Browsing by Author "Bauer, Amy M"
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- ItemAligning health information technologies with effective service delivery models to improve chronic disease care.(2014-08-06) Bauer, Amy M; Thielke, Stephen M; Katon, Wayne; Unützer, Jürgen; Areán, PatriciaOBJECTIVE Healthcare reforms in the United States including the Affordable Care and HITECH Acts and the NCQA criteria for the Patient Centered Medical Home have promoted health information technology HIT and the integration of general medical and mental health services These developments which aim to improve chronic disease care have largely occurred in parallel with little attention to the need for coordination In this article the fundamental connections between HIT and improvements in chronic disease management are explored We use the evidence based collaborative care model as an example with attention to health literacy improvement for supporting patient engagement in care METHOD A review of the literature was conducted to identify how HIT and collaborative care an evidence based model of chronic disease care support each other RESULTS Five key principles of effective collaborative care are outlined care is patient centered evidence based measurement based population based and accountable The potential role of HIT in implementing each principle is discussed Key features of the mobile health paradigm are described including how they can extend evidence based treatment beyond traditional clinical settings CONCLUSION HIT and particularly mobile health can enhance collaborative care interventions and thus improve the health of individuals and populations when deployed in integrated delivery systems
- ItemApplying 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.(0000-00-00) Bauer, Amy M; Hodsdon, Sarah; Bechtel, Jared M; Fortney, John CBACKGROUND Despite 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 OBJECTIVE The 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 METHODS Using 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 RESULTS Each 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 CONCLUSIONS Adhering 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
- ItemComparing Approaches to Mobile Depression Assessment for Measurement-Based Care: Prospective Study.(0000-00-00) Bauer, Amy M; Baldwin, Scott A; Anguera, Joaquin A; Areán, Patricia A; Atkins, David CBACKGROUND To inform measurement based care practice guidelines suggest routine symptom monitoring often on a weekly or monthly basis Increasingly patient provider contacts occur remotely eg by telephone and Web based portals and mobile health tools can now monitor depressed mood daily or more frequently However the reliability and utility of daily ratings are unclear OBJECTIVE This study aimed to examine the association between a daily depressive symptom measure and the Patient Health Questionnaire 9 PHQ 9 the most widely adopted depression self report measure and compare how well these 2 assessment methods predict patient outcomes METHODS A total of 547 individuals completed smartphone based measures including the Patient Health Questionnaire 2 PHQ 2 modified for daily administration the PHQ 9 and the Sheehan Disability Scale Multilevel factor analyses evaluated the reliability of latent depression based on the PHQ 2 for repeated measures between weeks 2 and 4 and its correlation with the PHQ 9 at week 4 Regression models predicted week 8 depressive symptoms and disability ratings with daily PHQ 2 and PHQ 9 RESULTS The daily PHQ 2 and PHQ 9 are highly reliable range 0 80 0 88 and highly correlated r 80 Findings were robust across demographic groups age gender and ethnic minority status Daily PHQ 2 and PHQ 9 were comparable in predicting week 8 disability and were independent predictors of week 8 depressive symptoms and disability though the unique contribution of the PHQ 2 was small in magnitude CONCLUSIONS Daily completion of the PHQ 2 is a reasonable proxy for the PHQ 9 and is comparable to the PHQ 9 in predicting future outcomes Mobile assessment methods offer researchers and clinicians reliable and valid new methods for depression assessment that may be leveraged for measurement based depression care
- ItemUse of mobile health (mHealth) tools by primary care patients in the WWAMI region Practice and Research Network (WPRN).(2014-11-08) Bauer, Amy M; Rue, Tessa; Keppel, Gina A; Cole, Allison M; Baldwin, Laura-Mae; Katon, WayneThe purpose of this study was to determine the prevalence of mobile health mHealth use among primary care patients and examine demographic and clinical correlates