Bipolar Disorder Lighthouse Project
Bipolar disorder or medical illness is a serious mental health condition in which a person experiences depression lasting weeks or months, alternating with bouts of ‘highs’ or mania of variable duration. For months, even years, the persons mood is otherwise perfectly normal. Research investigations over the past few decades have shown that on average 70% of the cause of bipolar disorder is genetic and the remaining 30% is due to environmental factors.
The Lighthouse Projects were launched with a specific focus to build an understanding of the benefits of an Electronic Health Record in the Irish healthcare system, with specific improvements in service delivery in 2016. These projects are also intended to enable learning within the system.
The Bipolar Lighthouse project is unique to the other two projects as there is nothing currently in the space. It builds on the insights gained from the 4theHealthIreland Ecosystem meeting on March 1st 2016 which brought together stakeholders including service users, clinicians, academics and industry professionals. The specific feedback on the bipolar disorder lighthouse is available here. It is noted that a theme that emerged was that the issues relating to bipolar disorder and an EHR are those which face mental health practice in general; it is not proposed that there be a “bipolar EHR” different from other areas of mental health. However, it was also felt that for the purpose of the Lighthouse Project, bipolar disorder was appropriate as it affects a clinically well defined population and interventions such as Early Warning Signs recognition have an evidence base.
A connected health approach to achieving and maintaining recovery in users of mental health services with a bipolar disorder. This will use technology to enable self-management and the detection of early warning signs of relapse, thus empowering the patient and easing contact with service providers. A patient portal will allow access to a care plan for service users and service providers, and allow the service user to monitor symptoms. This patient portal / mobile enabled solution that will be futureproofed and integrated into future Electronic Health Record with the Individual Health Identifier an integral feature of the project.
These will include patients with diagnosis of bipolar affective disorder and mental health professionals (including community psychiatric nurses; home based treatment team nurses; psychiatrists)
The Structure wil include:
- Elements of the future Electronic Health Record by using the Individual Health Identifier.
- Record of the previous logins so service user can see who is accessing care plan.
- Patient portal which will allow access to care plan.
- Early Warning Sign monitoring. This will be personalised and will vary from person to person. It may include sleep diary, overall mood diary, activity scheduling, possible log of purchases (to monitor overspending).
- A means of contacting service proffessionals via patient portal.
- Mobile Accessible Via an App. The patient will be able to access patient portal and care plans from an app on their mobile.
- Health Care Professional Portal. The access to care plan can be accessed, with opt in consent of service user, by their healthcare professional to allow them to view the self-monitoring overview.
The benefits include:
- Supporting the recovery model of mental health with an emphasis on strengths and developing personal resources
- Considerable evidence for benefits of early warning sign.
- Access to care plan for service user and service provider the aim to reduce unnecessary admission time for the patient and to ensure crises do not excessively disrupt the patients lives.
There is more information in Supplementary Documentation on research papers that were used in the formation of the above.
eHealth Ireland would like to create an EHR that will enable patients to have mobile access to record their medicinal compliance and quality of life. This will allow patients and clinicians to monitor and assess their condition for digital intervention. The development of a secure clinical communicator would allow patients and clinicians access to a support tool that could be used 24 hours a day as and when needed. This information could be analysed to provide important individualized treatment to patients and the population as a whole.