Mental healthcare is increasingly in focus worldwide. Mostly, it is due (and thanks) to an important and positive trend taking place \u2013 the destigmatisation of issues related to this area of life. We\u2019re becoming more aware of how these problems affect our existence and those around us. Also, we now better understand what role digitalisation plays in this respect.<\/p>\n
Although innovation may have disrupted a number of consolidated ways of approaching life events, risks, and people, it can also offer solutions that dramatically increase our mental well-being. Ready-to-use and quick means of communication can bring us closer to others\u2019 need for empathy and interaction. Digital solutions can support the work of healthcare professionals towards\u00a0providing a more patient-centric, personalised treatment<\/strong>\u00a0of mental disorders. Such is the paramount goal of Estonian company\u00a0DocuMental<\/a><\/strong>, founded by award-winning psychiatrist\u00a0Dr Eduard Maron<\/strong>.<\/p>\n The current framework in mental healthcare presents several issues with diagnostic and treatment. At a glance, as summarised from the\u00a0call-to-action<\/a>\u00a0co-signed by Dr Maron:<\/p>\n DocuMental<\/strong>\u00a0recently gained access to funds up to \u20ac 75 000 from\u00a0EIT Health<\/a><\/strong>, the largest public-private European consortium for healthcare innovation. Selected among a pool of 104 applicants, the company led by Dr Maron is now looking forward to filling the care gaps that currently haunt everyday practice in mental health. In our insightful compelling interview, Dr Maron tells us how digitisation can help both patients and specialists in their path towards better treatment of mental disorders.<\/p>\n Unfortunately, current mental health services across the world remain expert-centric and associated with\u00a0high rates of misdiagnosis and mistreatment<\/strong>. In other medical disciplines, diagnosing and treatment plan are based on highly sensitive and specific tests and technical solutions. Psychiatry, instead, is still positioned as a \u2018medical art\u2019. Practitioners engage in initial clinical impressions usually during the first minutes of interviewing or observation, and these often predetermine final decisions in terms of diagnosis and treatment choice. Despite the availability of internationally accepted diagnostic and treatment guidelines for mental disorders, the rates of adherence among clinicians to these standards remain low.\u00a0This is largely due to<\/strong>\u00a0traditional workflows<\/strong>.<\/p>\n Mental health teams are required to manage\u00a0very high case loads<\/strong>\u00a0and to put\u00a0great effort on documentation<\/strong>, but as a result they spend less time with patients and may not pay enough attention to\u00a0data quality, diagnostic, and treatment reliability<\/strong>. Psychiatrists are supposed to reach the most appropriate conclusions about diagnosis and treatment plan within short consultations \u2013 45 minutes for the first contact, 15 minutes for follow-ups. Such time pressure may lead to lapses in the assessment process, medical errors and unreliable decisions. In particular, not observing properly diagnostic and treatment guidelines raises risks.<\/p>\n We already entered the digital area, starting the transformation of mental healthcare from paper-based to electronic health record (EHR) systems. However, to this day, only 61.3% of psychiatrists use any type of EHRs, with only 40.8% of them using certified systems. The rest still uses paper-based documentation. Moreover, the existing EHRs in mental health services are mostly designed to support administrative needs and case loads. Better outcomes definitely require more focus on decision making.<\/p>\n Our recent survey among European psychiatrists showed that the existing EHRs in mental health are:<\/p>\n To this, add a general resistance to meaningful data tracking and searching. Users increasingly perceive these limited functionalities and traditional patterns in workflow as a serious disadvantage in making appropriate and informed decisions for diagnosis and treatment.<\/p>\n Further digitalisation of current mental healthcare means, first, the\u00a0implementation of decision support systems (DSS)<\/strong>. Improving both diagnostic and treatment standards, they contribute to the\u00a0personalised care and management<\/strong>\u00a0of mental problems. The issue is that, to date, there are no well-designed reports on the potential of such applications and methods.<\/p>\n The recent feasibility assessment of\u00a0DocuMental<\/strong>\u00a0as a DSS, carried out among an international network of experienced clinicians from 14 countries, gives hope in this direction. We concluded that the\u00a0diagnostic verification, treatment guidance, and data collection<\/strong>\u00a0provided by DocuMental significantly\u00a0improved and secured clinical workflow<\/strong>. This includes also assessment and management of mental disorders, and meeting the needs of patients and services. We see a higher diagnostic accuracy, guided treatment choice, and higher time-effectiveness due to automated documentation and quicker overview.<\/p>\n DocuMental<\/strong>\u00a0is a clinical DSS, purposefully designed for diagnosis, treatment and management of mental disorders. It is an impactful and innovative contribution to the\u00a0digitalisation of clinical workflows in mental health<\/strong>. To our best knowledge and based on our competitive analysis, DocuMental is the only clinical DSS with digitised and structured ICD-10 diagnostic criteria for all mental disorders. It also provides clinical presentation to treatment register tracking medication choices, and management of care plans in a standardised way.<\/p>\n According to specialisation level and tasks, DocuMental suits a broad range of primary users involved in mental health services provision. Clinicians, nurses, psychologists, social workers, care-coordinators and healthcare managers, they all can benefit from its use. It also provides access for patients to\u00a0support bilateral communication<\/strong>\u00a0with mental health teams and services.<\/p>\n It seems a very complex and multi-layered problem, where there\u2019s no existing single solution to solve it. \u00a0For example, the\u00a0median treatment gap in Europe for major depression is 45%<\/strong>, ranging from 36% in the Netherlands to 73% in Finland. No doubt that Finland is one of the leaders worldwide in digital innovation for healthcare, so\u00a0it\u2019s not just about digitalisation in itself<\/strong>. The problem calls for new approaches to deliver care and support for people with mental disorders and needs. But first, a change of heart in our attitude is necessary.<\/p>\n Fears, biases and a certain resistance towards digital solutions were well present until recently. And it was all coming from mental health practitioners. Fortunately,\u00a0a new understanding<\/strong>\u00a0and system of priorities marked a dramatic positive change. This is mostly due to political will, but also to the\u00a0involvement of patients\u2019 organisations<\/strong>. From clinicians to patients and authorities, we\u2019re all starting to recognise that mental health systems need to provide\u00a0more precise and personalised diagnosis<\/strong>, treatment and management of mental disorders.<\/p>\n We need a shift from traditional, outdated approaches and, as clinicians, we should accept\u00a0digital solutions as a valuable ally<\/strong>. They don\u2019t diminish or replace our professional skills, but help us instead put them to good use in full accordance with international quality standards. Digital mental health is the only\u00a0effective solution to close current gaps in patients\u2019 needs<\/strong>\u00a0for accessible support, personalised care, and better outcomes.<\/p>\n Patient-centric mental healthcare is our ultimate goal and a near reality, and not just because all countries are facing scarcity of specialised human resources.\u00a0Patients and their representatives<\/strong>\u00a0take more and more an active role practically in all respects. From legal issues to data access and protection, as well as regarding the collaborative design of digital solutions. By introducing new approaches, such as digital phenotyping, they become\u00a0active players in health management and care plan<\/strong>. It\u2019s important, and it\u2019s the right direction towards more precise and personalised medicine.<\/p>\n All the possibilities are there. But to assure the implementation of preventive and more proactive approaches, we need close collaboration with patients and their representatives. For example, in our case, pan-European patient-driven organisation\u00a0GAMIAN<\/a>\u00a0is a member of DocuMental\u2019s scientific committee, helping us in designing the most suitable solutions and approaches to meet patients\u2019 needs.<\/p>\n This very important recognition shows that what we are doing has potential and is needed. We take our development and business plan realistically, we know that replacing all existing EHR systems is unlikely. Our goal, instead, is to\u00a0fill the gap in their missing functionalities via\u00a0interoperability standards<\/a><\/strong>, enabling the integration of DocuMental with the current EHR systems. In this way, we ensure the implementation of digitised guidelines and personalised approaches in everyday practice.<\/p>\n We are\u00a0currently testing this scenario<\/strong>\u00a0in Estonian psychiatric clinics, and planning then to implement our integrated solution more broadly. In the long run, in full accordance with the strategic objectives of EIT Health, we are aiming to:<\/p>\n\n
Dr Eduard Maron, Psychiatrist and Founder of DocuMental<\/h2>\n
Are there any dysfunctional patterns in traditional practices in mental health? What\u2019s \u201cwrong\u201d with the current disease management, from diagnosis to treatment?<\/strong><\/h3>\n
Why does this field need to be more digital? What are the advantages?<\/strong><\/h3>\n
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So what is DocuMental, and who is it meant to be used by?<\/strong><\/h3>\n
There are gaps between the need for treatment and service provision. These\u00a0care voids<\/em>\u00a0span across countries too, generating inequalities in the treatment of severe mental disorders. How can a shift to digital mental health tackle these problems?<\/strong><\/h3>\n
From this conversation, it seems that mental health services have yet to become fully patient-centric. What steps lie ahead towards more precise and personalised approaches?<\/strong><\/h3>\n
DocuMental recently received funding from EIT Health, the EU consortium. What\u2019s the action plan from now on?<\/strong><\/h3>\n