Molly Finnerty*, New York State Office of Mental Health; Dept. of Psychiatry, Columbia University Medical Center, New York, United States Emily Leckman-westin, New York State Office of Mental Health; Dept. of Epidemiology and Biostatistics, State University of New York at Albany School of Public Health, Albany, United States Edith Kealey, New York State Office of Mental Health; Dept. of Psychiatry, Columbia University Medical Center, New York, United States Qingxian Chen, New York State Office of Mental Health, Albany, United States Veronica Hackethal, New York State Office of Mental Health, New York, United States Elizabeth Austin, New York State Office of Mental Health, New York, United States Track: Practice Presentation Topic: Consumer empowerment, patient-physician relationship, and sociotechnical issues Presentation Type: Rapid-Fire Presentation Submission Type: Single Presentation Building: Joseph B. Martin Conference Center at Harvard Medical School Room: C-Rotunda Room Date: 2012-09-15 04:45 PM – 05:30 PM Last modified: 2012-09-12

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Computer-assisted Shared Decision-Making and wellness planning tools have the potential to promote patient centered care and quality improvement across medicine. However, concerns have been raised whether these technologies can reach those who may need these tools the most: those with more serious illnesses, socioeconomic disadvantages, and low English proficiency. MyPSYCKES is an inter-active web-based application developed by the New York State Office of Mental Health that supports care coordination and integration of mental and general health issues. Consumers use MyPSYCKES before each psychiatric clinic visit with the aid of peer staff. MyPSYCKES has three components: My Treatment Data, with access to five years of Medicaid claims data; Common Ground, a health report filled out by consumers that helps them organize their thoughts about medication use and track their symptoms over time; and the Learning Center, which supports health education and illness management. All MyPSYCKES materials are available in English and Spanish. To date, planned implementation of MyPSYCKES has consisted of two phases: Phase I pilot implementation in two diverse New York City clinics serving individuals with serious mental illness, multiple medical co-morbidities, and 30% Spanish speaking populations; and Phase II expansion to three additional pilot sites in New York City. Phase I pilot clinics have a combined population of 500, with an average of: 52% male, 48% female, 53% Caucasian, 16% African American, 46% Hispanic, 53% Medicaid enrollees. The most common mental illness diagnosis is Schizophrenia. Several methods have been used to evaluate the MyPSYCKES pilot implementation, and reveal that the MyPSYCKES platform is successfully achieving its goal of promoting consumer empowerment and engagement in treatment planning. Experience from Phase I revealed that MyPSYCKES can be used by individuals with serious mental illnesses. Schizophrenia is not a barrier to use and may be a positive predictor of engagement. Moreover, the Spanish version has been selected by 20% of users, indicating that individuals with Spanish as a primary language can successfully use MyPSYCKES. Explanatory factors, like differences between diagnostic groups that could affect use, will be discussed. Preliminary data has shown that the top three medication concerns of users are: 1) Concerns over medication efficacy, 2) Effects of medication on physical health, and 3) Concerns about cardiometabolic risk of medication and current cardiometabolic co-morbidities. Ethnographic fieldwork has revealed the following three themes: 1) Quantifying symptoms on trend lines which consumers have begun to use as a way of validating their symptoms and experiences, 2) Ownership and pride in the Common Ground Report as a source of increased consumer investment in their own care; and 3) Discrepancies and accountability in answers recorded in the Common Ground Report. Planned evaluation of MyPSYCKES will also be discussed, including usability and usefulness of the MyPSYCKES application for different user groups and literacy levels. Highlights from pre-implementation data and usability testing for phase II expansion will also be presented.