A Tech Perspective on the 2023 State of the Union

New advancements in health IT are supporting the Biden-Harris Administration’s Unity Agenda, which aims to drive improvements across mental health, cancer innovation, veteran services, and the opioid and drug overdose epidemic. During the 2023 State of the Union address, President Joe Biden will announce a new set of policies to continue to advance the Unity Agenda and deliver results for families across the country, White House Communications Director Kate Bedingfield told reporters Tuesday.

To support these priorities, federal agencies including the Department of Veterans Affairs and the Department of Health and Human Services are leveraging artificial intelligence (AI), machine learning, data visualization dashboards, online training programs and more.

“These are issues that affect all Americans in red states and blue states, and one where the American people are counting on their elected officials, no matter their party, to come together and do big things. Over the last year, the president has made good on that promise. He was proud to work with Democrats and Republicans to enact major legislation that delivers on his Unity Agenda,” Bedingfield said Tuesday.

Executive Priorities for Mental Health, Substance Abuse

Federal agencies continue to pursue a variety of IT initiatives to address mental health and substance abuse, including the opioid epidemic, in line with Biden administration priorities.

To improve mental health care and access, Biden invested in expanding coverage and reducing costs for mental health services, increasing the number of mental health providers, and strengthening access to crisis services by building out the National Suicide Prevention Lifeline and implementing the Veterans Crisis Line.

These investments build on efforts at the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Centers for Disease Control (CDC) to collect and analyze data on mental health trends and launch new tech initiatives to address mental health and substance abuse disorders, such as SAMHSA’s Technology Transfer Centers (TTCs), which help upskill the health workforce to handle the surge in patients.

“Since the [lifeline] transition, calls to the suicide crisis hotline have grown by at least 50%, texts have increased more than 1,200%, and that’s all while response rates have increased and wait times have been reduced,” Deputy Director of the Domestic Policy Council for Health and Veterans Christen Linke Young said.

Additionally, the administration has expanded Medicare coverage to include additional mental health and substance use disorder services and providers and worked with Congress to make major investments in training the next generation of mental health professionals.

“We will continue to implement a whole-of-government strategy to expand the mental health workforce, reduce barriers to care and promote resilient environments. We will issue new rules to enforce mental health caregiver plans. … We’ll continue to expand the crisis care workforce — trained peers, first responders, licensed counselors and psychologists — and we will also expand global crisis intervention services. We will prioritize research, so that we build an evidence base to deliver proven therapies,” Linke Young added.

Agencies have also used digital services like telehealth to improve access to care. Assistant Secretary for Health Adm. Rachel Levine described how HHS is leveraging innovation, intersectional health, telehealth and other approaches to combat the opioid epidemic during a 2022 HealthCast interview with GovCIO Media & Research.

“Because of these efforts, combined with our historic public health advances, we’ve now seen five straight months where all those numbers have decreased. That’s almost 3,000 people who have not died and instead are at the dinner table each night. So, it is a hopeful sign, but we can’t slow down our efforts,” White House Director of National Drug Control Policy Dr. Rahul Gupta said.

During tonight’s State of the Union, Biden will lay out a detailed approach targeting fentanyl trafficking and expanding public health efforts to reduce overdose deaths. Gupta said the administration will use advanced technology to stop fentanyl at the border and work with commercial package delivery companies to intercept more packages containing fentanyl.

“We’re going to continue to expand access to life-saving medications for opioid-use disorder,” Gupta said. “We’re going to also hold traffickers accountable, we will reduce overdose deaths and we will save more American lives.”

Deliver on Commitments to Veterans

Since Biden’s passage of the PACT Act in 2022, VA has implemented new automated decision support tools to expedite claims processing and deliver benefits to veterans in a more timely manner. Last year, VA processed an all-time record of 1.7 billion veteran claims.

VA also permanently housed more than 40,000 veterans in 2022 with the help of data visualization and the new Supportive Services for Veteran Families (SSVF) Homelessness Prevention Screening Tool, which improves identification of veterans at risk of homelessness. The agency also is honing in on data transparency to drive better decision-making around housing efforts.

Linke Young said Biden will “announce additional actions in the months to come,” including new resources to reduce veteran suicide and expand mental health services.

Mental health providers increased digital and telehealth services during the COVID-19 pandemic to meet rising demand. VA’s 2020 PREVENTS program leveraged artificial intelligence (AI) and predictive analytics to identify and coordinate care for veterans at risk for suicide and mental health and substance abuse disorders.

Synthetic data, which can be modeled to mirror real veteran data while protecting veteran privacy, is also playing a critical role in preventing veteran suicide. In March 2022, VA announced its intent to develop a new pathway to generate synthetic data to derive meaningful insights.

“We’ll continue to focus on lethal means safety by training health care providers and expanding educational resources. And then we’ll support veterans at challenging moments that can increase suicide risk by expanding medical legal partnerships and expanding outreach,” Linke Young said.

Biden is also calling on Congress to fund housing assistance for veterans.

“We are going to be releasing additional details of the president’s budget in just a few weeks, but here we are looking at what ways we can firm up an entitlement to help support particularly low-income veterans who we know have difficulty finding permanent housing,” Linke Young said. “We’re looking to make it easier for them to afford rent and stay housed.”

Drive Innovation to Fight Cancer

Throughout 2022, federal health agencies leveraged emerging technologies such as AI, ML and predictive analytics to improve cancer research and patient outcome in addition to developing innovative programs dedicated to fighting cancer.

Both VA and the National Institutes of Health (NIH) have developed programs to improve the outcomes for cancer using AI and ML to improve detection rates. Technical priorities include developing methods for collecting and standardizing data used in AI-backed research and launching collaborative initiatives drawing medical informatics from multiple sources to create the data pools necessary for predictive model development.

Supporting these initiatives is the recently launched Advanced Research Projects Agency for Health (ARPA-H), enacted through the 2022 bipartisan government funding bill to deliver transformative, sustainable, and equitable health solutions.

The Biden-Harris administration also reignited the Cancer Moonshot initiative and set new goals to reduce the cancer death rate by at least 50% over the next 25 years and improve the lives of cancer patients and survivors, their caregivers and families.

“Tonight’s speech will highlight the progress we’ve made over the last year. This includes nearly 30 new federal programs, policies and resources from a first-ever ‘Cancer Cabinet,’ from steps to increase cancer screenings to innovative approaches to improve care for patients and those that support them to standing up and funding ARPA-H,” White House Cancer Moonshot Coordinator Danielle Carnival said.

To further accelerate progress, Biden will outline additional steps to bring cancer research and care systems into the 21st century. The administration will urge Congress to reauthorize the National Cancer Act to enable system modernization and lock in the strong investment in cancer research that passed in 2016 as part of the 21st Century Cures Act, which otherwise expires this year.

“The administration is going to take steps to ensure that patient navigation services are covered benefits going forward for as many people facing cancer as possible,” Carnival said. “In addition to pushing forward on research and patient experience, we’re going to continue to focus on prevention. That means taking steps to tackle the single biggest driver of cancer deaths in this country — smoking — and to continue to address environmental exposures.”