Dr. Steven Locke’s Perspective

Dr. Steven Locke is a professor of psychiatry at Harvard Medical School and practices medicine in Beth Israel Hospital and in private practice. Dr. Locke, as one of the nation’s experts in behavioral health, has been a pioneer in the use of technology to improve health outcomes and reduce the cost of care through health promotion and disease prevention. Dr. Locke is also known for his research in psychosomatic medicine, behavioral management of depression, and in mass psychogenic illness.

Below are five advances Dr. Locke suggests are key to achieving the goals of maintaining and improving the health of Americans while reducing the cost of care:

1) Use of Web-based Technologies to Increase Access to Health Services

It is essential that the American health system improves access to health services. The best way to do this at low cost is to intervene early through networked communication to provide better health promotion and disease prevention services to all Americans.

2) Increase Effectiveness and Efficiency of Population Health

Environment and lifestyle constitute the majority influences on health status. Through the use of advanced computing and communications combined with actuarial data and behavioral health applications, the American health system can and is engaging improved behavioral solutions to improve health status. However behavioral interventions are inefficiently distributed through populations of Americans, resulting in health inequities that can be addressed through population-based approaches and disease management.

3) Integrating Evidence-based Care into Primary Care and Population Health

Translating and integrating evidence-based care into primary care and population health is now feasible on a widespread basis. A few decades of evidence-based care have demonstrated their importance in medicine. However, the benefits of evidence-based care have not gained widespread benefit throughout the United States, especially within primary care and through widespread use of population health approaches. A crucial aspect of engaging evidence-based care is the appropriate alignment of incentives for health system stakeholders to foster transformation toward evidence-based care and population health approaches.

4) Adherence to Treatment

Adherence to treatment is often poor within the U.S. health system, especially for those with the highest burden of illness. Poor adherence to prescribed health regimes lead to poor health outcomes. As a result, poor adherence to treatment regimes put the country at risk for unnecessary medical costs. Advancing health care reform, especially during an economic downturn, should take advantage of behavioral health interventions that have proven useful to improving adherence to treatment and lowering the cost of care.

5) Management of Stress and Productivity

Health care reform should provide mechanisms for businesses to help their workers to improve their health status and productivity through more effective management of stress. Throughout the country, behavioral health programs have lessened the burden of chronic illness, the stress of caretaking for dependent family members, and reduced the negative impacts of substance abuse. The current round of health care reform should not only take advantage of advancements in management of anxiety and depression, that have such a clear impact of quality of life, cost of care, and productivity; It should go further to help Americans deal with the growing levels of stress that further exacerbate health and productivity, especially during economic downturns and times of uncertainty. Further NIH funding is warranted to improve research in the area of health informatics in general and behavioral health informatics in particular.