When doctors treat a patient for depression, weeks or even months may pass before they see that patient again. Psychiatric epidemiologist Peter Zandi calls this “clinical whitespace” — a time when doctors don’t know how their patient is doing. It’s why he’s developing a free app that generates real-time health data to improve the care of patients with depression and bipolar disorder.
The MHi-GO app’s Mental Health Integration feature, which for now is specifically for Johns Hopkins Medicine patients, connects directly to their electronic health records on Epic when they visit Johns Hopkins Medicine locations and log on to the guest Wi-Fi. The app uses the EPIC information to schedule automatic reminders for taking medications and for doctor’s appointments.
“We didn’t want patients to have to enter the medications themselves because we thought that would reduce the uptake and patients wouldn’t do it,” says Zandi.
The app also prompts patients to complete daily mood questionnaires. Data from the questionnaires shows daily mood patterns and medication compliance. This information is shared with the patient’s doctor who can, if needed, call the patient and adapt the treatment plan.
Zandi began building the app in 2017 with help from the Johns Hopkins Medicine Technology Innovation Center and funding from Johns Hopkins’ InHealth initiative, which supports precision medicine efforts. He’s now seeking more funding to improve the app’s functionality. He expects the app to be available in 2019, for both iPhones and Androids through MyChart. Zandi also plans to publish a pilot study of 10 patients using the app, and make MHi-GO available for non-Hopkins patients.
Eventually, Zandi wants the app to collect smartphone sensor data — such as a user’s daily number of steps — to studywhether patient activeness can be correlated with mood, and then whether specific app interventions can be created.“We could connect them with a resource when they’re starting to have trouble, or deliver some sort of behavioral therapy or motivational text,” says Zandi. “There’s a variety of things we could do to help.”