Interview: An epidemiologist powers Trayt’s patient and population health data for Access Programs 

Abigail (Abby) Koch is the Director of Population Health and Analytics at Trayt Health. Her role ensures programs are able to utilize Trayt’s platform to deliver measurement-based care. Abby’s focus is to provide rich data insights that give program leaders a deeper view of population health to improve clinical productivity and patient outcomes. 

Abby did not initially envision a career at a behavioral health tech startup. Prior to Trayt, she worked as an epidemiologist analyzing maternal health for large academic and government institutions that included stints at the New York City Department of Health and Mental Hygiene (NYC DOHMH) and the University of Illinois Chicago (UIC). While at UIC, Abby partnered with the CDC to support the development of their data platform for maternal mortality review. In that capacity, Abby researched untreated maternal mental health challenges and their impact on both mother and child. Her work contributed to CDC findings that 80% of pregnancy-related deaths were preventable and nearly a quarter of these preventable deaths were due to mental health conditions. 

Abby’s experience at large institutions also helped her identify internal gaps where third-party tech platforms like Trayt could provide out-of-the-box solutions to step in and fill the need for entities both large and small. Within behavioral health, she identified opportunities for tech to assist organizations in fulfilling goals like delivering measurement-based care and crafting a 360-degree data view of each patient and each program. 

“I truly believe Trayt is a mission-driven company that can use technology to transform the way behavioral health programs deliver care and to facilitate population-level analysis that can provide insights that otherwise may go unnoticed,” Abby said. “I’m absolutely invested in our platform’s potential to facilitate the expansion of psychiatric Access Programs, as well as to introduce measurement-based care that centers patient outcomes.” 

Abby said when she initially made the career leap to join Trayt, she thought there was a chance the work would be too removed from the patient. Nearly two years into her role, she sees daily and directly the impact her work has on patients through the integral relationship between Trayt and its customers, state Access Programs across the nation. This includes recent research analyzing the first 18-months of the Vermont Child Psychiatry Access Program (VTCPAP). 

“I translate between Trayt’s academic clinical and research partners who are organizing and managing Access Programs and the developers who know how to build a functional behavioral health care platform,” Abby said. “There’s always language to connect and I put the provider point of view into a data framework that software developers can understand.” 

Maternal Mental Health Month 

May is Maternal Mental Health Month, which is an opportunity for Abby to emphasize her previous experience researching maternal health. Maternal mental health is also a key Trayt priority. In addition to child and adolescent behavioral health and substance use disorder, building technology that supports perinatal Access Programs is core to Trayt’s mission. 

The need for these programs and the tech solutions that support them is immediate. Abby said that from a public health perspective, maternal mental health issues have been understudied with big breakthroughs only coming in the last 10 years. The contribution of maternal mental health conditions to adverse maternal and child outcomes historically only considered depression or anxiety, missing obsessive-compulsive disorder, posttraumatic stress disorder, bipolar, psychosis, and substance use disorders. In terms of mental health-related causes of maternal mortality, only deaths due to suicide and drug overdose are categorized as deaths due to mental health conditions, Abby said. While these deaths comprise the largest segment of pregnancy-related mortality compared to deaths attributed to other causes, maternal mental health conditions also contribute to and exacerbate other health challenges. 

“It was through the standardization of data collection at the state level that the reach of the problem became clearer,” Abby said. “Women suffering from mental health conditions may find it more difficult to address other medical conditions, keep prenatal and postpartum appointments, and deal with stressors relating to social determinants of health. We couldn’t see how often that contributed to maternal mortality until we could aggregate data across time and place.” 

The health of the child and spouse are also impacted by untreated maternal mental health issues. Children are likelier to experience preterm births, behavioral, cognitive or emotional delays, and an increased number of adverse childhood experiences. Spouses are likelier to experience depression or anxiety. 

A clear program and tech partnership 

Abby works with data teams at programs like the Texas Perinatal Psychiatry Access Network (PeriPAN), Texas Child Psychiatry Access Network (CPAN), NECOPE, and VTCPAP to ensure the Trayt product is tracking and reporting the most important insights on maternal mental health. Abby said the more information programs can understand about who, why, and at what point mothers are accessing their services, the better programs can structure their limited resources to meet patient needs.  

Since August 2022, PeriPAN has expanded from a small pilot program in select areas of Texas to a program serving all women and birthing people in the state, reaching a milestone of 1,000 consultations in April 2024. While about 40% of consultation requests originated with providers in obstetrics or other dedicated women’s health practices, approximately the same proportion of consultations came from general practices including primary care, family medicine, and pediatrics clinics, highlighting the importance of raising awareness about maternal mental health conditions among all health care providers.  

Among the 876 calls to PeriPAN about specific patients, 59% of women were postpartum and 33% were pregnant at the time of the consultation. Referrals were provided for 60% of patients, primarily for individual therapy and/or psychiatry. Medication management was the most common purpose for the consultation, followed by support for assessment or diagnosis and requests for general resources.  

“Fortunately, there’s a national network of state-based perinatal psychiatry Access Programs that are a vital link to connect primary care and maternal health providers, particularly rural or general, with a mental health professional who specializes in this area,” Abby said. “The care teams can get medication advice and behavioral consultations on cases they may be struggling to diagnose, which is all supported by the Trayt platform that makes it easier to facilitate workflows and track data and analytics on the backend.” 

To learn more about how Trayt’s supports perinatal Access Programs, contact us here

Read more from our Leaders in Maternal Mental Health series below, dedicated to Maternal Mental Health Month in May 2024 and celebrating the voices and perspectives of those at the forefront of maternal mental health policies and programs.

Explore profile of Dr. Nancy Byatt, leading perinatal mental health researcher and clinician

Learn more about the Texas Perinatal Psychiatric Access Network from Dr. Sarah Wakefield

Dig into policy with Jamie Zahlaway Belsito, founder of the Maternal Mental Health Leadership Alliance