried this, you tried that, what works and what doesn't. We're gonna see a lot of that horizontal landscape education amongst each other. I think we're also gonna have to take on, we have to really think about how to educate our staff. You know, thinking about like data privacy, it's gonna be a big thing. Thinking about more data and new alerts that come with this stuff. How do you onboard patients, especially if you have hardware or software that's attached to it. Again, come back to, you know, who downloads the app? If you have a patient does, I don't remember how to like set up my credit card with this stuff. I never bought an app off the store. Like, okay, well now we have to have that discussion. Maybe this is a patient that should not be on this stuff. But maybe you have patients like, yeah, this is a good fit. But what is a good fit? I think that's where we're gonna see a lot more guidance come around. Like X, Y, Z is consideration for what, you know, maybe a patient would benefit from this. You know, what's the roles or responsibilities for different devices and such like that? You know, what's your internal rules and metrics of success? You say to yourself, you know, we're gonna start using, you know, these types of things to measure our success. You know, it doesn't mean like less hospitalizations or patients calling in the office. You know, hey, you know, we implemented this new software and patients are not calling us with the same questions all the time now. Because we have something else that, you know, took on that work for us and that shows value of success. So there could be different markets. We have very small, could just be your process of care. Could be also like disease oriented outcomes that really matter to you at the end of the day. I think that's where we really have to take a step back and it's like, you know, what do we wanna tackle? Just because we can't doesn't mean we should at the end of the day. But I think identifying our own internal problems that you may be facing clinically, not just patient oriented, but also systems oriented is where this stuff will come into play. I think that's where I have to really think about workflow. You know, what is your workflow? What is, who's responsible for what? What's your different protocols? What would you do in X, Y, Z situation? What to tell patients to do? Because definitely I run through situations. If I had a patient saying they had, you know, intermittent internet connection and I wanted to use a digital therapy to help them out with management of psychiatric issues, I don't think I would want them on that then because my biggest fear would be, oh, they can't access this app in a moment of need. And because of that, they have a failure of therapy and it's due to technology limitation. You know, those are types of things that I think we really need to consider. Also all this data, you know, I think we need more information in terms of how to take this cloud of information and use it between visits. And the data itself is gonna be the big issue. You know, what do we do with this data? Who owns it? Is it you? Is it a patient? Is it a pharmaceutical company? Is it the EHR companies? I mean, I will not be surprised if all the information that is slowly gathered being dumped into EHR will eventually be pivoted off to be used for clinical research. I mean, we've seen it for other conditions, but with SMI, that could be another thing. That could be powerful. It could be very beneficial, but there's ethical considerations we'll probably have to be asking around it as well. You know, so I'm gonna close up here. I really wanna ask, you know, how do we adopt a digital first health care environment? What does this mean for SMI? I think for questions, because we have a varied audience, is things that you need to ask is, you know, what is your population? I think that's your lunch pen. What is the dynamics of your different patient groups? What's their access to internet? What's devices they used? If you work with a population that really uses iOS or you have a population where it's really heavily Android, what's the receptionist of technology? Do you work with a population that's like, yeah, I want the next best thing or more conservative than what they wanna do? How do you onboard into this? You know, those I think are serious questions to begin with before you wanna possibly just say, you know, again, just because we can doesn't mean we should. And then what's your resources? You know, what technology do you wanna commit to? What is your current infrastructure and support that you can build into? Who's gonna upkeep it? Is it you? Is it gonna be someone else in your network? Do you have to pay for it? How are you gonna educate your staff, your patients? Who's gonna be the vendors that you wanna go with? And this is where it can be a lot of like doing said pilots or talking to other people and creating a workflow that you wanna keep up when you integrate something new. And what are your outcomes? I think this is gonna be the biggest thing, like, you know, establish feasible goals that you can actually achieve, whether financially for that, whether it's patient outcomes, maybe personal outcomes you want, you know, what is this? And what's your roadmap to success? And when would you restructure? When would you say, hey, you know, we've been trying this, it's not working, we need to pull out, we need to try something else. I think that's gonna be the biggest thing. And then how to fit into a world that is very asynchronous in terms of providing care too, is what I think has to be asked, you know, how do you fit that in? So big takeaway points I want is, you know, expect that in a post-pandemic world, we are very going towards a virtual first approach and across healthcare overall, that we're gonna need to evaluate tools and resources. There are different organizations that are putting this together for psychiatric care, SMI. We need to understand limitations of current digital health products and services. You know, you will probably be called upon to work with an institution, a network that has a digital front door and working within those constraints and expanse in terms of new ways of engaging patients and then identifying, you know, whose roles are to do what in this kind of new workflow. I think those are things that really need to be asked too. So if you learned a lot, this is my bibliography. If you want to see and read up on more, there's a lot of stuff out there, it's really exciting. As I mentioned, I think there's been different therapeutic areas, specialties have been very adapt and psych is actually one of the big ones, I would say. So thank you for your time. And I'm open for any questions from the audience at this point. They will throw the slides back up for perfect. So thank you for such a interesting presentation. That was a tour de force of all of digital health. And I said, we appreciate you covering so much. Before we shift to Q&A, I want to take a moment to let everyone know that SMI Advisor is accessible from your mobile device. You can use the SMI Advisor app to access resources, education, upcoming events, complete mental health rating scales, like the PHQ-9, GAD-7, and even submit questions directly to our team of experts. You can download it at smiadvisor.org app. So we have a couple of questions, not too much time. So I'm going to jump right into it. Are you aware of any digital therapeutics are being developed or research to support clients with complex mental health substance use needs, i.e. clients on ACT teams, clients who may be homeless, clients with severe substance use disorder, for example, a wearable that may have no street value. It's a hard question. No, and that's a great question because the thing is that with these populations, again, as I mentioned, what technology you want to take on and understanding your population is very key. And this is actually what's popped up is we have seen in clinical studies actually wearables disappear. Years ago, there was one I was talking with a friend and they had a wearable device and the patient actually died during the course of the study. And then the researchers knows halfway through that it started moving again. And they were like, why is this moving? Then we'll collect the device back. And then the family members, children actually found it and started using it. And this is an example I think comes up as like, what do you want to use? And what cost you want to put into it? In terms of from a public health standpoint, what I've seen being discussed is definitely as wearable devices have come down in price, it's kind of like, you're going to do this, you give it out, you're going to start to lose it. And the thing is not letting it have all the bells and whistles that may make it attractive to other people to basically be like, oh, I got like a device that, if you don't mind me naming names, John, is that okay? It's okay, yeah. You've declared a competitive interest, so yeah. So like, I look at like examples like Whoop and some other ones where they don't have like a name, like the Amazon has one, doesn't have like a face on it. It's a very much a data collection tool that works through an app and a device. And for many people, they want a smartwatch, they don't look at this like, this is something I really want all the time, but something that's passively there to collect the data that you could use for different things. So that's where I think from a UI and user experience, like we've seen some devices like, man, it's who would want to use that, but it could be in these situations where you want to have something to collect that data and intervene. And then coming back to your question, like digital therapies for like SUD and other things like that. Yeah, there's, you know, Pair is one that's been doing some work, I would say is that, but we also see others, DTX work that being very expansive. And I think the uptake for it is, the fact is that substance use is a big issue and the cost associated with it, and then supplying interventions as scalable fashion that's valuable. So is there one I could just say off the bat, like you do this, do this, do this? No, I don't have that great answer. There's definitely like, you know, it's fragmented. I think that's the biggest thing that's probably that is a concern is a little bit of fragmentation approach. I think there's, you can skim off the top and say, hey, I'll just have to use this, or I have to use that, but these are considerations that would throw out. That's a good answer to a complex question. Well, I think we'll fit this one and you covered it briefly, but in terms of the legal implications for digital health interventions with regard to personal health information, and again, the privacy law like HIPAA, what's your kind of hot take in maybe one minute where we stand on what's happening there? Oh, we've seen the trepidation around this. What I will tell you is more encouraging is the FTC is very much into this now. FTC has been pushing on stuff, and even the FDA, the FDA has actually convened two working groups around data, especially around digital biomarkers and digital medicines. The FDA recognizes, FTC recognizes that this stuff cannot move unless we actually start putting our hands into it, saying what we will and will not look at, and also what is the expectation being put out there? I think FTC was the one that talked about HIPAA even saying like, if you have a health app, you need to consider this at that point to a certain extent. So yes, it is something that I think most people weren't heavily involved with, and it was always a lingering question. This year and next year, you're probably gonna see a lot of stuff slowly trickle down. If you work in this space, you'll see it. If you're passively engaging with this stuff, it may or may not be something you hear a lot about, but it is something that is actually a focus right now. So it's not something that we're gonna let finally go by. Yeah, that makes sense. And I may wrap up the Q&A and move us on to our next slide, only for sake of time, not for sake of interest in questions. But the good thing is if you have follow-up questions on this topic or any related to SMI, our clinical team of experts is available for any online consultations. Any mental health clinician can submit a question and receive a response from our SMI experts. Consultations are always free and always confidential. We may be able to push next slide and see that consult slide, but if not, no worries. It looks like we may be stuck on this slide, but while we're waiting for it, I also wanna tell people that we certainly like to invite you to the APA. There's our consult slide. Excellent. But, and we'll jump to the next one. So I'd like to invite everyone to the APA annual meeting. It's going to be in person in New Orleans on May 21st through 25th. There'll also be a virtual meeting taking place on June 7th through 10th. During the live conference, clinical experts and SMI advisor are leading a variety of sessions on how to improve care for folks with SMI, many technology sessions as well. Topics for these sessions include how to use Clozapine as we talked about digital navigators, which is perhaps a solution to the workflow that Dr. Ong's brought up. Also talking about physical health and mental health integration. So I encourage you to take a moment, browse what's there and take a look at psychiatry.org slash annual meeting. And to claim credit for participating in this webinar, you'll need to have met a requisite attendance threshold for your profession. Verification attendance can take about five minutes. You'll then be able to select next to advance and complete the program evaluation before getting your credit. And the last but not least, please join us on April 8th of this year as Dr. Umadi Nibido presents Primer in Nutritional Psychiatry. This is your brain on food, so not technology, but food. So again, this is a free webinar on April 8th. It's gonna be from 12 to one Eastern time. Thank you so much to our fantastic guest, Dr. Ong. Thank you all for joining until next time. Thank you for having me.
Video Summary
In the first video, Dr. John Torres discusses the use of digital health technology to improve care for people with serious mental illness (SMI). The video is part of the SMI Advisor webinar, with Dr. Timothy Angst as the speaker. Dr. Angst explains the different categories of digital health technology and highlights the importance of digital biomarkers in monitoring and intervening in patient care. He discusses the potential impact of digital health on telehealth, medication optimization, wearable devices, and self-care management. Dr. Angst also discusses the potential of digital therapeutics and prescribed digital therapies.<br /><br />In the second video, Dr. Michael Oberlander explores the potential of digital health interventions for improving patient care in mental health. He emphasizes the importance of data collection and analysis in tailoring treatment options and mentions the use of wearable devices to passively monitor patients' behaviors. Dr. Oberlander discusses the potential of digital biomarkers and provides examples of FDA-cleared digital therapies. He discusses the need for evidence and validation of these interventions and addresses privacy and legal implications. Dr. Oberlander concludes by urging healthcare providers to assess their patient populations, resources, and desired outcomes before adopting digital health interventions and emphasizes the importance of understanding workflow, data privacy, and patient engagement.<br /><br />Both videos provide valuable insights into the current and potential applications of digital health technology in improving care for people with serious mental illness and mental health conditions.
Keywords
digital health technology
serious mental illness
digital biomarkers
telehealth
wearable devices
self-care management
digital therapeutics
data collection and analysis
FDA-cleared digital therapies
patient engagement
Funding for SMI Adviser was made possible by Grant No. SM080818 from SAMHSA of the U.S. Department of Health and Human Services (HHS). The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement by, SAMHSA/HHS or the U.S. Government.
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