Behavioral health is rather specific, and technology-powered distant care is only cautiously developing in this realm. While providers recognize the need to employ technology for treating patients with anxiety, chronic stress, eating disorders, substance abuse, and other conditions, it is challenging to create a solution capable of effective intervention in human behavior that brings measurable and positive outcomes.

But there's more to this challenge. Behavioral disorders often go hand-in-hand with physical conditions. For example, a study initiated by the Robert Wood Johnson Foundation revealed that patients with asthma are nearly 2.5 times more likely to develop depression. Another viewpoint published in JAMA states that diabetes patients are twice as likely to suffer from a major depressive disorder during their lifetime.

Accordingly, some patients have to simultaneously take care of their physical and behavioral conditions, which is a huge burden. Good news is, technology is here to back up patients' efforts in-between support group meetings and one-on-ones. We are talking about patient-generated health data (PGHD) and its processing through the health data analytics methods.

Why PGHD for Behavioral Health?

Behavior is a constantly changing aspect of identity, which gives hope to patients who are feeling helpless in controlling their anxiety, depression, eating disorders, or other problems. But to initiate a positive change in a patient's condition, providers need more data. EHR data is great as a foundation for a patient profile, but it isn't enough to show gradual progress in treatment and establish short-term goals for patients to achieve.

PGHD can help in supporting patients with behavioral disorders in their daily struggle. It includes subjective and objective data collected by a patient (or their family) using wearables or medical devices, and is usually shared with caregivers through mHealth apps.

Subjective Data

A patient's self-evaluation is critical to successful treatment and recovery, be it depression, eating disorder, substance abuse, or another behavioral health condition. While each condition might require additional data on patients' feelings and emotions, the general list of subjective items to report can include:

Additionally, some objective information can be turned subjective with advanced wearable technology. For example, Spire tracks breathing patterns and analyzes them to understand how an individual feels, even before someone can recognize their own emotional state.

By continuously defining and reporting emotions, both patients and providers can understand certain patterns of how well the patient dealt with anxiety last week and how helpful the support group is (looking at the overall mood after each session). Moreover, strong negative trends in subjective items can indicate that the patient is on the edge of relapse, and the provider would get an automated notification about the possible problem. In this case, the caregiver would be able to discuss the patient's problem and take necessary actions, such as scheduling an appointment.

Objective Data

From the behavioral health perspective, objective data is supportive to the subjective data, a physiological reflection of a patient's mental and emotional state. The following vitals can help a caregiver understand the full picture of a patient's progress and current health status:

The readings from smart trackers can be aggregated and sent to the provider's health data analytics system to analyze the results and match them with previous measurements. If the analysis reveals any negative trends (e.g., weight loss dynamics for a patient with anorexia or decrease in activity because of a reduced number of steps), an application will notify the care team about possible risks to a patient's health status (via emails or text messages).

PGHD Supports Patients

Mental health is about keeping people strong and resourceful in the face of challenges. But with anxiety or depression crawling inside their mind, food becoming an obsession, or substance addiction developing, individuals can't think straight and can't live their lives to the fullest.

While there are various ways to help patients recover from disorders, including support groups, medications, and one-on-ones with a psychologist or psychiatrist, most of these measures are short-term interventions. Patients, in their turn, need continuous support, and PGHD can enable it.

A patient will be able to see the summary of their progress via their mHealth app. They can track mood swings during the month, relate anxiety bursts to insomnia cases, or celebrate the weight gain trend (this can be especially motivating for patients with anorexia) -- all backed up with automated push notifications if there's anything to worry about.

Not pretending to be a full-blown substitute for therapy, PGHD serves as a bridge between care points. This way, both a patient and their provider will be informed of the individual's overall progress with ups and downs, streamlining the process of tracking achievements, recognizing plateaus and, ultimately, patient recovery.

Lola Koktysh is a healthcare industry analyst at ScienceSoft, an IT consulting company headquartered in McKinney, Texas, where she focuses on healthcare IT including the industry's challenges and technology solutions.

2017-09-02T16:00:00-0400

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Will Behavioral Health Benefit from Patient-Generated Data? - MedPage Today