Many patients with depression only see a psychiatrist once every two or three months and often forget how they felt between visits and what factors might have affected their moods.
Keeping a mood diary can help patients remember, but their entries aren’t part of the electronic health record, so clinicians can’t develop a view of patterns and triggers for their patients. Enter Ganesh Gopalakrishna, M.D., a psychiatrist at University of Missouri Health Care, who was convinced there had to be a better way.
Working with a computer scientist at Missouri University of Science and Technology, Gopalakrishna developed a mobile app that could collect patient-reported mood data and incorporate it into the EHR, where it could be clinically useful. The pair worked with Missouri S&T’s technology transfer and economic development staff to create an initial proof-of-concept application that collected patient mood data. They then coordinated development of the app with the Tiger Institute for Health Innovation, a partnership between the University of Missouri and Cerner Corp. It has earned University of Missouri Health Care a Most Wired Innovator Award from the American Hospital Association and Hospitals & Health Networks.
The resulting app, MoodTrek, allows people to log not just their mood but their sleep and physical activity as well. The data are instantaneously uploaded into the EHR.
To record their moods, users select the emojilike face that matches how they feel on a scale of 1 to 5. The app, piloted in 2015, has an electronic journal function that allows patients to keep notes that give context to their mood entries. The tool syncs with Fitbit activity trackers to automatically upload activity and sleep information.
The app serves as a feedback mechanism so patients and their doctors can see how sleep and physical activity affect mood, which allows patients to adopt behaviors that might improve their mental health, Gopalakrishna says. The mood information also helps doctors determine whether a course of treatment is working.
Physicians invite patients to use the tool, which they can download for free from Apple’s app store and on Google Play. Patients control what information the physician may access.
At University of Missouri Health Care, the app is used by 88 patients and 45 doctors, most of them psychiatrists. It’s live at two other health systems and has been downloaded 2,300 times, says Aaron McKenzie, who manages the Tiger Institute’s Edge development team.
The app’s creators want to keep expanding its reach. To do that, they hope to leverage Cerner’s network and marketing capabilities. The standard monthly bill for dedicated secure web services is about $1,800. Currently, MoodTrek can handle 50,000 users, but the service can be scaled up quickly to handle more users if necessary.
A small, yearlong study comparing app users and nonusers suggests a correlation between the tool and reduced emergency department use and increased prescription drug treatment. A new study of 20 patients is testing whether the app improves scores on a standard depression questionnaire. Although results aren’t finalized yet, they look good, Gopalakrishna says.
The Most Wired Innovator Award honors hospitals that apply technology in innovative ways, finding creative solutions to serve their patients, staff and communities. A panel of chief information officers and others evaluate submissions on a variety of criteria, including universality and achievement of business objectives, creativity and uniqueness of concept, impact on the organization, scope of the solution, state of implementation, and technical creativity.