Virtual Mental Health Clinics need a new Digital Patient Journey

For decades, Mental Health consultation and therapy was considered an intimate in-person interaction, the proverbial ‘therapy on the couch’ that focused on the patient feeling comfortable in an informal environment to bare their mind and soul to the therapist or doctor to receive therapy and medication.

The pandemic drastically disrupted this well developed ‘visit’ paradigm and forced desperate patients to shift online for therapy. Quickly installed zoom, skype and google meet sessions enabled a face-to-face session, but created major issues and confusion around associated booking/canceling /rescheduling appointments, securing privacy of sensitive personal data across excel sheets, emails, PCs and shared drives with lurking risks of GDPR violations, syncing bank transfers with appointments, managing controlled drug prescriptions through emails and floundering with joint cognitive therapy activities traditionally done using penciled diagrams on paper.

Digitally challenged admins of traditional Mental Health clinics are finding it extremely difficult to manage paperwork across excel sheets, emails, file systems, cloud storage, zoom sessions and bank statements to enable a smooth patient experience. Practitioners are finding it difficult to correlate appointments to patient records and payments, emailing around sensitive patient data with GDPR risks lurking around. Patients are finding it difficult to collate and manage documents & statements for their record, while activity?based therapy has become cumbersome over chat sessions.

Post pandemic studies show that a large percentage wish to continue therapy from the unparalleled convenience & anonymity of their homes or while traveling, or combine in-person and virtual sessions, indicating a partial permanent mind-shift towards virtual clinics. Moreover, the burgeoning patient segment of young and millennial generation are absolutely comfortable with virtual sessions.

Thus, a new consultation paradigm needs a completely new patient-care approach and new age virtual clinics need to abandon the ad-hoc, siloed multi-tool administration process and embark on creating a completely new digital patient journey that will deliver the flexibility and engagement of a face-to-face process while offering the convenience and automation of technology.

The new Digital Patient journey has to be “Patient Centric”?as well as “Practitioner centric” and needs to consider usability best practices across both key participants of the system. Some of the driving factors of designing the journey would be Ease of Accessibility, Convenience & Flexibility?at every touchpoint in the journey, Connected Patient experience, Data?Security & Consent, while trying to reduce cost of therapy across the paperless journey.

Ease of Accessibility – the virtual clinic platform has to be highly accessible from anywhere globally, through multiple devices, through multiple channels like website, apps, social media, voice, chat, call, and available 24/7, beyond the limitations of office hours, by multiple parties like care providers and guardians, by couples and groups from different locations. Accessibility should extend to accessing a patients’?own data and history of treatment at anytime and anywhere

Convenience & Flexibility?–?the platform should offer utmost level of convenience at every touchpoint. For example, at registration, all physical forms can be converted to online questionnaires, manual signatures to digital signatures,?quizzes and questionnaires can help identify the right practitioner for the patient. Once patient information is in the system, subsequent appointment booking can be reduced to a simple 3 click process or a voice based booking. A Dashboard can provide a single view of the patients completed and upcoming appointments, medical records and actionables like prescribed self help activities. Some of these activities like Cognitive therapy in Psychology are usually done using problem solving diagrams interactively between the patient and therapist. Such Therapy tools can be converted to graphical digital interactive tools that both patient and practitioner can work on during live video sessions. This would be a giant step in paperless interactive therapy.

Digital journey has the opportunity to bring huge flexibility to age old clinical practices. Large multi-session appointment fees which had to be paid at one go, can be offered in installments, digital banks can be integrated to offer therapy loans. Promotional campaigns have been a taboo subject at Mental Health clinics, but with digital systems, variable pricing and personalized discounts can be offered to enable greater capacity utilization to the benefit of patients.?

Connected Patient?– the platform has to deeply engage patients across the journey through personalized content, reminders for appointments and payments, notifications of letters sent out to GPs, medicine orders sent out to Pharmacy’s , test reports sent out to labs to deliver a seamless ‘always connected’ experience. By bringing the entire care ecosystem in the realm of communication and connectivity, the patients challenge in remembering next steps and dealing with multiple parties is majorly reduced. Moreover, an option to provide feedback and rating at every appointment and experience will provide the patient an opportunity to contribute to improved clinical and administrative service for themselves. Post therapy continuous engagement through enquiries about wellbeing, through news about new emerging treatments or sharing news about new therapy available at the clinic will help the patient stay connected with the well-wishing clinic

Security & Consent?– with any digitization comes a concern for lack of privacy and information theft. The virtual clinic platform must have multiple layers of system and data security to ensure absolute protection and peace of mind from hacking and information theft and guarantee data privacy and total compliance with GDPR, UK Data Protection Act of 2018,?and Network and Systems Protection Act of 2018.

A 7 layer security architecture should include 2 Factor Authentication, HTTPS encryption and signatures, API gateways & Tokenization , Encryption of patient data in movement and at rest, Private Public keys for integrating with 3rd?Party API’s to establish care ecosystem connectivity and state of art Identity & access Management services.

Moreover, patient consent must be taken to use their data in the care ecosystem to provide the Connected Patient experience.

An illustrative journey encompassing the above design principles might look like the diagram below :-

As clinics migrate to, and adopt the above journey more and more, and patients become comfortable with the “Anywhere Therapy with secure history” practice, technology will have to learn rapidly and become more intelligent to personalize services and therapy.??

AI driven intelligence will have to be applied at every possible touchpoint to offer personalized self-help, triage on criticality when the booking queue is huge, attempt visual?assessment of disorders like depression and anxiety , provide voice based mood mapping apps for more accurate diagnosis and even create algorithms to predict nervous breakdown or attempted self-harm.

Technology has to look beyond immediate gains of digitization and try to solve the fundamental problem of large neurodivergent population globally and a very small number of experienced practitioners and optimize total cost of treatment.

However, that is an exciting, emerging space and deserves another blog.