Laboratories to Optimize Digital Health

Presenter:

Adam Haim, Ph.D.
Division of Services and Intervention Research

Goal:

The goal of this initiative is to foster research collaborations between academic researchers and digital health technology developers to test strategies to increase the reach, efficiency, effectiveness, and quality of digital mental health interventions. Research is also needed to optimize existing technology and understand factors related to engagement and sustainability of digital health platforms.

Rationale:

Digital health technology offers unprecedented opportunities to help consumers, clinicians, and researchers measure, manage, and improve health and productivity. These tools also have the potential to improve our understanding of mental illness across the lifespan, to track the course of illnesses and recovery, and to provide and enhance mental health care. Most importantly, digital health interventions offer the potential to bridge the treatment gap and provide evidence-based interventions to the many individuals who currently are unable to access treatment.

Over the last decade, NIMH has supported the development and testing of digital health technology, with a focus on establishing the efficacy of digital health assessments and interventions. This research has demonstrated that digital health technology can be used to passively monitor clinical states  and reduce symptoms. However, with few exceptions, the majority of NIMH funded research in digital health technology has not moved into or beyond the effectiveness stage of research. In contrast to the federally funded mental health research, the pace of commercial technology development moves rapidly and over the last 5 years commercially available digital health platforms for mental health have gained considerable traction in the marketplace. Current estimates suggest that greater than 25% of commercially available digital health apps  focus on mental health and a significant cross section of consumers (est. >25 million) are regularly utilizing digital health technology to access treatment for mental health. As digital health technology for mental health is being increasingly used to provide standalone self-managed interventions and/or to supplement in-person treatment, well-designed research is necessary to evaluate the effectiveness of existing digital health technology.

This initiative would encourage research that promotes partnerships between academic investigators and well-established digital health companies. Existing digital mental health platforms will be used as research test beds, will be required to have large user bases (>100k users), and will include evidence based mental health interventions  and/or assessments. These partnerships will enable research to be conducted with large samples of participants and will leverage existing digital health platform infrastructure. It is expected that these partnerships will enable both nimble studies to rapidly test ideas and conduct exploratory research as well pragmatic trials of digital health interventions. The general scope of research would include developing and testing:

1. Strategies to increase the reach, efficiency, and quality of digital health interventions;
2. Factors related to engagement, uptake, and sustainability of digital health platforms;
3. The effectiveness of digital health platforms to optimize the benefit of in-person treatment and bridge therapy sessions and promote between-session skill practice/acquisition;
4. Technology driven approaches to improve access/engagement and continuity of care during known periods of heightened risk (e.g., handoffs between emergency departments and inpatient psychiatric; transitions between primary care settings and outpatient mental health programs).