Please ensure Javascript is enabled for purposes of website accessibility

White Papers

Back to All
By ontrak
March 20, 2024

AI innovation for behavioral healthcare

Ontrak Health uses Augmented Intelligence (AI) to advance evidence-based practice and drive efficient, personalized member engagement—at scale

Many healthcare organizations tout AI as the magic bullet for revolutionizing care. Often, however, we see style without substance.

At Ontrak, we do things differently. For more than a decade we have focused on continuous AI innovation to solve real-world, practical challenges associated with behavioral healthcare. That means infusing AI across the entire behavioral healthcare value chain. Further, we’re continuously automating the inefficient, manual processes that create fragmented member experiences and undermine consistent engagement.

Today health plans and providers strive to meaningfully engage members. However, as the need for mental health care expands, it becomes more difficult to reach everyone.  Additionally, case managers and coaches are tasked with manual processes, play telephone tag with members and work across multiple systems to deliver care and analyze member progress.  It’s an incredible amount of work that yields inconsistent results.

At Ontrak, we achieve durable results, true scale and efficiency!

Introducing the Ontrak Advanced Engagement System: A four-pronged approach that leverages AI to identify, reach, engage, and provide access to members throughout the behavioral healthcare journey – powered by 200+ member-specific AI-enabled care signals.

Below we describe each program component, illustrating how we use AI to advance evidence-based practice and drive efficient, personalized member engagement—at scale.

Ontrak Identify: The power of AI for uncovering hidden member needs

The journey begins with Ontrak Identify, where we employ advanced AI and predictive algorithms to systematically analyze over 500 million member health records annually.

The magic is in our RINGS predictive model—a multi-source, risk-based analytics algorithm. This innovative tool allows us to identify members living with unaddressed behavioral health conditions even without a formal diagnosis. For example, RINGS can find members with a high-predicted probability of substance use disorder or depression, but no associated diagnosis in existing health records.

The ability to identify those flying under the radar of traditional healthcare models exemplifies the real-world utility of AI. We’re truly moving beyond buzzwords to bring critical help to those who might otherwise remain overlooked or underserved by the health system.

Most importantly, this approach to finding mid- and high-acuity members helps drive pathways to more appropriate diagnosis and treatment. Members finally get the care they need, and health plans can perform more accurate risk adjustments to optimize access to care and maximize revenue.

Ontrak Outreach: AI-enhanced, empathetic conversations

After we identify members who will benefit from our program, Ontrak Outreach takes the stage. Here, AI is more than just technology; it’s a bridge to human connection.

We use AI in a myriad of ways to achieve greater efficiency in outreach, systematically bringing new members into the program. Here’s what it looks like.

Prioritization and accuracy

First, we use AI algorithms to prioritize outreach based on factors like risk, readiness, acuity, claims, prescriptions, and enrollment history. We prioritize those most in need, ready to engage with care and willing to commit to change.

Next, our technologies scrub and triangulate member contact information. This configuration option lets us identify the best member number and time to call to ensure we connect with the right member at the right time.

Our approach leverages technology to enrich our member data and apply smart logic to improve our success.

Evidence-based motivational interviewing

Motivational interviewing (MI) is a conversational technique designed to strengthen a person’s motivation and commitment to change. We rely on this approach to maximize engagement. Given its strategic importance to our clinical framework, we strengthen this approach using AI.

Ontrak outreach specialists receive real-time skills-based training insights into how their MI techniques perform, so they can select and tailor techniques most likely to resonate with members. To support this iterative approach, generative AI provides all summarization and real-time customized dialogue prompts aligned with member readiness triggers.

It’s evidence-based practice at its best. A sophisticated dance of technology and empathy, where AI insights enable our specialists to build trust and empower members to take the next step towards better mental health.

Ontrak Engage: AI-driven analytics support 1:1 Care Coaching

The next piece of our approach is Ontrak Engage, where AI’s role shifts to personalized, evidence-based engagement to empower members on their behavioral healthcare journey.

AI-powered journey mapping and 360-degree member visibility

AI tools give Care Coaches real-time insights through our Measurement Feedback System (MFS). These technologies enable Care Coaches to create personalized care plans, while enhancing care quality through performance analytics.

After each interaction, AI-powered speech-to-text tools generate theme-based summaries. Simultaneously, natural language processing (NLP) systematically analyzes notes and summaries to concretely measure care practices and track member progress over time.

This is innovation where it’s needed most. Now Care Coaches, health plans, and providers can gain a clear, comprehensive view of care activities, delivering measurable evidence of impact and outcomes. In all cases, AI-driven analytics facilitate a continuous improvement loop, ensuring member interactions remain firmly rooted in evidence-based practice.

Omnichannel Engagement meets members where they are

Engaging members is also about meeting them where they are to deliver specific interventions at precisely the right time. Our members decide how and when they get support. This can be through phone calls, email, chat, virtual or AI virtual assistance.

Ontrak’s AI Virtual Assistant (VA) is used for collecting Patient Reported Outcome Measures (PROMs), member check-ins and reminders. The VA can grasp, in real-time, the nuances of a member’s intent and sentiments. This technology utilizes conversational rhythm, voice intonation, and several other factors related to how and what members communicate. As we do with all communication channels, we automatically transcribe conversations and generate call summaries. Further, our VA generates critical care signals and highlights any urgent issues that might require Care Coaches to take action.

Next-Best Action Engine surfaces actionable care recommendations

Ontrak developed a proprietary blend of 200+ AI-infused Care Signals to support effective care delivery. This is a testament to Ontrak’s commitment to practical, impactful innovation. Our algorithms comb through omnichannel conversation transcripts, PROMs, claims information, and care plans goals to ensure critical triggers are identified for every interaction we have with a member.

Based on AI-identified Care Signals and AI-generated call notes, our Next-Best Action Engine presents actionable recommendations to our Care Coaches through our integrated EHR platform. This empowers our Care Team to deliver the right resources at the right time by bringing a multitude of insights and actions directly to them.

Further, we have drastically improved operational efficiency by automating much of the data analysis and preparation work. Managing large caseloads requires coaches, case workers, and providers to collect and integrate data from multiple sources. These tasks are time-consuming and error-prone, and often require manual effort and coordination.

Ontrak’s Next-Best Action Engine automates virtually all of this. Leveraging advanced data analytics and machine learning algorithms provides Care Coaches with a centralized platform to assist them in making informed decisions, optimizing patient care pathways, and delivering personalized care. All next-best action recommendations consider:

– Each Care Coach’s case load
– Each member’s personal journey
– Existing workflows
– Provider and specialist interventions
– Care plans
– Existing priority list

Ontrak Access: 45-state behavioral health network

Finally, the last component of our approach is Ontrak Access. We have contracted with 7,900+ providers in 45 states to improve access, appointment availability, and accountability for our clients and members.

Provider Matching Engine

Ontrak Access is enhanced by our Provider Matching Engine, which selects the most appropriate specialist for each member based on their needs. The Provider Matching Engine considers more than a dozen specialties and 30 sub-specialties, operational performance, and outcomes as well as mode of delivery, diversity equity inclusion (DEI), and demographics. The information that feeds our matching includes patient preferences and results from initial assessments, prior claims, and imputed diagnoses. Connecting people with the best-fit provider increases their likeliness to remain actively engaged in treatment.

Through our Advanced Engagement System, we’re helping to ensure members get access to exactly the right provider for their unique needs.

Closed-loop, bi-directional HITRUST secure data sharing

Once we connect members with the right provider, our data infrastructure facilitates a closed-loop, bi-directional HITRUST secure data sharing ecosystem, seamlessly connecting health plans, providers, specialists, and our Care Coaches.

This integrated network ensures that the most current and comprehensive care information circulates in real time. As specialist providers tailor their interventions, they are informed by the latest insights from our Care Coaches through care coordinators and HITECH-certified interoperability frameworks, encompassing member interactions, progress, and challenges. Conversely, our Care Coaches receive timely updates from healthcare providers, including detailed care notes and treatment adjustments.

Beneath everything are next-generation AI-driven data management and analytics tools. Through a proprietary data infrastructure, the Data Exchange platform simplifies the process of managing electronic data interchange (EDI), while complying with federal requirements and best practices in the industry saving 80% in pipeline maintenance costs and delivered nearly 90% shorter turnaround times.

A continuous exchange of AI empowers our Care Coaches to effectively guide members in adhering to their treatment plans and following through on provider recommendations. The Ontrak Advanced Engagement System is designed to support informed decision-making and coordinated care efforts, thereby enhancing treatment adherence, and fostering better health outcomes for our members.

Augmented Intelligence with purpose – Ontrak Advanced Engagement System

Ontrak’s AI solutions are squarely focused on solving real-world challenges in behavioral healthcare.

By integrating AI across the Identify, Outreach, Engage and Access components of our Advanced Engagement System, we’re not just talking about innovation, we’re delivering it.

This is AI with purpose: efficient, personalized member engagement—at scale. Powering care in ways that are both meaningful and measurable.

In a world where technology often promises more than it delivers, we’re proving that the right tools, applied with expertise and empathy, can truly transform lives.

Schedule a meeting