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Providing Behavioral Resources to the Military Community: Mobile and Web-based Applications

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In this presentation Dr. Robert Ciulla and Dr. Julie Kinn discuss why technology is effective in supporting behavioral health care and how the National Center for Telehealth & Technology is leveraging …

In this presentation Dr. Robert Ciulla and Dr. Julie Kinn discuss why technology is effective in supporting behavioral health care and how the National Center for Telehealth & Technology is leveraging it.

Published in: Health & Medicine, Business

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  • 1. Providing Behavioral Resources tothe Military Community: Mobile and Web-based Applications Julie Kinn, Ph.D. and Robert Ciulla, Ph.D. National Center For Telehealth & Technology Joint Base Lewis-McChord/ Tacoma, WA American Telemedicine Association (ATA) 2012 Annual International Meeting & Expo
  • 2. Agenda • Military Behavioral Health – Needs – Challenges • Why Telehealth in Addition to TAU • National Center for Telehealth & Technology – Approach to Development – Current Tools for Military Behavioral Health • Future Development2
  • 3. Military Behavioral Health • Needs – Care for service members and families – Access to resources for providers – Agility to respond to emergent crises • Challenges – Costs – Distance3
  • 4. Why Use Technology in Military Health Care?• Overcome barriers to care (e.g., Hoge et al., 2004) – Stigma: • Web-based and mobile apps are anonymous • User interfaces/ platforms familiar to service members – Logistics: • “Hip pocket” availability • 24/7 access to care, 365 days a year
  • 5. National Center for Telehealth & Technology (T2)Mission: Lead thedevelopment of telehealthand technology solutions Research what works, what doesn‟t, and whyfor Psychological Healthand Traumatic Brain Injury Create and adapt Provide operational and technology administrative supportto improve the lives of ourNation‟s Warriors,Veterans, and their Integrate technology with health care andFamilies. health promotionVision: Technology to Pilot innovative Deliver population levelMake People Healthy – technologies behavior change technologiesLeading the greater Connect patients withmilitary community to providers & providers with consultantsimproved health throughevidence-informedtechnology innovation.5
  • 6. MHS Quadruple Aim EXPERIENCE OF CARE  Providing a care experience that is patient and family centered, compassionate, convenient, equitable, safe and consistently of the highest quality  Access, clinical telehealth, clinical support tools, integrated, comprehensive care POPULATION HEALTH  Reducing the generators of ill health by encouraging healthy behaviors and decreasing the likelihood of illness through focused prevention and the development of increased resilience  Improving health, prevention, self-help, medical management, registries, health psychology and lifestyle behavior change READINESS  Ready Force: Ensuring that the total military force is medically ready to deploy  Screening, surveillance, family support, stress inoculation, reintegration, suicide prevention  Ready Medics: Ensuring that the medical force is ready to deliver the full spectrum of healthcare anywhere – currency and competency  Professional development, education and training, currency and competency, telehealth standards and training, access to telehealth sub-specialty care and consultation PER CAPITA COST  Creating value by focusing on quality, eliminating waste and reducing unwarranted variation; considering the total cost of care over time, not just the cost of an individual health care activity; providing value for healthcare funding  Efficacy, evaluation, research, data-based decisions, culture of innovation to improve healthcare operations6
  • 7. T2 Approach to Development• Assessment at every stage – Focus Group – Usability – Efficacy – Effectiveness• Collaborations – Department of Veterans Affairs (VA) – Non-profit organizations – Universities
  • 8. T2’s Current Tools for Military Behavioral Healthcare • Web-based applications – AfterDeployment.org – MilitaryKidsConnect.org • Mobile applications8
  • 9. AfterDeployment.org • 18 Topics • 29 Self-Assessments • Multiple Media Libraries • Self-Paced Workshops • Video-Based Personal Stories • Community Forums • Expert Blogs • Links to Hotlines • Links to Other Sites/Content • Provider Locator Tool • Provider Portal • Podcasts • RSS Feeds • Polls and Quick Health Tips • Social Media Links • Daily Quotes9
  • 10. Self-Assessments • Twenty-nine standardized self-assessments across eighteen modules • Results are reflected along an acuity continuum, from low to moderate to high • Users receive immediate feedback on results and recommendations within a structured Learning Management System (LMS)10
  • 11. Interactive Workshops11
  • 12. Provider Education
  • 13. MilitaryKidsConnect.org • Launched January 2012 • Interactive map, personal stories, games, message boards, online scrapbook. • Separate content for children (6-8), tweens (9-12) and teens (13-17). • Resources for parents and educators of military kids. • Addresses each stage of the deployment cycle.
  • 14. MilitaryKidsConnect.org Site tailored depending on identified deployment location Features identified by text and graphics Passport “gamification” Age-differentiated message boards Stampy the Global Guide14
  • 15. T2 Mobile Applications15
  • 16. PTSD Coach T2 collaborated with the VAs National Center for PTSD to develop this app to assist veterans and active duty personnel (and civilians) who are experiencing symptoms of PTSD. It is intended to be used as an adjunct to psychological treatment but can also serve as a stand-alone education tool. Features: • Self-assessment of PTSD Symptoms • Tracking of changes in symptoms • Manage symptoms with coping tools • Assistance in finding immediate support • Customized support information16
  • 17. T2 Mood Tracker Self-monitor, track and reference emotional experiences over a period of days, weeks and months. Features: • Self-rating on pre-populated categories • Full note adding • Graphed results • Fully customizable categories • User-set reminders for self-rating • Send results to providers (upcoming)17
  • 18. Breathe2Relax Breathe2Relax is a portable stress management tool utilizing hands-on diaphragmatic breathing exercise. Breathe2Relax uses state-of-the-art graphics, animation, narration, and videos to deliver a sophisticated, immersive experience for the user. Features: • Setup guide to assist with tailoring app • Customizable backgrounds and music • Immersive tutorial videos • Body scanner to display effects of stress • Graphing to track effectiveness • Audio narration18
  • 19. mTBI Pocket Guide Clinical Practice Guidelines for treatment of mTBI Features: • Quick results with coding guidance • Symptom management lists • Summary of clinical recommendations • Patient education resources • Clinical tools and resources19
  • 20. Co-occurring Conditions Toolkit Co-occurring Conditions Toolkit: Mild Traumatic Brain Injury and Psychological Health Features: • Guidance to primary care providers on the assessment and management of patients • Synthesizes information from the following VA/DoD CPGS: mTBI, PTSD, depression, chronic opioid therapy and substance use disorder20
  • 21. LifeArmor Currently in beta version (soft release) A multi-topic application derived from AfterDeployment.org to provide the user with knowledge and tools to cope with the many challenges faced by today‟s service members. Features: • Multi-topic resource guide • Self-assessments of topic symptoms • Ease to manage, customizable views and favorites • Manage symptoms with coping tools • Video resources on topics21
  • 22. Provider Resilience Deploying Summer 2012 Currently field testing downrange Self-care tool for health care providers who work with service members and who may need support coping with burnout or compassion fatigue Features: • Quick dashboard view • Graphing to track resilience progress • Tools to assist increasing resilience • Inspirational value cards • User-set reminders to update assessments22
  • 23. Positive Activities Jackpot Currently in beta version (soft release) Provides suggestions for daily positive activities. Based on positive event scheduling, the active component of Behavior Activation. Helps with depression, self-harming behaviors, and individuals without any mental health difficulties. Features: • “Jackpot” suggests random activities • Users select from 376+ possible activities • Augmented reality technology to identify activities in immediate surroundings • Ability to invite friends or post chosen activity to social media23
  • 24. PTSD Family Coach Deploying Summer 2012 T2 collaborated with the VAs National Center for PTSD to create the PTSD Family Coach. This app provides support to families of Veterans and Active Duty personnel (and civilians) who are experiencing symptoms of PTSD. Features: • Education about PTSD • Coping tools to help manage stress • Guided deep breathing and progressive muscle relaxation • Assistance in finding immediate support and resources • Customized support information24
  • 25. Telehealth Clinical CoachIn DevelopmentProvides information and interactivetools to assist in the design of telementalhealth systems and guidance forconducting telemental health sessions.Features:• Interactive tools to assist with clinic set- up and maintenance• Instructional content to educate users about telemental health (TMH)• Interactive VTC back panel and remote control images• Graphical demonstration of effects of bandwidth on video quality• Decibel reader for measuring sound levels• Email and print capabilities
  • 26. Virtual Hope BoxIn DevelopmentSelf-care tool for patients. Helps the usercope with suicidal ideation and othersymptoms of depression by providing acustomizable, virtual “hope box” containingreminders for living, distraction tools,relaxation tools, coping cards, and othersymptom management tools.Features:• Customizable pictures, video, and music to remind user of reasons for living• Word games, photo puzzles, and other distraction tools• Guides user in controlled breathing and progressive muscle relaxation• Inspiring quotes• Crisis lines and customizable contact information for immediate support26
  • 27. Future Development Focus On: • Efficiency: – Content should be created once and applied across platforms – Applications and generic modules shared via library/repository • Security: – Address linkage of devices to Electronic Health Record (EHR) – Support mobile health in deployed settings, for reservists, etc. • Forward-thinking policy: – Identify and share best practices (“share first”) – Work to create an environment that supports the evolution of the Patient Centered Medical Home model across the MHS spectrum („participatory medicine‟)27
  • 28. Contact Information Julie Kinn, Ph.D. Mobile Applications Program Manager | Research Psychologist Population and Prevention Programs |P3| National Center for Telehealth & Technology |T2| TEL: (253) 320-5718 | FAX: (253) 968-4192 www.t2health.org | julie.kinn@us.army.mil Robert Ciulla, Ph.D. Chief Population and Prevention Programs |P3| National Center for Telehealth & Technology |T2| TEL: (253) 968-2849 | FAX: (253) 968-4192 www.t2health.org | robert.ciulla@us.army.mil To view or download a copy of this presentation, please visit: http://www.slideshare.net/t2health28