Holistic Psychiatric Information Technology A Decision Support System for Mood and Personality Disorders Sirbrittie C.L. G...
Technology Background <ul><li>Decision Support System (DSS) </li></ul><ul><ul><li>Gathers, analyzes, presents data to help...
Market Segment <ul><li>2003 New Freedom Commission on Mental Health  </li></ul><ul><ul><li>Consumer driven mental health <...
Present Business Model Pre-Care Point of Care Post-Care Provider Consumer Individual Follower Unregulated Group Leader Reg...
Project P-DSS Survey Methods <ul><li>Participants </li></ul><ul><ul><li>3 Holistic Psychiatric Consumers (HPCs) </li></ul>...
Project P-DSS Gap Analysis
Project P-DSS Gap Analysis
Project P-DSS Requirements  <ul><li>Consumer-centered </li></ul><ul><ul><li>Leading to equitable psychiatric system </li><...
Project P-DSS Public Policy Issues <ul><li>Certifications/Accreditation </li></ul><ul><ul><li>Providers, non/profit health...
Project P-DSS Public Policy Issues <ul><li>Naturopath/Homeopaths </li></ul><ul><ul><li>Inability to Fully Define </li></ul...
Project P-DSS Demo Disclosures  Copyright © 2011 drBrettaGrant.com (Screen Shots vs Live Demo) Exploratory application wit...
Project P-DSS Demo Disclosures  <ul><ul><ul><li>Meditation Music (YouTube.com) </li></ul></ul></ul><ul><ul><ul><li>Trainin...
Screen Demo Login Screen Holistic Mental Health Network
Project P-DSS Demo User Management
Screen Demo User Views Provider Supporter Consumer Administrator
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...
Screen Demo Diary Mandatory Fields <ul><li>Stable mood is a normal state, no intervention needed. </li></ul><ul><li>Escala...
Screen Demo Daily Diary Provides date/time stamp 3 mood states Assumes HPC is on one med, but scalable to more than one med
Screen Demo Select Button Functions <ul><li>In functional state </li></ul><ul><ul><li>Search </li></ul></ul><ul><ul><ul><l...
Screen Demo Select Button Functions In functional state:  Provides system suggested coping skills complete with comments, ...
P-DSS Flow Chart for Analysis Questions
Project P-DSS Demo External Alerts
Project P-DSS Internal Demo Alerts
Screen Demo Ratings Systems My Rating is HPC Ratings Peer Rating is aggregate of 2 supporters and one provider (excludes H...
Live Demo Test case: 1 Holistic Psychiatric Consumer (HPC) 2 Supporters 1 Provider
P-DSS Analysis Question #1 Does the P-DSS make the HPC more accountable to their network in demonstrating their independen...
P-DSS Analysis Question #2 Does the P-DSS help the HPC make an informed decision to take medications when specific warning...
P-DSS Analysis Question #3 Does the P-DSS help the HPC de-escalate a potential crisis situation on their own prior to outs...
P-DSS Analysis Question #3 Does the P-DSS help the HPC de-escalate a potential crisis situation on their own prior to outs...
P-DSS Analysis Question #4 Can the supporters and providers of the HPCs network make similar or complementary decisions as...
P-DSS Analysis Question #4
P-DSS Effects on Direct Persuasion (HPC)  <ul><li>Advantages </li></ul><ul><ul><li>Camaraderie </li></ul></ul><ul><ul><li>...
P-DSS Effect on Supporter Comparison <ul><li>Advantages </li></ul><ul><ul><li>Reduce supporter learning curve </li></ul></...
P-DSS Effect on Provider Comparison <ul><li>Advantages </li></ul><ul><ul><li>Value added services </li></ul></ul><ul><ul><...
P-DSS Demo Evaluation
P-DSS Demo Evaluation
P-DSS Demo Evaluation
P-DSS Summary/Conclusion Prescription Therapy Institutionalize Provider Consumer Pre-Care Point of Care Post-Care Provider...
P-DSS Evidence Based Research  <ul><li>Raw Data Output  (Excel) </li></ul><ul><li>Individual </li></ul><ul><ul><li>Study a...
Future Development <ul><li>More HPC Specific Protocols </li></ul><ul><ul><li>Transitioning off Meds </li></ul></ul><ul><ul...
Thank you for your time! Questions? Feedback?  [email_address]
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Mental Illness to Master's Degree: Holistic Psychiatric Information Technology

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Mental Illness to Master's Degree: Holistic Psychiatric Information Technology

  1. 1. Holistic Psychiatric Information Technology A 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 Engineering School of Computer Science Tepper School of Business Heinz College
  2. 2. Technology Background <ul><li>Decision Support System (DSS) </li></ul><ul><ul><li>Gathers, analyzes, presents data to help users make decisions </li></ul></ul><ul><ul><li>Ultimate decision is still users to make </li></ul></ul><ul><li>Clinical Decision Support System (C-DSS) </li></ul><ul><ul><li>Provider Centric (Diagnosis, Psychotropic Meds) </li></ul></ul><ul><li>Psychiatric Decisions Support System (P-DSS) </li></ul><ul><ul><li>None (for consumer) </li></ul></ul><ul><ul><li>WebMD.com </li></ul></ul><ul><ul><li>HealthLine.com </li></ul></ul>Knowledge System (Dynamically built by community)
  3. 3. Market Segment <ul><li>2003 New Freedom Commission on Mental Health </li></ul><ul><ul><li>Consumer driven mental health </li></ul></ul><ul><ul><li>Technology used to access mental health care and information </li></ul></ul><ul><li>Mental Health Population </li></ul><ul><ul><li>1 in 4 adults with at least one diagnosable mental illness per year </li></ul></ul><ul><ul><li>18M with diagnosable mood and/or personality disorders </li></ul></ul><ul><ul><li>90% of suicides </li></ul></ul><ul><ul><li>$193B society cost (lost earnings, co-existing conditions, incarceration) </li></ul></ul><ul><ul><li>60% don't seek any treatment from mental health providers </li></ul></ul><ul><ul><li>Vested Interest (Disclosure) </li></ul></ul><ul><ul><li>Holistic Psychiatric Consumer (HPC) (Mind, Body, Spirit) </li></ul></ul>
  4. 4. Present Business Model Pre-Care Point of Care Post-Care Provider Consumer Individual Follower Unregulated Group Leader Regulations Beliefs Opinions Decisions Decisions
  5. 5. Project P-DSS Survey Methods <ul><li>Participants </li></ul><ul><ul><li>3 Holistic Psychiatric Consumers (HPCs) </li></ul></ul><ul><ul><li>8 HPC Supporters </li></ul></ul><ul><ul><li>1 Provider </li></ul></ul><ul><li>Methods </li></ul><ul><ul><li>2 Surveys (WebMD.com, HealthLine.com) + Prototype Evaluation </li></ul></ul><ul><ul><li>5 Open-ended questions </li></ul></ul><ul><ul><li>Think-aloud protocol </li></ul></ul><ul><ul><li>Guided Tasks (Interviews) </li></ul></ul><ul><li>Study Limitations </li></ul><ul><ul><li>Surveyor Assumptions </li></ul></ul><ul><ul><li>Direct Influence </li></ul></ul><ul><ul><li>Sample Size </li></ul></ul><ul><ul><li>Non-Discriminated Results </li></ul></ul>
  6. 6. Project P-DSS Gap Analysis
  7. 7. Project P-DSS Gap Analysis
  8. 8. Project P-DSS Requirements <ul><li>Consumer-centered </li></ul><ul><ul><li>Leading to equitable psychiatric system </li></ul></ul><ul><ul><li>One-stop location </li></ul></ul><ul><ul><li>Pre-Care, Point-of-Care, Post-Care Decision Support </li></ul></ul><ul><ul><li>Diary Tracking/Behavior Identification </li></ul></ul><ul><ul><li>Peer Knowledge/Support, ie Alternative Medications, Coping Skills </li></ul></ul><ul><ul><li>Rating System </li></ul></ul><ul><ul><li>Ad-Free </li></ul></ul><ul><ul><li>Simplicity </li></ul></ul>
  9. 9. Project P-DSS Public Policy Issues <ul><li>Certifications/Accreditation </li></ul><ul><ul><li>Providers, non/profit health organizations, insurers, public interest </li></ul></ul><ul><ul><li>Health on the Net Foundation (HonCode) </li></ul></ul><ul><ul><ul><li>For medical and health Web sites. trustworthy, reliable, credible information </li></ul></ul></ul><ul><ul><li>Utilization Review Accreditation Commission (URAC) </li></ul></ul><ul><ul><ul><li>Best practices for operational policies/procedures health care technology orgs </li></ul></ul></ul><ul><ul><li>Health Level Seven International (HL7) </li></ul></ul><ul><ul><ul><li>ANSI-accredited, framework and related standards in (electronic) healthcare </li></ul></ul></ul><ul><li>Health Insurance Portability and Accountability Act (HIPAA) </li></ul><ul><ul><li>Protects security/privacy of all medical records/shared information </li></ul></ul><ul><ul><li>Patient right to access and control of health information </li></ul></ul><ul><ul><li>Fines/Penalties </li></ul></ul><ul><ul><li>P-DSS may not be a covered entity </li></ul></ul>
  10. 10. Project P-DSS Public Policy Issues <ul><li>Naturopath/Homeopaths </li></ul><ul><ul><li>Inability to Fully Define </li></ul></ul><ul><ul><li>Inability to Fully Regulate </li></ul></ul><ul><ul><li>North Carolina Legislation SB31 </li></ul></ul><ul><ul><ul><li>Criminal felony violations for practicing medicine without a license </li></ul></ul></ul><ul><ul><li>Liability/Insurability </li></ul></ul><ul><ul><ul><li>Mental health economic system </li></ul></ul></ul><ul><li>Self-Medicating </li></ul><ul><ul><li>Benefits/exclusion of medical establishment </li></ul></ul><ul><ul><li>Illegal substances </li></ul></ul><ul><ul><li>Risky behaviors </li></ul></ul>
  11. 11. 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'
  12. 12. Project P-DSS Demo Disclosures <ul><ul><ul><li>Meditation Music (YouTube.com) </li></ul></ul></ul><ul><ul><ul><li>Training Video (YoutTube.com) </li></ul></ul></ul><ul><ul><ul><li>Chatting Tool (© 2011 LivePerson.com) </li></ul></ul></ul><ul><ul><ul><li>Gmail Calendar (calendar.gmail.com) </li></ul></ul></ul><ul><ul><ul><li>Breathing Apparatus (© 2011 Mobile Health Innovations) </li></ul></ul></ul>Prototype hosted at GoDaddy.com Integrated Architecture
  13. 13. Screen Demo Login Screen Holistic Mental Health Network
  14. 14. Project P-DSS Demo User Management
  15. 15. Screen Demo User Views Provider Supporter Consumer Administrator
  16. 16. 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
  17. 17. Screen Demo Diary Mandatory Fields <ul><li>Stable mood is a normal state, no intervention needed. </li></ul><ul><li>Escalating mood, patient should be monitored. </li></ul><ul><li>Critical mood, patient no longer in control. </li></ul><ul><li>Meds - assumption that the patient is on one main meds. </li></ul>
  18. 18. Screen Demo Daily Diary Provides date/time stamp 3 mood states Assumes HPC is on one med, but scalable to more than one med
  19. 19. Screen Demo Select Button Functions <ul><li>In functional state </li></ul><ul><ul><li>Search </li></ul></ul><ul><ul><ul><li>Find keywords in the diary </li></ul></ul></ul><ul><li>In demo state </li></ul><ul><ul><li>List All </li></ul></ul><ul><ul><ul><li>Retrieves all diary entries, filtered by date/time, mood, med </li></ul></ul></ul><ul><ul><li>Add New </li></ul></ul><ul><ul><ul><li>Adds new diary entry </li></ul></ul></ul><ul><ul><li>Excel </li></ul></ul><ul><ul><ul><li>Outputs raw data in Excel spreadsheet </li></ul></ul></ul>
  20. 20. 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
  21. 21. P-DSS Flow Chart for Analysis Questions
  22. 22. Project P-DSS Demo External Alerts
  23. 23. Project P-DSS Internal Demo Alerts
  24. 24. 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.
  25. 25. Live Demo Test case: 1 Holistic Psychiatric Consumer (HPC) 2 Supporters 1 Provider
  26. 26. P-DSS Analysis Question #1 Does the P-DSS make the HPC more accountable to their network in demonstrating their independence?
  27. 27. P-DSS Analysis Question #2 Does the P-DSS help the HPC make an informed decision to take medications when specific warnings are provided?
  28. 28. P-DSS Analysis Question #3 Does the P-DSS help the HPC de-escalate a potential crisis situation on their own prior to outside intervention?
  29. 29. P-DSS Analysis Question #3 Does 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
  30. 30. P-DSS Analysis Question #4 Can 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
  31. 31. P-DSS Analysis Question #4
  32. 32. P-DSS Effects on Direct Persuasion (HPC) <ul><li>Advantages </li></ul><ul><ul><li>Camaraderie </li></ul></ul><ul><ul><li>Similar values, beliefs, motivations </li></ul></ul><ul><ul><li>Support </li></ul></ul><ul><ul><li>Unbiased opinions </li></ul></ul><ul><ul><li>Faster </li></ul></ul><ul><ul><li>Removes external barriers </li></ul></ul><ul><ul><li>HPC specific EBR </li></ul></ul><ul><li>Disadvantages </li></ul><ul><ul><li>Minimizes provider input </li></ul></ul><ul><ul><li>Lack of tested EBR </li></ul></ul><ul><ul><li>Questionable Motives </li></ul></ul><ul><ul><li>Removes external barriers </li></ul></ul><ul><ul><li>Anonymity </li></ul></ul>
  33. 33. P-DSS Effect on Supporter Comparison <ul><li>Advantages </li></ul><ul><ul><li>Reduce supporter learning curve </li></ul></ul><ul><ul><li>Support for the supporter </li></ul></ul><ul><ul><li>Standardization </li></ul></ul><ul><ul><li>Paradigm shift </li></ul></ul><ul><ul><li>Example </li></ul></ul><ul><li>Disadvantages </li></ul><ul><ul><li>Paradigm shift </li></ul></ul><ul><ul><li>Persistence </li></ul></ul><ul><ul><li>Longevity </li></ul></ul><ul><ul><li>Example </li></ul></ul>
  34. 34. P-DSS Effect on Provider Comparison <ul><li>Advantages </li></ul><ul><ul><li>Value added services </li></ul></ul><ul><ul><li>Decentralization </li></ul></ul><ul><ul><li>Example </li></ul></ul><ul><li>Disadvantages </li></ul><ul><ul><li>Peer pressure </li></ul></ul><ul><ul><li>Ostracized </li></ul></ul><ul><ul><li>Licensing compliance </li></ul></ul><ul><ul><li>Loss of control </li></ul></ul><ul><ul><li>Example </li></ul></ul>
  35. 35. P-DSS Demo Evaluation
  36. 36. P-DSS Demo Evaluation
  37. 37. P-DSS Demo Evaluation
  38. 38. P-DSS Summary/Conclusion Prescription Therapy Institutionalize Provider Consumer Pre-Care Point of Care Post-Care Provider Consumer Prescription Therapy Institutionalize Provider Consumer Pre-Care Point of Care Post-Care Provider Consumer Decisions
  39. 39. P-DSS Evidence Based Research <ul><li>Raw Data Output (Excel) </li></ul><ul><li>Individual </li></ul><ul><ul><li>Study and manipulate their own behavior </li></ul></ul><ul><ul><li>Study pharmacological effectiveness specific to them </li></ul></ul><ul><ul><li>Reduce habitual hospitalization </li></ul></ul><ul><ul><li>Leads to long-term recovery </li></ul></ul><ul><ul><li>Empowerment to “push” back to the establishment </li></ul></ul><ul><li>Community </li></ul><ul><ul><li>Grassroots efforts </li></ul></ul><ul><ul><li>Immediate benefits </li></ul></ul><ul><ul><li>Reaches voluntarily or involuntarily remote segments </li></ul></ul><ul><ul><li>Does not require widespread acceptance </li></ul></ul><ul><ul><li>Creates demand for services </li></ul></ul>
  40. 40. Future Development <ul><li>More HPC Specific Protocols </li></ul><ul><ul><li>Transitioning off Meds </li></ul></ul><ul><ul><li>WRAP/Advanced Directives/Medical Power of Attorney </li></ul></ul><ul><li>User/Profile Customization </li></ul><ul><ul><li>Color Code based “skins” based on Mood State </li></ul></ul><ul><li>Portability </li></ul><ul><ul><li>Platform Independent (Smart phone, Desktop, Laptop) </li></ul></ul><ul><ul><li>Social Networking Apps (Facebook, Blog sites, LinkedIn) </li></ul></ul><ul><li>On-line Education/Training </li></ul><ul><ul><li>Certified Peer Supporter </li></ul></ul><ul><ul><li>Mental Health First Aid </li></ul></ul><ul><li>Children Specific Areas </li></ul>
  41. 41. Thank you for your time! Questions? Feedback? [email_address]

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