Keith Boswell On Using Telehealth to Treat ADHD

DocWire News recently spoke with Keith Boswell, Vice President of Marketing at ADHD Online, about the challenges families face in diagnosing and treating children with ADHD, and how new treatment modalities, specifically telehealth, can help address the condition.

DocWire News: Can you give us some professional background on yourself?

Keith Boswell: Yeah, so I’m Keith Boswell. I’m the vice president of marketing at ADHD Online. I have been working as a entrepreneur and digital strategist for 25-plus years, both on the agency side as well as on the healthcare side, and currently work for one of the largest telehealth practices focused exclusively on ADHD in the country. You can view this more on our company website!

What are the challenges that children with ADHD (and their families) face?

Well, I think there’s a big misunderstanding around ADHD. I mean, I was diagnosed in my late 40s, so I can relate. I was not the bouncing-off-the-wall boy that I think a lot of people expect, but I was more the bouncing around in my head. I think the first thing parents have to understand is what is it that their child is dealing with. I mean, inattentive ADHD, typically you’re seeing a lack of paying attention to details, people that don’t seem like they’re listening, they’re not very organized, their spaces are messy, they can’t keep appointments. You hear about people that are constantly late and there’s this thing called time-blindness where someone with ADHD can literally just disappear for hours within a thought because they get so focused on something. I think for parents, a lot of it is understanding what’s going on with their child, how it’s presenting. It’s important to, I mean, one of the challenges with ADHD is you really have to understand how it’s presenting in multiple outlets, so you’re looking at it in school, you’re looking at it at home, and any extracurricular things as well.

How can ADHD testing and diagnostic methods, as well as treatment, be improved?

I think one of the biggest challenges that a lot of parents and individuals face is if someone refers them for diagnosis or for assessment in their local treatment system, a lot of health systems, a lot of testing facilities are nine to twelve months out to get tested, so you’re talking about you’re not in the front of the line for emergency mental health services, you’re queued up to find out when you can. That was actually part of what was the impetus for creating ADHD Online was we started an assessment and diagnosis where people go through the same evaluation that you would at a provider’s office. In fact, I think the thing that we feel about it is people can spend more time because they can really put as much information as they want in for the psychologist to evaluate. Again, you’ve got to understand it in multiple contexts, so a big part of it is just people having access to treatment. The mental health resources in the US today post-COVID, still with COVID, are extremely taxed, and so a big part of it is just being able to provide access.

I think the other thing is there was a big question in treating ADHD specifically through telehealth. We’re currently operating under the public health emergency exceptions that allow for the ongoing treatment without requiring someone to be seen by a doctor in person. We actually are preparing for that future where we’ll be more integrated with the health system. We’re not trying to be the other, we’re trying to really be an extension of the health system, and we think that’s important because people need that data to take back. Not everyone chooses to do treatment with us. Some people want treatment from their primary care provider, so we like being able to have that relationship. Some people just choose us for that, some people choose us for treatment as well. Again, for a lot of our patients that are choosing treatment, telehealth may be one of the only options because if they’re rural, or live in an area that doesn’t have a lot of providers, it could be hours to get to the closest one in person.

What role does ADHD Online play in enhancing ADHD care?

I think we have three prongs that we talk about all the time. I mean, one is we view ourselves as an educational resource both for our patients and for just the general population. There’s so much stigma around ADHD, the treatment of ADHD. There’s a big misunderstanding, I think, in the just general conversation. When people hear that you’re treating a certain population with stimulants, the big question emerges, “How can one person be under medical treatment for something using a substance that’s very similar to something they might get illicitly and get addicted to?” It’s really how the ADHD brain works. I mean, the ADHD brain is seeking stimulation, so a stimulant actually allows an ADHD brain to go into a mode of focus and not getting so stuck. One of our providers calls it, it’s kind of like freeing up sticky brakes.

But medication isn’t for everyone, and a lot of people use organizing, or systems that they develop for themselves to cope with it. You hear about people that have been in the military and they’ve developed routines and processes for themselves and they don’t need treatment, but they might still need support because you still deal with emotional dysregulation sometimes, you’re still dealing with the symptoms of it, so there’s a big piece of what we do in terms of educating, and making sure we help people understand what’s going on, and break those stigmas. The second is around that assessment and diagnosis. Again, it’s up to our patients to decide if they want to take that. If they get a diagnosis of having ADHD, or they’re excluded, we are able to tell them a little bit more about their mental health, and they can go back to their primary care provider, and use our assessment report as a way to start a conversation with their provider, and see where to go. Then the third option is really treatment. In 39 states, we have providers that can provide medication for patients that are diagnosed with ADHD.

Just real quick, I want to touch on one of the big things that I think that has gotten our industry a lot of attention over the last year has been a number of providers in this space, that their model was a quick meeting with a provider, they ask you some questions, they diagnose you, they prescribe you medication, and you get onto their pharmacy plan. We don’t have any alliance to pharmacy, or pharmaceutical ties in any way, and we think that’s important. The reason that the assessment and diagnosis is really a separate practice under our business is so the psychologist can just provide the diagnosis. They’re under no pressure to have a certain number of positive or negative diagnosis.

On the flip side, for the providers that are doing treatment, they know that anyone they’re dealing with has been diagnosed through us, they can reach out to one of our psychologists if they have questions, and that coordination of care, really, we think is the future of where it’s headed. But again, we don’t want pressure on either side because it’s up to, really, the patient and the provider to decide what the best course of treatment is. It’s such a complex arena, but I think we’re very encouraged by where everything is going by the way that people are taking to us, and really letting us know that we’re making a difference. That’s just a great thing to be a part of.

Any closing thoughts?

I would just say we’re excited about the future. We’re excited about where things are going. We believe that the integration of the traditional health system with digital platforms like what we’re doing is the future. We don’t see it being an either/or. We’re really excited we’re going to be at the International Conference on ADHD in Dallas, November 17th through the 19th, and so anybody that’s going to be there, we would welcome stopping by and seeing us. But it’s fun to be at a point where we’re out there trying to put a face on telehealth and let people know that this is a really safe way to treat people and we think it’s here to stay.