Digital tools are rapidly reshaping how mental health care is delivered, monitored, and reimbursed. Their promise lies in delivering more precise insights into a patient’s condition, enabling earlier interventions and expanding access to services beyond traditional care settings. But as with any rapid transformation in health care, there is risk of leaving some patients behind. Without an equitable standard by which to measure and assess patients, digital mental health very likely will unintentionally reproduce, and even amplify, disparities as use of the technology scales.
Recently, the Digital Medicine Society (DiMe), the Federal Drug Administration (FDA), and more than twenty partners, including the American Psychiatric Association, Mass General Brigham, and Talkspace, announced an initiative to move away from outdated self-report questionnaires toward standardized digital measures of sleep, activity, and speech. These efforts are designed to create a shared framework that improves care, accelerates innovation, and allows reimbursement models to keep pace with the digital era.
The potential of this initiative is exciting as clinicians and payers alike, for decades, have struggled from the absence of standardized, objective data in mental healthcare. As Talkspace’s Erin Boyd noted when the initiative launched, the field has never had a common baseline for outcomes. That leaves, though, the real challenge of adoption and consistency of use. If health systems, payers, and technology vendors fail to use the same standard, the current and fragmented state of behavioral healthcare will remain unchanged. Providers will continue to struggle, payers will be unclear on value provided, and patients will continue to experience uneven access to treatment.
Standardization in digital mental health is a technical issue and an equity issue. Psychiatric patients today experience disparities in diagnosis and treatment based on race, gender, socioeconomic status, and geography. If digital tools are designed and subsequently deployed without careful attention to these differences, they inevitably will hardwire bias into the system.
For example, biomarkers or activity trackers calibrated to one demographic may underrepresent the behaviors of another. And reimbursement policies tied to nonstandardized digital outcomes could mean that access to treatment varies based on the technology available at a given clinic or covered by a particular insurer.
This is why it is essential to ensure that standardized measures are validated across diverse populations and settings. Otherwise, technology is not closing gaps in mental health access, but rather risks widening them.
Our team at Acuity has spent the past several years working with major health systems to develop the first standardized patient acuity measurement platform for inpatient psychiatric care. While our focus is different from some other digital health initiatives underway today, the challenges are similar.
Inpatient psychiatry has long lacked objective measurement tools that clinicians can trust. Our work has underscored two important lessons that apply broadly to digital mental health:
These lessons from the inpatient world also relate directly to building consensus for digital measures for outpatient care.
Health systems face a delicate balance. On the one hand, there is financial pressure to adopt digital tools to improve efficiencies, better address increased patient demand, and to align with evolving payer requirements. Still, there is the overriding responsibility to do no harm so digital solutions must be thoughtfully considered to ensure they are valid, reliable, and equitable across the patient population.
Responsible integration will require:
The digital transformation of mental health is inevitable and urgently needed, more so each day that passes. But the requirement for a shared baseline for measuring patient outcomes is foundational, much like standard units of measurement required to build a house. If every builder on-site used something different chaos would ensue, and the result would be something unrecognizable. So too a fragmented system serving mental healthcare would only deepen inequities rather than reducing them. Standardization is about ensuring innovation benefits all patients, period, and not just those who happen to fit the profile on which a tool was built.
The stakes are extremely high and time is not our friend. Mental healthcare has existed far too long without standard models and objective, reliable measures. They are now within reach and it is up to our industry to ensure that the path forward is both clinically effective and fair to all.
ABOUT THE AUTHOR
Jim Szyperski is a seasoned entrepreneur with over 30 years of experience leading technology companies across industries including mental healthcare, education, energy, financial services, and telecommunications. He has a proven track record of driving innovation, building high-performing teams, and guiding companies from early growth to successful outcomes. As co-founder and CEO of Acuity Behavioral Health, Jim is focused on transforming how mental healthcare is delivered and measured. Over the past decade, he has developed technology solutions that improve access, quality, and outcomes in behavioral health.
Prior to Acuity, Jim held executive roles at Proem Behavioral Health, Power Generation Services, Inc., and WebTone Technologies, among others. He has also served on the boards and advisory councils of several technology companies and nonprofits offering expertise in strategy, scaling, and product development.
Jim holds a degree in Business Administration from the University of North Carolina at Chapel Hill and lives in Atlanta, Georgia.