December 16, 2020, OAKLAND, Calif. -- Kaiser Permanente physicians and therapists now have the ability to refer their patients to evidenced-based mental health and wellness apps through the organization's electronic health record system. With a simple referral to an app, Kaiser Permanente patients can begin using it on their own or under the guidance of a clinician -- at no cost.
A new case study shows that patients are more receptive to using mental health and wellness apps and feel better when referred by a clinician. These are among the takeaways published in the January 2021 issue of NEJM Catalyst Innovations in Care Delivery. This case study provides important learnings to support the integration of mental health apps in care and expand patient engagement with digital tools as part of their overall treatment plan.
"What we're tapping into is the existing relationship people have with their Kaiser Permanente therapist. We know that our patients are more likely to use these digital resources if their provider refers them," said Don Mordecai, MD, national leader for mental health and wellness at Kaiser Permanente. "Digital therapeutics such as mental health apps have a clear place in a care plan and it's very exciting to be on the forefront of this."
In 2018, Kaiser Permanente began providing patients access to apps by simply signing in to their kp.org account. The organization also trained clinicians on the use of the apps, workflow, documentation, and evidence-based best practices. Following the rapid expansion of the app referral effort earlier this year, clinicians referred 44,000 mental health care patients to the digital tools. More recent data shows app referrals have increased to 115,000, and the number continues to grow.
The role apps play in an overall treatment plan
The pandemic is taking a toll on Americans' emotional well-being. The prevalence of depression symptoms in U.S. adults is 3 times higher than before the COVID-19 pandemic began. When mental health issues are left untreated, they can get worse. Digital apps for mindfulness, meditation, and cognitive behavioral therapy can offer significant help for patients with mild-to-moderate anxiety or depression.
The case study showed promising results that more patients use the apps when referred by a clinician than if they had to seek out apps on their own. The apps Kaiser Permanente offers in clinical settings include Calm, Headspace, and Whil -- mindfulness and meditation apps aimed at reducing stress and anxiety, and improving sleep -- and myStrength, SilverCloud, and Thrive -- cognitive behavioral therapy apps providing higher-touch guided support through interactive activities and/or coaching. All of these apps are secure and confidential and available to Kaiser Permanente members at no cost to them. Adult members can access Calm and myStrength through kp.org without a clinician's referral.
"I suffer from anxiety. I cannot stop thinking," said Kaiser Permanente member Rosa Salguero-Rodriguez. "So, I started using Calm. I practice the sessions like breathing and gratitude, and morning exercises and stretching. Now, I can relax more and sleep better."
While Kaiser Permanente digital self-care resources do not replace treatment or clinical guidance, they provide additional support.
"It's been amazing to watch patients' progress just by using the apps in between sessions," said Leigh Miller, a Kaiser Permanente clinical social worker who offered feedback during early testing. "We found that these tools really enhanced how we support our patients' mental health and we are thrilled to see the positive changes in our patients."
Ongoing commitment to mental health and wellness
Kaiser Permanente's focus on encouraging members to use self-care apps is part of its ongoing commitment to addressing the mental health and wellness needs of its members and communities. Kaiser Permanente offers mental health care focused on early intervention, personalized treatment, patient empowerment and support, and the latest innovations in care delivery, including virtual care.
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Anyone can access the range of mental health and wellness resources Kaiser Permanente offers on kp.org, including articles, videos, and exercises, now also available in Spanish. In the spring of 2020, Kaiser Permanente began offering Calm and myStrength to its members at no cost and without a referral. Members must be registered on kp.org and can get started with Calm and myStrength by visiting kp.org/selfcareapps. The other apps mentioned in this release require a referral from the patient's mental health clinician.
About Kaiser Permanente
For 75 years, Kaiser Permanente has been committed to shaping the future of health and health care -- and helping our members, patients, and communities experience more healthy years. We are recognized as one of America's leading health care providers and not-for-profit health plans. Since July 21, 1945, Kaiser Permanente's mission has been to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve. We currently serve 12.4 million members in 8 states and the District of Columbia. Care for members and patients is focused on their total health and guided by their personal Permanente Medical Group physicians, specialists, and team of caregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the-art care delivery, and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education, and the support of community health.
Journal
NEJM Catalyst