Oncology start-ups leverage data to develop predictive analytics and personalized treatments. Can therapy do the same?
The algorithm knew that Nancy was depressed before she did. A Medicare patient, she was aging and had been diagnosed with diabetes. She felt isolated from others and was mourning the loss of her spouse. The remote mental health start-up AbleTo, meanwhile, had begun employing analytics across a database of patients, a campaign that pinged Nancy as someone who was likely to have undiagnosed depression because of how her disease had progressed. When AbleTo contacted her, it became clear that the algorithm was correct.
“She was so overwhelmed, her depression interfered with the management of her diabetes,” Jason Goodhand, AbleTo’s vice president of product management, told Healthcare Analytics News™. The clinical team confirmed a diagnosis of moderate depression. Then, using cutting-edge technologies and evidence-based therapies, AbleTo tailored a program to confront Nancy’s aging, depression, and diabetes monitoring.
Before long, she graduated from the behavioral health company’s 8- to 12-week diabetes program. She had engaged with her care team and learned how to get through perhaps the most difficult period of her life. All the while, she underwent treatment from home, dodging the stigma associated with therapy. But it was the algorithm, designed to identify people with undiagnosed co-morbidities, that made it possible. “We may not have kept her in treatment if we jumped to only focusing on her health or her disease and not her lifestyle factors,” Goodhand said.
AbleTo has made headlines for its venture capital, high-profile leaders, and status as a growing force in telehealth. What has gone mostly overlooked, however, is the organization’s bent on predictive analytics and personalized medicine. Just as oncology analytics start-ups Flatiron Health and Cota are harvesting insights from sprawling data sets to combat cancer, AbleTo is doing much the same for behavioral health.
The effort requires a partnership between data scientists and clinicians, and it’s meant to spur greater value and better outcomes. The problem at hand is large: 1 in 5 adults suffer from mental illness, and at least half don’t get the care they need. The number of American adults with a chronic condition and a behavioral health condition, meanwhile, is roughly 34 million, running up an avoidable annual tab of roughly $300 billion, according to AbleTo.
The New York City-based start-up partners with health plans and larger employers to identify people with a condition like diabetes and a co-morbidity such as anxiety or depression. From there, it structures a treatment plan designed to far outrun the traditional 1- to 3-session path traveled by most brick-and-mortar therapists, facilitated by a remote clinical team.
“We have taken decades of clinical research and put that intelligence into our platform,” said Aimee Peters, MS, chief clinical officer of AbleTo.
AbleTo examines its variety of data sets—medical, behavioral, lifestyle, cultural, regional, and demographic—to view population subgroups and how they respond to treatment. Claims data offer many insights to the company, and so do its own outcomes data. It all adds up to the ability to inform patient treatment pathways before treatment starts and halfway through the process, Peters said.
The result: More than half of patients make it through an 8-week therapy program, with a 95% satisfaction rating, according to the company. “Tens of thousands of patients” have completed AbleTo programs, adding to a trove of data that includes billions of data points.
After treatment ends, about 3 to 6 months later, AbleTo checks in with its graduates. That contact furthers its outcomes-driven mission by compiling even more data—and it also allows patients to undergo additional sessions if necessary.
The key, Peters and Goodhand said, is the connection between data scientists and clinicians. Their start-up marriage is built on evidence and adaptation. “You reach the patients at the right time, and that really is a good combination for scaling a solution like ours to the patients who need it,” Peters said.
In old-school therapists’ offices, there is often no standardized battery of assessments, she noted. That means, if you’re lucky, your therapist does a 1-paper rundown to make sure the diagnosis is clear, and then care shifts to focus on the problem of the week, conveying the typical image of a patient spread across a couch, opining about their parents, and a provider who’s bucking the tenets of cognitive behavioral therapy.
Goodhand recalled an AbleTo patient who underwent that sort of unstructured therapy in the past, leaving a sour taste in his mouth. Despite the man’s hesitance, the data- and action-oriented nature of AbleTo’s regimen proved important to him. “He had 2 or 3 kids and a long commute. He just didn’t have a lot of time,” Goodhand said. “But because of AbleTo’s structure and delivery, he got a lot of value for a lot less time than he was investing previously.”
All of this is not to say that AbleTo has conquered the world of mental health. Stigma still plagues the landscape, and the company’s leaders acknowledged that progress must continue in this area. But AbleTo’s advantage is that patients can connect with care at home, away from prying eyes.
What’s more, it’s natural to wonder how patients with mental illnesses might feel about data collection at such a large scale. This sort of tracking, it seems, might scare them off, or even feed into their existing health issues. AbleTo confronts this problem by being upfront about its data gathering. The clinical team has found that patients approve of the monitoring, as the system helps them set and meet goals. “Tracking is an asset,” Peters added. “It helps patients stay engaged and is a desired part of their experience with us.”
Perhaps the data’s utility becomes most obvious when AbleTo is courting a prospective patient tapped by its predictive algorithm. The engagement team can say that the company has helped people like them, and most saw this sort of result after 8 weeks. Then AbleTo can tout the scale at which it has delivered this care—and this outcome.
“That’s very compelling,” Goodhand said. “We’re not going to talk forever and cry on the couch. There’s a plan, and we’re going to get you there.” That’s also true of AbleTo at large: There is a plan, and it’s going to be the data, analytics, and clinicians that get it there.