Julia E Hoffman*, VA National Center for PTSD, Menlo Park, CA, United States Deborah Estrin, UCLA, Los Angeles, CA, United States Ida Sim, UCSF, San Francisco, CA, United States Eric Kuhn, VA Sierra Pacific MIRECC, Menlo Park, CA, United States Adam Miner*, VA National Center for PTSD, Menlo Park, CA, United States Katherine L Taylor, VA National Center for PTSD, Menlo Park, CA, United States Joshua Selsky, UCLA, Los Angeles, CA, United States Mickey T. Trockel, Stanford University, Stanford, CA, United States C Barr Taylor, Stanford University, Stanford, CA, United States Josef I Ruzek, VA National Center for PTSD, Menlo Park, CA, United States Track: Practice Presentation Topic: Mobile & Tablet Health Applications Presentation Type: Oral presentation Submission Type: Single Presentation Building: Joseph B. Martin Conference Center at Harvard Medical School Room: Auditorium Date: 2012-09-15 02:45 PM – 03:30 PM Last modified: 2012-09-11

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The National Center for Posttraumatic Stress Disorder, within the Department of Veterans Affairs, in collaboration with the Department of Defense’s National Center for Telehealth & Technology, has created PTSD Coach for iPhone and the Android OS. PTSD Coach provides users with education about Posttraumatic Stress Disorder (PTSD), information about professional care, a self-assessment for PTSD, opportunities to find support, and tools that can help with managing the stresses of daily life with PTSD. Tools are based on evidence-based PTSD treatment and range from relaxation skills and positive self-talk to anger management and other common self-help strategies. Users can customize tools based on their preferences and can integrate their own contacts, photos, and music.

In order to avoid the unintentional loss or exposure of sensitive patient data no data is transmitted to or from PTSD Coach. By contrast, a “connected” app – one which is integrated and able to exchange data with other components of the user’s digital healthcare and personal experience, including clinical services, electronic health records, social media, and other related apps – would permit much more effective incorporation into clinical care, and potentially lead to better outcomes.

What is called for is the development of an open architecture for HIPAA-compliant exchange of medical data across mobile platforms and applications. Such an architecture will provide the necessary standards for interoperability between various digital healthcare platforms and will reduce the cost and effort to implement HIPAA-compliant solutions for both commercial and public sector providers, and should thus accelerate the deployment of innovative mHealth solutions. The availability of these standards is inherently valuable for all who use and provide healthcare, but specifically, large-scale healthcare systems such as the Department of Veterans Affairs could reap tremendous clinical and systemic benefits from an open solution.

The goal of our project is to create a proof-of-concept for this type of data-informed, integrated psychological health care treatment process on top of a HIPAA-compliant open architecture. There were five phases. First, to extend the PTSD Coach application so that data may be collected by it (resulting app is called PTSD Explorer). Second, to engage open protocols to transmit that data to an IRB-approved, HIPAA-compliant server. Third, to consult with a focus group of clinical subject matter experts to determine how to optimize this data for maximum clinical utility. Fourth, to build a display web-based visualization mechanism (ClinVis) that displays meaningful clinical data to both the user (patient) and healthcare provider. Fifth, to execute a pilot study to demonstrate (a) that an open architecture can be used in the ways described above to collect and analyze data from an mHealth app (b) there is clinical utility in the usage of this app with the addition of the visualization tool.

This pilot study will be complete by May 2012 and preliminary data will be presented. This project represents a collaboration between researchers, clinicians, and technologists at the VA, UCLA, UCSF, Stanford, and the Open mHealth Consortium.