Busy doctors can miss mental health crises. Can this San Diego startup help?

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People with mental illness swing in and out of doctors offices every day, but their ailments often go unnoticed and untreated. Bogged down by busy work schedules, general physicians don't have the time—or the expertise—to dig into mental illness.

The result is a large population of sick, yet untreated, people in America. Now, a new startup in San Diego—founded by a well-known tech entrepreneur—is bridging the gap between the doctor's office and real psychiatric care.

The company, called Concert Health, makes it easier for doctors to link their with therapists and psychiatrists. Unlike popular mental wellness startups like TalkSpace and BetterHelp, which offer talk therapy online, Concert Health's platform fits into the existing . That's critical, both for the business and the patients, because the services can now be reimbursed by Medicare and many .

Concert Health was founded by Spencer Hutchins, 37, who's best known for co-founding the fast-growing virtual reality startup Reflexion Health. That company brought physical therapy into the home by using video game technology to guide and monitor exercise. The company uses Microsoft's Kinect spatial camera to track and analyze patient movement during physical therapy sessions, and videos of the sessions are sent to therapists for review.

As co-founder and former CEO of Reflexion, Hutchins raised nearly $12 million in startup capital (on top of funding from the Centers for Disease Control and Prevention) and grew the team to employ 20 people.

Hutchins left Reflexion in 2015 and started working on the concept for Concert Health shortly after. Although incorporated in 2016, Concert got to work last year, Hutchins said. What inspired his idea for the new business? The broken health care system.

The Problem

The Affordable Care Act changed a lot of things about the health care system, one of which was a shift toward the "pay for performance" model. The idea here is that doctors should get paid based on patient outcomes instead of process. This shift spurred a slew of data collection efforts because doctors and clinics needed to provide evidence of their success.

One such effort was the suggestion that doctors regularly screen their patients for mental health issues like anxiety or depression. When patients go in for their annual check-up, for example, they might be asked to take a questionnaire that gauges their risk for mental health issues.

"If you go to Kaiser or Sharp in San Diego, then these questionnaires are part of your annual wellness exam," Hutchins said. "These are important because many people don't bring up this stuff in their exam."

Dr. Prabhdeep Singh, a physician at Imperial Valley Family Care Medical Group, said the questionnaires used at his clinic have uncovered a lot of untreated individuals who needed care.

"Mental health issues are some of the most under recognized in primary care," Singh said. "I'm not talking about the person crying in your office because a loved one has passed away, or because they've lost a job. Anyone can pick that up. But the vast majority of patients with are high functioning, so it's difficult to recognize them."

In the United States, about 45 million adults have a mental illness such as anxiety or depression—that's nearly 1 in 6 adults. Among these adults, a 2016 study found that 60 percent didn't get treatment during the previous year: no medication, no talk therapy, no support groups.

When doctors do recognize mental health issues, Singh said the first course of action is usually prescription medication. It's often effective and it only takes a few minutes to write a prescription and get the patient on their way.

"But not every condition can be treated with a tablet, and there are other techniques that could help empower the patient to feel better," Singh said.

Sometimes, a doctor might know a psychiatrist to whom they can refer the patient. The process is burdensome and time-consuming, Singh said, requiring multiple phone calls from the doctors themselves and triage nurses. And in the end, the onus is on the patient to follow through to schedule an appointment with the psychiatrist, and often the patient bows out.

How Concert Bridges The Gap

Unfortunately, behavioral health has long been separated from primary care, so there isn't much infrastructure connecting psychiatrists to medical doctors. But collaborating is in the patient's best interest, according to several studies. That's why in 2018 a new Medicare reimbursement code was created to help doctors get paid for coordinating treatments with therapists, psychiatrists, and case managers. This means doctors can get paid for their time getting patients in the right hands. But that doesn't solve the problem that doctors are always short on time.

Concert Health basically takes a ton of work off doctor's plates. The company has a staff of 15 therapists (who all work remotely) who can deliver screening, assess the severity of a patient's symptoms, and provide therapy. When cases are particularly serious, the therapist can connect the patient with psychiatrists, who are better equipped to handle such cases and can write prescriptions when necessary.

All have to do is connect the patient with Concert Health. Once they do that, the doctor's office can bill the insurance company or Medicare for their work, and Concert Health will ensure the patient gets the care they need. Concert Health gets a cut of the reimbursement.

Traction So Far

Concert Health has about 15 customers, Hutchins said, including Imperial Valley Family Care Medical Group. The company has raised $500,000 in a pre-seed round and is in the middle of raising a $2 million seed round right now.

Neal Bloom, an at Tech Coast Angels, has invested in Concert Health in both rounds.

"It's always hard for an investor to find a company where the team is good, the opportunity is good, and the timing is right," Bloom said. "Capturing this new Medicare billing code is a really big deal. (Concert Health is) the first mover capturing that, so I'm like, 'Let's go. Let's go right now.' "

©2019 The San Diego Union-Tribune
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