The behavioral health industry’s use of technology has lagged behind other segments of the health care sector. Two of the industry’s biggest providers want to change that track record.
LifeStance Health Group Inc. (Nasdaq: LFST) and Acadia Healthcare (Nasdaq: ACHC) are taking different approaches to developing their digital strategies. However, both are exploring AI and other digital tools, while also ironing out pain points among clinicians and patients.
“The behavioral health industry is very ripe for automation and technology because it has traditionally been a paper-based, manual part of health care,” Laura Groschen, chief information officer of Acadia, told Behavioral Health Business. “Acadia Healthcare is committed to investing in technology to really focus on two things: our patients’ experience and all our clinicians who are helping our patients.”
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Acadia operates a network of 253 behavioral health care facilities in 38 states and Puerto Rico, as of December 2023. The provider claims to be the largest stand-alone behavioral health care company in the U.S., with approximately 23,500 employees who serve over 75,000 patients daily.
Acadia’s Q1 revenue in 2024 totaled $768.1 million, a 9.1% year-over-year increase. The provider has also spearheaded an aggressive five-point growth strategy, consisting of facility expansion, de novo growth, joint venture partnerships, acquisitions and expanding its care continuum.
LifeStance is also identifying ways to help patients and clinicians as it rolls out an updated digital strategy.
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“It’s about improving access to mental health through technology and trusted, affordable care,” Pablo Pantaleoni, chief digital officer of LifeStance, told BHB. “It’s all about making sure that through the tools, we can make clinicians more efficient, and get rid of all the tasks that are not adding value to them so they can focus on patient care.”
LifeStance operates approximately 550 centers in 33 states and employs around 6,800 psychiatrists, advanced practice nurses, psychologists and therapists.
The provider has increased its revenue year-over-year and reported total Q1 revenue of $300.4 million in May. The results follow the closure of 82 clinics and a pivot away from M&A, which executives announced in February.
Digital strategies
Acadia’s digital strategy consists of two key pillars: modernity and security, and digital experience.
Its modernity and security push ensures Acadia has the technology to help patients and ease team members’ experiences.
This includes implementing an electronic medical record (EMR) in its acute service line, which currently operates on paper.
“While we’re implementing all that technology, we’re focused on ensuring our defensive posture is current and secure so we can continue to make investments in this space,” Groschen said. “One of the things we do in the secure space is a whole training program for our team members.”
The training program includes regular phishing exercises for employees and monthly training sessions. The monthly training was implemented this year and can include, for example, education on what a good password is.
The digital experience pillar involves automating and simplifying for all stakeholders across the company.
“[It’s] treating data and information as an asset that we can leverage to streamline and strengthen both the patient and the team member experience,” Groschen said.
Examples of this pillar include Acadia’s enhancement of its patient intake and admissions process. These processes were traditionally manual, so the company simplified the process using technology solutions.
LifeStance’s digital strategy involves an evolution from telehealth to fleshed-out digital care.
Dr. Ujjwal Ramtekkar, LifeStance’s chief medical officer, previously told BHB that the provider currently operates using telehealth and some virtual care, but is using a stepped approach to a digital health strategy that is a “full extension” of its current capabilities.
The provider’s digital health strategy involves thinking about the “whole journey,” Pantaleoni elaborated to BHB.
“It’s the whole patient journey and clinician journey, and thinking about how we can better support with different tools at different parts of the journey,” Pantaleoni said. “Meaning not just the visit itself, but way before somebody realizes that they need support. Or way after, not just in between visits.”
This strategy also includes support for patients even months after their last visit.
LifeStance strives for its telehealth patient experience to be consistent with an in-person visit, Pantaleoni said, and allows patients to easily switch between telehealth and in-person care.
The provider has mapped its patient journey and identified a few key pain points ripe for digital innovation.
One pain point was matching patients with clinicians. To improve the experience, LifeStance built two different tools, one that is online and another in which patients can call a person who can guide them through the matching process. The process of building these tools was extensive.
“We interviewed hundreds of people, between clinicians and patients,” Pantaleoni said. “ We even decided to think about all their industries, even testing dating apps. … Because if you go online and try to find a clinician, it’s always the same thing. The insurance, where you are located, it’s ABC. When we’re talking about behavioral health, … there needs to be this connection. Because it’s all about building trust. It’s all about building confidence. And that’s how we build this algorithm.”
As part of its initiative to support patients before, in between and after visits, Pantaleoni is considering a variety of different tacks.
“It’s about offering the right support at the right time,” Pantaleoni said. “Maybe it’s a library of different tools for the patient to go and self-serve. Maybe it’s the opportunity to chat with somebody using, eventually, a chatbot. … [or] digital therapeutics as well.”
However, offerings like a chatbot would never replace a clinician, Pantaleoni emphasized.
Leveraging AI
Both LifeStance and Acadia are exploring the use of AI in clinical documentation.
AI-enabled programs can reduce clinicians’ documentation time by around 70%, according to the American Academy of Family Physicians.
LifeStance plans to launch a technology pilot that listens to a clinician’s conversation with a patient, transcribes, and integrates into the EMR, “pretty soon.” Clinicians can then read, edit and publish the AI-generated note.
The provider will collect de-identified data from these notes.
“As we collect all this data, we can get smarter and help people in different parts of the journey, both patients, clinicians, as well as team members,” Pantaleoni said.
Acadia has already embarked on a trial of ambient documentation for physicians and is currently testing the technology at three of its locations.
The pilot is part of Acadia’s “AI roadmap.”
The roadmap spans its business functions, including HR uses and the patient care continuum. Along with the note-taking tech, Acadia has also implemented a pilot to collate a knowledge base of its own data to help with grant writing and another pilot designed to help predict possible patient relapse.
“We’re progressing [the roadmap by] creating an innovation council,” Groschen said. “It won’t be just focused on AI, but all forms of innovation that we can use to catapult ourselves in the industry on the premise of better patient care, better quality outcomes.”
While testing AI use cases, Acadia has also developed an appropriate use policy for AI.
The policy involves restrictions on the usage of PHI data and requirements for team members to regularly review algorithms and AI output.
“Yes, AI is great, but we all know with any technology, it can’t just operate on its own,” Groschen said. “You have to have someone watching over it, especially the space of AI.”
When (not) to consolidate EMRs
EMRs have become commonplace in physical health care, but adoption has lagged behind in the behavioral health industry.
The Health Information Technology for Economic Clinical Health Act (HITECH Act) of 2009 provided incentive payments for many health care providers to adopt EMRs. Behavioral health providers were excluded from these funding opportunities, resulting in persistent usage of fax machines, pens and papers.
Still, many behavioral health providers have now pivoted to more tech-savvy systems.
LifeStance operates using one EMR, one phone system, one email system and a single enterprise data warehouse, of which Pantaleoni says he is very proud.
The provider’s EMR offers patients helpful digital tools, including clinician messaging and an online payment portal, in addition to collating data.
Unlike LifeStance, Acadia is not interested in completely consolidating its EMRs.
Acadia has four service lines: acute care, specialty care, residential treatment centers (RTC) and comprehensive treatment centers (CTC).
Its acute service line currently operates on a paper-based medical record. Rolling out a digital offering is a priority, Groschen said.
“I don’t know that we need to get to one [EMR], but I would like to ideally, possibly be at two,” Groschen said. “Three of our four service lines are pretty similar in nature. Yes, they have variations, but there is similarity between our acute, our specialty and our RTC. When you look at our CTC business, which is really about opioid use, a traditional EMR can be a technology-heavy solution, and I think that might be too much.”
The provider has previously announced plans to integrate its service lines to improve cross-selling, but technology integration needs to be deployed in the right circ*mstances, according to Groschen.
