Lessons from the deployment of the SPIRIT app to support collaborative care for rural patients with complex psychiatric conditions

Bauer, Amy M.; Hodsdon, Sarah; Hunter, S.; Choi, Youlim; Bechtel, Jared M; Fortney, John C.

doi:10.1145/3123024.3125610

Cited by 20 publications

(23 citation statements)

References 16 publications

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“…The SPIRIT app is available in English and Spanish. Details of the system have been previously published [ 43 ] and are summarized below.…”

Section: Methodsmentioning

confidence: 99%

“…A detailed description of the steps involved in the SPIRIT app design and development, including proof of concept and other preliminary activities, was previously published [ 43 ] and are summarized below ( Textbox 2 ). Service providers such as care managers, health center directors, supervisors, and psychiatrists informed the core content specifications built in CMTS and the SPIRIT app, while patients representative of the final SPIRIT target population were engaged to provide feedback on early concept development, as well as direct feedback and design direction for the app’s user experience, including layout, expected use, new features, and visual design.…”

Section: Methodsmentioning

confidence: 99%

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Applying the Principles for Digital Development: Case Study of a Smartphone App to Support Collaborative Care for Rural Patients With Posttraumatic Stress Disorder or Bipolar Disorder

Bauer¹,

Hodsdon²,

Bechtel³

et al. 2018

J Med Internet Res

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BackgroundDespite a proliferation of patient-facing mobile apps for mental disorders, there is little literature guiding efforts to incorporate mobile tools into clinical care delivery and integrate patient-generated data into care processes for patients with complex psychiatric disorders.ObjectiveThe aim of this study was to seek to gain an understanding of how to incorporate a patient-provider mobile health (mHealth) platform to support the delivery of integrated primary care–based mental health services (Collaborative Care) to rural patients with posttraumatic stress disorder and/or bipolar disorder.MethodsUsing the Principles for Digital Development as a framework, we describe our experience designing, developing, and deploying a mobile system to support Collaborative Care. The system consists of a patient-facing smartphone app that integrates with a Web-based clinical patient registry used by behavioral health care managers and consulting psychiatrists. Throughout development, we engaged representatives from the system’s two user types: (1) providers, who use the Web-based registry and (2) patients, who directly use the mobile app. We extracted mobile metadata to describe the early adoption and use of the system by care managers and patients and report preliminary results from an in-app patient feedback survey that includes a System Usability Scale (SUS).ResultsEach of the nine Principles for Digital Development is illustrated with examples. The first 10 patients to use the smartphone app have completed symptom measures on average every 14 days over an average period of 20 weeks. The mean SUS score at week 8 among four patients who completed this measure was 91.9 (range 72.5-100). We present lessons learned about the technical and training requirements for integration into practice that can inform future efforts to incorporate health technologies to improve care for patients with psychiatric conditions.ConclusionsAdhering to the Principles for Digital Development, we created and deployed an mHealth system to support Collaborative Care for patients with complex psychiatric conditions in rural health centers. Preliminary data among the initial users support high system usability and show promise for sustained use. On the basis of our experience, we propose five additional principles to extend this framework and inform future efforts to incorporate health technologies to improve care for patients with psychiatric conditions: design for public health impact, add value for all users, test the product and the process, acknowledge disruption, and anticipate variability.

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“…The SPIRIT app is available in English and Spanish. Details of the system have been previously published [ 43 ] and are summarized below.…”

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Applying the Principles for Digital Development: Case Study of a Smartphone App to Support Collaborative Care for Rural Patients With Posttraumatic Stress Disorder or Bipolar Disorder

Bauer¹,

Hodsdon²,

Bechtel³

et al. 2018

J Med Internet Res

Self Cite

View full text Add to dashboard Cite

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“…Self-tracking technologies are systems that make use of personal data collection about the sufferers. A majority (19) of papers present novel designs [11,13,17,59,60,60,61,75,77,81,88,89,110,115,120,130,157,163,179], whereas nine [8,15,56,58,90,111,117,148,159] are concerned with methodologies for developing self-tracking technologies attending to the specificities of affective disorders.…”

Section: Analysis Of Reviewed Work System Functionsmentioning

confidence: 99%

“…Regarding reasons for collecting data and sharing with others, seven systems [13,17,60,61,110,115,163] are aimed at encouraging the patient to adhere to a particular course of treatment, a medication prescription or a set of healthy routines, such as exercising. These are often crucial components of any therapy for affective disorders.…”

Section: Analysis Of Reviewed Work System Functionsmentioning

confidence: 99%

HCI and Affective Health

Sanches

Janson

Karpashevich

et al. 2019

Proceedings of the 2019 CHI Conference on Human Factors in Computing Systems

144

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In the last decade, the number of articles on HCI and health has increased dramatically. We extracted 139 papers on depression, anxiety and bipolar health issues from 10 years of SIGCHI conference proceedings. 72 of these were published in the last two years. A systematic analysis of this growing body of literature revealed that most innovation happens in automated diagnosis, and self-tracking, although there are innovative ideas in tangible interfaces. We noted an overemphasis on data production without consideration of how it leads to fruitful interventions. Moreover, we see a need to promote ethical practices for involvement of people living with affective disorders. Finally, although only 16 studies evaluate technologies in a clinical context, several forms of support and intervention illustrate how rich insights are gained from evaluations with real patients. Our findings highlight potential for growth in the design space of affective health technologies.

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“…The first necessary step in creating an mMHealth app is to define its goals according to the needs of the target population. This includes, for example, the decision whether the primary purpose of the app is assessment like 'Smart Assessment on your Mobile' ("SAM", van der Meer et al, 2017), symptom tracking and selfmanagement of symptoms like the SPIRIT app (Bauer et al, 2017) and PTSD Coach (Kuhn et al, 2014), treatment as the CBTi Coach (Kuhn et al, 2016), or treatment assistance like PE Coach (Kuhn et al, 2015), or a combination of those, each resulting in radically different medical and technical requirements for the app. Ideally, this step is informed by previous research into how to convert the usual methods of assessment, tracking and treatment into their digital counterparts effectively.…”

Section: Defining Healthcare Goals According To Patient Needsmentioning

confidence: 99%

Proposing a standardized, step-by-step model for creating post-traumatic stress disorder (PTSD) related mobile mental health apps in a framework based on technical and medical norms

Schellong

Lorenz

Weidner

2019

European Journal of Psychotraumatology

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Lessons from the deployment of the SPIRIT app to support collaborative care for rural patients with complex psychiatric conditions

Cited by 20 publications

References 16 publications

Applying the Principles for Digital Development: Case Study of a Smartphone App to Support Collaborative Care for Rural Patients With Posttraumatic Stress Disorder or Bipolar Disorder

Applying the Principles for Digital Development: Case Study of a Smartphone App to Support Collaborative Care for Rural Patients With Posttraumatic Stress Disorder or Bipolar Disorder

HCI and Affective Health

Proposing a standardized, step-by-step model for creating post-traumatic stress disorder (PTSD) related mobile mental health apps in a framework based on technical and medical norms

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