While many cardiologists have seen first-hand the negative impact mental health disorders, such as depression and anxiety, can have on the physical health of their patients, the American Heart Association recently published a scientific statement about the important connection between mental health and heart health.
In the announcement of the statement on January 21, 2021, Glenn N. Levine, M.D., FAHA, master clinician and professor of medicine at Baylor College of Medicine, chief of the cardiology section at the Michael E. DeBakey VA Medical Center, and chair of the writing committee for the Scientific Statement said, “A person’s mind, heart, and body are all interconnected and interdependent in what can be termed ‘the mind-heart-body-connection.’ Research has clearly demonstrated that negative psychological factors, personality traits, and mental health disorders can negatively impact cardiovascular health. On the other hand, studies have found positive psychological attributes are associated with lower risk of cardiovascular disease and mortality.”
Hundreds of studies have been done linking the connection between a person’s mental health and physical health, and some have focused specifically on heart health. In a 2020 Karger report entitled, “The Call for Cardiopyschiatry,” the authors, all cardiologists with a long record in addressing cardiac health in patients with severe mental illness (SMI), presented data on patients with acute coronary syndrome (ACS) from the Danish national patient register from 1996-2016. “Negative symptoms such as apathy, anhedonia, ambivalence and social withdrawal will reduce the patients’ interest in their own well-being and the motivation and energy necessary for help-seeking behavior. The same symptom cluster is also partly responsible for the reduced ability in sustaining a healthy lifestyle and reduce cardiometabolic risk in the first place.”
Cardiologists have a responsibility to look holistically at their patients, which includes conducting assessments of the mental health conditions that can dramatically impact patient outcomes. Without proper mental health, patients will struggle to improve their heart health.
Accurately identifying mental health issues, however, is often more difficult than identifying cardiovascular health, especially if the cardiologist does not have the proper training and tools. Unlike physical health that can be measured with instruments and tests that capture hard evidence, mental health assessment involves patient-reported symptom data that is often considered subjective. Cardiologists should be diligent when selecting the right mental health assessment solutions. Here’s a checklist for what physicians should look for to help ensure a proper diagnosis can be made.
As more healthcare providers shift to value-based care reimbursement models, the high prevalence and associated high costs of caring for patients with cardiovascular disease puts cardiologists front and center in the fight to control costs and improve outcomes, according to a report published on the National Institutes of Health website entitled, “Value-based Payment Reforms in Cardiovascular Care: Progress to Date and Next Steps.” To meet the challenges of these new payment models, cardiologists must deploy more modern technology that can help them more accurately diagnose and treat the mental health of their patients.
Modern, digital assessment solutions, such as those from nView Health, can be used to give cardiologists the insights they need to properly identify, assess and build an integrated treatment plan for their patients. Here’s how nView solutions work:
Cardiologists screen every patient with the nView digital Screener that typically takes less than 5 minutes to complete. It can be done by patients at home in advance of the visit or in the waiting room on a tablet or mobile phone. Typically, providers can bill CPT 96127 up to four times per patient per year.
If the screener identifies certain risk factors, cardiologists can administer nView’s digital diagnostic interview (Mini International Neuropsychiatric Interview – M.I.N.I.), a single assessment platform that can identify virtually all major mental health disorders in adults and pediatric patients. The M.I.N.I. has been cited in more than 17,000 clinical studies and has been used by physicians for nearly 25 years. Taking an average of 20 minutes to complete, the nView digital M.I.N.I. can be administered during the patient visit by a clinician or taken at home by the patient. CPT code 90791 can be used to support this activity.
Depending on the results of the M.I.N.I., cardiologists can then work with the right mental health professional to determine the best treatment plan, whether it be medication or cognitive behavioral therapy (CBT), or some combination of both.
Once the patient’s mental health disorder has been accurately diagnosed and is undergoing treatment, cardiologists can use the nView digital patient Trackers to monitor the patient’s progress. These brief, digital patient surveys can be set up to run automatically via email or text at regular intervals. The data captured from these ongoing surveys can be plotted to easily view the patient’s trending status. By monitoring patients in a more automated fashion, cardiologists are able to spend time with the at-risk patients before their condition results in a costly complication or hospital readmission. Besides, physicians are embracing remote patient monitoring for physical health, so why not do the same for patients’ mental health?
Proem Health is one company that is trying to make a difference. Jim Szyperski, the CEO of nView, and his team are on a mission to improve the accuracy of mental health diagnosis through the use of its digital screening and assessment tools. The company’s flagship product, the Mini International Neuropsychiatric Interview, the M.I.N.I., has been used by clinical and academic research organizations for more than 25 years to help researchers screen for disorders among study candidates. In 2020, the company took aim at healthcare providers who started using their tools to more accurately identify mental health disorders in their patients. Hundreds of physicians are now able to evaluate patients for virtually all mental health disorders from one assessment tool instead of having to predetermine the disorder and then administering the proper screen. By being able to evaluate the patient more completely, the chances of getting the diagnosis right on the first try increase.
