Improving Behavioral Health Delivery Through Digital Strategies
November 3, 2022
Ensuring access to healthcare is critical to overall mental and physical wellness, alleviate chronic conditions, and prevent illnesses and deaths. However, the onset of the COVID-19 pandemic in March 2020 brought strict lockdowns for hospitals, clinics, treatment centers and healthcare systems, which in turn greatly reduced access to care for people seeking much-needed treatment and support. As a result, many people had no choice but to forgo urgent care for accidents or illness, surgical procedures, diagnostic or medical screening tests, treatment for an ongoing condition, regular check-ups, prescription drugs or medications, as well as dental care, vision care and hearing care.
Compounding matters even further, the effect of the pandemic on the population’s mental health has been significant. The isolation from social-distancing mandates and stay-at-home orders, loss of jobs and loved ones, in addition to the ensuing economic uncertainty, proved to be detrimental to many people’s mental health. In some cases, this perfect storm of unpredicted factors exacerbated pre-existing conditions and added to newfound mental health concerns.
The World Health Organization (WHO) put a glaring spotlight on the pandemic’s devastating impact on patients with behavioral and mental health issues. According to a recent WHO survey, the pandemic disrupted or halted critical mental health services in 93% of countries worldwide. The survey of 130 countries provided the first global data showing the devastating impact of COVID-19 on access to behavioral and mental health services and underscores the urgent need for increased access and funding.
While the pandemic caused many behavioral health providers to either greatly limit or altogether halt services and treatment to patients, Arizona-based behavioral health provider Crisis Preparation and Recovery, Inc. (CPR) quickly pivoted to build a friendly, digital experience for its patients.
In a recent webinar, CPR Co-CEO Drew McSherry joined Botco.ai CEO and Co-founder Rebecca Clyde to discuss CPR’s strategy to improve access to behavioral and mental health services for its patients, the behavioral health industry’s drastic shift over the last 24 months into the digital realm, how forward-thinking companies like CPR and Botco.ai are utilizing technology and the power of artificial intelligence (AI) for the industry, as well as valuable lessons learned along the way.
Providing innovative, effective and compassionate service since 1995, CPR offers a variety of services including outpatient counseling, high-acuity emergency response care, medication management, crisis interventions, transitional care, severe mental illness (SMI) evaluations, as well as certified information security manager (CISM) training, community services and disaster/crisis management consulting. As the largest behavioral health provider in Arizona providing such a multitude of services, CPR leadership was quick to foresee that the pandemic’s mandates and lockdowns would greatly reduce access to behavioral health care for its patients.
“We needed to make a clean, low-friction experience for the clients so they could continue to access the services they needed—and fast,” McSherry said.
But the transition was no easy feat. In March of 2020, CPR made the decision to go completely virtual. Building a friendly and digital experience to elevate the patient journey for its clients through telehealth was imperative.
“The biggest thing we had to do was to quickly turn to telehealth,” McSherry said. “We stopped seeing patients in person on a Friday, and we were able to see people via telehealth the very next Monday. We basically transitioned our entire company over a weekend. We had to procure equipment, increase our software ability and ensure internet access for all staff. The success of our transition to virtual for patients and staff is because of CPR’s extraordinary informatics team.”
McSherry added, “For many people, the pandemic highlighted the fact that the isolation and loneliness exacerbated a lot of things that were already going on. This resulted in many people seeking support and treatment for mental and behavioral health challenges.”
In just one year, from 2019 to 2020, CPR saw a 32% increase in behavioral health services provided. Another increase for behavioral health services from 2020 to 2021 further highlighted some system issues and clinician shortages that CPR was already aware of.
“It was difficult because we were trying to find 50% more clinicians to be able to handle 50% more volume,” McSherry explained. “We understood that a lot of clinicians’ schedules were full and wait times for appointments increased because people really needed the help. And with the increased patients came an increase in the acuity level. We didn’t have the access to care we were hoping to have at that time, so it was definitely a challenge to try and meet that demand.”
McSherry understands that while telehealth is not for everybody, the demand for the virtual delivery of behavioral treatment, support and care is still persisting and has become the norm. Overall, the shift to telehealth illustrates that the reticence around the adoption technology that’s been circling for years has not been grounded in reality. In actuality, it didn’t take long for people to accept and actually prefer telehealth versus an in-person therapy session.
“Some of the feedback we received from clients was that it was just easier,” McSherry said. “They didn’t have to get a babysitter, find transportation, take time off work or catch an uber. They could just close their door, log in for their session at home, and then go right back to what they were doing afterwards.”
In fact, CPR’s show rate actually increased with the adoption of telehealth. Even now as society inches closer to a post-pandemic environment, McSherry noted that patients show up to virtual appointments more so than in-person therapy sessions. And although face-to-face sessions will always play a part in behavioral health treatment, the interest in telehealth has clearly taken hold.
“In the last year, we’ve been trying to find what that balance is between virtual and in-person therapy,” McSherry added. “Each healthcare organization is answering that question differently. The population will dictate some of that. The behavioral health industry will face challenges going forward as it balances the expectations of digital natives that now comprise a large percentage of the population it serves.”
And with an ongoing shortage of clinicians, CPR realized the adoption of additional technology beyond telehealth was necessary to increase access to care, answer inquiries from potential patients and their families, and enable clinicians to do what they do best—care for their patients.
“We understand in today’s fast-paced digital world, people expect immediate feedback,” McSherry said. “They want things to work the first time, and they want it to be easy and streamlined.”
Taking into consideration that generations of digital natives now comprise a big part of the population, CPR wanted people to be able to access information on its services at all hours of the day, any of the week. And although CPR has had a call center for years, they also wanted to provide another way to disseminate information in order to continue to meet the needs of the newer generations. This mindset led CPR to collaborate with Botco.ai in the development of Tom, CPR’s virtual assistant designed to guide people during their path to a better self.
Further improving the patient journey, Tom is an AI-powered chat agent that was created to elevate some of CPR’s client interactions. Having baseline info available through a chat, interacting with Tom is not only easier than making a call, but more straightforward than searching CPR’s website for answers.
“We noticed that our call center was being inundated with simple calls asking for our fax number, our location address, if they could cancel or reschedule an appointment, or inquiring about the services we provide,” McSherry explained. “We wanted to elevate interactions the call center had with clients and find a way to provide responses to general inquiries for those who didn’t want to click around the website or want to make a phone call.”
With its deep knowledge, expertise and innovation, Botco.ai created Tom the chatbot to address inquiries on CPR’s baseline information, as well as answer questions about pretty complex things thanks to AI and Tom’s machine-learning capabilities.
“It’s been a great experience to meet with the Botco.ai team every other week to hear how Tom is learning and able to answer questions better, faster and more accurately,” McSherry said. “We’ve noticed a difference in the calls we’re getting, as they really don’t know what type of services CPR offers and they need to actually talk to somebody.”
McSherry added, “We can still answer the simple questions, but we want to be able to have those higher-level conversations over the phone. And that’s why Tom is so crucial for us and our patients…it allows CPR to be able to do that better. I’m especially impressed that Botco.ai continues to train Tom to do more things, which has alleviated some administrative tasks and provides greater support for CPR’s clinicians.”
One important feature that Botco.ai has spent a lot of time and effort building into their chatbot technology is sentiment analysis for crisis situations, particularly around self-harm detection. The capability for Tom to handle questions regarding self-harm or suicide is crucial for behavioral health organizations like CPR. With Botco.ai’s built-in methodology and protocols for handling critical situations, Tom can quickly respond with vital resources or provide an immediate connection that enables a live agent to take over, assess the situation at hand and better support the chatbot user in that moment.
“If someone interacting with Tom is signaling they might be in crisis, it’s imperative for Tom to prompt them immediately to contact 911 or emergency services,” McSherry said. “It’s the one thing we have been cognizant about and wanted to make sure that we didn’t leave anybody who really needed help right at that moment.”
Botco.ai’s intelligent chatbots provide many other advantages and benefits for its clients. They run 24/7/365, they never take a break, they don’t need to take vacation, and there’s no turnover rate for virtual assistants. Intelligent chatbots powered by AI are a very reliable resource that are always available to answer questions, no matter what time of the day or night.
This on-demand feature is especially beneficial for the behavioral health industry as mental health crises have no regard for regular business hours. Oftentimes, people wishing to seek help can’t talk during normal business hours. Another added benefit of utilizing chatbots in a behavioral health setting is it provides a judgment-free environment for people to initiate the process of seeking the care they need.
McSherry also shared some leadership lessons for navigating the changes that lie ahead for the behavioral healthcare industry.
“If anything, the pandemic forced everyone to be more flexible, compassionate and to embrace new technology in order to communicate and do business,” McSherry said. “Additionally, this population health crisis also shined a light on the fact that the shortage of healthcare professionals needs to be addressed.”
There is no easy solution to this problem, as clinicians, nurses, doctors and other healthcare professionals need extensive training and specific qualifications. The issue has become especially acute due to the aging population and advances in medicine enabling people to live longer overall. To address this deficit, CPR has developed a workforce development strategy to build its own talent pipeline.
“We’ve developed intern programs with Arizona State University and other universities that provide a robust experience in which graduate students can shadow clinicians and gain real-world training doing SLA evaluations, working in an outpatient setting, doing transitional care and working with psychiatric units,” McSherry said. “We have put a lot of effort, time and resources into giving interns what they need in order to become independently licensed. We see it as such a valuable component of a journey of a clinician that we’ve made it a priority at CPR to meet the expected demand in the coming years.”
If you’d like to learn how to integrate automation and AI technology into your healthcare organization or to see a product demo from Botco.ai, schedule a call with our team or email us at email@example.com.