1. Design and evaluation of a youth friendly eHealth platform, TickiT for the clinical encounter
Daniel Penn
COO/Co-Founder
Shift Health Paradigms
Sandy Whitehouse, MD
Dept. Pediatrics
University of British Columbia

2. Disclaimer
Dr. Sandy Whitehouse is a founder and shareholder of Shift Health Paradigms

3. Introduction
-Psychosocial screening in Adolescent Medicine, why and how
Considerations in making an effective eHealth tool
co-creative process
addressing stakeholder needs
evaluation in a clinical setting

5. Asking adolescents about psychosocial risk in practice40
902
80%
Practices
Patients
Presented with physical reasons
Family doctors were trained with psychosocial interviews
90% had 1 or more psychosocial risks
Lena Sanci, Australian Association of Adolescent Health Meeting

6. Psychosocial risk in hospital settings Surgical Wards only 50% were asked percentage of patients reporting concerns was significant Hayden W. Archives of Disease in Childhood

7. Challenges with HEADSS Interview
Time Consuming
Documentation Challenges
Personal and Individualized, but may be incomplete
Can Be Uncomfortable

8. Development of a HEADSS Checklist
ASQ- Adolescent Screening Questionnaire
P. Lam, M.Yeo
Self administered
Paper
Challenge to quickly read responses
Secondary manual data entry
Poor Uptake:
25% (10/40) adolescents refusal higher in male patients
Patient experience
make questions more positive
some questions confusing
Literacy and language
A study at BC Children’s Hospital (BCCH) found psychosocial assessment was present on 50% of hospital records and a paper-based questionnaire had a 75% uptake.

9. This abstract outlines the developmental steps and prototype evaluation of an eHealth initiative undertaken to improve uptake of psychosocial screening among youth.
Is there a better way?

10. Who are the stakeholders? What are the goals?
Patients
Health Care Providers
Administrators
IT- Security and Regulatory

11. Experience Continuum in a clinical setting
Communication Design
Experience Continuum in a clinical setting
Youth are sophisticated “technology natives.” The objective was to leverage youth’s comfort with technology, creating a youth-friendly interactive mobile eHealth psychosocial screening tool, TickiT. The goal of the platform design is to engage youth (ages years) in their health issues and subsequently improve health care outcomes by helping them inform and communicate personal health information to providers.
Before
Arrive
On Location
Depart
After
Physical
Action
Social
Interaction
Emotional
Reaction

12. eHealth platform: TickiT
Patients enter data into the mobile application prior to the face-to-face clinician visit. Response data is recorded in a report,

13. Co-creative process

14. Co Creation: User testing Initial extensive field testing UBC Study Icons and platform comprehensible across age, gender and ethnicity Saewyc E, in press

15. Interactive Survey Templates

16. Chapters decrease survey fatigue and increase interest
Survey Chapters

17. Doctor’s view

18. Flagging System Red flags rapidly identify risks
Green flags help providers engage patients
Healthcare providers (HCPs) required straightforward reports with relevant information and alerts which generates
alerts that highlight both risk and protective factors, shifting the clinical focus from collecting information to strengths-based focused management

19. Branch to the
Relevant Questions

20. Multiple Language
Support

22. TickiT Feasibility Study: BC Children’s Hospital and McMaster Hospital
N=80, age years
Dr Lam et al.
Co-Creation With TickiT: Designing and Evaluating a Clinical
eHealth Platform for Youth
(JMIR Res Protoc 2013;2(2):e42) doi: /resprot.2865
Co-Creation With TickiT: Designing and Evaluati2013;2(2):e42)

23. TickiT Feasibility Study: Physician Responses Dr Lam et al
Pediatric residents (n=25) were most positive about the application (100%) and surgeons (n=3) were least positive. All inpatient providers obtained new patient information

24. A new era in Psychosocial Screening Engaging all stakeholders critical Informed through Co-creative design processes Evaluation using Triple Aim criteria Unexpected results Next steps- cost effective analysis
Co-creative design methodology with stakeholders was an effective strategy for informing design and development processes to leverage effective eHealth opportunities. Continuing stakeholder engagement has fostered further platform development. With respect to Triple Aim, TickiT improves patient engagement and provider information. Recent preliminary data indicates the platform helps youth feel more prepared for the face-to-face clinical encounter. While efficient, detailed cost benefit analysis is needed.