Using telemedicine and machine learning to improve access and quality of care.
Brightside Health is leveraging data and technology to address mental health challenges, including access disparities and the need for measurement-based care. The company uses artificial intelligence (AI) and machine learning to improve treatment selection and provide real-time support for patients. Dr. Mimi Winsberg, chief medical officer and co-founder, sees potential for AI to enhance diagnostic accuracy and treatment efficacy in the mental health industry. Dr. Winsberg also advocates for policy changes to support telemedicine expansion, including the creation of a telemedicine registry for controlled substances.
Watch the interview to learn more.
Stephanie Butler:
Welcome everyone. I'm delighted to be here with Dr. Mimi Winsberg, who is the Chief Medical Officer and Co-Founder of Brightside Health, so welcome. Before we start, I want to ask just an opening question, because I'd love to get your perspective on what you think the biggest challenge is facing the industry today.
Dr. Mimi Winsberg:
Yeah, well, I think we've seen a number of challenges.
Stephanie Butler:
Yeah, that's absolutely true.
Dr. Mimi Winsberg:
The first is, of course, a mismatch between supply and demand. One in five Americans is struggling with a mental health condition, and over half of counties in the United States don't have a single psychiatrist. So we are trying to figure out how to meet the demands of people and how to meet them where they are, essentially.
We also have a quality problem in mental health in the sense that payers have, for a long time, I think, resisted covering open-ended services. And rightly so because we need some measurement-based care to show payers that in fact the care we're delivering is moving the needle for patients, that they're improving, and that it's overall reducing cost of care in order to treat mental health conditions.
Stephanie Butler:
Makes sense. I mean, how can the healthcare industry, then, more effectively address the increasing demand for mental health services, particularly in underserved populations?
Dr. Mimi Winsberg:
Yeah, and I'm a strong believer in telemedicine to solve this problem.
Stephanie Butler:
Me too.
Dr. Mimi Winsberg:
So we can, using telemedicine tools, accomplish multiple things. One, we can meet people where they are, be that rural communities, be that in their homes if we're dealing with working moms who have child care responsibilities, older adults who may have mobility issues, but also just people who don't have access to a mental health clinic or are worried about the stigma of parking in the parking lot of a community health center.
Stephanie Butler:
I was just going to say, yeah.
Dr. Mimi Winsberg:
So telemedicine can, I think, solve this. It can also solve the problem of scarcity of providers in certain counties because the provider can be located anywhere as long as they're licensed where the patient sits, they're able to deliver quality mental healthcare over telemedicine. And so we can at Brightside, for instance, leverage the providers we have in states that have more access to serve communities that don't have access to mental healthcare.
Stephanie Butler:
Right, exactly. Yeah.
Dr. Mimi Winsberg:
I think the other thing telemedicine can solve is that by putting a layer of technology on top of the care we're delivering, we can, one, raise the overall level of care by doing things like offering providers clinical decision support tools, practice management tools, closed loop systems where they get alerts when patients are struggling rather than having to wait for an appointment. So there's a number of factors that tele can do besides just providing access.
Stephanie Butler:
So I want to follow on that. How can partnering with technology-enabled providers then help the healthcare systems, right, reduce costs and also improve outcomes?
Dr. Mimi Winsberg:
Yeah, I mean, it can help reduce overall cost of care because, you think about an emergency room visit or hospitalization, these are very expensive events. And so if somebody has access to a healthcare provider, a mental healthcare provider, they're a lot less likely to show up in the emergency department because they have somebody they can turn to.
Now, the technology piece. We can layer, and we do layer at Brightside, things like 24/7 messaging with your provider on top of the care, real-time alerts for the provider. So we're doing asynchronous check-ins with patients, giving them tools they can use in between visits. So they can do lesson plans, they can do exercises that we know will reduce their symptoms and accelerate good outcomes in their care. And then providers get alerts when the patient may need extra attention so we don't have to wait for the next appointment. We can intervene in real-time.
Stephanie Butler:
And that makes such a difference.
Dr. Mimi Winsberg:
It really does. And it makes a big difference in terms of patient engagement too, because the patient feels heard, the patient has somewhere to turn to, they don't need to worry that they have to show up in the emergency department.
Stephanie Butler:
Or feel lost, right? And, in the long term, that will end up saving on hospital costs and other expenses and burdens for the healthcare system.
Dr. Mimi Winsberg:
Right, and even cost of physical care.
Stephanie Butler:
Yeah, right. That's true too.
Dr. Mimi Winsberg:
If you're diabetic and you have a mental health condition you're probably going to take better care of your diabetes if you're not depressed.
Stephanie Butler:
Yeah, that's a great point. So what policy changes do you think could help overcome current barriers to accessing mental health?
Dr. Mimi Winsberg:
I mean, we've seen certain policy changes happen during the pandemic in efforts to increase access, but I'd like to see those, one, continue and, two, taken another step. In other words, we are still dealing with a fairly archaic state-by-state system when it comes to telemedicine laws.
Stephanie Butler:
Oh yeah, definitely. Yeah.
Dr. Mimi Winsberg:
And then I think in terms of controlled substances we need to establish a telemedicine registry so that patients have a way to get things like their buprenorphine if they're opiate addicts, be able to have access to these medications via telemedicine. The Ryan Haight Act prohibited that prior to the pandemic. We've now seen a lifting and extension of those regulations, but I think we're looking for ongoing guidance and regulation as to how we can continue to treat these important conditions over telemedicine.
Stephanie Butler:
No, I think that's a great point. So just generally as we look forward, if we look forward five, 10 years, what do you think will be some of the biggest disruptors in innovation and healthcare 10 years down the road?
Dr. Mimi Winsberg:
Yeah, we've started to see some of these things at Brightside. We are using very sophisticated machine learning technology to help select treatment for patients. So mental health conditions are very heterogeneous. They can present with a myriad different number of symptoms. And if you don't know what you're treating, you're not likely to get the treatment correct, so the first go around. And so what we hope to do is increase diagnostic accuracy, increase treatment selection, and then I think you'll see technology get layered in important ways throughout care. This may include things like care navigation, AI tools to assist providers to make them more efficient, software that may recognize when you are headed for a crisis or... So, recognizing patterns in your language, for instance-
Stephanie Butler:
Oh, that's interesting, yeah.
Dr. Mimi Winsberg:
... that can predict suicidality or predict a suicidal crisis. We've published on this at Brightside where we, just looking at patients' language in terms of how they're expressing themselves when they come in, we trained an LLM to predict whether that patient was going to have a suicidal crisis with the same accuracy as a team of trained psychiatrists and psychologists.
Stephanie Butler:
That's great.
Dr. Mimi Winsberg:
But we'd like to get it even better.
Stephanie Butler:
Well, yeah, of course.
Dr. Mimi Winsberg:
Yeah.
Stephanie Butler:
But think of all the other things you could do with that.
Dr. Mimi Winsberg:
Yeah, exactly.
Stephanie Butler:
Each step you can take to make it better for the next time.
Dr. Mimi Winsberg:
That's right. That's right and I think we'll continue to see a refinement in these technologies, which will help patients be able to access the right care at the right time.
Stephanie Butler:
I think it's going to make a big difference. I'm really looking forward to what you're going to be doing next. I think there's so much opportunity in this space. So I'm excited.
Dr. Mimi Winsberg:
We're excited. We're excited. It's a fun and exciting time to be in digital health.
Stephanie Butler:
And it feels like you can make a big difference, and I think that's important.
Dr. Mimi Winsberg:
Yeah.
Stephanie Butler:
So thank you. Great to meet you, Mimi. Thank you to you and to Brightside Health. Looking forward to seeing what you're doing next.
Dr. Mimi Winsberg:
Thanks.