DEVELOPING AND EVALUATING A WEB-BASED PATIENT REPORTED OUTCOMES AND DECISION SUPPORT TOOL (MYPSYCKES)

Purpose: Patient reported outcomes and shared decision-making are two related strategies for promoting patient centered care. Web-based tools hold the promise of improving quality of care, but little data is available on the use and impact of such systems in mental health, particularly for individuals with serious mental illness. MyPSYCKES combines these elements for use in the outpatient setting. We describe the MyPSYCKES program and evaluation, and will allow participants to log on and interact with the web-based application. 

Method: MyPSYCKES is a bilingual web-based application developed by the New York State Office of Mental Health (NYS OMH) to strengthen patients' ability to participate in clinical decision-making. Before each medication appointment, patients use the MyPSYCKES program in their clinic with the assistance of peer staff, answering questions about their use of wellness activities and medications, symptoms and status, medication concerns, personalized health risks, and goals for treatment. MyPSYCKES produces a one-page report that synthesizes their answers and aggregates data from previous visits to show trends over time. The patient and physician use this report in session and develop a shared decision about next steps in treatment. After conducting usability testing and developing robust training and implementation protocols with our two pilot sites, we expanded the program to ten additional sites statewide. 

Result: Guided by a diverse Stakeholder Advisory Committee that included patients, clinicians, researchers, policymakers, and payers of care, we developed an extensive evaluation protocol for MyPSYCKES. The research involves several methods of data collection to address the questions of interest identified by stakeholders, including the following priority outcomes: 1) patient empowerment, activation and health outcomes, 2) changes in clinical discussions and decision-making processes, 3) greater inclusion of patient preferences in records, 4) program use by different groups, and 5) implementation best practices. 

Conclusion: The MyPSYCKES evaluation will provide important information about the usability of such a system for individuals with SMI and other vulnerable subgroups, as well as critical information on the value and impact of patient reported outcomes and shared decision-making on patient activation, engagement in care, and health outcomes. These data will help guide patients, families, providers, payers, and systems of care on investment decisions for future practices methodologies.