mental illness to master's degree: holistic psychiatric information technology
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1The INI is a cooperative endeavor of: College of Engineering School of Computer Science
Tepper School of Business Heinz College
Holistic Psychiatric Information TechnologyA Decision Support System for Mood and Personality Disorders
Sirbrittie C.L. Grant
Fall 2011
The Information Networking Institute is a cooperative endeavor of:
College of EngineeringSchool of Computer Science
Tepper School of BusinessHeinz College
2The INI is a cooperative endeavor of: College of Engineering School of Computer Science
Tepper School of Business Heinz College
Technology BackgroundDecision Support System (DSS)
Gathers, analyzes, presents data to help users make decisions Ultimate decision is still users to make
Clinical Decision Support System (C-DSS) Provider Centric (Diagnosis, Psychotropic Meds)
Psychiatric Decisions Support System (P-DSS) None (for consumer) WebMD.com HealthLine.com
Knowledge System(Dynamically built by community)
3The INI is a cooperative endeavor of: College of Engineering School of Computer Science
Tepper School of Business Heinz College
Market Segment2003 New Freedom Commission on Mental Health
Consumer driven mental health Technology used to access mental health care and information
Mental Health Population 1 in 4 adults with at least one diagnosable mental illness per year 18M with diagnosable mood and/or personality disorders 90% of suicides $193B society cost (lost earnings, co-existing conditions,
incarceration) 60% don't seek any treatment from mental health providers Vested Interest (Disclosure) Holistic Psychiatric Consumer (HPC) (Mind, Body, Spirit)
4The INI is a cooperative endeavor of: College of Engineering School of Computer Science
Tepper School of Business Heinz College
Present Business Model
Pre-CarePoint of Care
Post-CareProvider Consumer
Individual Follower
Unregulated
Group Leader
Regulations
Beliefs
Opinions
Decisions
Decisions
5The INI is a cooperative endeavor of: College of Engineering School of Computer Science
Tepper School of Business Heinz College
Project P-DSS Survey MethodsParticipants
3 Holistic Psychiatric Consumers (HPCs)8 HPC Supporters1 Provider
Methods2 Surveys (WebMD.com, HealthLine.com) + Prototype Evaluation5 Open-ended questionsThink-aloud protocolGuided Tasks (Interviews)
Study LimitationsSurveyor AssumptionsDirect InfluenceSample SizeNon-Discriminated Results
6The INI is a cooperative endeavor of: College of Engineering School of Computer Science
Tepper School of Business Heinz College
Project P-DSS Gap Analysis
7The INI is a cooperative endeavor of: College of Engineering School of Computer Science
Tepper School of Business Heinz College
Project P-DSS Gap Analysis
8The INI is a cooperative endeavor of: College of Engineering School of Computer Science
Tepper School of Business Heinz College
Project P-DSS Requirements Consumer-centered
Leading to equitable psychiatric system One-stop location Pre-Care, Point-of-Care, Post-Care Decision Support Diary Tracking/Behavior Identification Peer Knowledge/Support, ie Alternative Medications, Coping Skills Rating System Ad-Free Simplicity
9The INI is a cooperative endeavor of: College of Engineering School of Computer Science
Tepper School of Business Heinz College
Project P-DSS Public Policy IssuesCertifications/Accreditation
Providers, non/profit health organizations, insurers, public interest Health on the Net Foundation (HonCode)
For medical and health Web sites. trustworthy, reliable, credible information Utilization Review Accreditation Commission (URAC)
Best practices for operational policies/procedures health care technology orgs Health Level Seven International (HL7)
ANSI-accredited, framework and related standards in (electronic) healthcare
Health Insurance Portability and Accountability Act (HIPAA) Protects security/privacy of all medical records/shared information Patient right to access and control of health information Fines/Penalties P-DSS may not be a covered entity
10The INI is a cooperative endeavor of: College of Engineering School of Computer Science
Tepper School of Business Heinz College
Project P-DSS Public Policy IssuesNaturopath/Homeopaths
Inability to Fully Define Inability to Fully Regulate North Carolina Legislation SB31
Criminal felony violations for practicing medicine without a license
Liability/Insurability Mental health economic system
Self-Medicating Benefits/exclusion of medical establishment Illegal substances Risky behaviors
11The INI is a cooperative endeavor of: College of Engineering School of Computer Science
Tepper School of Business Heinz College
Project P-DSS Demo Disclosures Copyright © 2011 drBrettaGrant.com (Screen Shots vs Live Demo)
Exploratory application without industry based guidelines
Personal experiences, observations, communication
Information capture/dissemination via pre-populated tables
HPC inactivity with the system, med noncompliance and decision support for 2 mood state changes, 'escalating' and 'critical'
12The INI is a cooperative endeavor of: College of Engineering School of Computer Science
Tepper School of Business Heinz College
Project P-DSS Demo Disclosures
Meditation Music (YouTube.com) Training Video (YoutTube.com) Chatting Tool (© 2011 LivePerson.com) Gmail Calendar (calendar.gmail.com) Breathing Apparatus (© 2011 Mobile Health Innovations)
Prototype hosted at GoDaddy.com
Integrated Architecture
13The INI is a cooperative endeavor of: College of Engineering School of Computer Science
Tepper School of Business Heinz College
Screen Demo Login Screen
Holistic Mental Health Network
14The INI is a cooperative endeavor of: College of Engineering School of Computer Science
Tepper School of Business Heinz College
Project P-DSS Demo User Management
15The INI is a cooperative endeavor of: College of Engineering School of Computer Science
Tepper School of Business Heinz College
Screen Demo User Views
ProviderSupporterConsumer
Administrator
16The INI is a cooperative endeavor of: College of Engineering School of Computer Science
Tepper School of Business Heinz College
Project P-DSS Daily Diary Questions
What did I do today?What did I wear?What did I eat?Where did I go?What music did I listen to?Any new ailment today?How much do I weigh?How much water did I drink?My notes/Comments of the day.My networks observations/feedback.
Questions derived from observed behavior
Tracks daily changes to better define triggers
Specific to HPC
17The INI is a cooperative endeavor of: College of Engineering School of Computer Science
Tepper School of Business Heinz College
Screen Demo Diary Mandatory Fields
• Stable mood is a normal state, no intervention needed.• Escalating mood, patient should be monitored. • Critical mood, patient no longer in control.• Meds - assumption that the patient is on one main meds.
18The INI is a cooperative endeavor of: College of Engineering School of Computer Science
Tepper School of Business Heinz College
Screen Demo Daily Diary
Provides date/time stamp
3 mood states
Assumes HPC is on one med, but scalable to more than one med
19The INI is a cooperative endeavor of: College of Engineering School of Computer Science
Tepper School of Business Heinz College
Screen Demo Select Button Functions
In functional state Search
Find keywords in the diary
In demo state List All
Retrieves all diary entries, filtered by date/time, mood, med Add New
Adds new diary entry Excel
Outputs raw data in Excel spreadsheet
20The INI is a cooperative endeavor of: College of Engineering School of Computer Science
Tepper School of Business Heinz College
Screen Demo Select Button Functions
In functional state: Provides system suggested coping skills complete
with comments, ratings, etc. (similar to other features of the prototype)
In demo state: Defaults to Breathing, Meditation Music, and Online
Chatting for an 'escalating' mood, in that order, and as a part of the 'critical' mood state's checklist
21The INI is a cooperative endeavor of: College of Engineering School of Computer Science
Tepper School of Business Heinz College
P-DSS Flow Chart for Analysis Questions
22The INI is a cooperative endeavor of: College of Engineering School of Computer Science
Tepper School of Business Heinz College
Project P-DSS Demo External Alerts
23The INI is a cooperative endeavor of: College of Engineering School of Computer Science
Tepper School of Business Heinz College
Project P-DSS Internal Demo Alerts
24The INI is a cooperative endeavor of: College of Engineering School of Computer Science
Tepper School of Business Heinz College
Screen Demo Ratings Systems
My Rating is HPC Ratings
Peer Rating is aggregate of 2 supporters and one provider (excludes HPC ratings)
Scores are based on a 1 (poor) to 5 (excellent) rating system. Total peer rating is out of 6 users.
25The INI is a cooperative endeavor of: College of Engineering School of Computer Science
Tepper School of Business Heinz College
Live Demo
Test case:
1 Holistic Psychiatric Consumer (HPC)2 Supporters
1 Provider
26The INI is a cooperative endeavor of: College of Engineering School of Computer Science
Tepper School of Business Heinz College
P-DSS Analysis Question #1Does the P-DSS make the HPC more accountable to their network in demonstrating their independence?
27The INI is a cooperative endeavor of: College of Engineering School of Computer Science
Tepper School of Business Heinz College
P-DSS Analysis Question #2Does the P-DSS help the HPC make an informed decision to take medications when specific warnings are provided?
28The INI is a cooperative endeavor of: College of Engineering School of Computer Science
Tepper School of Business Heinz College
P-DSS Analysis Question #3Does the P-DSS help the HPC de-escalate a potential crisis situation on their own prior to outside intervention?
29The INI is a cooperative endeavor of: College of Engineering School of Computer Science
Tepper School of Business Heinz College
P-DSS Analysis Question #3Does the P-DSS help the HPC de-escalate a potential crisis situation on their own prior to outside intervention?
© 2011 Mobile Health Interventions (© © 2011 Live Person
30The INI is a cooperative endeavor of: College of Engineering School of Computer Science
Tepper School of Business Heinz College
P-DSS Analysis Question #4Can the supporters and providers of the HPCs network make similar or complementary decisions as the HPC when in a crisis situation?
Critical Protocol CheckList.doc
31The INI is a cooperative endeavor of: College of Engineering School of Computer Science
Tepper School of Business Heinz College
P-DSS Analysis Question #4
32The INI is a cooperative endeavor of: College of Engineering School of Computer Science
Tepper School of Business Heinz College
P-DSS Effects on Direct Persuasion (HPC) Advantages
CamaraderieSimilar values, beliefs, motivationsSupportUnbiased opinionsFasterRemoves external barriersHPC specific EBR
DisadvantagesMinimizes provider inputLack of tested EBRQuestionable MotivesRemoves external barriersAnonymity
33The INI is a cooperative endeavor of: College of Engineering School of Computer Science
Tepper School of Business Heinz College
P-DSS Effect on Supporter ComparisonAdvantages
Reduce supporter learning curveSupport for the supporterStandardizationParadigm shiftExample
DisadvantagesParadigm shiftPersistenceLongevityExample
34The INI is a cooperative endeavor of: College of Engineering School of Computer Science
Tepper School of Business Heinz College
P-DSS Effect on Provider ComparisonAdvantages
Value added servicesDecentralizationExample
DisadvantagesPeer pressureOstracizedLicensing complianceLoss of controlExample
35The INI is a cooperative endeavor of: College of Engineering School of Computer Science
Tepper School of Business Heinz College
Limited or no consumer input
Limited or no data retrieval and distribution across health systems
Point of care focused
Lack of regulation and consensus on use
0.00% 20.00% 40.00% 60.00% 80.00% 100.00%
P-DSS Shortcomings Prototype Evaluation
HealthLine.comWebMD.comPrototype
P-DSS Demo Evaluation
36The INI is a cooperative endeavor of: College of Engineering School of Computer Science
Tepper School of Business Heinz College
P-DSS Demo Evaluation
37The INI is a cooperative endeavor of: College of Engineering School of Computer Science
Tepper School of Business Heinz College
P-DSS Demo Evaluation
Question #1 Question #2 Question #3 Question #40.00%
20.00%
40.00%
60.00%
80.00%
100.00%
P-DSS Question Analysis Prototype Evaluation
YesNo
38The INI is a cooperative endeavor of: College of Engineering School of Computer Science
Tepper School of Business Heinz College
P-DSS Summary/Conclusion
PrescriptionTherapy
Institutionalize
Provider
Consumer
Pre-CarePoint of Care
Post-Care
Provider
Consumer
PrescriptionTherapy
Institutionalize
Provider
Consumer
Pre-CarePoint of Care
Post-Care
Provider
Consumer
Decisions
39The INI is a cooperative endeavor of: College of Engineering School of Computer Science
Tepper School of Business Heinz College
P-DSS Evidence Based Research Raw Data Output (Excel)Individual
Study and manipulate their own behavior Study pharmacological effectiveness specific to them Reduce habitual hospitalization Leads to long-term recovery Empowerment to “push” back to the establishment
Community Grassroots efforts Immediate benefits Reaches voluntarily or involuntarily remote segments Does not require widespread acceptance Creates demand for services
40The INI is a cooperative endeavor of: College of Engineering School of Computer Science
Tepper School of Business Heinz College
Future DevelopmentMore HPC Specific Protocols
Transitioning off Meds WRAP/Advanced Directives/Medical Power of Attorney
User/Profile Customization Color Code based “skins” based on Mood State
Portability Platform Independent (Smart phone, Desktop, Laptop) Social Networking Apps (Facebook, Blog sites, LinkedIn)
On-line Education/Training Certified Peer Supporter Mental Health First Aid
Children Specific Areas
41The INI is a cooperative endeavor of: College of Engineering School of Computer Science
Tepper School of Business Heinz College
Thank you for your time!
Questions?Feedback?
drBrettaGrant@gmail.com
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