This year’s EHI Live 2014 had a lot of excellent seminars on offer. Fennie Wiepkema from Minddistrict gave a thought-provoking seminar on the topic of a key area of my research – mental eHealth.
A summary of the seminar, along with some additional points from Mind District’s ‘Smart Interventions’ white paper are detailed below.
The NHS and mental eHealth
On the 25th of September 2014 the Mental Health Network NHS Confederation published a paper discussing the future of mental health and digital technology. The paper detailed how patients are increasingly using digital technology and as a result their expectations are changing. Patients want more insight into their treatment, more transparency and actively want to take part in their treatment. As a result of this the NHS is now focused on modernising mental health in accordance with patient expectations by investigating the feasibility of integrating mental eHealth into their health services.
The benefits of mental eHealth
EHealth solutions increase productivity by reducing the amount of time a therapist spends filling in paper work on a day to day basis. This in turn allows a therapist to have more quality time spent with their patients. Each patient builds up a picture of their wellbeing by carrying out exercises and interventions during their daily life. This information is shared in real time with the therapist meaning that when a patient’s next appointment is due the therapist is already fully aware of how the patient’s week has gone; their state of mind and the areas the session should potentially focus upon. Having everything integrated in this way improves the therapy’s efficiency and effectiveness.
Minddistrict’s technology Roadmap
The Netherlands started eHealth online care in 2000; one of the first programs created was e-therapy. During this period Computerised Cognitive Behaviour Therapy (cCBT) programs began development. These standalone programs were developed to be used independently of therapy sessions. Examples of this type of program in the UK include FearFighter and Beating the Blues.
Post 2000 cCBT specialists began to consider how online therapy could be integrated into the therapy process rather than kept as a patient independent standalone approach.
Minddistrict began looking at how online therapy could be integrated with face to face therapy and using their existing online platform developed a solution called Blended care.
Seamless care allows therapy to be accessed anywhere at any time via a multitude of devices such as tablets and mobiles. It integrates advanced communication tools to allow patients to communicate with their therapist through video calling and secure messaging services. A mobile app connected to the platform’s cloud allows patients to safely and securely record thoughts, feelings, exercises and diary entries on the move.
Personalised treatment plans allow therapists to build adaptable courses suited to a patient’s needs. Patients can also request additional self-help programs from a library of available modules created in the platforms Content Management System (CMS). Modules written by content editors based upon the latest behaviour change techniques, NICE guidelines and IAPT service protocols.
The Interventions and screening are done at a patient’s pace and the data from these activities shared with the therapist, who in turn can review the data and decide whether their personalised treatment plan requires adjustment. No two treatment plans are the same making the care person-centred. With this system, expectations can be met and the patient’s treatment becomes more transparent because they have insight into the healing process as it is accessible anywhere. The patient can review their progress by looking at the graphs of their mood, anxiety and activity.
The result of this is the patient has the same insight as the therapist, but the therapist gives an extra dimension by translating data into therapy and coaching the patient through the self-help interventions. In addition, it helps patients to have control over their treatment progress because they can look over their interventions again and again and they’re in control of when to contact their therapist to get extra coaching.
Smart interventions are the next phase in mental eHealth. They take all the emotional, demographic, biomedical and symptoms data from web and mobile interventions and pass them to an algorithm, which analyses for patterns. This is used to train a reinforcement algorithm which will adapt the frequency, timing, content and intervention medium to the unique characteristics of the client. It can predict behaviors and trigger interventions accordingly, which allows a greater degree of self-management by clients.
This is achieved through experiencing sample methods (ESM) which is the sampling of real time feelings, thoughts, and emotions combined with already known parameters such as genetics and context. Correlations between context and emotions are calculated to determine personal, protective and risk factors. These are reported to both the therapist and the user, in order to raise awareness.
Some clients may struggle to identify their emotional state or situational context. In this situation, emotional mining can be used. This is the automated identification of emotions by analysing patterns in users’ text. It also allows for subconscious emotions to be addressed, possibly allowing for the prediction of future emotional states. This is currently being studied in association with Maastricht University.
Authored by Matthew Bennion
Proof Read by Jakob Andrews and David Clayton