Talking therapies and the role of tech – thoughts from Boston

posted in: Opinion | 0

By Barnaby Perks, CEO, Ieso Digital Health

It’s Friday morning in Boston. I’m sitting on the tarmac at Logan airport, my flight departure delayed by at least two hours due to snow and ice. I’ve spent the last week shuttling between Boston and Cambridge (Massachusetts) for meetings with various investors and our US commercial partner, Beacon Health Options. It’s always a delight to visit Boston but it’s also a wonderful feeling to be on the way home after a week of restaurant food and jetlag-disturbed sleep. So I hope that the aeroplane gets going soon so that I can return home to see my wife and children.

We’ve been developing our US proposition for more than a year. And we’re making good progress, with patients going into treatment this month. With its myriad contract types – employer, federal, state employee, Medicaid, private insurance – and different regulatory and reimbursement regimes, we knew that our experience in the US health system was going to be quite different to our work in the NHS. But we’ve been surprised by some of the clinical differences.

We may not always appreciate it fully but in the NHS Improving Access to Psychological Therapies (IAPT) programme we have an absolute gem. Through IAPT the NHS is leading the world in patient access, accreditation and quality of therapist workforce, and focus on evidence-based treatments such as CBT. This, combined with the rigorous collection and analysis of clinical outcome metrics and open reporting of provider data, makes IAPT the most measured and transparent primary care mental health programme in the world.

The Ieso therapy method is not just about technology. Central to our offering is the IAPT approach to evidence-based interventions and measurement of both patient outcomes and therapist performance, including fidelity to the CBT model and adherence to treatment protocols. The IAPT-inspired approach is at the heart of our US offering too. We believe that we can use this to help the US healthcare system to realise its ambitions of accessibility, affordability and accountability.

Coming from our strictly regulated IAPT world, we have been surprised by the variation in US therapist qualifications and accreditation, the apparent lack of standardisation of therapeutic intervention and scarcity of clinical outcomes data. While this presents training and clinical management challenges, it also represents a great opportunity to deliver game changing levels of quality in the US system.

We must be careful to avoid trying to run before we can walk, or even crawl. The current focus of the US system is about improving access to psychological therapy, with less urgency around quality for the time being. But quality will become important over time as health payors see from the data how better access to quality controlled therapeutic interventions can have a positive impact by reducing the cost of both physical health and secondary care mental health. So a focus on quality from the start will pay dividends later.

I’m excited about the coming months and years. Very few are presented with the opportunity to help transform mental health in the US. So this is a great opportunity for Ieso, and a great honour too, as is being a standard bearer for the NHS’s excellent IAPT method.



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