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Enhancing Patient Care: Telemetry Access via Handhelds in Mental Health

The study by David Kreindler, MD, and Nicholas Woolridge, MSc, explores the use of handheld devices for mental health telemetry. Conducted at Sunnybrook Health Science Centre, this research focuses on improving patient quality of life through real-time data transmission of mood and symptom tracking. Key projects include utilizing Palm smartphones for data collection and developing dynamic self-report instruments for children. By integrating clinician access to patient data on demand, the project aims to enhance clinical utility and compliance, paving the way for future telehealth applications in mental health.

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Enhancing Patient Care: Telemetry Access via Handhelds in Mental Health

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  1. PATH: Physician Access to Telemetry from Handhelds David Kreindler, MD, FRCP(C) Nicholas Woolridge, MScBMC

  2. Centre for Mobile Computing in Mental Health • Clinical Base: Sunnybrook Health Science Centre (SHSC) • Investigators: • David Kreindler (Psychiatry) • Charles Lumsden (Medicine/Physics) • Anthony Levitt (Psychiatry) • Nicholas Woolridge (BMC) • Goals: • Clinical implications of handheld computers… • … thereby improving patient quality-of-life

  3. CMCMH: Selected Projects • VMQ/VADIS (2000-2003) • Implemented visual analogue scale on Palm smart phones (tablet and stylus) • Collected twice daily mood symptom ratings on 38 participants for 18 months • MAAC • Animated instrument for mood self-report in children • LifePattern • Companion to VADIS • Displays a self-report ratings on Treo smart phone

  4. Mental Health Telemetry (MHT) • Using wireless handheld computers to transmit symptom information in 'real time' • Typical platform: cell phones • Self-report questionnaire  free-text comments • Links to symptom journaling, 'Ecological momentary assessment', e-diaries / blogs

  5. Mental Health Telemetry (2) • Advantages: • No paper distribution / collection • Portable / prevalent / carried anyway • No data loss <- RT transmission • e-reminders • Time stamped • Better compliance / acceptance • e-questionnaire <-> dynamic medium • e.g. flexible presentation (order; content)

  6. PATH: The Next Logical Step • At present, MHTpatient database • Information retrieved manually / later • PATH: MHTpatient database  clinician • Information retrieved on-demand • Information: timeliness  clinical utility • Hypothesis: Value added by PATH exceeds hassle of using PATH. • I.e., clinicians will find PATH useful, and be willing to use it in routine clinical practice.

  7. PATH: The Next Logical Step

  8. PATH: Methodology • Phase 1: Design (6 months) • Consult with stakeholders, experts, users • Product: Fully functioning prototype (v0.1) • Phase 2: Implementation (12 months) • Three rounds of propose / consult / revise / implement • Product: Final product (v1.0) • Phase 3: Clinical Trial (18 months) • Users: clinicians treating patients with mood & anxiety disorders • Goal: assess usability.

  9. PATH: Role of BMC • Initial design / proof-of-concept sketches • Decision points at months 1, 7, 11, 15 • Software: MHT data stream visualization • User interface design (clinicians) • User interface studies for MHT & PATH

  10. References • CMCMH: http://sunnybrook.ca/research/?page=sri_groups_cmcmh_home

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