Latest / Becker’s Payer Issues Podcast / Scaling Mental Health Support with Woebot

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Scaling Mental Health Support with Woebot · Becker’s Payer Issues Podcast

• 0:00
  Hi, everyone, and thanks for tuning in to
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  the Becker's Healthcare Podcast. My name is Lucas
• 0:04
  Voss, and I'm very excited to be joined
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  by Trina Histon, PhD and VP at clinical
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  product strategy at Wolbot Health to discuss scaling
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  mental health support with health systems. Trina, thanks
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  so much for joining us today.
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  Lucas, it's a pleasure to be here. Looking
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  forward to today's conversation.
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  Yes. And it's so so interesting to have
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  you on. You've done so much work
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  in the health care space. You've been around
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  for such a long time. I briefly scanned
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  over some of your papers that you've done
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  on on overweight and obesity and a lot
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  of that work, and it's there's it's so
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  multifaceted,
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  which I love. You have such a deep
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  background in health care. Can you just give
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  us a little bit of an introduction to
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  yourself and and your work at Wolcott?
• 0:49
  Sure. Sure. Happy to.
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  So I'm a health psychologist by background. And
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  as as you referenced, I've over 2 decades
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  of experience
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  in health care. And a lot of that
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  in health care was kind of building end
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  to end clinical pathways
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  for prevention and treatment. And I would say
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  the last 7, 8 years of my time
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  in health care before I joined robot health
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  and startup world was building and scaling a
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  digital mental health ecosystem
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  that deployed in primary care and in specialty
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  care. So in in doing that work, it's
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  really
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  translating the evidence base into care delivery and
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  doing that with methodologies
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  like human centered design and performance improvement. So
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  you're really thinking deeply about not just the
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  what you're deploying,
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  but where you're deploying it and who you're
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  deploying it with at both in the care
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  team side and on the patient side. So,
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  delighted to bring that skill set to what
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  about health where I really lean into clinical
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  enablement with our partners. So it's been it's
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  been great so far. Start up world is
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  different to health care, but I'm in my
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  happy place for sure. That's fantastic. And it
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  it like you mentioned, it's become such an
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  important part of the industry, I feel, like,
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  to be able to look to those new
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  solutions, to look to new developments, technology,
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  digital solutions, etcetera. I think that that's really
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  the way of the future. And you've mentioned
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  you've you've started to work with health systems
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  on this quite extensively.
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  One of the systems you work with is
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  Virtua Health.
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  What were the initial goals when you first
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  started that collaboration
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  and and sort of the objectives as you
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  were looking into how can we help patients?
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  How can we improve care?
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  Absolutely. Quick question. So I would say Virtua
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  Health for those who aren't familiar as a
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  health system in New Jersey. In fact, it's
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  Southern New Jersey's largest healthcare provider.
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  And when we started talking with the Virtua
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  team,
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  you know, we're thinking about primary care and
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  the primary care setting and patients coming in
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  to see their doctor. And, you know, one
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  of the initial sort of pain points not,
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  unfamiliar to pro perhaps most of health care
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  in the US was making a referral to
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  behavioral health and then having a wait list.
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  I think Virtua really wanted to explore might
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  there be other ways
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  that patients who might need support in living
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  better with
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  symptoms of anxiety, depression,
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  might there be other tools? And, of course,
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  in the last several years, digital tools have
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  become more and more common in deployments in
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  in primary care and specialty care. So the
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  initial pain point we were looking to solve
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  was those patients seen in primary care who
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  may get a referral and then they're on
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  a wait list. But I think we we
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  quickly then explored more deeply with the team
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  and,
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  you know, these tools are an adjunct to
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  care. So again, robot health, in adults, that's
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  the tool we've deployed with with the virtual
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  team can be that support that's 247 for
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  that patient.
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  So I think, you know, that was really
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  the initial discussion that we had with the
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  virtual team. But but as I'll explain later
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  on, we've we've expanded. So it's been tremendously
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  exciting, and they've been a great team to
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  partner with.
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  Lots of options. And I feel like, again,
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  that's that's where really those those digital solutions
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  can really fill some of those gaps, fill
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  some of those care gaps, and be able
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  to to truly make an impact on the
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  patient at the end of the day. And
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  I think that's what we want. That's what
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  we Absolutely. We're looking for help in the
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  moment. Mhmm. Yeah. To to supplement
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  to supplement and being able to help. I
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  think that that's really key.
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  Again, a lot of this is new for
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  a lot of folks. A lot of people
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  are might be hesitant.
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  There's all of these solutions, all of these
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  different companies that are doing this. What are
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  some of the challenges
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  in integrating a digital solution, especially if you
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  already have a built out infrastructure?
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  Sure. Sure. Great great question. I think, you
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  know, I feel that the work we've been
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  doing in partnership with Virtua really does, you
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  know, offer a blueprint for success. So
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  when we're we're the first sort of digital
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  mental health tool that Virtua is deploying.
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  And so we think of scale at the
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  beginning. So you're not just sort of adding
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  on and iteratively doing piecemeal, but you're thinking
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  of your end goal in mind. And so
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  we tend to implement in phases or or
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  kind of what we call internally crawl, walk,
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  run. And so, you know, when you're crawling,
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  you're learning, like, you're exploring something new. I
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  would say, you know, I think about the
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  ABCs of implementation. And so I I think
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  I've talked about the a, which was access,
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  which which is a pain point for many
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  systems in the US. And and I think
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  the b is not to be pity, but
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  it's it's beginning and being bold. I think
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  a lot of folks who might be hesitant,
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  you just you just have to take that
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  first step. And so what does that look
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  like? Well, we actually started in telehealth in
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  in primary care in VirTra. In fact, our
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  clinical lead, doctor Skrinsky leads leads that that
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  team.
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  And in doing that, like, the the c
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  of the ABC's is context. Deep understanding and
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  respect for
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  how patients move through their visits pre, post,
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  and after.
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  How doctors are spending their time with patients
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  kind of where's their attention going, what are
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  they holding space for, what are they listening
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  for. You know, we know from the literature
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  that on average primary care doctors might have
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  about 17 minutes and there are 6 to
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  7 topics that are usually covered in those
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  17 minutes. So there's a lot happening and
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  they're they're doing a lot and they're obviously
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  documenting in the EMR as well and and
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  Virtua use epic. So in the crawl phase,
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  you're really understanding,
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  you know, where might they be there'd be
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  good points to get robot in in a
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  patient's hands. What does the workflow look like?
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  So
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  making sure that you're not adding it undue
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  burden to the care team because we know
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  clinician burnout is very real and we know
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  that teams are doing more and more and
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  more, in in a visit. So we didn't
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  wanna be one more thing that adds burden.
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  So really listening for where are the opportunities
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  for us to deploy,
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  and really have that minimal impact on workflow,
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  but really lean into where there's already good
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  muscle memory on on different places in the
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  EMR that a doctor is going to provide
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  care. And so we really wanted to do
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  that in crawl and we sort of launched
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  in January
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  in telehealth and then quickly added some, what
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  I'll call more traditional primary care face to
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  face care,
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  sites in virtual health care footprint as well.
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  We learned a lot, you know, in those
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  first 15 to 20 patients in, how are
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  the conversations going, what quest questions do patients
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  have because,
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  you know, part part of the getting ready
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  is, you know, developing clinical training because
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  a lot of doctors, you know, they've obviously
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  deep expertise
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  in in their degree, but things like mental
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  health and digital mental health and and concepts
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  from cognitive behavioral therapy may not be something
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  they've had a lot of exposure to. So
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  making sure that they really are comfortable
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  with robot health and that they can talk
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  about it knowledgeably
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  in making the referral and that they get
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  to ask and answer all their questions. You
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  know, doctors are very discerning and and rightly
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  so. And so we had a lot of
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  great conversations to get ready and a number
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  of clinical trainings to get ready. And so
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  that would cover, you know, what robots is
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  for adults and, you know, who might be
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  a good fit for robots and maybe who
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  isn't a good fit for robots and then
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  how you make the referral.
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  And and I would say one of the
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  nice things Virtua has to,
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  if I think of kind of workforce of
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  the future and sort of care team configuration
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  of the future, they have also got,
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  technical consultants that support
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  telehealth. And I think these are newer roles
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  in in health care that we're seeing pop
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  up like digital navigators or care coordinators,
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  and they are really in a really nice
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  connection then between the care team and the
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  patient.
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  So in the crawl phase, you know, figuring
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  all those moving pieces
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  out, looking at how the flow of the
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  first, as I said, 10 to 20 patients
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  is looking and might there be anything we
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  need to optimize. And then we scaled quite
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  quickly across their primary care footprint
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  in the springtime and continue to to learn
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  as we go. In fact, you know, Virtua
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  made the decision to to bring in other
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  specialties because, you know, the other thing that's
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  happening in health care and I'm personally applauding
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  it is the recognition that the the head
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  is connected to the body. And so physical
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  health and mental health are are intertwined. And
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  and Yes. You know, if you're struggling
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  with your mental health, it's gonna impact how
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  well you might manage your diabetes or or
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  anything else of chronic conditions. So we've actually
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  launched another specialties like GI, like cardiopulmonary,
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  and and those care settings and and are
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  about to add some more because those specialties
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  we're recognizing, look, we we wanna really support
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  our patients and giving them tools to kind
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  of help them at at at 4 in
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  the morning. I mean, candidly, about 77% of
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  patients who are using robots in our virtual
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  deployment are doing so outside of traditional office
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  hours. So we can act as that digital
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  layer of support
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  that's available in the moment. And then, obviously,
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  we're adjunctive to care. So, those patients know
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  they can always go back to their, you
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  know, referring provider as well.
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  Yeah. And I think, again, that's what I
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  love about digital about these digital solutions and
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  specifically what you've mentioned with WoBot Health. Right?
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  It's it's ax we're also solving an access
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  issue. We're providing access to people that normally
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  might not have it or that might not
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  be able to get the help that they
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  need, and these digital tools are able to
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  do that in a way that's so much
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  more just inclusive for everyone. And I think
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  that that's such a key such a key
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  piece to being able to have a strategy
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  like this
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  for for health systems, I think. Absolutely. And
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  and Virtu the Virtu team exceed those opportunities
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  early. Yes. And and they want to avail
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  of them. So that's been, you know, such
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  a joy to to partner and think through,
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  okay, might we adjust any of the materials
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  for different specialties or or do we sort
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  of point to different parts of robot that
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  might be supportive in different ways for for
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  different kinds of patients. So they've they've just
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  really been very innovation mindset, which is wonderful.
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  I definitely really enjoy the partnership. And and,
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  you know, you're building the company, you know,
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  and now I'm on the other side, right,
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  that I wasn't healthcare and I'm in a
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  startup. But, you know, you move at the
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  speed of trust and you're building
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  relationships with folks every day. And so, you
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  know, our data is growing every day, but
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  you're learning from that. And then you're infusing
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  the learnings from data in the context of
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  say virtual health footprint. And then, you know,
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  you're continually, you know, moving and optimizing and
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  it's a dynamic process. But, you know, you
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  always want to keep at the heart of
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  it is, you know, you're being deployed
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  in in a clinically mediated way and it's,
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  you know but the relationship between a clinician
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  and a patient. And so we never take
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  that for granted and and really sort of
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  hold that that trust as well because we
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  are also supporting those patients.
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  Yeah. And and I think it comes back
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  to your your ABCs that you've mentioned earlier
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  in the conversation. Right? And I think the
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  the b here is really crucial. As you've
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  mentioned, you have to be bold.
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  You have to Uh-huh. You have to innovate.
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  You have to start. And I I think
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  that's such a key piece. And and looking
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  ahead
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  right now for you as you as you've
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  been in the industry for such a long
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  time, you've been on different sides of things.
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  Where do you see this going? Where do
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  you see the partnership with Virtua going? But
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  in general, also, how do you see this
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  overall evolving for other health systems as well?
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  Yeah. Yeah. Great question. I think there are
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  a couple things with Virtua. Obviously, we're we're
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  expanding into other specialties. So I think we're
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  gonna learn a lot as those mature and
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  evolve in terms of different types of patient
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  populations and and what's resonating with them as
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  as we are providing that support.
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  We're also doing a case study with Virtua.
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  So, you know, again, they're, you know, very
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  innovative, but they also want, you know, as
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  do we want to understand how are we
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  impacting
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  patient care, down the line. So really looking
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  at the context of the deployment in different
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  settings. So I would say keep your eyes
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  peeled for for that case study.
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  And if I zoom out to the whole
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  field, I mean, there are many big moving
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  pieces now happening in the US. So recently,
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  you know, with parity, you know, seeing how,
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  that's going to land with parity between mental
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  health and physical health.
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  Also, CMS will be releasing their physician fee
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  schedule final ruling
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  in early November. And that is, you know,
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  with the goal to supporting the deployment of
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  digital mental health. I'm personally very excited about
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  that because it kind of creates a a
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  strong reimbursement pathway.
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  So I'm excited that those big pieces are
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  moving. The other things I'm seeing also are
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  looking at more whole person care. And I
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  think Virtu have been one of the early
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  movers in this in terms of addressing social
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  determinants of health. And so both assessing it
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  but also addressing it. So I think in
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  healthcare and I can say this after 2
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  2.5 decades and, you know, a lot of
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  times you're assessing a lot of things, but
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  maybe you're not able to act on them
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  because there may not be something in place
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  to do something candidly. And, you know, I
• 13:08
  think mental health might have been one of
• 13:10
  those areas where that was challenging. But I
• 13:11
  think again with digital mental health growing and
• 13:14
  growing year on year, that's now becoming less
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  of an issue. But newer things like social
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  terms of health and what you need to
• 13:20
  have in place to support whole person care,
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  I think there's tremendously
• 13:24
  exciting efforts,
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  you know, underway and understanding, you know, the
• 13:28
  assessment and also the deployment of solutions to
• 13:30
  really support that human being. And we're part
• 13:33
  of that story and that architecture. So we're
• 13:35
  excited to to partner with our healthcare partners
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  and and lean in and see how might
• 13:39
  we be part of that touch point for
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  that patient over, say, a 24 hour period.
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  What else can we do? So I'm excited
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  by all of that because the promise of
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  digital mental health, I think we're in the
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  the second era, if I can frame it
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  that way Mhmm. In the field. And, you
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  know, I'm excited for the future.
• 13:56
  Absolutely. That sounds so fascinating. And we'll have
• 13:59
  obviously, Trina, we'll have to do a second
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  podcast once the study comes out. Right? Absolutely.
• 14:04
  Happy to come back and talk. Once it
• 14:06
  comes out, we'll have to talk about the
• 14:07
  findings. We'll have to talk about all the
• 14:09
  interesting things that come out of that. Again,
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  thank you so much for sharing your time
• 14:13
  today with our audience and your insights, certainly.
• 14:16
  What a great conversation. Thanks for being here.
• 14:18
  Thanks a million, Lucas. Take care. Thank you.
• 14:20
  And I'd also like to thank WolBot Health
• 14:22
  for sponsoring today's content. And to our listeners,
• 14:25
  thanks for joining us today, and make sure
• 14:27
  to check out other Becker's podcasts.
• 14:29
  Have a wonderful rest of your day, and
• 14:31
  make sure to tune in for the next
• 14:33
  one.