A New Standardized Assessment and Data … a standardization of clinical assessment data points over...
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Mar 2, 2014 Jun 10, 2014 Sep 18, 2014 Dec 27, 2014 Apr 6, 2015 25 20 15 10 5 0 Grams per day Patient-reported average daily dosage of dried cannabis P E R M IS S I O N P R E C I S I O N C O ND I T I O N C O M P ASS I O N R E S E A R C H C L I I N I C A L E N C O U N T E R We report satisfactory usability for both clinicians and patients in entering demographic and clinical data using the Wellpad for patient assessment and follow-up in cannabinoid clinical research settings. The focus on inclusive digital design and aesthetic data visualization display allows for a standardization of clinical assessment data points over time, enhancing ease-of- use as well as providing a facile visual communication tool between clinician and patient as clinical progress is tracked based on illness course, change of medication variety or other clinically relevant factors. In the context of clinical research, the ability to readily extract and display data that has been shown to be clinically relevant is a major advance in studying short- and long-term follow-up of patients. CONCLUSION MOOD RELAX PAIN STRESS SLEEP 5 4 3 2 1 21.4% PAIN 14.3% SLEEP 32.1% MOOD/ ANXIETY 32.1% OTHER Reliable tools to guide clinicians and researchers in the emerging field of cannabis medicine remain lacking. Furthermore, in providing short- and long-term follow-up, it is challenging to authentically and reliably obtain clinical data in a standardized format. We have developed a digital global assessment tool for initial and recur- rent assessment of patients engaged in cannabinoid therapy, and present proof of concept and emerging clin- ical research data for this tool. Intended be inclusively designed, i.e. highly usable by clinical participants com- ing from a wide variety of ages, cognitive abilities, cultures and digital literacy levels, Wellpad has standardized assessment of patient progress in supervised therapeutics over the past two years at PRAXIS Holistic Health. (Moller & Saynor, 2014,13th Intl Mobile HCI Health Conf., Toronto, ACM, Canada; Moller et al., 2014; Proc. 10th ICDVRAT, Gothenburg, Sweden). INTRODUCTION Wellpad is a tablet-first patient intake and progress tracking tool for clinicians and researchers in cannabis medicine and other holistic therapies. Patients tap and swipe through an illustrated, gamified question- naire that collects demographics, condition and symptoms, lifestyle, cannabis use data, and five core assessment clusters of wellbeing enquiry: (1) internalized relaxation state, (2) extrinsic stress perception, (3) internalized mood state, (4) pain perception, and (5) sleep quality. These clusters are rated on 5-point sad/happy likert sliders prior to initial consultation, then at every follow-up to visualize relative well being over time. METHOD Despite significant comorbidity, we were readily able to parse out four primary clinical indications that 15 fully informed consecutive sample patients (11M, 4F, mean age =38.8) sought therapy for as a primary ther- apeutic indication: 32.1% mood/ anxiety disorder, 21% pain disorder, 14.3% sleep disorder, and 32.1% other serious medical conditions. RESULTS Wellpad gives clinicians and researchers valuable insight into their patients’ prior experience with cannabis, dosing, intake method, and varieties they have found most helpful for their symptoms. Patient-reported grams per day can be cross-referenced with the clini- cian’s authorization history and external averages. 4. DETERMINE CANNABIS USE For instant data visualization and clinic analytics, data must be complete and uniform. Below, a patient database was cleaned up with a combination of automated processes and manual record veri- fication. Data accuracy is more readily achieved during initial collection by making instructions and text input larger, focusing on one or two items per slide, and requiring specific alphanumeric format for relevant fields (eg. Postal code, phone number.) 2. COLLECT ACCURATE DATA AND KEEP IT SAFE 3. CLARIFY APPLICANT’S MEDICAL HISTORY, CONDITION AND SYMPTOMS A holistically designed intake app not only consistently extracts clinically necessary in- formation but sets expectations with a diverse applicant pool. Policies can be broken down into checkbox slides to establish detailed knowledge and approval. The applicant must understand how and why their medical data will be collected, uploaded, stored, used, and shared (or not); or the risks associated with the treatment they are applying for, in simple language with rich illustrations. The care provider may start with templates our team has developed: EMR Privacy Policy; Informed Consent for a Re- search Study; and Release, Acknowledgement & Indemnity for Patients Seeking a Medical Cannabis Authorization. 1. ENSURE CONSENT AND IMPROVED UNDERSTANDING Wellpad is a viable alternative to long boring forms of irrelevant, confusing questions patients don’t answer correctly. In our presentation at MobileHCI 2014, we noted that, although Inclusive Design (Nussbaum, 2001) has spread since the Americans with Disabili- ties Act in 1990, easy-to-use, accessible, aesthetically-pleasing environ- ments, products and technologies optimized for a total population--in- cluding the aging, illiterate or differently abled--have ironically been lacking in the primary care of those with medical ailments. The unfavourable movement in stress level between Oct 1 and Nov 26 indi- cates the patient experienced significant stressor(s) which opened a helpful dis- cussion about this as soon as the followup consultation started. Here, five core wellbeing factors based on most com- mon clinical presentation are periodically assessed with an intuitive “sad face” to “happy face” slid- er: (1) internalized relaxation state, (2) ex- trinsic stress perception, (3) internalized mood state, (4) pain perception, and (5) sleep quality. In the centre of this poster, you can see what a collection of inputs looks like. Cannabis varieties listed by 15 participants are col- lected as a tag cloud. Condition-specific favourites can be compared visually. Participants found it easy to drag the sliders to rate how they were feeling Clinical data, organized and secured automatically. Wellpad prevents inappropriate database access with SSL (Se- cure Sockets Layer) and protects sensitive patient data with hashing/encryption. Wellpad develops a shared language between patient and care provider Wellpad’s geolocating feature showed 4 sample patients resided in the Toronto downtown core, 6 in suburban regions, and 5 in outlying towns or cities. The number of clinical data assessment data points ranged from 1-5, based on the number of assessments. Longitudinal clinical symptom patterns and fluctuations based on touchscreen Likert Scale inputs from initial baseline assessment and subsequent assessments are graphically displayed using the Wellpad data visualization panel, including fluctuation in our core assessment clusters of pain, sleep quality, stress perception, relaxation and mood. Geolocation of participant dwellings in relation to target care provider Where overwhelming Electronic Medical Record (EMR) systems might do more to interrupt the patient encounter than facilitate it, Wellpad gathers information about the participant’s condition and symptoms discreetely and engagingly. 3 5 5 5 4 5 5 1 3 4 5 5 5 5 5 2 3 3 3 3 2 4 4 3 3 MOOD STRESS RELAX SLEEP PAIN MOOD RELAX STRESS SLEEP PAIN Jun 6, 2014 Oct 1, 2014 Nov 26, 2014 Feb 25, 2015 Jun 30, 2015 Cannabinoid Conference 2015 7th European Workshop on Cannabinoid Research & IACM 8th Conference on Cannabinoids in Medicine 17-19 September 2015 in Sestri Levante, Italy Henry J. Moller 1,2,3,4 , Kunal Sudan 4 , Lee Saynor 3,4 , Daniel Tabak 4 1 Faculty of Medicine, Dept. of Psychiatry, University of Toronto, Canada 2 Knowledge Media Design Institute, University of Toronto, Canada 3 Digital Futures Initiative, OCAD University, Toronto, Canada 4 PRAXIS Holistic Health, 785 Carlaw Ave. Suite 101, Toronto, ON M4K 3L1 Canada A New Standardized Assessment and Data Visualization Tool for Clinicians and Researchers in the Field of Medical Cannabinoid Therapy Wellpad: Patient 290F: Wellbeing Self-Ratings Over Time
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Transcript of A New Standardized Assessment and Data … a standardization of clinical assessment data points over...
Mar 2,2014
Jun 10,2014
Sep 18,2014
Dec 27,2014
Apr 6,2015
25
20
15
10
5
0
Gra
ms
per
day
Patient-reported average daily dosage of dried cannabis
User ID
Last Nam
eFirst N
ame
DO
BPhone N
umber
AddressEm
ailPrim
ary Clinical Indication
# of SurvM
ost Recent Survey
User ID
Last Nam
eFirst N
ame
DO
BPhone N
umber
AddressC
ityProv
Postal Co
Primary C
linical Indication# of Surv
Most R
ecent Survey
PERMISSION PRECISION CONDITION COMPASSION
R
ESEA
RCH
C
LIINI
CAL ENCOUNTER
We report satisfactory usability for both clinicians and patients in entering demographic and clinical data using the Wellpad for patient assessment and follow-up in cannabinoid clinical research
settings. The focus on inclusive digital design and aesthetic data visualization display allows for a standardization of clinical assessment data points over time, enhancing ease-of-
use as well as providing a facile visual communication tool between clinician and patient as clinical progress is tracked based on illness course, change of
medication variety or other clinically relevant factors. In the context of clinical research, the ability to readily extract and display data
that has been shown to be clinically relevant is a major advance in studying short- and long-term
follow-up of patients.
CONCLUSION
MOOD
RELAX
PAIN
STRESSSLEEP
5
4
3
2
1
21.4%PAIN
14.3%SLEEP
32.1%MOOD/
ANXIETY
32.1%OTHER
Reliable tools to guide clinicians and researchers in the emerging field of cannabis medicine remain lacking. Furthermore, in providing short- and long-term follow-up, it is challenging to authentically and reliably obtain clinical data in a standardized format. We have developed a digital global assessment tool for initial and recur-rent assessment of patients engaged in cannabinoid therapy, and present proof of concept and emerging clin-ical research data for this tool. Intended be inclusively designed, i.e. highly usable by clinical participants com-ing from a wide variety of ages, cognitive abilities, cultures and digital literacy levels, Wellpad has standardized assessment of patient progress in supervised therapeutics over the past two years at PRAXIS Holistic Health. (Moller & Saynor, 2014,13th Intl Mobile HCI Health Conf., Toronto, ACM, Canada; Moller et al., 2014; Proc. 10th ICDVRAT, Gothenburg, Sweden).
INTRODUCTION
Wellpad is a tablet-first patient intake and progress tracking tool for clinicians and researchers in cannabis medicine and other holistic therapies. Patients tap and swipe through an illustrated, gamified question-naire that collects demographics, condition and symptoms, lifestyle, cannabis use data, andfive core assessment clusters of wellbeing enquiry: (1) internalized relaxation state, (2)extrinsic stress perception, (3) internalized mood state, (4) pain perception, and(5) sleep quality. These clusters are rated on 5-point sad/happy likert slidersprior to initial consultation, then at every follow-up to visualize relativewell being over time.
METHOD
Despite significant comorbidity, we were readily able to parse out four primary clinical indications that 15 fully informed consecutive sample patients (11M, 4F, mean age =38.8) sought therapy for as a primary ther-apeutic indication: 32.1% mood/anxiety disorder, 21% pain disorder, 14.3% sleep disorder, and 32.1% other serious medical conditions.
RESULTS
Wellpad gives clinicians and researchers valuable insight into their patients’ prior experience with cannabis, dosing, intake method, and varieties they have found most helpful for their symptoms.
Patient-reported grams per day can be cross-referenced with the clini-cian’s authorization history and external averages.
4. DETERMINE CANNABIS USE
For instant data visualization and clinic analytics, data must be complete and uniform. Below, a patient database was cleaned up with a combination of automated processes and manual record veri-fication.
Data accuracy is more readily achieved during initial collection by making instructions and text input larger, focusing on one or two items per slide, and requiring specific alphanumeric format for relevant fields (eg. Postal code, phone number.)
2. COLLECT ACCURATE DATA AND KEEP IT SAFE
3. CLARIFY APPLICANT’S MEDICALHISTORY, CONDITION AND SYMPTOMS
A holistically designed intake app not only consistently extracts clinically necessary in-formation but sets expectations with a diverse applicant pool. Policies can be broken down into checkbox slides to establish detailed knowledge and approval.
The applicant must understand how and why their medical data will be collected, uploaded, stored, used, and shared (or not); or the risks associated with the treatment they are applying for, in simple language with rich illustrations.
The care provider may start with templates our team has developed: EMR Privacy Policy; Informed Consent for a Re-search Study; and Release, Acknowledgement & Indemnity for Patients Seeking a Medical Cannabis Authorization.
1. ENSURE CONSENT AND IMPROVED UNDERSTANDINGWellpad is a
viable alternative to long boring forms of
irrelevant, confusing questions patients don’t answer correctly.
In our presentation at MobileHCI 2014, we noted that, although Inclusive Design (Nussbaum, 2001) has spread since the Americans with Disabili-ties Act in 1990, easy-to-use, accessible, aesthetically-pleasing environ-ments, products and technologies optimized for a total population--in-cluding the aging, illiterate or differently abled--have ironically been lacking in the primary care of those with medical ailments.
The unfavourable movement in stress level between Oct 1 and Nov 26 indi-cates the patient experienced significant stressor(s) which opened a helpful dis-cussion about this as soon as the followup consultation started.
Here, five core wellbeing factors based on most com-mon clinical presentation are periodically assessed with an intuitive “sad face” to “happy face” slid-er: (1) internalized relaxation state, (2) ex-trinsic stress perception, (3) internalized mood state, (4) pain perception, and (5) sleep quality. In the centre of this poster, you can see what a collection of inputs looks like.
Cannabis varieties listed by 15 participants are col-lected as a tag cloud. Condition-specific favourites can be compared visually.
Participants found it easy to drag the sliders to rate how they were feeling
Clinical data, organized and secured automatically.
Wellpad prevents inappropriate database access with SSL (Se-cure Sockets Layer) and protects sensitive patient data with hashing/encryption.
Wellpad develops a shared language betweenpatient and care provider
Wellpad’s geolocating feature showed 4 sample patients resided in the Toronto downtown core, 6 in suburban regions, and 5 in outlying towns or
cities. The number of clinical data assessment data points ranged from 1-5, based on the number of assessments. Longitudinal clinical symptom patterns
and fluctuations based on touchscreen Likert Scale inputs from initial baseline assessment and subsequent assessments are graphically displayed using the Wellpad data visualization panel, including fluctuation in our core assessment clusters of pain, sleep quality, stress perception, relaxation and mood.
Geolocation of participant dwellings in relation to target care provider
Where overwhelming Electronic Medical Record (EMR) systems might do more to interrupt the patient encounter than facilitate it, Wellpad gathers information about the participant’s condition and symptoms discreetely and engagingly.
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5 5 5
4
5 5
1
3
4
5 5 5 5 5
2
3 3 3 3
2
4 4
3 3
MOODSTRESS
RELAX
SLEEPPAIN
MOOD
RELAXSTRESS
SLEEPPAIN
Jun 6,2014
Oct 1,2014
Nov 26,2014
Feb 25,2015
Jun 30,2015
Cannabinoid Conference 20157th European Workshop on Cannabinoid Research &
IACM 8th Conference on Cannabinoids in Medicine
17-19 September 2015 in Sestri Levante, Italy
Henry J. Moller1,2,3,4, Kunal Sudan4, Lee Saynor3,4, Daniel Tabak4
1 Faculty of Medicine, Dept. of Psychiatry, University of Toronto, Canada2 Knowledge Media Design Institute, University of Toronto, Canada3 Digital Futures Initiative, OCAD University, Toronto, Canada4 PRAXIS Holistic Health, 785 Carlaw Ave. Suite 101, Toronto, ON M4K 3L1 Canada
A New Standardized Assessment and Data Visualization Tool for Clinicians and Researchers in the Field of Medical Cannabinoid TherapyWellpad:
Patient 290F: Wellbeing Self-Ratings Over Time
