Spotlight with Dr. Noah DeGaetano: Transcranial Magnetic Stimulation and AI in Psychiatric Care
This spotlight covers an introduction to Transcranial Magnetic Stimulation, as well as Dr. DeGaetano's marrying of mental health services and advanced technology. Read about his work with Acacia Clinics and his visions for the future of psychiatry and digital health landscapes.
Meet Dr. Noah DeGaetano:
He is a psychiatrist invested in mind-body healing, an innovator in the field of neuromodulation, and a proponent of advanced technology in mental health care.
With 17 years of psychiatry experience, he has worked with the Palo Alto VA, Stanford University Medical Center, and is currently the Chief Medical Officer at Acacia Clinic.
Acacia, a top Northern Californian psychiatry clinic, merges research and state of the art technology with patient-centered care, offering accelerated Transcranial Magnetic Stimulation (TMS) therapy.
TMS is an effective, FDA-approved, non-invasive treatment for depression and other mental health conditions that activates specific brain regions with magnetic pulses.
Q&A:
Q: How has your journey led you to Acacia and why did you choose to specialize in PTSD and pain management?
A: My fascination with the mind and body connection, as well as my interest in innovative procedures, led me towards specialties like PTSD and pain management where this connection is most apparent.
I was particularly drawn to procedures that help patients regulate their nervous systems such as estella ganglia block or vagal nerve stimulation.
Q: Can you elaborate on your work with Transcranial Magnetic Stimulation (TMS) and its benefits?
A: I found TMS incredibly compelling as an intervention approach alternative to traditional medication or therapy. Studies show that TMS achieves response rates as high as 50%, with about 30% of people going into remission.
A study out of Stanford University published results that achieved close to a 90% remission rate in the first month. TMS, especially the accelerated, neuronavigated version, stands at the core of Acacia's unique approach to patient care.
Q: Your thoughts on Telehealth and transition to digital healthcare in psychiatry?
A: With the arrival of Covid-19, the transition to telehealth in psychiatry was significant. Many clinicians, including myself, appreciated the flexibility it accorded while patients liked the convenience.
Still, there are challenges to overcome, including the need for regulations that accommodate digital healthcare, and the implementation of systems that provide interconnectivity in a fragmented digital healthcare landscape.
Q: How would AI help expedite processes for clinicians working in mental health?
A: AI voice and text agents can immensely improve efficiencies by performing scheduling, patient intake, medication management, bill pay, and more, all integrated within your EHR so that it reduces the time spent by clinicians on routine aspects and improves the quality of care.
A particular vision for the future is to include interactive, graphical interfaces, such as mind maps, that could greatly aid in capturing and visualizing complex patient information.
Whether it’s navigating the challenges of telehealth or innovating with cutting-edge procedures like TMS, Dr. DeGaetano’s work is a testament to Acacia's drive towards the integration of technology and mental health care as they strive to provide the best possible mental health treatment.
Deep Dive:
At Acacia, Dr. Noah DeGaetano and his colleagues have been pioneering the use of Transcranial Magnetic Stimulation (TMS) as a transformative treatment for depression and other conditions. TMS targets and stimulates underactive nerve cells in the brain, providing relief where other treatments may fall short.
TMS therapy, which is FDA-approved and backed by over 60 clinical trials, leverages Theta Burst stimulation using a MagVenture™ device. This pattern of stimulation mirrors the brain's natural communication and has consistently delivered remarkable results, often in as short as six weeks.
DeGaetano's mission to incorporate innovation in mental health treatment has led to effective strategies for individuals struggling with depressive symptoms, especially those who are either resistant to antidepressants or wary of their side effects.
Patients have reported TMS therapy sessions to be both quick and tolerable, typically lasting less than 15 minutes without the need for any form of anesthesia. The process is so gentle that patients are comfortably able to drive themselves to and from their appointments.
Though some experience a mild, temporary tapping sensation on the head during initial sessions, it usually subsides quickly, making subsequent sessions much more comfortable.
When it comes to treatment access, telehealth has changed the playing field. Acacia, with Dr. DeGaetano's support, has adopted telehealth practices, allowing for expedited patient evaluations and seamless transitioning into TMS therapy.
This rapid intake and referral process starkly contrasts with often prolonged waiting times seen in traditional mental health services, aligning with contemporary patient expectations for swift and effective health care solutions.
By staying on the cusp of technological integration in psychiatry, Acacia, backing the insights from their clinician Dr. DeGaetano, is reshaping the landscape for treating depression and other mental health disorders.
"We're really in the vanguard of what's happening, not only in TMS but in neuromodulation in general...You could take an eight to nine week treatment, shrink it down to five days and get better results than you were getting in that eight to nine week period."
Noah DeGaetano, MD
To Dr. Noah DeGaetano, AI is a hopeful tool for mental health clinicians, offering to refine processes from patient intake to care measurement and administrative tasks. He emphasizes the need for intuitive systems within electronic health records (EHRs) to reduce administrative costs, while efficiently handling tasks like benefits checks, capturing demographic information, and updating insurance.
Moreover, measurement-based care and robust digital tools can feed back into clinical decisions, ideally presented in intuitive dashboards or graphical interfaces.
These systems, if designed around the physician perspective, can deliver critical information and support providers in making the most efficient clinical decisions.
The aim, according to Dr. DeGaetano, is finding a balance between qualitative aspects of mental health care with quantifiable data to foster nuanced patient-clinician interactions.
The need for these innovative tools are increasingly evident.
According to a 2021 study, administrative complexities often cause delays in care or lead patients to skip treatments and the impact of this is comparable to barriers caused by financial costs.
Addressing this issue, AI and large language models can be leveraged to reduce administrative burden by automating repetitive, time-consuming tasks without additional staff.
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