If you like the technology, invest in the firm

Over the past year, the University of Pittsburgh Medical Center forged partnerships or made investments with more than a dozen startup firms offering technological solutions that expand patient access to healthcare.

While most focus on expanding primary care options, often using different types of telehealth, a few have explored online options for offering behavioral health and other specialty services. “We started looking at what are the other specialties and subspecialties that we thought might be next that most lent themselves to creating better access virtually and through digital technology,” said Mark Stabingas, executive vice president of UPMC Enterprises.

Last February the system invested $17 million in San Francisco-based startup Lantern, which is developing an online cognitive behavioral therapy platform. UPMC clinicians worked with Lantern on a pilot program that integrated its platform into the health system's primary care settings.

The software gives primary care clinicians a tool for treating patients with mild to moderate mental health issues without having to refer them to a behavioral health specialist, a process that can delay treatment for weeks or months.

Here's how it works. Patients coming to visit a primary care physician get screened through a survey. If the answers indicate a possible need for behavioral healthcare services that can be addressed with the use of Lantern's online cognitive behavioral therapy software, the electronic health record sends an alert to the physician.

The doctor has the option of discussing with the patient the possibility of using Lantern to address their issues. If the patient agrees, he or she is given directions for online access. When he or she begins using the software, the physician gets an alert, which enables him or her to monitor their progress.

“One of the keys is to have a tight integration and connectedness with a clinician in a closed loop that allows them to understand how the patient is progressing,” Stabingas said.

UPMC has been encouraged by preliminary results that show a high completion rate for the program. No results have been published.

The system plans to make Lantern available for patients at its irritable bowel disease clinic later this year. “The feedback so far has been quite strong,” Stabingas said.

A growing number of hospitals and health systems are looking at adopting online tools like Lantern to deliver behavioral healthcare services. It addresses the rise in demand by patients in an environment where there is a growing shortage of psychiatrists and counselors capable of meeting that demand.

“With these digital tools you're not geographically bound anymore,” said Peter Kung, system vice president of innovation and virtual health at SCL Health, a 10-hospital network based in Denver. ”As we move to value-based care and as our incentives become aligned to those models, it starts making sense that you have to start taking care of people beyond our four walls.”

By investing in such start-ups, UPMC and other systems are hoping to reap financial rewards as well as clinical benefits. “Health systems that are investing in early-stage companies (are) hoping to capture a piece of the upside on the company's potential,” said John Fryer, a senior consultant with national healthcare strategic firm ECG Management Consultants.

But investing in digital technologies requires risk capital, and it's usually only larger health systems have the capacity to take on the financial risk. Others have turned to consulting firms that specialize in vetting start-ups on behalf of a consortium of major providers.

Avia, Modern Healthcare's partner in the Transformation Hub, is one such firm. “It's an interesting approach that has grown like crazy over the past year,” ECG's Fryer said.

“Hospitals and health systems are traditionally very risk adverse organizations,” Fryer said. “So they're always looking for ways that they can reduce their exposure – it's kind of a different approach from the home-grown philosophy that propagated in healthcare.”