Oct 11, 2016
According to Gartner, in 2015, smartphone sales reached 1.4 billion units [1], and in the first quarter of 2016, they represented 78% of total mobile phone sales. [2]
A new report by the IMS Institute for Healthcare Informatics revealed that there are now more than 165,000 mobile health apps on the market. Nearly two-thirds are focused on general wellness issues like fitness, lifestyle, stress, and diet. The remaining third consists of apps focused on specific health conditions (9%), medication info & reminders (6%), and women’s health & pregnancy (7%). Mental health apps led among disease-specific apps, followed by diabetes. [3]
Nevertheless, with telemedicine, mobile health (mHealth) solutions, and wearable devices, the future of better patient engagement is certainly favourable.
During the last few years, the development of wearable devices that can track heart rate, blood pressure, calories and step-counters have experienced an enormous growth. This type of technology is revolutionising the level of patient engagement by proving individuals with an accessible platform to monitor their progress; information that until now was not available.
Nowadays, patients are increasingly looking for health information online, including their medical records. They request access to information and tools to take control of their health. To make this possible, clinics and patients can use a software platform that allows them to share information with each other while keeping the information safe.
Mental health care is not an exception. Now, more than ever, individuals want to be involved in their treatment. Up until a few years ago, patients with a mental illness, had a very passive role in their treatment. They were required to attend weekly consultations, take their medication every day and report their symptoms to the clinician at their next consultation.
The Monsenso mHealth platform empowers patients suffering from mental and behavioural illnesses, to take control over their illness and play an active role in their treatment.
The Monsenso platform helps individuals and clinicians to monitor the illness symptoms and mood patterns continuously. It also helps them handle their medication, as well as to recognise behavioural trends and early warning signs (EWS). [4]
Based on self-reported and automatically collected sensor data, it provides timely feedback to the patient, therefore, increasing illness awareness. By using it on a daily basis, it provides insights into the illness progression. These types of personal health technologies have the potential to apply machine learning techniques that can monitor and learn to recognise a patient’s circumstances and state and supply personalised context-appropriate clinical responses. [5]
Furthermore, clinicians need truthful information to offer better-quality treatment to their patients and assist in their recovery. Traditionally, psychiatrists provide patients with paper-based self-assessments. However, on a clinical study made with bipolar patients ranging from 18 to 65 years old, the raw adherence percentage of paper-based self-assessment is 58%. [6]
Most of the time, patients forgot to complete these assessments, and most people filled them out while sitting in the waiting room. This process generates a problem since most individuals couldn’t remember with certainty how they have felt since their last appointment.
Besides, clinicians may become distracted with paper-based self-assessments during the consultation. At the same time, they are required to interpret the self-assessments and enquire about the patient’s wellbeing. Likewise, once the consultation is over, the self-assessments are probably stored in a patient’s file and seldom retrieved.
On the other hand, recent research shows that the adherence rate of self-assessments when using the Monsenso smartphone app is 88% [7], making it a more reliable source of information.
The Monsenso system is much more than an mHealth platform; it is a personal technology solution that simplifies the continuous monitoring of critical patients, provides a historical overview of a patient’s condition and underlying behaviour. Furthermore, it also offers patients a list of self-help tools facilitating patient engagement and empowering them to become self-aware.
For example, improving illness awareness is vital to the treatment of individuals suffering from bipolar disorder. It is critical that patients monitor their mood and have a good action plan that helps them cope with their risk situations; this helps patients to manage their illness [7].
During the last few years, we have witnessed the development of wearable devices, mHealth solutions, and personalized medicine. Once mental health care providers widely adopt this technology, it will enable them to improve patient engagement. MHealth solutions like the one offered by Monsenso, allow clinicians to provide better-quality treatment based on accurate, real-time data.
The smartphone self-assessments helps patients become more aware of their condition as it helps them identify and learn more about their personal triggers and early warning signs. Furthermore, the information collected by the smartphones facilitates and speeds up the dialog between patients since symptoms and early warning signs can be discussed immediately.
References:
[1] Gartner Says Worldwide Smartphone Sales Grew 9.7 Percent in Fourth Quarter of 2015. Gartner. (2016, February 18)
http://www.gartner.com/newsroom/id/3215217
[2] Gartner Says Worldwide Smartphone Sales Grew 3.9 Percent in First Quarter of 2016. Gartner. (2016, May 19)
http://www.gartner.com/newsroom/id/3323017
[3] New report finds more than 165,000 mobile health apps now available, takes a close look at characteristics & use. Satish Misra, MD. iMedicalapps. (2015, September 17) http://www.imedicalapps.com/2015/09/ims-health-apps-report/
[4] The MONARCA a Self-assessment System: A Persuasive Personal Monitoring System for Bipolar Patients. J. E. Bardram, M. Frost, K. Sz´ant´o, G. Marcu, in: Proceedings of the 2nd ACM SIGHIT International Health Informatics Symposium, IHI ’12, ACM, New York, NY, USA, 2012, pp. 21–30. doi:10.1145/2110363.2110370.
[5] Supporting Disease Insight through Data Analysis: Refinements of the MONARCA Self-assessment System. M. Frost, A. Doryab, M. Faurholt-Jepsen, L. V. Kessing, J. E. Bardram. Proceedings of the 2013 ACM international joint conference on Pervasive and ubiquitous computing, UbiComp ’13, ACM, New York, NY, USA, 2013, pp. 133–142. doi:10.1145/2493432.2493507. URL http://doi.acm.org/10.1145/2493432.2493507
[6] Designing Mobile Health Technology for Bipolar Disorder: A Field Trial of the MONARCA System. Bardram, Jakob E., Frost, Mads, Szántó, Károly, Faurholt-Jepsen, Maria, Vinberg, Maj and Kessing, Lars Vedel. In Proceedings of the SIGCHI Conference on Human Factors in Computing Systems, pages 2627-2636, New York, NY, USA, 2013.
[7] Increasing Awareness, Insight and Adherence in Treatment of Bipolar Disorder through Personal Health Technology: Pilot Study. Mads Frost, Maria Faurholt-Jepsen, Afsaneh Doryab, Lars Vedel Kessing and Jakob E Bardram. Paper submitted for review to JMIR Mental Health (JMH), 2015.
Sep 28, 2016
Baby Blues occur within the first three days after birth and may last until a few weeks later. It is expected that between 60 to 80% of new mothers experience baby blues [1].
However, is estimated that 10 to 15% of new adult mothers develop Postpartum Depression (PPD) within the first year after giving birth, and the percentage increases up to 26% in adolescent mothers [1].
Furthermore, a recent study made with women suffering from bipolar disorder, indicated that 67% of them had a depressive episode after the first child, and they all experienced a relapse with their next birth [1].
According to Dr. Shoshanna Bennett, there are two main ways to differentiate Baby Blues from PPD. Firstly, Baby Blues always begin in the first few days following delivery and should be gone two weeks after childbirth. Besides, the symptoms are mild – frequent tearfulness, feelings of dependence and stress [2].
Unlike Baby Blues, the severity of the postpartum depression disrupts a woman’s ability to function. Therefore, if the symptoms are severe enough and last more than two weeks, it can be considered PPD and she should seek help [2].
While PPD is a major health issue for many women, it often remains undiagnosed. Although several measures have been created to detect depressive symptomatology in women who have recently given birth, the development of a postpartum depression screening program requires careful consideration [3].
Evidence-based decisions need to be made regarding two aspects. Firstly, healthcare systems need to develop an effective screening test that not only has good sensitivity and specificity, but is also quick, easy to interpret, readily incorporated into practice, and culturally sensitive. Second, health care systems should use these tools as a cost-effective, potential harm, and policies for a referral [3].
Fortunately, preliminary research suggests postpartum depression is responsive to treatment interventions thus providing a rationale for the development of a screening program [3].
The Monsenso mHealth solution can help healthcare professionals identify PPD at an early stage. New mothers can be asked to download the app and fill in self-assessments on their smartphones on a daily basis. With the self-assessments, new mothers can rate themselves on relevant parameters such as their levels of stress, anxiety, and tearfulness, as keeping track of the number of hours they slept within a 24-hour period. The system can also collect sensor data such as their level of physical activity, social activity and mobility.
Healthcare professionals can monitor new mothers on a regular basis and contact them if the system indicates any triggers or early warning signs that their Baby Blues is evolving into PPD. It is important to take into consideration that the early intervention of PPD reduces the long-term disadvantages that PPD causes for mother and child.
Current research suggests that postpartum depression has salient but selective effects on the mother/infant relationship, and child growth and development. Young children of mothers with postpartum depression have greater cognitive, behavioural, and interpersonal problems than children of nondepressed mothers. Overall, it is exposure to prolonged episodes of postpartum depression or to recurrent episodes of maternal depression that are most likely to have long-term effects on the child [3].
References:
- The Environmental, Cultural, Relational and Physiological Aspects of Postpartum Depression. The Faculty of the Adler Graduate School. Joanne E. Campbell. 2010.
http://www.alfredadler.edu/sites/default/files/Campbell%20MP%202010.pdf
- Do you have Baby Blues or Postpartum Depression? PBS.Org. Dr. Shoshanna Bennett.
http://www.pbs.org/thisemotionallife/blogs/do-you-have-baby-blues-or-postpartum-depression
- Postpartum Depression: Literature review of risk factors and interventions. Toronto Public Health. 2003.
http://www.who.int/mental_health/prevention/suicide/lit_review_postpartum_depression.pdf
Sep 14, 2016
Approximately 450 million people worldwide suffer from mental disorders. One fifth of teenagers under the age of 18 suffer from developmental, emotional or behavioural problems, and one in eight have a mental disorder. Five of the ten leading causes of disability worldwide are psychiatric conditions, including depression, alcohol abuse, schizophrenia, and obsessive compulsive disorder. [1]
The Institute of Medicine Report has proposed a framework of mental health intervention for mental illness based on the classification and the public health distinctions between primary, secondary and tertiary prevention. [1]
Primary prevention focuses on promoting mental well-being, and decreasing adverse conditions such as child abuse, violence, discrimination, poverty, and lack of education to the general population. It also seeks to target individuals or subgroups of the population whose risk of developing a mental illness is higher due to biological, psychological or social risk factors.
Secondary prevention seeks to reduce the symptoms and decrease the number of episodes through early detection and treatment. [1]
Tertiary prevention includes interventions that reduce disability, enhance rehabilitation, and prevent relapses and recurrences of the illness. [1]
A Dutch study found a 50% reduction in the incidence of major depression among mildly depressed primary care patients who received a stepped-care intervention, compared with the incidence among primary care patients who received treatment as usual. Other studies showed that low-dose antidepressants or problem-solving therapy helped reduce the incidence of major and minor depression in post-stroke patients. [2]
Preventive measures such as mental health promotion and early intervention are the most cost-effective way to tackle mental illness on a global scale. Research reveals that common mental disorders such as depression and anxiety can be prevented. For instance, Cognitive Behavioural Therapy (CBT) has proven to be useful for people who already have mild depressive symptoms.
During the last few years, technology has crossed a new frontier in mental health support and data collection. Mobile health (mHealth technology) provides doctors, researchers and the general population with new ways to monitor a patient’s progress, access self-help tools, and increase understanding of mental wellbeing.
Mobile mental health support can be very simple but effective. For example, the Monsenso mHealth solution which consists of a smartphone app for patients and carers and web portal for clinicians uses self-reported data and the device’s built-in sensors to collect patient information. Based on the self-reported data, the Monsenso smartphone app identifies any triggers or warning signs, and it notifies patients and clinicians that help is needed before a crisis occurs. The Monsenso smartphone app also provides users with self-help tools that are always available in case of an emergency.
Although there are many mental health apps available on both the iTunes and Android app stores, this new technology includes a lot of uncertainty. There isn’t enough information on the quality, security and effectiveness of the different apps available, which can confuse clinicians and users.
The advantages of mental health apps
Experts believe that technology has a lot of potential for users and clinicians. A few of the benefits of mobile care include:
- Convenience:Treatment can take place anytime and anywhere (e.g. at home in the middle of the night or on a bus on the way to work) and may be ideal for those who have trouble with in-person appointments.
- Anonymity:Clients can seek treatment options without involving other people.
- An introduction to care: Technology may be a good first step for those who have avoided mental health care in the past.
- Lower cost: Some apps are free or cost less than traditional care.
- Service to more people: Technology can help mental health providers offer treatment to people in remote areas or to many people in times of sudden need (for example following a natural disaster or terror attack).
- Interest: Some technologies might be more appealing than traditional treatment methods, which may encourage clients to continue therapy.
- 24-hour monitoring: Technology can provide round-the-clock monitoring and self-help tools or interventions.
- Consistency: Technology can offer the same treatment plan to all users.
- Support: Technology can complement traditional therapy by extending an in-person session, reinforcing new skills, and providing support and monitoring. [3]
Trends in smartphone apps for mental health
- Self-management apps
Users enter self-reported data into the app so it can provide feedback. For example, medication reminders, stress-coping strategies or sleep problems. Some apps can also track sensor data and may help users monitor their progress and receive feedback.
- Apps to improve thinking skills and skills training
Apps that help users with improved thinking skills (cognitive remediation) and learn new coping or thinking skills. For example, they provide educational videos about anxiety management or the importance of social support. Additionally, users might pick up some new skills and use the app to practice those skills. This type of app may feel a little bit like a game, and often target people with severe mental illness.
- Supported care
This type of app allows users to interact with a trained health care provider or a peer support group who can offer guidance in case of an emergency.
- Monitoring and data collection
This type of mental health app can collect two types of data. On one hand, it gathers data using the sensors built into smartphones such as movement patterns, social interactions, behaviour at different times of the day, speech patterns and more. On the other hand, it collects self-reported data in the form of a mood diary or electronic questionnaire.
Although mental health apps may not replace mental health professionals, they allow clinicians to provide better support to more people regardless of their geographical location.
References:
[1] Prevention of mental disorders. Effective interventions and policy options. World Health Organisation. http://www.who.int/mental_health/evidence/en/prevention_of_mental_disorders_sr.pdf
[2] The future looks promising for mental health prevention. Psychiatric News. Joan Arehart-Treichel. 2013 (January 18). http://psychnews.psychiatryonline.org/doi/10.1176/appi.pn.2013.10b1
[3] Technology and the future of mental health treatment. National Institute of Mental Health. http://www.nimh.nih.gov/health/topics/technology-and-the-future-of-mental-health-treatment/index.shtml
Aug 23, 2016
This blog post was written by Anne Zieger, CEO at Zieger Healthcare Communications. It was originally published in the Zieger Healthcare Blog and it is © published with the permission of Zieger Healthcare.
Like many Americans, I have a family member with a major mental illness who sometimes needs inpatient hospital care. Because I have been a healthcare researcher and journalist for 25 years, I’m particularly well prepared to help him navigate the system and get him the attention he deserves.
But there’s one issue which crops up again and again, and despite decades of trying I haven’t been able to find any kind of remedy. And as far as I can tell, this policy — which is universal in my region — actually encourages the delivery of substandard care.
As many people are aware, there’s far too few inpatient mental health beds in many regions of the country. My sense is that the problem may be a bit less acute where I live, in metro DC, as my relative can generally find inpatient care when he needs it. But which bed in which hospital? That’s another story.
Like any other service, inpatient mental health treatment can vary substantially from one institution to another. And as a member of a family support group for mental health problems, I get lots of feedback on which psych units are well-staffed, clean, efficient, thorough, kind to patients and good with discharge planning. (Of course, I also have my relative’s feedback and my own impressions to refer to as well.)
However, area hospitals with psych units absolutely, categorically refuse to tell patients or their families whether a bed is available. Yes, they will typically tell a psychiatrist with admitting privileges whether they can take additional patients, but for reasons which are not clear to me, a shrinking number of psychiatrists choose to obtain such privileges. In fact, in many years of trying, my relative hasn’t found a single one who does do direct admissions.
So here’s what happens. Our family realizes that he needs help, so one of us takes him to a hospital where he feels comfortable and safe. That hospital puts him through several hours of “medical clearance,” and only then do they let us know that there are no open beds there. Then they try to convince us to take whatever bed is available anywhere they can find.
In the most recent case, they pressured us to send him to Hospital X, an underfunded, poorly-rated facility which I’d dearly love to see decertified and closed. Since his episode seemed to be tailing off, we decided to take him home and bring him to another good facility the next day, which we did, successfully. But given the coercive nature of the original facility’s approach, it took all of the strength we could muster to do so.
I am certainly aware that with the limited availability of psych beds, every hospital will turn patients away at times. But if the hospitals let patients and/or family members know whether there was even a chance of admission, patients could make informed choices. They could also choose between their preferred hospitals, rather than being side-tracked into those that did not deserve their patronage.
My guess is that such hospitals, whose psych units are often unprofitable, are colluding to make sure that the more effective, humane and resource-rich psych units don’t get all of the traffic. After all, if patients don’t know which units can serve them, it’s easier for facilities to ricochet them across the region and give some of the inpatient days to whichever player is next in line.
But even if there’s no conspiracy involved, the policy of keeping patients out of the loop is unconscionable nonetheless. If patients end up wherever they’re sent, hospitals have no incentive to offer improved services. And that just about defines “anti-competitive.” I dearly hope someone calls these hospitals to account someday.
To view the original blog post click on this link: http://www.ziegerhealthcare.com/2016/08/21/hospital-policies-make-it-tougher-to-get-high-quality-inpatient-mental-health-treatment344/
Aug 18, 2016
mHealth technology is a cost-efficient solution for insurance companies. Technology start-ups are disrupting many existing business models, including the insurance industry. Most of the current trends in the insurance industry have technology as a driver.
By 2020, the global Internet of Things market is expected to reach 1.7 trillion USD, and the number of connected devices is expected to reach 29.5 billion. Due to the low cost of sensors, improved communication methods, and increased data processing power, mHealth solutions are now becoming a cost-efficient solution for insurance companies, therefore, insurers are increasingly leveraging the Internet of Things for various purposes, including identification of customers’ needs and risks.
Mobile health (mHealth) technology and Big Data are also expected to have a significant impact on the insurance industry on both insurers and customers. The most common uses of mHealth technology are: to prevent illnesses, to monitor patients remotely, to support treatment and to serve as self-help tools. Insurers are focusing on mHealth apps to monitor and improve the health of their customers, and to reduce their healthcare spending.
Some of the key determinants of a person’s health include lifestyle, environment, and hereditary traits. Therefore, the data obtained from mHealth apps can be used as a cost-efficient solution for insurance companies that helps them to understand a customer’s risk profile. For example, with all the information collected by a person’s smartphone, insurance companies can predict how likely that person is to be affected by an illness and implement a preventive action.
MHealth technology can help reduce administrative costs of health insurers since all the customers’ data is readily available, which makes policy renewals easier. Besides, insurance companies can also use this data to cross-sell insurance policies to their existing clients.
Since the cost of healthcare is on the rise, insurance companies need to adopt new methods to reduce this, and mHealth solutions allow customers to maintain a healthier lifestyle with lower spending.
Until now, patient adherence to medication has been a big challenge in the healthcare industry. For conditions such as depression, the adherence rate is as low as 50%. This non-adherence increases the healthcare spending of customers.
However, mHealth apps, such such as the Monsenso mHealth solution for mental illness, can help reduce the healthcare spend. These smartphone apps can remind customers to take their daily medication, reinforce the need to follow a medication schedule, educate patients about their illness, and inform patients of the consequences of not taking their medication.
If you want to know more about how can the Monsenso mHealth solution for mental health can help your insurance company save costs, click here.
Reference:
Top 10 Trends in Insurance in 2016. Capgemini Insurance. 2016
https://www.capgemini.com/resources/insurance-top-10-trends-2016
Aug 9, 2016
Using apps for mental health was written by Ross Campbell, Chief Underwriter of Research & Development based in Gen Re London.
It was originally published on the Gen Re blog and it is © published with the permission of General Reinsurance AG 2016.
Improved awareness and recognition of mental health problems and their complexity puts pressure on health systems to increase care. This stimulates exploration of the potential value of software applications (apps) run on mobile devices. The ubiquity of smartphones makes them an ideal tool for apps that can help individuals manage mental health.
Apps create long-term patient health data in a way that episodic clinic consultations cannot. They generate a personal health record fundamentally different from a clinical patient record [1]. Doctors have much to gain from the comprehensive and detailed information gathered by this form of continuous monitoring. Insurers can also benefit from the potential of this technology, especially for claims.
Apps for mental health can monitor physiological cues associated with sleep disturbance, anxiety, depression, phobias and psychosis. For example, depression is associated with a fall in activity levels – less exercise, movement and fewer social interactions. Sensors in smartphones can help spot patterns of altered behaviour that may represent the early warning signs of lowered mood.
Some apps for mental health can even help diagnose problems. Others help people track and manage mood using self-assessment techniques augmented by coaching functionality. Online environments are a gateway to support from more specialist clinical resources. The resources allow patients more control of their mental health management while enabling clinicians to monitor and support them remotely.
Some other apps for mental health can also help with treatment by sending reminders about medication or appointments, regardless of the person’s location. And they can provide distraction from cravings or link with social networks at times of stress. This “nudging” is effective at altering behaviour; for example, integrating text messaging in smoking cessation programmes improved six-month cessation rates by 71% compared to the regular treatment [2].
However, work remains to be done before apps can integrate with insurer’s processes. The confidentiality and use of personal data generated and stored by apps is complicated and needs clarification. The accuracy and sufficiency of information is a potential concern while hardware constraints may limit potential. More evaluation of the impact of digital technology is needed in research and clinical practice. [3]
Meanwhile, insurers could engage with emerging providers of software solutions. Services like these will, over a relatively short time horizon, become highly influential in the lives of people living with mental health problems. Pilot schemes that compare current insurance methods while evaluating new ones would take us one big step forward.
Click on the links to learn more about the Monsenso mHealth solution mental health consisting on a smartphone app for individuals, carers and a web portal for clinicians.
To view the original post click on this link: http://www.genre.com/knowledge/blog/can-apps-set-the-mood-for-managing-mental-health-en.html
- Marley, J. and Farooq, S., (2015) Mobile telephone apps in mental health practice: uses, opportunities and challenges, The British Journal of Psychiatry (2015), 39, 288-290, doi: 10.1192/pb.bp.114.050005.
- Whittaker, R. et al Mobile phone based interventions for smoking cessation. Chochran Database Systematic Review. 2012;11. CD006611. Doi:10.1002/14651858.CD006611.pub3.
- Hayes, JF., Maughan, DL., Grant-Peterkin, H. (2016) Promotion of mental health and prevention of mental disorder in the digital age, The British Journal of Psychiatry (2016) 208, 205–207. doi: 10.1192/bjp.bp.114.161067.
