Technical Supported Nursing: Why Clinicians Must Stay in Centers of Digital Behavioral Health

The stubborn legacy of the COVID-19 pandemic is an intensification of the mental health crisis. In the beginning, long-standing problems such as lack of access to care and fragmented systems were almost impossible to ignore overnight. In response, behavioral health has entered a new era of rapid digitalization, marked by the flood of investment in mental health technologies that promise to increase access and innovation on a large scale.

On the surface, this explosion of digital solutions is a much-needed step. Virtual care, AI-powered platforms and mental health applications have surged, providing tools for everything from depression screening to medication adherence. According to the 2023 Rock Health Digital Health Venture Capital Report, nearly 9 of the 10 digital health startups in 2023 are focused only on point solutions. Now, after a decade since the pandemic, we are starting to see that this surge in this solution has not simplified care, but has created a disconnected ecosystem that often overcomplicates the delivery of care and disrupts clinical workflows.

Limitations of platform-first mental health models

The key reason for this split is the way digital behavioral health companies are built. Many mental health technology startups today follow the traditional tech company blueprint: build a stylish platform, scale quickly, and strive to impress users with growth. But behavioral health is not a typical technology industry, but a clinical nursing delivery industry. Moreover, when company value is rooted in platform capabilities rather than clinical expertise, the solutions that arise can be inconsistent with real-world needs and create an environment where the clinical resources needed are not available, while clinicians cannot access the information needed to provide great care.

I’ve seen many dynamic plays: Digital Health startups pour everything into developed software that connects patients to a wide network of clinicians through gig-style models. On the surface, they expand access to care by reducing certain barriers, such as geography and scheduling conflicts, but true continuity of care remains elusive. There is no common clinical culture, no consent pathway to care, and no unified commitment to measurable outcomes. Without full-time, supportive clinician foundations, these platforms are simply a revolving door.

Use technology to bridge instead of splitting

Next-generation behavioral health technologies must prioritize connection over proliferation. This means creating a system that can be unified rather than using tools to unify, allowing patients to give a single longitudinal view of the patient throughout the care continuum.

Today, clinicians often try to piece together information from different sources: the drug management application here, a therapy annotation system, and perhaps an EHR that won’t talk to. In fact, less than 20% of mental health applications are integrated in clinical systems or verified by evidence. The burden of integration falls on the provider, spending time and from the patient care center.

For example, imagine a patient with anxiety and diabetes who might see a therapist on one platform, a psychiatrist on another system, and a primary care physician in another system. Without interoperable data, there is no comprehensive view of its health. Lack of cohesion can lead to extra treatment, body diagnosis or worse – the patient is completely trapped in a crack.

Instead, imagine a fully connected system that functions like a digital backbone for all aspects of behavioral health diagnosis and treatment. It will automatically aggregate medical history, laboratory results, social determinants of health and behavioral data into one interface. Clinicians will be able to spend less time switching between tools and provide more time to provide care. Other layers of technology such as AI may show clinical insights and propose the next step, but clinicians will firmly control and use technology as support, not as a substitute. Unfortunately, only 38% of behavioral health providers are currently connected to interoperable EHRs, even though some of them may have some limitations to gain a comprehensive view of patient health.

Clean up the road to care for all people

Responsible advanced algorithms and AI have the potential to guide treatment decisions by analyzing complex inputs (clinical annotations, patient-reported results, comorbidities) and superficially feasible suggestions.

Imagine that patients treated for depression also complain about chronic pain. In addition to routine questionnaires and clinician notes caused by patient access, the clinical decision support system layer in the data from the complete electronic health record – recent laboratory results, comorbidities, comprehensive diagnosis, complete history of patient-reported symptoms – as well as social determinants and any other relevant data. Given the patient’s current pain management protocol, the system found that there could be a risk of recurrence of drug-induced depression.

Systems like this can also surface research and measured pathways of care that have been shown to be effective in patients with similar characteristics, in which case this suggests integrating pain-centric CBT procedures and reevaluating the initial dose of antidepressants.

This support is especially important in behavioral health, where there is no size suitable for all treatments. Whether clinicians practice CBT, drug management or traumatic care, a unified technology platform can enhance their ability to personalize treatments.

Making high-quality care more affordable

In addition to improving results, connected technology systems also provide avenues for more sustainable cost models. Traditional reimbursement for expenses for services stimulates quality quantities, an approach that is increasingly untenable in behavioral health. However, when clinicians have access to data that shows valid data (and and and not), we can start to align reimbursement with real value.

Since technology helps determine the most effective pathway to care, it in turn helps reduce unnecessary utilization – reducing costs for payers and providers. In this way, technology-centric rather than technology-centric care is not only clinically reasonable, but also financially feasible at all parts of the healthcare system.

The future of digital behavioral health will be found in another standalone application or a series of fragmented platforms. It will be established by re-core care around clinicians authorized by digital technology. The result is truly high-quality, whole-person care that is both clinically, operationally and financially scalable and sustainable.

Photos: metorworks, Getty Images

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