King's College London

The myHealthE (MHE) platform is a novel NHS digital health monitoring system developed to provide a simple and secure way for families accessing Child and Adolescent Mental Health Services (CAMHS) to report clinical information. It aims to support children and young people with psychiatric conditions and their caregivers between clinic visits and to improve the quality of data available for monitoring treatment effectiveness.

The concept was initially developed under ‘APPROaCh (Agent Platform for automating patient PROvided Clinical outcome feedback) by Dr Zina Ibrahim and colleagues at the Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience at King’s College London. The concept was then adapted and evaluated under the MHE inter-disciplinary research programme led by Dr Johnny Downs. The project is a collaboration of experts from academic (Professor Emily Simonoff, Dr Zina Ibrahim, Anna Morris, Professor Richard Dobson), clinical (Dr Omer Mograhby), bioinformatics and system engineer (Dr Lukasz Zalewski, Dr Ian Grant, Matthias Michaluk and Garry Moriarty), commercial partners (Jeremy and Andy (Digital Marmalade; Jeremy Jones and Andy McEniry) and health IT governance by the Centre for Translation Informatics.

MHE uses a secure and automatic text and email system to collect clinically important information from caregivers about their child’s mood, behaviour and activities on a regular basis and present it back to families and clinicians graphically. The web-application provides instant feedback about treatment progress as an incentive for caregivers to respond to requests for updates about how their child is feeling. All data recorded by MHE is then fed back in real time to the user’s electronic health records. This enables clinicians to identify problems earlier and offer more tailored treatment. This system is designed to empower families with mental health conditions to manage their own care outside of hospital and enhance their experiences of using CAMHS by making it much easier to complete questionnaires on symptoms and medication side-effects.

A recent 12-week feasibility study conducted with 196 families undergoing treatment with the South London and Maudsley (SLaM) Lewisham Neurodevelopmental service revealed that MHE afforded a 14-fold increase in caregiver reported outcome measurement compared to paper-based monitoring (70 vs 8%). Furthermore, 72% of caregivers who were due to complete a follow-up electronic questionnaire during the trial accomplished this. Follow up process evaluation interviews demonstrated that the system was well received by caregivers. The trial and MHE development are Guys and St Thomas’ Charity and Maudsley BRC funded.

Since trialling the platform, the SLaM CAMHS executive committee have agreed to support the extension of MHE implementation across national and specialist CAMHS teams and remaining SLaM CAMHS teams with the local catchment (Southwark, Croydon and Lambeth). Furthermore, Guy and St Thomas’ Neurodisability services are now conducting a quality improvement programme which will implement and evaluate the MHE platform as their outcome collection tool.

Additional funding has also been secured via two large scale NIHR research programmes (totalling ~£3.1 million): NIHR OPTIMA (https://fundingawards.nihr.ac.uk/award/RP-PG-0618-20003 ), which will implement MHE across 5 other Trusts ( 27 CAMHS sites) for use as an outcome monitoring tool and platform to trial digital intervention, and NIHR REMAIN (https://fundingawards.nihr.ac.uk/award/CS-2018-18-ST2-014) which extends the MHE platform to monitor ADHD symptoms and treatment response in local CAMHS referred children.