7th Annual Meeting American Association for Technology in Psychiatry Changing Our Minds Saturday, May 18, 2002 Room 113C, Pennsylvania Convention Center Philadelphia, Pennsylvania

AATP 2002 Annual Meeting Abstracts

Internet treatment of jet lag

Daniel Z. Lieberman, MD
George Washington University
Washington, DC

Seventy percent of individuals who suffer from psychiatric illness do not receive treatment. One way to address this problem is to develop highly cost effective computer-assisted forms of treatment. Delivering this type of intervention via the Internet maximizes the availability and ease of access, but raises questions related to confidentiality and the lack of professional supervision. This study selected a highly benign treatment -- timed exposure to bright light for jet lag -- in order to explore the issues involved in delivering a fully automated, unsupervised intervention for a behavioral health problem. Computer software was developed that calculated a schedule of bright light exposure designed to maximize circadian phase adjustment to a new local time after a transmeridial flight. The software was designed with an interface that allowed it to be accessed anywhere in the world via the Internet. IRB approval for an unsupervised informed consent and treatment was obtained. Participants were asked to periodically rate their symptoms using the Columbia Jet Lag Scale, and to rate how closely they followed the light exposure schedule. There was no control condition. 4644 visitors accessed the site, and generated jet lag reduction plans. Twenty individuals returned completed symptom rating scales. There was a significant negative correlation between how closely subjects followed the light exposure schedules, and the severity of their jet lag symptoms.

Electronic medical records essentials

Daniel Deutschman, MD
Case Western Reserve University
Cleveland, OH

Healthcare is under assault. Medical knowledge is growing exponentially. While demanding more comprehensive data to meet NCQA and JCAHO requirements, managed care payors steadily decrease reimbursements. Medicare's rigid data criteria tied to reimbursements threaten MDs with fraud and abuse charges. Psychiatrists struggle to provide quality care at the same time that they comply with these additional documentation requirements. Maintaining a reasonable income in the face of these challenges is difficult.

Electronic medical records (EMR) may hold the answer to the quality, documentation and productivity challenge. EMR provide: comprehensive data, MD decision support, quality of care enhancement and increased productivity.

Three such EMR, in university affiliated mental health facilities, more than meet the challenges outlined above. They represent years of work by leaders in EMR design and implementation from Columbia University, University of Louisville and Case Western Reserve University. In aggregate, these EMR offer:

1. Prompting data input forms
2. Automated data entry
3. Print outs of interviews, treatment plans and prescriptions
4. MD decision support for diagnostically complex and treatment resistant patients
5. Electronic scheduling
6. Billing
7. Naturalistic studies
8. Multi-site capacity
9. Seamless inpatient and outpatient data integration

The data systems will be demonstrated and compared. Costs, implementation issues, patient/MD satisfaction and future developments will be discussed.

Last updated: September 18, 2002
URL: http://www.techpsych.org/02/abstracts.html