In partnership with healthcare IT company Wellframe, Vinfen has developed a Smartphone application that combines Wellframe's innovative healthcare platform with Vinfen’s clinical content to help young adults with Serious Mental Illness (SMI) manage their health. The app is designed to educate and engage the young adults and reinforce the coaching done by staff around self awareness, self regulation and self management.
The app has three components: (1) a personalized daily schedule that includes medication reminders, questions on emotional and mental status, an exercise log, clinical tools and health related videos and articles; (2) a personalized ‘tool box’ that contains the young adults' goals, their strengths and their most effective coping strategies and problem solving techniques; and (3) a content library that provides articles, video and audio links to a variety of key topics such as nutrition, safe sex, and personal safety. Through a desktop application on the back end of the app, Vinfen staff are able to monitor adherence to the app, utilization of the daily schedule, initiate and receive communications and assess the most frequently accessed content.
The app is currently being piloted with 20 young adults in the Peabody/Lowell area.
Developing the app has been a collaborative process between Wellframe and Vinfen, with Vinfen developing much of the content based on publically available sources and existing Vinfen clinical protocols. We solicited input from clinical and program staff and most importantly, from young adults in our program. All the videos in the content library are creative and practical and feature either staff members or young adults in the program. In one video a staff member is at a McDonalds comparing the nutritional value of the food choices, in another a young adult is demonstrating a relaxation technique she finds most effective. Alternately, ‘Personal Expressions' in the content library features links to videos and articles about celebrities with mental illnesses and provides an avenue for the young adults to share health related information with their peers - whether it’s a recipe, a problem solving strategy or their personal experience with mental illness.
Use of technology and Smartphone apps in Behavioral Health is a prominent issue and has the potential for significant impact in the field. Our recent blog about the app was widely read and received extensive positive feedback including a request to be on the waitlist for the program. Our progress in this project has generated much interest and has been shared across our organization through Vinfen’s Interdepartmental Council, with our funders including managed care organizations and Massachusetts Department of Mental Health (DMH) and with our peer health and human services organizations both locally and nationally. Progress in the project will also be reported at the College for Behavioral Healthcare Leadership conference in March, the National Provider’s Council in April, a Massachusetts DMH symposium in June and a conference on Evidence Based Practices and technology in Boston also in June.
Vinfen, a private nonprofit 501(c)(3) organization provides services and support to individuals with psychiatric illness and intellectual and developmental disabilities across eastern MA and northern CT and is the largest vendor of services for Massachusetts Department of Mental Health.
In July 2014 Vinfen received a 2 year grant from the Cummings Foundation for the pilot program and subsequently has received additional support from Sprint, for phones and data plans, and from a class in ‘Public Problem Solving and Philanthropy’ at Harvard’s Kennedy School of Government. As we gather data from the pilot program including acute care utilization and resource allocation data, we will be able to quantify the value of the app in impacting real world outcomes. We anticipate embedding this technology into our service delivery and in to our pay for performance contracts with managed care organizations, State agencies and commercial funders.
There are very few barriers to widespread adoption of this technology. The app is android and iOS compatible and data storage and transmission are HIPPA compliant. The app is practical, simple to use and we have built in incentives for engagement and adherence. The biggest barrier for our Medicaid funded population is access to a Smartphone and data plan. As the cost of a Smartphone decreases, this barrier will diminish.
We will solicit regular feedback on the app from staff and young adults and will make modifications and improvements as the program continues. On conclusion of a successful pilot program we will expand the use of the app to young adults in other programs at Vinfen, and to other adults with SMI receiving our services across eastern Massachusetts. We will also engage with partner organizations providing services to similar populations locally and nationally.
Vinfen has developed extensive infrastructure systems to track and report on information. We are tracking young adults’ engagement with and use of the app, changes in healthcare utilization and changes in self efficacy. In addition to qualitative feedback we are tracking adherence to the app, patterns and frequency of use as well as most frequently accessed content library topics and responses to emotional and mental health status. We will compare data from young adults using the app to data from non-users. Data will include: health outcomes such as acute service utilization and ER visits, currently tracked by Vinfen; in person and telephonic encounters, communications with staff through the app, alerts triggered and escalated to the appropriate clinician; and overall satisfaction using the SF-12. All data from the app can be reviewed at the individual level by the care team for clinical support or in the aggregate for analysis and evaluation.