Disclaimer: This is transcribed using AI. Expect (funny) errors.
Mindy Peterson: [00:00:00] I’m Mindy Peterson, and this is Enhance Life with Music, where we explore the ways music makes our lives better. A few episodes back in episode 172, Dr. Tasha Golden came on the show and explained what the Arts on Prescription model is. It’s also called social prescribing, and in a nutshell, the Arts on Prescription model takes the scientifically demonstrated health benefits of the arts and asks, So what? If we know the arts and art experiences can benefit our health, what are we going to do about it? This model acts on that by providing the infrastructure to allow arts activities, such as attending a concert, to be prescribed by your health care provider as part of your wellness plan. In this episode, we won’t be going into too much detail about what the Arts on Prescription model is because we did that with Dr. Golden. If you haven’t already listened to that episode, I encourage you to pause this one and go back to episode 172 and listen to it. It’s just a few episodes back. That way you’ll have a better understanding of our conversation today. Today we are talking about Art Pharmacy, a tech enabled health care company that is making social prescribing happen. Art Pharmacy is based in Atlanta and it works with managed care plans, health systems and community partners to enable healthcare providers to prescribe evidence informed arts interventions for patients as a supplement to other forms of care. Its founder and CEO is with me today. Chris Appleton is a national leader in the cross sector arts movement and has been featured on platforms including The New York Times, CNN, ABC, CBS and NPR. Welcome to Enhance Life with Music, Chris.
Chris Appleton: [00:01:51] Hello. Thank you so much for having me, Mindy.
Mindy Peterson: [00:01:53] It’s great to have you; looking forward to our conversation today and learning more about how Art Pharmacy works. Starting out, I want to hear about why Art Pharmacy is needed. Your website I know mentions a few simple facts that are really enlightening. One is demand for mental health. You point out that more than 20% of people in the United States will suffer from a mental health disorder in 2023, which is kind of shocking. Um, you mentioned that there’s a shortage of mental health care providers. A second simple fact that you mention is easy and effective care is needed. Patients need greater access to treatments that address the biopsychosocial elements of mental health. And then that third simple fact is related to evidence driven scale. Providers and payers are looking for innovative, proven and scalable alternatives to support needs. So can you just unpack those a little bit more and help us understand why Art Pharmacy is needed?
Chris Appleton: [00:02:56] Absolutely. So half of the people in the United States will suffer from a mental health disorder in our lifetime. That’s anxiety disorder, depression disorder, uh, a mood related disorder. It’s half of us. Wow. And prior to the last few years, the US health care system has not done enough to invest in the mental health workforce, to invest in solutions for care. And as a result, there’s a real disequilibrium in the market. There’s not enough providers to meet the demand. This is exacerbated by the pandemic, of course, uh, exacerbated by, um, sort of social media generation, if you will. Suicide rates are up amongst adolescent girls in the United States. They were up pre-pandemic. And it’s even worse post pandemic. And so there’s just a tremendous amount of need to get people culturally competent, culturally relevant, accessible mental health care. Yet because of the lack of investment, there have not been the available resources. And so Art Pharmacy is a way to introduce new supply into the mental health marketplace. We tap into the existing evidence, the existing resources that are in most every community in America at your local theater, your local museum, your local dance studio. These are individuals and organizations that have already been providing culturally relevant, accessible care, meeting patients where they are and then matching the patients. The individuals that need this care to those to those resources.
Mindy Peterson: [00:04:55] One thing that came to my mind as you were talking is I know it’s. And in the news a lot here because of the shortage of health care providers, mental health care providers, uh, there’s huge wait times. And I know I’ve actually had a friend whose daughter was in need of some mental health care, and the parents and us as friends were just blown away by the lack of care that was available without these long wait times. It was just sort of like, let’s just keep her in literally survival mode until we can get her the help that she needs. And when we talk about utilizing the arts for a supplement to some of this care, I don’t think there’s a wait a wait time for most of that. I mean, people can get access to this pretty quickly.
Chris Appleton: [00:05:44] That’s right. We guarantee access to care within 72 hours at our pharmacy. Um, which is certainly not what most health systems and individual providers are able to do. I like to tell a story about a friend of mine who spent her entire career as a behavioral health provider at Children’s Healthcare of Atlanta, and in the middle of the pandemic, uh, health care worker burnout is real. And and she said, I’m going to leave and I’m going to go into private practice because just the realities are working at the health system are too challenging. So she goes into private practice. And because of the rising demand and kind of the economics of it, people were able to pay her really expensive rates out of pocket. So she says, well, maybe I don’t need to go through the burden of getting in-network with big insurance companies like United Healthcare or Blue Cross Blue Shield or Aetna. So in that moment, you have both children’s health care and these insurance companies lose an in-network provider. So when we as consumers of mental health services show up to children’s health care, show up to United Health Care, they are not able to provide us with that time to care. That is so important, especially for somebody that that is potentially in crisis or could be in crisis if they didn’t receive lower levels of care more urgently. And this is, you know, no, you know, single institutions fault. It’s, uh, it’s a complex set of factors that all sort of emerged. But we are in a, in a time of crisis as a, as a country around mental health.
Mindy Peterson: [00:07:27] Sure. Well, another thought that came to my mind as you were talking is from my conversation with Doctor Golden. I know that she mentioned that health care providers are loving this. She’s not really having to convince them at all. They find it very intuitive. It’s more they just haven’t had the infrastructure in place to make it happen before. And I’m guessing that’s a huge benefit that Art Pharmacy provides. As you provide the structure and the resources and the platform to make this happen. And I just want a quick point out to you that social prescribing has decades of success in Europe, which is really interesting. We think of it as pretty new and novel here in the US, but it’s had decades of success in Europe. Tell us a little bit more about who Art Pharmacy is for. Are you here for patients or providers or both?
Chris Appleton: [00:08:15] We think of four key stakeholders in our model. And first and foremost are the patients, the members, the individuals that have mental health concerns, maybe experiencing social isolation or loneliness or, you know, be diagnosed with an anxiety disorder or depression disorder. You know that first and foremost, that’s who we’re here to serve. We’re we’re in the business of improving individual health and well-being. We also have these three other stakeholders that are necessary for the orchestra of social prescribing to work and musical references. And that is, uh, that that includes what we call the prescribing partners. Those are the those are the doctors and the school counselors, the providers that write the prescriptions for their patients. Those are the arts and culture partners. These are the community based organizations that, again, have been providing these resources in their communities, in many cases for decades and decades. And then the last is the health plans, the third party payer Art Pharmacy is, I don’t know if we’re the if we’re the conductor or not, but Art Pharmacy is is really the infrastructure as you as you mentioned a moment ago, Mindy, that that makes what otherwise are disparate pieces of a social prescribing scheme or model or orchestra to work.
Chris Appleton: [00:09:36] We do here all the time that just as Doctor Golden shared with you, that the doctors love this. If they’re a primary care provider or an oncologist or engaging with a patient’s mental health, they may not have a readily available mental health resource for their patient. If a. Expresses concern about their emotional well-being until they have Art Pharmacy. And so, you know, it’s it’s certainly an easy button for providers and not a burden to them at all. Our customers really are those health plans, right? It’s the third party payer, and we know that doctors and health systems have been doing community referral for a really long time. That’s why the convincing part on the clinical side is really pretty easily. They know that these types of resources are helpful to patients, the arts and culture organizations, the community organizations, they’re already providing these resources to community members. And there just needs to be that plumbing or wiring in between to make it all work. And so that’s that’s where Art Pharmacy steps in.
Mindy Peterson: [00:10:48] Well, I do like that orchestra metaphor, because if you think about an orchestra, you have the conductor, you have the music, the individual musicians in the orchestra, you have the audience who wants to hear a concert. And art. Pharmacy sort of is that administrative piece that brings it all together and says, let’s create an orchestra. We’re going to contact the individual musicians, we’re going to interview conductors. We’re going to bring in advertisers to let the audience members know that we exist. And when our concerts are and you make it happen, I know that participation in Art Pharmacy is no cost to patients. And you’ve mentioned the third party. The payers. Tell us a little bit more about how this works, what reimbursement is in place, things like that. And also, you mentioned the school counselor. I hadn’t thought about that. I’m thinking of more clinic settings, hospitals, but, um, school counselors, there’s probably other people who can prescribe these types of services that I and other listeners aren’t really even thinking of.
Chris Appleton: [00:11:56] Art Pharmacy works in a in a number of settings, so we’re very focused on student mental health. Students at Stanford have access to Art Pharmacy as a health and wellness benefit. You know, obviously, the opportunity for Stanford to invest in their students health and well-being by providing them access to these types of non-clinical interventions and resources, which improve outcomes for everyone involved, improve outcomes for the students, which should in turn improve outcomes for Stanford, we partner with networks of school based mental health clinics. These are in middle schools and high schools. We partner with value based provider groups that have Medicare as their client. We really work with a number of different patient populations or cohorts. Prescribing partners. One of my favorite prescribing partners that we have is a physician at Emory Hospital here in Atlanta who is in the palliative care space, um, often engaged with often engaging with patients who are, you know, near the end of their life. And he prescribes Art Pharmacy to his patients, prescribes participation in arts and culture engagements to his patients. And then when his patients come back for their in clinic visit with him, he says that a lot of times they just spend the whole time talking about the experience that the patient had at the theater or at the concert. Um, and, um.
Mindy Peterson: [00:13:30] And I think that when that happens. So, for example, when that particular doctor prescribes or pharmacy to his patient, I think that he doesn’t need to specifically say, I want you to go to a museum, or I want you to go to to go to a concert. I think he can just refer them to you. And then you have care, a care navigation team that sort of does triage and figures out what the best fit will be for that patient. How does that work?
Chris Appleton: [00:13:58] You’ve nailed it. The prescribing partner typically writes a prescription for 12 doses of arts and culture over a 12 month period, or over a six month period, whatever that may be, and then calls that prescription into Art Pharmacy. And through a combination of a digital intake utilizing our technology. And then with the care Navigator, the patient is matched to the highest efficacy arts and culture engagements for that patient. And that recommendation engine or that matching takes into consideration the patient’s clinical needs, their social needs, what access barriers may exist, their preferences around arts and culture, and then the research that’s out in the world that says, you know, group dance is really good for adolescent girls with social anxiety disorder or shared music experiences is really great for older adults experiencing isolation or loneliness. Um, okay. And um, and so the patient gets matched to the, to the right type of activity for. For them, the right medicine for them. And we think of Art Pharmacy as precision mental health.
Mindy Peterson: [00:15:05] So those recommendations are based on the intake. Information that’s provided by the patient. Is an actual activity actually prescribed to them or is it sort of. Here’s three things to choose from. You pick the one that you like the most.
Chris Appleton: [00:15:21] Patient agency is so important in mental health. People need to be able to choose the types of activities that they’re engaged in. And so our software delivers a set of recommendations. So 3 or 4 recommendations. And then with assistance from the Care Navigator the patient chooses the one that they want to participate in. And some times the patient will say, you know, I want to go to that dance class Saturday afternoon at the community dance studio. And that’s that’s what they participate in for their first dose of arts and culture. But they go and maybe they had a fine time, but it didn’t. It wasn’t really the right thing for them. And so they come back and they get rematched and they say, you know, I really like dance, but I prefer a different setting.
Mindy Peterson: [00:16:07] Okay, a.
Chris Appleton: [00:16:07] Smaller group or, you know, maybe dance isn’t actually the thing for me. Maybe visual art is a thing that’s going to sort of unlock the self-esteem or the sense of belonging or the confidence that’s needed.
Mindy Peterson: [00:16:19] Well, that’s nice to know, too, that if they get a prescription for 12 arts activities or the course of six months or a year or whatever it is, they’re not locked into the first one that they try. And yet, if they go to a watercolor class and absolutely love the instructor and love the other participants, they could probably stick with that and become a part of that group and really tap into that social bonding that takes place with their group to their class.
Chris Appleton: [00:16:45] It’s it’s very important to and this this already exists in health care. I mean, the way that we again, as healthcare consumers should want to participate in our treatment plans, whatever that may be. For if we were prescribed an antidepressant, we should be engaged with the prescriber of that antidepressant in the early months of taking that to understand whether or not it worked, rather than getting a script, taking it to Walgreens and then coming back a year later. And if our doctor isn’t checking in with us and knowing how we’re doing on that prescribed course of treatment, it may not be working. And you know what could happen? Hey, this doesn’t work, or it’s got side effects I don’t like, so I’m just going to stop taking it and disengage from my treatment plan. And so art is not a good idea.
Mindy Peterson: [00:17:36] Yeah.
Chris Appleton: [00:17:37] Right. But but adherence or compliance to antidepressants to SSRIs antidepressants is in the low 40 percents 4,142% compliance to that. Wow. Compliance interesting. Compliance to art. Pharmacy is 80%. And and and certainly people are much more inclined to want to participate in these types of arts activities than they are to want to take a pill. But also our care navigators really develop that relationship with the patients. And, well, and I think that’s.
Mindy Peterson: [00:18:09] A pretty significant benefit that you bring to providers is your care navigation team monitors patient well-being in between their visits with their provider. And so that’s a really significant benefit. I know the benefits that you offer to patients are significant. Also, I’m guessing that explaining those benefits to my audience is like preaching to the choir, because they know that music and other arts experiences can improve emotional well-being. There’s scientific evidence to back up that includes belonging, social connections, relaxation, inspiration, coping skills, resilience, and it goes on and on, um, including lowering stress hormones and boosting the the happy hormones, whether it’s serotonin or dopamine, other things. But tell us some more. Kind of elaborate on the benefits that Art Pharmacy provides or offers to providers. So tell us a little bit more about what kind of monitoring goes on by your care navigation team. In between visits to their primary care provider, those providers.
Chris Appleton: [00:19:13] We are asking doctors as a society, we are acting doctors, asking doctors to do more than we’ve ever asked them to do before and with less.
Mindy Peterson: [00:19:22] Time, probably with.
Chris Appleton: [00:19:24] Less patient time and, and, uh, pressures, you know, financial.
Mindy Peterson: [00:19:28] And more paperwork required after each appointment.
Chris Appleton: [00:19:31] All of those things we’re asking doctors to do so, so much more. And we should be expecting a lot of our of doctors. We should be expecting a lot of our primary care providers. Where we make big investments in primary care is where we see great outcomes. Um, getting, you know, further upstream is is important to addressing the cost of care to our system. It’s important to reducing chronic disease. These. Those are very important things. But our primary care providers need additional tools and their tool belt. And so so our pharmacy is one of those tools for those pcp’s, whether it’s a pediatrician or a geriatrician or just a family medicine provider. That is one of the things that we’re really proud of is that we help those providers monitor how their patients are doing outside of the clinical setting. And between the Care Navigator and our software, there are protocols built in so that if a patient’s well-being starts to decline or there’s a big drop between engagements or between doses, alarm bells go off and we can get in touch with the patient with their caregiver if appropriate, and then certainly back with the referring care provider so that they can know that there’s potentially a need to intervene with a higher level of care, but reduce that likelihood of an emergency department visit or, you know, something that is dangerous for somebody’s health and health and well-being.
Mindy Peterson: [00:21:07] You mentioned in your website that 70% of patients preferred alternatives to antidepressants. And you mentioned in our conversation with the low, the very low compliance rate that there is for people taking those pills, probably in large part because of some of the side effects. I love that you provide this alternative or supplement, depending on the situation, to antidepressants and other care. You also point out on your website that this is a great way for providers to differentiate themselves from their competitors. I’m a business and marketing major, so I love hearing that kind of language, and I think that is huge, especially with so many people wanting more natural care these days, looking for things that are preventative. You also mentioned on your website the cost effectiveness of this and that. It helps prevent that really costly crisis care that happens when people aren’t sort of maintaining their care. And like you mentioned, maybe just not taking their pills because they don’t like some of the side effects and it seems to be going fine until it’s not. And then it’s a big problem and it’s very expensive. Talk to us just a little bit more about what our pharmacy offers to providers and the people paying the bills, the health insurance when it comes to some of these benefits?
Chris Appleton: [00:22:32] Well, all of us in society, whether you work in health care or you’re a consumer of health care, should want to improve patient health outcomes, and we should want to reduce the cost of care. Bad health outcomes and expensive care have a negative consequence to all of us. Research has made very clear that investing in mental health improves compliance to chronic disease treatment. Investing in mental health reduce losses, the degradation of people’s health. On the physical health side, I think as a industry just beginning to really adopt that, we are seeing increased regulation at both local and federal levels, requiring parity for how health insurers cover mental health and traditional medical care. And that’s really great, because that means insurance companies have to pay for our mental health needs, and that will have benefits to society at large.
Mindy Peterson: [00:23:38] What reimbursement is currently in place for our pharmacy services, and how quickly is the answer to that question changing?
Chris Appleton: [00:23:47] It is a it is a long and complicated answer. Um, the the the short answer is that we have wonderful partnerships in place with a number of third party payers that make access to Art Pharmacy possible for their members or their patients. That’s the short answer. The longer answer is that way too few people across the United States have access to social prescribing, whether it’s at art, pharmacy or elsewhere, and we are working day and night to increase the coverage of access to, to social prescribing for, for people who need it.
Mindy Peterson: [00:24:27] Are there any big health insurers that are offering reimbursement right now that you can name or not?
Chris Appleton: [00:24:35] We do have a number of pilots underway with health insurers today, and we’ve gotten out of pilots with some partners and are expanded beyond the pilot stage. But it’s unlikely that you would be able to walk into your doctor’s office and say, my insurer is company A does access to Art Pharmacy. For me, it’s it’s unlikely that the answer to that question would be yes.
Mindy Peterson: [00:25:04] So what do you recommend to listeners as patients to find out if this is something that they can take advantage of in their area?
Chris Appleton: [00:25:13] People should visit our website, Art Pharmacy.co, where you can enter in your contact information and learn if Art Pharmacy is an available benefit to you. We also love to hear when patients contact their insurance company and say, this is a benefit that I would like available to me, and in fact, we have a contract. Um, we have a customer as a result of a patient telling their insurer that they would like access to Art Pharmacy, that insurer called us. Then, you know, much later we worked out a partnership where their members get access.
Mindy Peterson: [00:25:53] Is there a more effective way to do that? For example, reaching out to your insurer via their website contact form? Or hopefully the answer to this is not yes, calling them on the phone because I hate, I hate, hate, hate having to call my insurance. It’s like telephone maze. Hell yeah, trying to do that. But is that or like going through your human resources department? Um, at work, if it’s an employer provided medical plan, is there a preferred way that’s more effective than others?
Chris Appleton: [00:26:28] Sending an email to customer support at your health plan is saying you would like access to Art Pharmacy, and directing them to the Art Pharmacy website is a great thing to do.
Mindy Peterson: [00:26:38] I like that answer. Do you have a template form on your website that people can use?
Chris Appleton: [00:26:44] We don’t yet, but we should.
Mindy Peterson: [00:26:46] You should totally, because that would be probably the biggest thing stopping people is, oh, what do I say and are just not going to do it. So if you do that, let me know and I’ll link to it in the show notes. Get that up. Tell us yes. Where is our pharmacy currently providing services and how quickly is the answer to that question changing?
Chris Appleton: [00:27:10] We are currently providing services in Georgia, California and Massachusetts, and that is changing with a pretty good pace here. In the first quarter of 2024, we will expand to two additional states with several other on the roadmap for 2024.
Mindy Peterson: [00:27:29] Okay, I work with a lot of performing arts organizations. If a listener is hearing this and they’re part of an opera, a museum, an orchestra, a musical school, whatever it is, and they think, I want to get involved in this, I would love to have people prescribing attendance at one of my concerts or a visit to my museum. What do you recommend to them? Can they contact you directly?
Chris Appleton: [00:27:54] They can. There is a pre-registration form on our website for those arts and culture partners that want to enroll as As partners with us to participate in this national network. And that network is growing by the hour, not just by the day. So yes, please use our website and join the movement.
Mindy Peterson: [00:28:14] Okay, I know we’re running out of time, but I do want to ask about this relationship that Art Pharmacy has with Stanford, because I do work in my day job a lot with college faculty members, particularly music department faculty. And I know that you mentioned your collaboration with them. You’re bringing social prescribing to their campus. Can you tell us some more about your collaboration with Stanford and what Art Pharmacy offers college campuses and students? Because I know that student mental health is a huge, huge issue across not only the country, but across the world right now.
Chris Appleton: [00:28:51] It really is. They’re, you know, they’re just tremendous pressures on students to perform and a lot of obstacles to overcome in order to to do so and so. Art Pharmacy is partnered with Stanford. We work with the student Health services, with the visual and performing arts team, and they’ve just been an incredible partner bringing social prescribing to the campus. And we’re great. You know, we’re very grateful that they’ve selected Art Pharmacy as the implementation partner for that work. Okay.
Mindy Peterson: [00:29:21] Anything that you want to mention to college faculty who would like to get some more information on specifically how you can help their campus or how they could collaborate with you?
Chris Appleton: [00:29:32] We have a national college and university strategy to bring social prescribing to college campuses across the country. We would welcome contact from you all. There is a inquiry form on our website for faculty and administrators at universities. Please get in touch with us and we’d love to learn more about your needs on your campus.
Mindy Peterson: [00:29:57] Okay, we’ll certainly have links. To the website in the show notes, I love the tagline for Art Pharmacy. Creativity improves clinical outcomes. I know on your website you do have some resources. There’s an experience guide that can be downloaded. There’s also a blog, so I encourage listeners to check those resources out. Are there any other resources either that Art Pharmacy offers that you want to mention, or any other resources that you want to recommend or spotlight for listeners?
Chris Appleton: [00:30:27] We are big fans of the work that’s going on at the Arts and Minds Lab at Johns Hopkins, with Doctor Tasha Golden and Susan Magsamen, huge fans of the work that’s going on at the University of Florida Center for Arts and Medicine. Jill and Jill’s team in the World Health Organization has just launched a new social prescribing playbook, and the work there that is fantastic, you know, is fantastic. Christopher Bailey does work. Wonderful work. The World Health Organization. So those are three there are there are many, many centers for arts and medicine and arts and health across the globe. As you mentioned earlier, the science is really clear that engaging with the arts can improve health outcomes, and now’s the time to put that science to work.
Mindy Peterson: [00:31:12] Well, this has been so fun to chat with you about this. I wish you the highest success with Art Pharmacy. I hope it takes off really quickly and is hugely successful and comes to Minnesota really soon. As you know, I ask all my guests to close out our conversation with a musical ending coda by sharing a song or story about a moment that music enhanced your life. Do you have a song or story that you can share with us today in closing?
Chris Appleton: [00:31:39] I have so many songs and stories that I could share knowing we have just a couple of minutes left. Uh, reflecting on this question, music for me is related to having shared experiences and connecting with other people. As a bit of an introvert. Music sort of greases, you know, greases the wheels. For me, I have a four year old son and a two year old daughter. Um, and there’s a wonderful Talking Heads song, “Stay Up Late,” that we sing and dance, and my wife and I just look at each other, you know, as we’re, you know, having this family music experience of seeing our children dance. Um, and you know how it’s past bedtime. It is time for those kids to go to bed. We need to finish up our chores and get in bed ourself. But, uh, there’s just not much better than staying up late and listening to music with your kids.
Mindy Peterson: [00:32:31] That’s a great anthem for your stage of parenthood, man. A four and a two year old… Staying up late!
Transcribed by Sonix.ai