Exploring the Intersection of Health Tech and Psychedelic Medicine
How Technology is Revolutionizing Healthcare
Health is one of the most important determinants of how we live, what we do, and whether we have the opportunity to fulfill our human potential. In the past, most people entrusted doctors and had little insight into their own treatment and progress. Many practitioners made diagnoses using quantitative parameters consisting of the number and type of symptoms a patient exhibited. After all, there wasn't many other tools available to doctors or their patients to aid in diagnosis, prevention, and care. The ability to maintain one’s physical and mental health was dependent on health insurance, transportation, and the quality of care delivered by the doctors available.
Over the past decade and especially in the past year, there has been a shift in this paradigm, due in large part to healthcare technology (health tech). Health tech such as telemedicine, Electronic Health Record (EHR) systems, wearables, and a growing number of mental health apps have surged since the pandemic. In fact, according to George Washington University, in the next two years “500 million consumers and healthcare providers will use a mobile healthcare app.” A survey from Deloitte stated that “in 2020, 42% of US consumers said they used digital tools to measure fitness and track health-improvement goals. A 2.5x jump from just 17% in 2013.”
One important technological development that has boomed in the past year is virtual care or telehealth. A report published by McKinsey found that between 2019 and 2020 alone, the use of telehealth rose from 11% to 46% and it is safe to say that this is a trend that’s here to stay. A positive tradeoff from the shift towards telehealth is that care is becoming more accessible. Patients no longer have to take hours from their day to travel to their nearest clinician. They now have around the clock access to a larger network of physicians with different specialties and on-demand availability across the U.S.
Electronic Medical & Health Records
A shift towards the use of electronic medical records (EMRs) and electronic health records (EHRs) has led to a more data-driven approach to care. Data analytics are now being used to develop measurement-based algorithms that create more effective and precise guides for preventing and managing diseases. According to Forbes, data analytics "will allow more doctors to maximize the health of patients with chronic illnesses, thereby reducing mortality." The use of EMRs and EHRs has also supported the shift from a reactive, one-size-fits-all approach to healthcare to a more proactive, patient-centered approach, where prevention and control are just as paramount as management and treatment.
Data is also transforming the way patients advocate for their own health. Wearable biometric technologies like the FitBit, Apple Watch, and Touchpoint have grown in popularity exponentially over the past five to ten years. These devices use sensors and other advanced technologies to measure biometrics like blood oxygen, heart rate, sleep, BMI, and stress levels to provide a more holistic view of one’s health. This incredibly personalized approach puts people back at the center of their health and gives them the ability to make educated, data-driven decisions about their behaviors in real-time.
Additionally, health tech has enabled more people to become increasingly engaged with research initiatives. Citizen science platforms like Quantified Citizen and Zooniverse are democratizing health research by bridging the gap between passionate individuals and professional researchers to create a community where both can work together. On the Quantified Citizen platform, amateur and professional researchers can “easily participate and create their own scientific studies, building a movement towards more timely insights into the latest health research.” This trend is paving the way for more community-based research and empowers people the power to help develop the research that will inform changes in their healthcare system.
Mental Health Tech
The innovations and paradigm shift spurred by health tech is applicable to the field of mental health as well. In recent years, there has been a rise in a new field called mobile health (mHealth), including health-related apps. In fact, some experts are projecting mental health apps to experience an annual growth rate of approximately 24.2% from 2020 to 2027. Apps like Headspace, Shine, and Moodfit equip users with tools to help them track and manage their own mental health with features like goal setting, guided meditations and breathing exercises, daily mood tracking, and personalized insights. Applications like Talkspace and Mindstrong, which specialize in digital therapy have also dramatically increased in popularity over the past year.
While rising in popularity with consumers, mental health apps are not yet being fully embraced by experts in the field. This is because mHealth is still a fairly new, unregulated field and there still isn’t a lot of information on mental health app efficacy. It’s also important to note that these apps do not replace licensed mental health specialists, especially when it comes to diagnosing chronic mental health conditions. This concern is currently being addressed by organizations like The American Psychiatric Association, which has developed an app rating system for clinicians to use when prescribing mental health apps to clients. Regardless, mHealth has so many potential benefits and has made it easy to access a variety of supportive tools to assist consumers with behavioral change, awareness, and self-advocacy.
Changes in Patient Attitudes & Expectations
The emergence and widespread adoption of health tech has fundamentally shifted the way people engage with their own health, as well as their expectations around outcomes. Armed with devices, consumers can actively monitor and manage their own health in real-time and feel confident to collaborate with or even challenge healthcare providers. According to Deloitte, in 2020, “51% of consumers said they were very or extremely likely to tell their doctors when they disagree with them.”
A Demand for Insights & Outcomes
Apps and wearables have also conditioned consumers to be able to track health outcomes in the form of easy-to-read charts and graphs. The expectation around personalized insights–to see and understand progress in real time–poses challenges to the way care has traditionally been provided. Healthcare professionals should be prepared for patients to request access to their own health records and new kinds of data points for visual proof of their health outcomes. This is especially true when it comes to expensive mental health treatments and alternative forms of therapy, where the “return on investment” has often been left to subjective feelings and abstract results.
Increased Advocacy & Quantified Self
Access to personal data generated by health tech devices means that patients are able to stay proactive with their healthcare, set goals, and make educated adjustments to their behaviors. As a survey from Deloitte stated, “Among individuals who track their health, 77% say it changes their behavior at least moderately. Younger generations (Gen Z and millennials) are much more likely to say it changes their behavior.” This shift in consumer attitudes towards healthcare can be summarized as the evolution from "passive patient" to "engaged advocate."
Health tech is driving the paradigm shift from the dated one-size-fits all approach in healthcare to one that is patient-centric and data driven. Health tech and the rise of the cultural phenomenon of the “quantified self” are making this shift possible. In tandem with social justice movements centered around health equity and sovereignty, consumers are seeking a new care model that puts them in control of their own health.
Changes in the Way Health is Measured & Managed
The data and information collected by new technological innovations has also dramatically changed the way we measure and manage health. One of the most transformative examples is the ability to aggregate multidimensional data about the variety of biological and cognitive factors that impact mental health. Health tech has opened up the doors to innovative processes like digital phenotyping and measurement-based care that enable practitioners to conceptualize, address, and track physical and mental illness in an unprecedented way. According to an article published by Deloitte,
"Digital medicine products present an opportunity to move beyond the pill, better understand patient needs and patient journey, and enhance patient experience and outcomes while on a therapy."
Digital phenotyping uses data from personal devices like smartphones to measure health and wellbeing. For decades, the field of psychiatry and psychology have depended solely on self-reports of mental health symptoms and the stringent classifications of the Diagnostic and Statistical Manual of Mental Disorders (DSM) for patient diagnoses. Using digital phenotyping, mental health providers could monitor patients for critical points of intervention when there are sudden behavioral changes. Instead of using a fixed, one-size-fits-all protocol, digital phenotyping is already beginning to enable practitioners to understand the intricacies of an individual’s thoughts, moods, and behaviors to create truly personalized treatment plans and even preventative care.
In addition to digital phenotyping, health tech has simplified practitioners’ ability to implement measurement-based care (MBC), so they can see clearly what works for their patients. MBC is the “the practice of basing clinical care on client data collected throughout treatment.” Patient data is collected before, during, and after mental health treatment sessions through different assessment tools to give practitioners a more holistic view of patient outcomes and the ability to make data-driven adjustments to care in real-time.
MBC has been proven to enhance medical treatments and provide better health outcomes. According to a manuscript published in the HHS Journal,
“Preliminary research suggests that MBC, when used as a framework to guide practice, results in superior client outcomes when compared to usual care.”
The use of MBC has even been called to become standard care for mental health conditions like depression in projects like the Texas Medication Algorithm Project. MBC empowers practitioners to be able to easily collect and examine data to gain a deeper understanding of their patients’ progress and outcomes. Harnessing the power of these insights, they can see what protocols, treatments, and compounds are working in a multidimensional way.
What This Means for Psychedelic Medicine & Research
While technology is fundamentally changing people’s interactions with–and attitudes towards–health, widespread support for plant medicine and alternative therapies is accelerating the psychedelic renaissance. This synchronicity provides an unparalleled opportunity and demand for innovation. We can use the tools and knowledge that health tech has provided, to advance psychedelic medicine–from the implementation of measurement-based care in psychedelic therapy practices–to the application of digital phenotyping in psychedelic research.
Maya is an example of how these two worlds intersect. The Maya platform was designed to make it easy for practitioners to implement measurement-based care in their practices, so that long-term there will be more evidence to support best practices and protocols for psychedelic medicine.
In the world of academia, the demand for innovation using digital phenotyping is also top-of-mind. The Trial of Psilocybin versus Escitalopram for Depression, conducted by top scientists and published in the New England Journal of Medicine was recently deemed inconclusive due the way the study was conducted. As covered by a recent article in The Trip Report, the primary outcome measure of this study was QIDS-SR-16. This measure is dependent on a multiple-choice survey given to participants that correlates with the DSM-IV symptoms used to diagnose depression. Of the different outcome measures used, this was the only one in the study where there was no statistical significance between psilocybin and the SSRI. As Dr. Boris Heifets’ stated on Twitter,
“The inconclusive outcome may say more about a generation of psychiatric scales designed for SSRIs than it does about psychedelic potential.”
Starting in 2013, the National Institute of Health has begun to move away from the DSM and towards a new project called, Research Domain Criteria (RDoC). This shift also includes retiring self-reported surveying of patients and using digital phenotyping as a more valid and comprehensive way of assessing one’s overall health and wellbeing. It is telling that the single largest psychedelic research organization, Compass Pathways, has partnered with Mindstrong to use digital phenotyping technologies within their research.
What This Means to Maya
Advancements in technology and psychedelic medicine have the potential for a symbiotic relationship, if we choose to use them benevolently. Armed with the new abilities and processes bestowed by technology, we can collect the data that is needed to deepen our understanding of the human condition as well as psychedelic medicine. This innovation is required to create more holistic, effective methodologies, treatments, and ways to approach mental health. Simultaneously, it allows us to contribute diverse, multidimensional data to the research community.
In many ways, it is our responsibility to harness the power of technology and plant medicine to find new ways to help people live healthier, more fulfilled lives. Simultaneously, it is also our responsibility to do so in a way that is driven by community, ethics, and integrity.