Ginger is offered directly by many employers, is in-network with several health plans, and counts Cigna and Kaiser Permanente among its investors. By addressing less acute issues directly and triaging people to therapists or physicians as needed, the program provides scalable, cost-effective support. Coaches focus on needs including stress management, goal attainment, and recovering from loss using tools such as motivational interviewing and app-delivered content. (Many virtual care platforms use algorithms to match users to providers there’s some evidence this can increase patient satisfaction and even clinical efficacy.) With Ginger, patients are escalated to a therapist or physician if they request it, or if the AI or coach recognizes the need for escalation. Ginger is an on-demand support program that guides users in addressing low-acuity mental health care needs, such as mild depression or anxiety, through secure texting with trained coaches supervised by therapists and supported by artificial intelligence. And meQuilibrium, a stress and resilience app and program now available through many employers, showed a significant positive dose-response effect on stress and related symptoms in enrollees in a digitally administered resilience program.Įach of these types of care solutions can be delivered in a HIPAA-compliant manner with appropriate privacy protections. A chatbot developed by Woebot which provides CBT, DBT (dialectical behavior therapy) and mindfulness support led to significant improvement in young adults’ anxiety and depression in randomized clinical trials. That technology, marketed today as Sleepio, has been implemented by many large employers.
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One randomized, placebo-controlled trial of web-based CBT for insomnia demonstrated improvements in sleep quality and wakefulness. Digital CBT programs have proven as effective as in-person CBT in treating anxiety and depression and insomnia. Similar results have been generated by digital tools that provide animated and/or human video instruction, content libraries and exercises. Overall, most published studies show telephonic mental health care is as effective as in-person care in treating depression, anxiety and obsessive-compulsive disorder. And a 2020 Veterans Administration study found that video telepsychotherapy was as effective as in-person office-based care for treating depression and post-traumatic stress disorder. How well do digital services and virtual care work? A 2016 metanalysis of 452 studies of telepsychiatry found high patient satisfaction and quality equivalent to in-person care. Because of these benefits, the majority of employer-sponsored health plans now offer virtual and digital options for mental health care. This combination of tools provides the mental health care system with scalable solutions and increased flexibility while improving access and convenience for consumers. Increasingly, innovative mental health vendors are combining digital tools and virtual care to create a robust ecosystem for end-to-end patient care, including steering patients to in-person care when needed. Non-clinician based digital mental health services, such as chatbots, video and written content, gamified user exercises and digital cognitive behavioral therapy (CBT) programs, are a good adjunct to clinician-based virtual care, allowing 24/7 access for those with less intensive needs. Asynchronous messaging, for example, lets patients text a clinician or coach at any time and get a response later. This provides alternatives to the traditional 50-minute therapy hour and allows for a better match of supply and demand across times of day and geographies.
Clinician-based virtual care replaces traditional in-person office visits with synchronous video or audio visits or with asynchronous text messaging.
Because of the pandemic, virtual care and other digital tools are more important than ever in supporting existing care, providing scale and increasing capacity.
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