Trina Histon joined Woebot Health as our Vice President of Clinical Product Strategy after 25 years at Kaiser Permanente. Since then, Trina has talked with numerous health systems to help them design and integrate behavioral health tools in clinical care. Trina shares insights and looks ahead to a new year where evidence-based digital tools are increasingly used to augment care. 

It’s a new year. Let’s get straight into it. What do you see ahead in 2024?

New models of care will emerge. Right now we’re kind of embedding digital tools into existing structures. We have to think about how new roles like digital navigators and technical consultants can help us find ways to reach people in more non-traditional ways. How do health systems form a connection with patients and how can they be a warm touchpoint along the way? The opportunity is in understanding where the human is very important, and where AI tools can be an extender. The power lies in leveraging that synergy to support the person who has the need. 

What’s a consistent theme you’ve heard health systems talk about in the last 12 months?
The reality that we can’t recruit our way toward meeting the demand for mental health care. We have nowhere near the number of clinicians we need given demand. I’ve had lots of conversations about how to augment care with evidence-based digital solutions in a responsible way, so that we can deliver a good user experience when the lights are off in a medical office building. Many of the conversations have centered on access pain points and how support that is 24/7 is an important way to meet a wider range of patient needs.

What advancements in mental health have you seen?
There’s a growing acceptance that digital tools are here. More clinicians are curious and asking questions. The conversation has shifted to how do we innovate and show up differently and leverage humans and digital tools, together. The value of digital is actually reaching and connecting and supporting a person long before they’re at a point of crisis. And that’s the other thing that is beginning to change. I’ve heard more people talk about going upstream. So I would say there’s been broader acceptance that digital is here and there are good tools that people can leverage. Enablement is still an evolving space, but there is a growing expectation regarding interoperability. It is important to have a launch point for health care clients who are starting to deploy digital tools, along with deeper integrative capabilities.

What do we need to improve on?
What hasn’t changed is the complexity of who pays. And I think what drives some of that is a lack of common metrics that matter, not just to healthcare organizations, but to patients. Often in the clinical realm patient drivers don’t even get touched on. I think that needs to change. We need to have a more holistic measurement set. 

Looking back, that was quite a job switch. What surprised you most?
It’s been a 180-degree experience going from working in an integrated delivery system and  integrating digital tools into care to being in industry and understanding what it takes to deliver digital mental health tools for different types of healthcare clients. The consistent thing is I continue to get to work with amazing clinical teams who really want to give their patients and clients tools that work. Payors are also keen to offer more digital solutions to their members that add value. The context of deployment remains a key fulcrum from which to operate: who is introducing the tool, how easy is it for the user to access it, and how are they finding value. 

What advice do you have for health systems in 2024? What are the top things they need to focus on to provide whole health care?

I think we will see a deeping on a number of areas that have emerged post-pandemic. Personally, I am excited to see an ever growing recognition of the social determinants of health. I can see even more work in 2024, not just assessing SDOH needs but ecosystems of solutions to meet those needs to support whole person care. NCQA’s HEDIS measures for behavioral health continue to evolve as well, with 30 percent of metrics focused on these areas. These measures relate to adults and adolescents, and I’m excited about the potential role that digital tools can play in supporting response and remission for those experiencing symptoms and emotions associated with depression and anxiety. 

Overall, mental health needs will continue to grow and be a focus area for healthcare and employers alike. The application of AI as a partner to meet this growing need will also be a feature in 2024. Health systems are already exploring how and where AI can best support care. While early focus has been on administrative burden elimination, use cases will also emerge in clinical practice. We’re already seeing frameworks and principles for use being established, and I see deepening ethics, privacy and security frameworks as being table stakes for delivering value.