Rural college students have a significant need for improved quality and efficiency mental health services for Major Depressive Disorder. Iconic Health proposes to address this need by building upon the HomePsych communication platform, integrating a process whereby mobile symptom reporting is visually formatted for enriched understanding by mental health professionals. The HomePsych communication platform was developed, validated and commercialized in rural communities primarily through prior USDA funding with Phase I and II SBIR awards. In its current incarnation, HomePsych represents a transformative approach to mental health care delivery in two primary ways. One, this platform integrates a mental health record keeping system with a video telepsychiatry system. Two, it optimizes mental health care by enriching the provider's understanding of the patient by leveraging Web 2.0 technology to efficiently collect information from the patient and presents it effectively to the provider. By making patient information quickly accessible and understandable to the provider, HomePsych has improved the process of mental health care provision. With the current HomePsych system, patients log into the secure online patient portal to provide progress reports and complete ongoing rating scales for symptoms of mental illness. Iconic Health proposes to expand the patient's interface, developed beyond its current Internet browser interface to an iPhone mobile application to allow frequent reports of psychological symptoms as they occur, as well as events and behaviors relevant to treatment of depression. This method of data collection, often referred to as ecological momentary assessment (EMA; Stone & Shiffman,1994), allows the collection of real time data while the individual is in his or her natural environment. EMA is presently used as a research tool for studying mood swings, but, to our knowledge, has never been integrated into an electronic health record for ongoing assessment and treatment of mood disorders by psychiatrists. The expected benefits for college students from rural areas suffering from Major Depressive Disorder are significant and broad reaching. Through enhancing mental health providers' understanding of their symptoms in context, college students will receive more accurate diagnosis and optimized medication management, which will lead to quicker recovery from depressive episode and more effective prevention of future depressive episodes in this vulnerable population. The anticipated end benefits for rural college students are improved quality of life, higher collegiate achievement, fewer dropouts, fewer suicides. OBJECTIVES: The purpose of this project is to determine the feasibility of technology relating to the solicited research topic "Development of information and managerial systems that improve the efficiency and effectiveness of the service industry, especially in critical areas, such as health, transportation, and telecommunications, and in turn, enhance the economic vitality of rural areas". This project is applicable to USDA Strategic Goal 3, "Support Increased Economic Opportunities and Improved Quality of Life in Rural America" and Strategic Goal 5, "Improve the Nation's Health and Nutrition". The proposed project aims to improve mental health care by leveraging the cutting edge of telecommunication technology to develop and implement an innovative solution to shortcomings of depression treatment in a receptive population. The economic effects of Major Depressive Disorder on rural communities is profound, when missed work days, lost opportunities due to low motivation, hospitalizations and suicides are considered. The aims of this Phase I SBIR project are: 1. To develop a working prototype mobile EMA data collection application for the iPhone with automatic upload capability to Iconic Health's server; 2. To use the iPhone EMA prototype to assess symptoms, experiences and behaviors characteristic of major derpessive disorder, reported multiple times daily by 12 college students from rural areas for a 6 week period; 3. To present students' reports to 6 mental health providers on a visual dashboard in the context of an electronic patient chart, formatted as sparklines and an interactive iconic event timeline. 4. To analyze usage data and feedback from students and providers to determine the feasibility of this system and its perceived merit for treating depression in college students from rural communities; 5. To synthesize study results and feedback into a revised blueprint for the EMA and data visualization features optimal for incorporation within the commercial HomePsych product
