- We have entered a new hybrid behavioral health model.
- Telehealth has seen a drastic increase because of COVID-19.
- Virtual options will help increase medical research diversity and inclusion.
It's been a little over a year since the COVID-19 pandemic has turned our lives upside down, including how we seek and receive our health care, particularly with the rise of telehealth, and the field of psychiatry is no exception. From delivering therapy to conducting scientific research, we have now entered a new long-lasting hybrid behavioral health model.
Throughout the pandemic, Athenahealth, a health tech company, released an interactive dashboard that shared telehealth trends from 18.4 million virtual appointments by 60,000 providers. It reported that telemedicine had the most significant impact on mental health, with 33% of appointments going virtual, according to their data.
At Zucker Hillside Hospital and the Feinstein Institutes for Medical Research, my colleagues and I had to quickly rethink how we engaged and interacted with our patients. We were tasked with implementing and tackling obstacles that digital medicine presented. While we may still have some hurdles to overcome, virtual health and medicine may ultimately increase diversity and equity for mental health care and medical research studies.
Amidst the pandemic, many of my patients were happy to have telehealth as an option. Without the need to seek transportation to attend appointments or take time off from work or school, I saw an increase in appointment retention and engagement. But that wasn't the case for everyone. If clinicians are to implement this model for the long run, we need to address some of the hurdles and determinants of health that may impact telehealth options.
How virtual technology intersects with research
The lack of access to the internet or digital devices (tablets, cell phones) may prevent some people from participating in virtual care options. However, there are ways to work around these issues; for example, if a patient were to enroll in a clinical study, the institution could provide the necessary hardware. My colleagues at the Feinstein Institutes have successfully launched an at-home virtual COVID-19 clinical trial looking at the common heartburn drug famotidine, and to cut out any digital divide, patients are sent an iPad and other equipment to the participant's home to conduct for the trial. As an incentive, they get to keep the iPad once the trial is finished.
In regards to medical research, utilizing two-way video and virtual communications may help increase participants' clinical trial awareness and hopefully diversity. Researchers must collect data from various people from different walks of life, socioeconomic status, and background to ensure that research findings are generalizable. This helps represent a broader population that is more representative.
We need to consider that each patient is different and may have challenges with adhering to a virtual schedule and counseling. It's up to us to develop personalized plans for our patients.
One issue to overcome, regardless of telehealth options, is the general lack of trust or stigma associated with clinical trials and research in general. Many are skeptical of volunteering for science. However, leveraging technology may help address and ease some of these barriers. For example, I am conducting research around the use of internet search and personalized advertisements. By utilizing these methods, we can tailor digital advertisements for clinical studies to target specific groups of people in certain neighborhoods. Technology and virtual communication may help ease the hesitancy and burden to sign up for a trial by increasing access to online education and supports, ease the burden of transportation, and reduce the need to miss work and other personal responsibilities.
With a proper blend of in-person and virtual telepsychiatry, we are at the cusp of changing how mental health and research are conducted, paving the way for more access, inclusion, and overall care.