Ujjwal Ramtekker, MD, joined LifeStance Health as chief medical officer at the beginning of 2024. The Scottsdale, Ariz.-based company operates 550 behavioral health centers in 33 states and employs nearly 7,000 psychiatrists and therapists.
Dr. Ramtekker told Becker’s that this year, the company is prioritizing patient and clinician matching, patient engagement, and quality improvements while measuring those outcomes.
LifeStance offers both in-person and virtual care visits. As of June 2024, 71% of the company’s visits were virtual and 29% were in person. The company has slowed facility growth plans in 2024, as the majority of the company’s services are offered through telehealth. On the other hand, Dr. Ramtekker said the system is seeing more demand for in-person care.
Dr. Ramtekker sat down with Becker’s to discuss LifeStance’s approach to data measurement and the challenges and opportunities new technologies present.
Editor’s note: Responses have been lightly edited for clarity and length.
Question: Collecting outcomes data can be a challenge in behavioral health. What does your process for collecting data look like?
Dr. Ujjwall Ramtekker: With regards specifically to outcomes and data points, we focus on the unique needs [of patients]. We are really looking at the severity spectrum, the demographic spectrum. We’re trying to personalize things. The depression of an 18-year-old college-going boy looks different than a 35-year-old father of two kids, to a 60-year-old who also has chronic diabetes and has just retired. So we are trying to make sure that we are measuring the outcomes that are reflective of their ages and stages of disorder. We use some standard measurement based tools, for example, for depression, we use PHQ-9, and for anxiety, we use GAD-7. We are also going to deploy in a more standardized way, disorder-specific tools. We don’t stop at collecting the data at one point. We actually follow through with repeated assessments through this data so that we can show the trend and data and showcase those at an aggregate level. Sometimes predictive analytics help in creating some of these [insights] as well, and so at the end, we definitely have better insights.
The second piece we look at is overall length of stay. The more [patients] are engaged in their treatment, the less they are in the emergency rooms, in the inpatient hospitals. We are also measuring some of our outcomes and success through the engagement, the metric and longitude of engagement.
The third thing, which we are super excited about, is we are adapting the Institute of Healthcare Improvement framework for quality improvement. We can actually design and implement end-to-end clinical pathways, so that it’s very predictable. Someone presenting with a particular concern or complaint could expect what their care journey looks like. The whole system, not just the clinicians, but the administrative support staff and all the other aspects of the organization could really revolve around that patient journey that follows the clinical pathway for their diagnosis. We are very excited about that piece because it’s innovative, it’s personalized. It’s evidence-based, extremely standardized and very, very reliable.
Q: What are patients’ preferences for in-person versus virtual care right now? How are you striking a balance between the two modes?
UW: We have somewhere around 35% in-person, 65% virtual. It’s not dichotomous. It doesn’t mean those 65% are only virtual. That means that sometimes they’re virtual, sometimes they’re in-person. We are seeing a little bit of a trend more toward in-person care based on patient demand.
The last three to four years, all organizations have learned a lot about how to effectively integrate telehealth and technology. I think we are at the forefront of that. I think this balance will continue to change, and somewhere, it will be probably 50-50 in-person, virtual care. I see that as a differentiator for us from a quality perspective, that we can provide both and be very effective and timely through the use of this hybrid care model.
Q: What are the challenges and opportunities you’re anticipating in 2025?
UW: One thing that I see as a huge opportunity and a challenge, and at the same time keeps me up at night, is technology. Even in my previous roles, for more than a decade, I have advocated at the policy level for more and more integration of virtual care that includes technology. It’s all about technology enablement to improve the efficiency and the efficacy of care. It’s not to replace the care.
I think there’s a huge opportunity [for] technology integration. [Whether] it’s digital therapeutics, the use of AI for clinical decision making, chatbots for better patient experience, or digital solutions that are useful for reducing the documentation burden on clinicians. Digital therapeutics [can] help with patient engagement, because they can talk to their pocket therapist. It’s not necessarily a therapist, but using AI, and particularly generative AI-models, we’re seeing it helping [patients] between sessions. I think there’s a huge potential for that. I think it’s going to be good for patients, good for health systems, [it] might reduce burnout and eventually improve outcomes for clinicians and our patients.
My biggest worry is that there are many [technologies] that are not rooted in science and evidence-based medicine. Whenever we prioritize operationally driven technology, driven integration, rather than clinical effectiveness, we risk prioritizing convenience over quality and outcomes, and that cannot happen. Without a solid clinical foundation, these tools may not deliver on the promise of quality and care. That’s a concern because, if anything, it might result in poor patient outcomes because it is taking them in a non-scientific, non-evidence-based, non-supervised way of doing things.
