Most therapists didn't go to graduate school to troubleshoot app downloads.
And yet, one of the fastest ways to undermine an RTM program is to dump the tech support onto already-stretched clinicians. When a therapist spends 10 minutes of a session helping a patient navigate a login screen or explaining how to complete a digital mood check-in, that's 10 fewer minutes for clinical work. It's frustrating for the provider, it erodes the therapeutic frame, and it's not sustainable.
Enter: The digital navigator.
The digital navigator is a relatively new role that emerged from research at Harvard's Beth Israel Deaconess Medical Center, led by Dr. John Torous and the Division of Digital Psychiatry. The concept was proposed in 2020 by Wisniewski and colleagues and has since been piloted, studied, and refined across multiple behavioral health settings.
At its core, a digital navigator is a member of the healthcare team who is specifically trained to support the integration of technology into clinical care. Their responsibilities typically include:
- Helping patients set up and learn to use digital monitoring tools
- Troubleshooting technical issues outside of clinical sessions
- Recommending and evaluating health apps based on evidence-based criteria
- Monitoring patient engagement data and flagging concerns to clinicians
- Promoting digital literacy, especially among populations with limited technology experience
- Interpreting and summarizing digital data for clinical review
The role doesn't require a clinical license. Digital navigators can be care coordinators, peer specialists, community health workers, research assistants, or administrative staff who receive focused training. A systematic review published in The Lancet Digital Health (Perret et al., 2023) examined 48 studies involving digital navigators in behavioral health and found significant variation in how the role is implemented, but consistent evidence that having dedicated human support for technology integration improves patient engagement with digital tools.
This matters for RTM because the success of an RTM program hinges on two things: patient engagement with the technology (they need to log data for at least 16 days per month to meet billing thresholds) and clinical integration of the data (providers need to review, interpret, and act on the information).
The digital navigator bridges both.
On the patient side, the navigator handles onboarding, reduces technology friction, and provides ongoing support that keeps engagement rates high. On the clinical side, the navigator can pre-process data, generate summary reports, track billing compliance (who's met the 16-day threshold and who hasn't), and ensure interactive communications are scheduled and documented.
There's also a compelling financial argument. Since the role doesn't require a licensed clinician, practices can often fill it at a salary point well below that of a therapist or psychologist, while the navigator's work directly supports revenue generation through proper RTM billing. A 2024 implementation study by Jaso-Yim and colleagues found that when patients connected with a digital care navigator within 24 hours of referral, 97% went on to register with the digital mental health tool. At 48 hours, that dropped to 76%. By day five, it was 41%. For RTM, faster registration means earlier data capture, earlier billing eligibility, and fewer patients lost before the program even starts.
I want to be thoughtful about something here. Not every practice needs a full-time digital navigator. For smaller practices, the navigator responsibilities can be distributed across existing staff: a front desk coordinator who handles onboarding, a care manager who monitors data compliance, or a billing specialist who tracks coding. The important thing is that someone owns each function. If everyone is responsible, no one is responsible.
For larger practices, especially those with ambitions to enroll 50, 100, or more patients in RTM, a dedicated digital navigator becomes increasingly valuable. The role scales well because it's not tied to clinical licensure, and it directly reduces the burden on clinicians who should be spending their time on clinical care.
The digital navigator model also has important implications for equity. Mental health tech tools are only useful if patients can access and engage with them. For older adults, patients in rural settings, individuals with limited English proficiency, or those unfamiliar with smartphone technology, a navigator can mean the difference between successful engagement and abandonment. Research from the Division of Digital Psychiatry's training program, which trained 80 participants across 21 community-based organizations, demonstrated the feasibility and acceptability of this model for expanding equitable access to digital mental health tools.
As RTM expands in behavioral health, I expect the digital navigator to become a standard role within high-performing mental health practices; as common and essential as the medical assistant is in a primary care office.
In the final post of this series, I'll look toward the future: where is RTM headed, what role will AI play, and what should forward-thinking behavioral health leaders be preparing for?
REFERENCES & SOURCES
Perret, S., et al. (2023). Standardising the Role of a Digital Navigator in Behavioural Health: A Systematic Review. The Lancet Digital Health, 5(12), e925-e932. https://www.thelancet.com/journals/landig/article/PIIS2589-7500(23)00152-8/fulltext
Wisniewski, H., et al. (2020). The Role of Digital Navigators in Promoting Clinical Care and Technology Integration into Practice. Digital Biomarkers, 4(Suppl 1), 119-135. https://pubmed.ncbi.nlm.nih.gov/33442585/
Alon, N., et al. (2024). Digital Navigator Training to Increase Access to Mental Health Care in Community-Based Organizations. Psychiatric Services, 75(6), 608-611. https://pubmed.ncbi.nlm.nih.gov/38595120/
Jaso-Yim, B., et al. (2024). Evaluation of the Impact of a Digital Care Navigator on Increasing Patient Registration with Digital Mental Health Interventions in Routine Care. Internet Interventions, 38, 100777. https://pmc.ncbi.nlm.nih.gov/articles/PMC11474210/
