scholarly journals Moving from development to implementation of digital innovations within the NHS: myHealthE, a remote monitoring system for tracking patient outcomes in child and adolescent mental health services.

2021 ◽  
Author(s):  
Anna Charlotte Morris ◽  
Zina Ibrahim ◽  
Omer S Moghraby ◽  
Argyris Stringaris ◽  
Ian M Grant ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Digital Health ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Remote Monitoring System ◽  
Iterative Development ◽  
Patient Reported ◽  
Health Care Records

This paper reports our experience of developing, implementing, and evaluating myHealthE (MHE); a digital innovation for Child and Adolescents Mental Health Services (CAMHS) which automates the remote collection and reporting of Patient Reported Outcome Measures (PROMs) into National Health Services (NHS) electronic health care records. We describe the logistical and governance issues encountered in developing the MHE interface with patient identifiable information, and the steps taken to overcome these development barriers. We describe the applications architecture and hosting environment to enable it to be operable within the NHS, as well the as the capabilities needed within the technical team to bridge the gap between academic developers and NHS operational teams. We present evidence on the feasibility and acceptability for this system within clinical services and describe the process of iterative development, highlighting additional functions which were incorporated to increase system utility. This article provides a framework with which to plan, develop and implement automated PROM collection from remote devices back to NHS infrastructure. The challenges and solutions described in this paper will be pertinent to other digital health innovation researchers aspiring to deploy interoperable systems within NHS clinical systems.

scholarly journals Do CAMHS collect less PROM data from certain sociodemographic groups?

2020 ◽  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Outcome Measures ◽  
Treatment Efficacy ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Outcome Monitoring ◽  
Patient Reported ◽  
Low Rate

Patient-reported outcome measures (PROMs) are routinely used to inform clinicians and policymakers on clinical need and treatment efficacy. Yet despite their great value and utility, it seems that there is a low rate of outcome monitoring in Child and Adolescent Mental Health Services (CAMHS).

scholarly journals Using Feedback From Patient-Reported Outcome Measures in Mental Health Services: A Scoping Study and Typology

2015 ◽  
Vol 66 (3) ◽  
pp. 224-241 ◽  
Author(s):  
Christian U. Krägeloh ◽  
Karol J. Czuba ◽  
D. Rex Billington ◽  
Paula Kersten ◽  
Richard J. Siegert
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Outcome Measures ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Scoping Study ◽  
Patient Reported

Patient-reported outcome measurements (PROMs) and provider assessment in mental health: a systematic review of the context of implementation

2019 ◽  
Author(s):  
David Roe ◽  
Yael Mazor ◽  
Marc Gelkopf
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Outcome Measurement ◽  
Data Extraction ◽  
National Policy ◽  
Patient Reported Outcome ◽  
Self Report ◽  
Patient Reported ◽  
The Impact

Abstract Purpose To review and integrate the vast amount of literature yielded by recent growing interest in patient-reported outcome measurement and routine outcome measures (PROMs/ROMs), in order to suggest options and improvements for implementation. PROMs are the systematic assessment of service users’ health using standardized self-report measures. Specifically, for ROMs, it includes routine provider or caretaker assessment measures. Both are administered to ascertain routinely, the impact of treatment in mental health settings and to improve care. A review is needed because of the large differences in setting, conceptualization, practice and implementation. Here, we examine the different major projects worldwide. Data sources Psych INFO and PubMed including Medline, Biomed Central, EMBASE Psychiatry and Elsevier Science’s Direct. Study selection We conducted a systematized review of the literature published from 2000 to 2018 on the implementation and sustainability of PROMs and ROMs in mental health services for adults. Data extraction, synthesis and Results We described and characterized the programs in different countries worldwide. We identified 103 articles that met the inclusion criteria, representing over 80 PROMs/ROMs initiatives in 15 countries. National policy and structure of mental health services were found to be major factors in implementation. We discuss the great variability in PROMs/ROMs models in different countries, making suggestions for their streamlining and improvement. Conclusion We extracted valuable information on the different characteristics of the numerous PROMs/ROMs initiatives worldwide. However, in the absence of a strong nationwide policy effort and support, implementation seems scattered and irregular. Thus, development of the implementation of PROMs/ROMs is left to groups of enthusiastic clinicians and researchers, making sustainability problematic.

scholarly journals Implementing a digital health model of care in Australian youth mental health services: protocol for impact evaluation

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sarah Piper ◽  
Tracey A. Davenport ◽  
Haley LaMonica ◽  
Antonia Ottavio ◽  
Frank Iorfino ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Impact Evaluation ◽  
Digital Health ◽  
Youth Mental Health ◽  
Model Of Care ◽  
Health Service Provision ◽  
Industrial Grade ◽  
The Impact

Abstract Background The World Economic Forum has recently highlighted substantial problems in mental health service provision and called for the rapid deployment of smarter, digitally-enhanced health services as a means to facilitate effective care coordination and address issues of demand. In mental health, the biggest enabler of digital solutions is the implementation of an effective model of care that is facilitated by integrated health information technologies (HITs); the latter ensuring the solution is easily accessible, scalable and sustainable. The University of Sydney’s Brain and Mind Centre (BMC) has developed an innovative digital health solution – delivered through the Youth Mental Health and Technology Program – which incorporates two components: 1) a highly personalised and measurement-based (data-driven) model of youth mental health care; and 2) an industrial grade HIT registered on the Australian Register of Therapeutic Goods. This paper describes a research protocol to evaluate the impact of implementing the BMC’s digital health solution into youth mental health services (i.e. headspace - a highly accessible, youth-friendly integrated service that responds to the mental health, physical health, alcohol or other substance use, and vocational concerns of young people aged 12 to 25 years) within urban and regional areas of Australia. Methods The digital health solution will be implemented into participating headspace centres using a naturalistic research design. Quantitative and qualitative data will be collected from headspace health professionals, service managers and administrators, as well as from lead agency and local Primary Health Network (PHN) staff, via service audits, Implementation Officer logs, online surveys, and semi-structured interviews, at baseline and then three-monthly intervals over the course of 12 months. Discussion At the time of publication, six headspace centres had been recruited to this study and had commenced implementation and impact evaluation. The first results are expected to be submitted for publication in 2021. This study will focus on the impact of implementing a digital health solution at both a service and staff level, and will evaluate digital readiness of service and staff adoption; quality, usability and acceptability of the solution by staff; staff self-reported clinical competency; overall impact on headspace centres as well as their lead agencies and local PHNs; and social return on investment.

scholarly journals Assessing the Attitudes, Awareness, and Behavioral Alterations of Patients Awaiting Total Hip Arthroplasty During the COVID-19 Crisis

2020 ◽  
Vol 11 ◽  
pp. 215145932096937
Author(s):  
Stephen Fahy ◽  
Joss Moore ◽  
Michael Kelly ◽  
Shane Irwin ◽  
Paddy Kenny
Keyword(s):  
Mental Health ◽  
Short Form ◽  
Hip Osteoarthritis ◽  
Surgical Care ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Harris Hip Score ◽  
Physical And Mental Health ◽  
Patient Reported ◽  
Hip Function

Background: COVID-19 has placed a huge burden on healthcare systems which has led to widespread cancellation elective surgical care. Ireland is recovering from the first wave of COVID-19 and as such the expeditious return of elective surgical care is important. This is the first study to examine the attitudes of patients to undergoing total joint arthroplasty during the COVID-19 crisis. Methods: A prospective qualitative study was undertaken in our institution during the week 13/05/2020-20/05/2020. 65 patients completed a questionnaire assessing attitudes, awareness, and behavioral changes associated with COVID-19, a Charlson Comorbidity Index, modified-Harris Hip Score, and a Short Form-12 score. Results: 86% of patients felt that they were at little to no risk of COVID-19 infection. The majority of patients were happy to proceed with surgery at the current level of COVID-19 related threat (86%). Patients with higher mHHS were more likely to postpone their operation than those with lower mHHS scores. Our cohort had low patient reported outcome measures in both mHHS and SF-12, indicating the significant burden of hip osteoarthritis on both physical and mental health. Conclusion: Patients reported a significant disease-related impairment of physical function and subsequent deterioration in mental health as a result of hip osteoarthritis. Patients with worse hip function, as measured by the mHHS are more willing to proceed with surgery than those with superior hip function. This offers a potential mechanism by which to triage patients once elective surgical pathways reopen in the coming months.

scholarly journals Predictors of Pain and Function Before Knee Arthroscopy

2019 ◽  
Vol 7 (5) ◽  
pp. 232596711984426 ◽  
Author(s):  
◽  
Matthew C. Bessette ◽  
Robert W. Westermann ◽  
Alan Davis ◽  
Lutul Farrow ◽  
...  
Keyword(s):  
Mental Health ◽  
Outcome Measures ◽  
Knee Arthroscopy ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Education Level ◽  
Smoking History ◽  
Female Sex ◽  
Patient Reported ◽  
Surgical Data

Background: Patient-reported outcome measures are commonly used to measure knee pain and functional impairment. When structural abnormality is identified on examination and imaging, arthroscopic partial meniscectomy and chondroplasty are commonly indicated for treatment in the setting of pain and decreased function. Purpose: To evaluate the relationship between patient characteristics, mental health, intraoperative findings, and patient-reported outcome measures at the time of knee arthroscopy. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Between February 2015 and October 2016, patients aged 40 years and older who were undergoing routine knee arthroscopy for meniscal and cartilage abnormality, without reconstructive or restorative procedures, were prospectively enrolled in this study. Routine demographic information was collected, and the Knee injury and Osteoarthritis Outcome Score (KOOS) Pain, Quality of Life (QoL), and Physical Function Short Form (PS) subscales and the mental and physical component subscales of the Veterans RAND 12-Item Health Survey (VR-12 MCS and VR-12 PCS) were administered preoperatively on the day of surgery. Intraoperative findings were collected in a standardized format. Patient demographics, intraoperative findings, and the VR-12 MCS were used as predictor values, and a multivariate analysis was conducted to assess for relationships with the KOOS and VR-12 as dependent variables. Results: Of 661 eligible patients, baseline patient-reported outcomes and surgical data were used for 638 patients (97%). Lower scores on both subscales of the VR-12 were predicted by female sex, positive smoking history, fewer years of education, and higher body mass index (BMI). All KOOS subscales were negatively affected by lower VR-12 MCS scores, female sex, lower education level, and higher BMI in a statistically meaningful way. Positive smoking history was associated with worse scores on the KOOS-PS. Abnormal synovial status was associated with worse KOOS-Pain. Conclusion: The demographic factors of sex, smoking status, BMI, and education level had an overwhelming impact on preoperative KOOS and VR-12 scores. Of interest, mental health as assessed by the VR-12 MCS was also a consistent predictor of KOOS scores. The only intraoperative finding with a significant association was abnormal synovial status and its effect on KOOS-Pain scores.

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