Sacramento-area youth in the early stages of serious mental illness can receive a new smartphone app that helps them detect early warning signs of psychosis, through a one-year, $588,000 grant to the UC Davis Early Diagnosis and Preventive Treatment (EDAPT) Clinic from the Robert Wood Johnson Foundation, to study whether harnessing mobile technology improves patient care.
The app, called Ginger.io, enables individuals to actively record their symptoms on a daily and weekly basis, while information on their movements and daily social contacts, such as the number of incoming telephone calls and text messages, is gathered in the background.
“We are trying to identify the early warning signals that someone is struggling, so we can intervene earlier and hopefully prevent relapse,” said Tara Niendam, assistant professor in the Department of Psychiatry and Behavioral Sciences and director of operations for the EDAPT Clinic. “If an individual is having a bad week, we can reach out to them quickly, rather than waiting for them to call us or come in to the clinic for their next appointment.”
The early stages of psychotic illness, which affects an estimated 2 percent of Americans, represent critical periods for intervention. Eighty percent of individuals relapse within the first five years of receiving a diagnosis. Annual health-care costs associated with psychosis are approximately $23 billion. Using Ginger.io, the UC Davis EDAPT clinic aims to improve early identification of symptom exacerbations, giving providers the ability to intervene early in the hope of preventing relapse.
Ginger.io's three-part platform — patient app, behavioral analytics engine and provider dashboard — gives care providers a window into their patients' health between office visits. The patient app and behavioral analytics use smartphone sensors to detect abnormalities in the patient's sleep, communication and movement patterns. Any concerning changes in daily patterns are communicated to the provider via the dashboard, allowing clincians to deliver timely interventions. Ginger.io has offices in San Francisco and Cambridge, Mass.
The clinic will test the effectiveness of the Ginger.io application over a 12-month period in as many as 120 patients. Clients who do not own Web-enabled phones will receive one through a partnership with T-Mobile. Individuals enrolled within the UC Davis EDAPT and SacEDAPT clinics are eligible to participate, Niendam said.
Patients receiving treatment typically see their clinical team on a weekly basis, but that provides only a limited snapshot of patient status, and patients often struggle to report day-to-day fluctuations in their mood and behavior, causing clinicians to miss the early signs of relapse. Using Ginger.io, EDAPT clinicians hope to begin to fill in the gaps.
The app also enables clients to review their data with their clinician each week to see how they are improving or if certain things, such as forgetting a dose of medication, can trigger an increase in symptoms, Niendam said.
“For example, they can see how the number of arguments they have had with family members affects their mood, to give them concrete things to work on between therapy sessions,” she said.
Niendam noted that younger people are very comfortable interacting with apps on smart phones and other mobile devices.
"We hope that this new technology will provide a unique opportunity to enhance their treatment and yield better patient outcomes,” she said.
The EDAPT and SacEDAPT Clinics serve youth with illnesses on the psychosis continuum. It offers comprehensive diagnostic and treatment services for children and young adults who recently have developed a psychotic disorder, or who are at high risk of developing such a disorder, with the goal of intervening as early as possible to limit or arrest the course of their disease. Visit http://earlypsychosis.ucdavis.edu for more information.
For more than 40 years the Robert Wood Johnson Foundation has worked to improve the health and health care of all Americans. As the nation’s largest health-focused philanthropy, we work with a diverse group of organizations and individuals to identify solutions and achieve comprehensive, measurable, and timely change. The Foundation brings experience, commitment, and a rigorous, balanced approach to the problems that affect the health and health care of those it serves. They are striving to build a national culture of health that will enable all Americans to live longer, healthier lives now and for generations to come.