There are more than 22 million veterans in the United States, 2.7 million of whom have recently returned from active service in Iraq and Afghanistan. This surge of veterans in the past two decades is significant, surpassing the the 2.6 million veterans who returned from combat in Vietnam.
Numerous obstacles threaten the health of this rapidly growing population.
Research has repeatedly shown veterans are especially at risk for a variety of mental illnesses and have a strikingly high suicide rate. Despite efforts to connect this population to evidence-based mental health services, attitudes towards treatment often result in avoidance or discontinuation of care. In fact, 50% of veterans with PTSD do not seek treatment, and only half of those who do receive “minimally adequate” treatment.
Avoidance or discontinuation of care in veteran populations is a critical concern and one that is growing in importance as research constantly validates the positive impact of early recognition of mental-health disorders.
Failure to intervene early can have devastating effects: hindering veterans from reintegrating into their communities, raising the incidence of chronic mental illness and exacerbating suicide risk, among other negative scenarios.
As more individuals join the military and more veterans return from active service, developing innovative treatment programs to better serve this at-risk population is paramount.
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Better Standard of Care
In hard-to-engage populations with high treatment-attrition rates, novel, engaging technologies that augment standard care have immense potential.
The Department of Veterans Affairs (VA) and Cogito Corporation have partnered to deliver treatment based on innovative technology. The VA is offering to a large group of veterans a Cogito smartphone application that gathers validated behavioral indicators and provides feedback through an engagement-increasing interface.
The application, Cogito Companion, utilizes built-in phone sensors to perform non-invasive, real-time behavioral signals analytics. The app also analyzes voluntarily recorded audio diaries, detecting “honest signals” transmitted through the human voice to deliver accurate and immediate reports on mood.
The VA can then pass the behavioral information Cogito Companion collects along to clinicians so that they can track patient health longitudinally and in real-time. As opposed to the episodic feedback veterans receive from limited in-person visits with clinicians, the app allows patients to benefit from real-time, continuous feedback. Passive data collection does not burden patients and is free from self-report, which is subject to biases.
Increased Patient Engagement
Patients can use the application to improve self-awareness and self-manage symptoms. This increases their engagement in their own treatment and helps them seeking help when care is required.
Care providers can monitor the behavioral indicators and mood of their patients over time, using this information to better assess a patient’s mental health, implement outreach strategies to potentially at-risk veterans, and provide better informed clinical care. Both patients and care providers can use behavioral data to recognize more objectively and definitively when they need to seek additional services.
Cogito Companion is highly scalable. Though the VA is starting out by using the app with large groups of veterans at two locations, it is feasible that all veterans and their care providers could integrate the technology into their workflows in years to come.
Furthermore, in providing feedback on individual behaviors rather than diagnostic symptoms, the technology is not only well equipped to provide important insights into the health of veterans but also into health in general. Built to include a wide cross-section of target patients, Cogito Companion is helpful and actionable for diverse groups: those with mood disorders, anxiety, generalized behavioral health conditions, comorbid mental health disorders, diabetes, heart failure and other issues.
In addition to the overarching goal of improving the lives of patients and the quality of care provided to them, technology solutions such as Cogito Companion aptly responds to the widespread call for innovative sources to generate new scientific evidence.
The NIH Precision Medicine Initiative devised by President Obama has the goal of harnessing more expansive data collection through sources such as mobile technologies. The use of behavioral biomarkers through engaging mobile applications could do exactly that, allowing clinicians and researchers to track episode onset, symptom progression, and relapse across populations.
Joshua Feast is CEO of Cogito Corp.