Digital Clinic — Division of Digital Psychiatry

What is the Digital Clinic?

The Digital Clinic is a fully operating therapeutic clinic integrating technology from smartphone apps and sensors into outpatient visits to improve care. Patients meet regularly with a clinician and use the mindLAMP app between visits to monitor symptoms, access tips and resources, and complete clinician-assigned exercises.

Patient-Centered

Patients are provided with skills and a toolkit to manage their symptoms beyond the short-term care context. The patient-driven approach aims to teach patients to manage their own emotions.

Accessible

Totally cost-free with fully remote sessions. Targeted therapy is provided in a brief (6-7 sessions) structure. Digital Navigators (DN) guide patient engagement and are able to provide support with technology.

Data-Driven

Surveys and various aspects of behavior and device use are collected and monitored through mindLAMP. This data is then fed back to the patient and clinician by the digital navigator to inform shared clinical decision making.

Evidence-Based

The therapy modules and mindLAMP resources and activities are informed by a growing evidence-base, utilizing CBT and Unified Protocol principles and techniques.

The Need

As demand for mental health care rises, the limited supply of clinicians makes it difficult to meet the need for services. To increase supply, there must be innovation in both workforce capacity and digital solutions. But innovation must not come at the price of reduced quality of care because the need to balance access and quality requires more than offering self-help applications (apps) or coaching.

Toward exploring one such solution, the authors describe the Digital Clinic, a model of hybrid synchronous and asynchronous mental health care led by a licensed clinician. (Although they developed a treatment manual to address mental health, the Digital Clinic care delivery model can be applied to other areas.) To increase access and quality, they integrated into treatment a smartphone application offering digital phenotyping and digital interventions, as well as a new care team member, the Digital Navigator, to collectively support engagement, digital equity, and clinic integration.

How does the Digital Clinic operate?

Patient meets with clinician over 8 weeks via telehealth therapy.

Outcomes for the Digital Clinic

GAD-7 (8 Visits)
PHQ-9 (8 Visits)

Mean PHQ-9 scores and GAD-7 scores for the cohort that completed all eight visits. Lower scores indicate improvement.

Technology & Data

mindLAMP app

Digital phenotyping data from smartphones and wearables offer a powerful avenue to enhance clinical care by capturing real-time, ecologically valid metrics such as GPS, actigraphy, and sleep patterns. These data hold immense potential for optimizing personalized treatments and detecting clinically significant changes in disease processes. However, widespread impact is limited by the specialized expertise required to process these datasets and the lack of user-friendly tools to derive actionable insights. At the Digital Psychiatry Division of Beth Israel Deaconess Medical Center, our team has advanced this field by developing mindLAMP, an open-source platform for collecting and analyzing behavioral data, and its analytics suite, Cortex.

Data sharing Reports

Designed to provide clinicians and patients with more valuable insights in a concise and efficient format, the current report is generated using Python.

Various visualization tools are utilized, including line graphs to track the changes of the daily or weekly active survey scores, bar graphs to illustrate the activity counts, a correlation matrix to explore the relationships between the phenotyping and psychopathological features, and polar graphs to show further relationships chronologically.

The report is shared with clinicians and patients during weekly clinical and digital navigator meetings, providing ongoing care and support and facilitating the efficiency of digital clinics. This report develops a clearer and standardized approach to provide a consistent framework that enhances efficiency and ensures duplicability across different projects.