According to The Agency of Healthcare Research and Quality (AHRQ), an estimated “44 million people 18 and over suffer from mental disorders.” Further, “major depressive disorder is the leading cause of disability among adults”. This is a major concern for healthcare providers throughout the United States. As more patients struggle to manage their mental health condition, they are showing up in emergency rooms, where they are finding staff and systems ill equipped to deliver the specialized care that they so desperately need. This missed opportunity not only creates a negative experience for patients but also drives up healthcare expenses for providers.
Novant Health, one of the largest healthcare systems in the country (15 hospitals, 350+ physician practices in NC, SC, VA, & GA), is proactively helping behavioral health patients, reducing readmissions and preventing costly emergency room visits.
In 2013, Novant Health partnered with behavioral analytics company Ginger.io on a successful depression program in a Novant perinatal clinic. In 2014, Novant Health expanded the partnership with Ginger.io to address the unique needs of adult patients with depression by developing a customized care solution for this historically underserved population.
Ginger.io Depression Patient Survey
The Ginger.io Behavioral Health Program initially enrolled patients who were already engaged in a partial hospitalization program or an intensive outpatient program at the Forsyth Medical Center. In an effort to complement the standard support groups and therapy 3-5 days a week over a 12-month period, Novant Health offers patients the continuous sensing smartphone. Patients download the smart phone app solution from Ginger.io to “connect the dots” between their behavior and their health and “stay in touch with the care team between visits”, according to co-branded patient communications from Novant Health.
The smartphone app actively collects information from the patient about symptoms and medication. Based on the patient’s specific behavioral health condition (e.g., depression), she receives personalized questions to gather a specific set of data. The mobile app also passively gathers data in the background on her mobility, social interaction and sleep patterns. The patient’s active and passive information is then combined and fed into Ginger.io’s analytics engine to identify which patients are in need of intervention and to share that information through an alert with care staff. After receiving a dashboard alert, a licensed mental health professional (e.g. nurse, social worker or case manager) contacts the patient to discuss what is going on in the patient’s life based on her responses and behavior—what Ginger.io refers to as a “behavioral signature”.
Novant Health is already receiving positive feedback and insights from both clinicians and patients.
“Most innovation in Behavioral Healthcare in the past 20 years has been primarily focused on pharmaceutical development,” explains Dr. Todd Clark, Director of Behavioral Health Sciences at Novant Health. “This was necessary for treating patients in the acute phase, but there has only been minor progress related to services detecting mental illness upstream. The Novant Health Innovation Team led by Matt Gymer has created a platform in our healthcare system to leverage the cutting-edge advantage of Ginger.io for our behavioral health population. Ginger.io has revolutionized our ability to connect with patients in real time, even remotely, and allows us to provide patients with the most appropriate and timely care. This not only puts the patient on the most optimal pathway for treatment and recovery, but it also increases the number of treatment options for the patient—rather than the overused default option of the local emergency department. Ginger.io has flexed to meet our system’s particular needs, and our patients have expressed a high degree of engagement with the service.”
Patients appreciate the opportunity to reflect on their mental state and the proactive contact they receive when experiencing challenges in their day-to-day life.
According to one Novant Health patient, “I look forward to the surveys. For the first time in my life I feel that someone truly cares if I live or not. Someone cares how I feel and helps me work through those feelings. I feel I have purpose in my life again.” This is a powerful endorsement from a community in need.
Ginger.io Behavioral Health Program Expansion
Novant Health expanded the program in June to an outpatient drop-in assessment center and mobile crisis unit and then again in September to psych inpatient and psych outpatient clinics. Although these patients come into care during a crisis moment, it is important that they leave with a new tool for ongoing support and empowerment.
Based on qualitative feedback Novant Health from the clinicians and patients using the mobile monitoring solution, care teams have decided to share historical survey responses and behavior patterns with patients through a provider-facing dashboard displaying past data and care alerts. Doctors/Care Managers can share this information with the patient to discuss behavior patterns, life situations, triggers and treatment plans.
Novant Health recently rolled out the Ginger.io technology in their main Psychiatric Clinic in Winston-Salem. Psychiatrists are giving the smartphone app tool to their patients and viewing the dashboard to respond to patients in need. The doctors will also use the information gathered to enrich their conversation with the patient during their office visit.
Novant Health continuously evaluates the value of the program through key quantitative metrics including patient satisfaction and engagement, operational efficiencies and outcomes improvement based on clinically validated measurements such as PHQ-9.
In the future, Novant Health plans to extend the Ginger.io Behavioral Health Program to five other regional hospitals across their health system. The expansion is intended to deliver “a remarkable patient experience,” according to Matt Gymer, Corporate Director of Innovation at Novant Health.
Clinicians are interested in expanding the use of the Ginger.io platform to help them identify patients earlier, understand triggers for their symptoms and proactively provide needed support. This important behavioral health initiative aligns closely with Novant Health’s ability to innovate solutions to deliver proactive care to patients and customize services.