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Copyright,iHopeNetwork,Inc2016 1
TelementalHealthForWhom,WhatandWhen?
StevenE.Locke,MDChiefMedicalOfficer
iHopeNetworkClinicalAssociateProfessorofPsychiatry
HarvardMedicalSchool
TelementalHealth:ExpandingtheDigitalFron6er
WilliamJamesCollege September23,2016
Copyright,iHopeNetwork,Inc2016 2
AnotherQuesRon…
WhyTelementalHealth?
Copyright,iHopeNetwork,Inc2016 3
Amotherwhosechildissick,requiringhertocancelherappointmentwithmebecauseshecan'tleavehome.
Copyright,iHopeNetwork,Inc2016 4
Afrail,elderlyphysicianlivesalone,reRred,andstruggleswithgriefanddepression.HehasParkinson'sDiseaseandcannolongerdrivetomyoffice.HisMedicareAdvantageplanwillnotpayfortelecare.
Copyright,iHopeNetwork,Inc2016 5
Ahospital-basedphysicianwholeYworkforapsychiatryappointment15milesawayledhisservicechieftothreatenhisjob.
Copyright,iHopeNetwork,Inc2016 6
Achildwhosemotherhastoleaveworktopickherchildupatschoolanddrivehertohertherapist’soffice.Themotherlosesincome,thechildlosesclassroominstrucRonandmissesaYerschoolacRviRes.
Copyright,iHopeNetwork,Inc2016 7
Ayoungwomanwithpersistentdepressionunsuccessfullyusesaself-guidedprogramfordepressionshefoundontheInternettoself-managehercondiRonbecauseshecannotfindatherapistwhocouldprovideCBT,thetreatmentrecommendedbyherPCPwhoprescribesheranRdepressant.
Copyright,iHopeNetwork,Inc2016 8
Ahighschoolsenior,apopularathlete,screensposiRvefordepressionatthepediatricianandisreferredtoatherapist.HerefusestogobecauseheisworriedhewillrunintoclassmatesinthewaiRngroom.
Copyright,iHopeNetwork,Inc2016 9
Why?WhataretheDrivers?
• Epidemiology• Quality• Outcomes• Costs• Access• Payers• Integratedcare
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ForWhom?
o TargetpopulaRons• Military/VA• Isolatedenvironments• Prisons• Primarycare• Homebound• Employers
o Providers:careeropportuniReso Payers(commercial,public,ACOs)
Copyright,iHopeNetwork,Inc2016 11
What?
• Typesofapproaches• Technologies• IntervenRons• Mobilehealth(mHealth)• Guidedself-care• GamesandgamificaRon• Clinicians• Training
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TypesofApproaches
• Guidedself-care• Listservs• Chatroomsandsupportgroups• Onlinecoaching• Referralsites• TeleconsultaRon:clinicians• Telemedicineservices:consumers• Integrated,collaboraRvecare
Copyright,iHopeNetwork,Inc2016 13
What?
• Typesofapproaches• Technologies• IntervenRons• Mobilehealth(mHealth)• Guidedself-care• GamesandgamificaRon• Clinicians• Training
Copyright,iHopeNetwork,Inc2016 14
When?
o Newtechnologies!opportuniReso Barrierstocare• Access• SRgma• Reimbursement• Licensing• Regulatory(Boards,CMS,FDA)• LegislaRon(state,federal)• Liability(statutoryvs.caselaw)
Copyright,iHopeNetwork,Inc2016 15
When?
o Telementalhealthacrossthelifespan• Children• Adolescents• Students• Adults• Seniors• Endoflife
Copyright,iHopeNetwork,Inc2016 16
When?
o TheFuture:MovingtheBall• Avatars• VirtualReality(VR)• Virtualworlds(SecondLife,Whyville)• IntegraRonwithwearables• SpeechandvoiceanalyRcs• SimulaRons,seriousgames• AnalyRcsandmachinelearning• Psychogenomics
Copyright,iHopeNetwork,Inc2016 17
MentalHealthinSecondLife
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MentalHealthinWhyville
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What’sNext?
o LegislaRon• State• Federal
o Regulatorychanges• EliminateoriginaRonsiterestricRons
o Licensure• Interstatecompacts
o Lobbyingeffortso Moreresearchtoproveclinicalandcost
effecRveness
