Ron Oberleitner, CEO of Behavior Imaging Solutions, has been keeping busy attending several conferences this fall, including the 60th Annual Meeting of the American Academy of Child and Adolescent Psychiatry (AACAP) in Orlando, Florida late in October. At the conference, Ron and his team demonstrated our Med smartCapture App for dozens of doctors, researchers, and professionals and we were pleased to discover several new uses for this app. Some talked about its potential as a way doctors could stay connected with international or long-distance practices or research projects while others were interested in how it would help during pharmaceutical clinical trials. Most exciting, Ron and his team also trained investigators of a National Institute of Mental health-backed study on the use of Behavior Connect for another upcoming study using this technology.
The aim of this study is to customize SmartCapture, a mobile device app for caregivers to video capture social scenarios in natural environments, and share them with an expert clinician. We will conduct a feasibility study of using NODA (Natural Observational Diagnostic Assessment) SmartCapture, tailored to specifically measure elements of social behavior, to evaluate its ability to provide an accurate representation of social functioning.
Behavior Imaging Solutions will customize NODA to meet the needs of specific outcome measures of a research study. The system will guide families to capture ‘social situations’, compatible with the goals of the clinical trial targeting social behavior. For this study, one of our research partners, SARRC, will recruit will recruit adolescents with ASD and their caregivers. Participants will be asked to capture on video the adolescent participating in social interactions with parents, siblings or friends. Clinicians will view the videos online and then score the appropriate elements of social behavior. The results of these assessments will be compared results from structured informant based assessments conducted with a caregiver.
Some of the goals are:
- Provide conclusions regarding the clinical value of having the added smartCapture information.
- Study reception to technology, ease of use, and what type of video data gets shared via our modified system.
- Show this ‘social disability’ sample data to related ‘social disability’ researchers, and learn if it is a recommended tool set for future FAST-ASD research.
Some of the broader implications are:
- Improving the type and clarity of data that can be gathered while studying social scenarios.
- Facilitating fast and secure transmission of study data.
- Reducing subjectivity by adding visual evidence data to support existing methods of interview and description.
>> More to Come ….
A multi-site clinical trial, led by Principal Investigator (PI) Dr. James McCracken of UCLA, is designed to measure the effects of an investigational product to mitigate social disability Changes in social functioning will be measured through the use of structured assessments that are administered by trained raters. The variability in rater’s skill levels with these kinds of assessments administered at multiple sites can potentially mask a significant effect of the investigational product.
On HIPAA-conforming Behavior Connect-for Clinical Trials, the PI or designated clinicians at one site can watch the recorded assessment that took place at other sites, and then rate the behaviors observed during the assessment. This method of scoring will help to control for variability introduced by multiple raters with varying skills. As part of this clinical trial the Social Communication Interaction Test (SCIT) will be performed in examination rooms at 4 different sites around the country, Behavior Capture™ Online technology will automate the video images of these assessments to be securely uploaded to Behavior Connect for subsequent review by the PI to help him perform:
1. Inter-site Reliability checks
2. ease-of centralized scoring of primary assessments
3. Post hoc “microanalysis” of video’s assessments
Use of Behavior Imaging during this study should show “proof of principle” that Behavior Imaging can improve multi-site clinical trial methodology for variety of symptoms associated with various brain disorders.
The goals of this study are to Implement a System to Allow 4 Clinical Sites to Share Behavior Images to Improve Multi-site Operations of Ongoing Assessments:
a. Use of video capture technology in the proposed FAST-ASD Clinical Trial will require developing and implementing video capture technology in interview rooms with the ability of the clinician to control video enabling during the interview and to review and annotate video clips at a future time.
b. Support Principal Investigator(PI) and others regarding Security, Regulatory and Documentation Requirements for Behavior Connect 2.0 to have System compliant with IRB and other regulations
c. Ensure that each Clinical Site participant is able to use Behavior Capture to archive and securely share Assessment interactions via video capture
d. Customize Behavior Connect – Clinical Trials online Platform Customized for the Right Clinical UI Interface for PI to Interact with Clinicians at Multiple Sites, ‘Rate’ Video assessments in Behavior Connect, and other desired features he may want to improve project oversight
e. Maintain Technical and Client Support throughout FAST-ASD to ensure that platform can be accessed and used by authorized users identified by PI
f. Assess PI’s, Gold Standard Rater(s), and Remote Clinicians’ Perspective of use of Behavior Connect
g. Write Report re multiple stakeholders’ Strengths, Weaknesses, and Recommendations
Behavior Imaging Solutions announces the results of its research study funded by an Innovative Small Business grant from AutismSpeaks.org evaluating how doctors, patients and caregivers can utilize its Telehealth technology to better monitor the effectiveness of medications prescribed to individuals with autism. The research study involved the development and evaluation of a new mobile device app called Med SmartCapture.
The results showed that caregivers who used the new Med SmartCapture app could avoid expensive and difficult (and therefore often postponed) follow-up appointments with their doctor and, instead, could submit recorded video data via the Behavior Connect platform. The participating doctors found that they could obtain necessary contextual information by requesting appropriate video data from the caregivers via the Behavior Connect online platform and the smartphone app. With such information, the doctors could successfully monitor and subsequently optimize their patient’s medication. Such a process normally involves numerous in- office visits.
Using the Med SmartCapture app, families in the research study were able to maintain a consistent and informative relationship with their prescribing doctor. With such positive results, Med SmartCapture gained the attention of several other professionals, including community medicine and public health professionals such as Uwe Reischl, PhD, MD, who concluded that “the Med SmartCapture technology can revolutionize the way people reach out to access healthcare services. The BIS technology can become a game-changer in telemedicine.”
Dr. Robert L. Hendren, D.O., Vice Chair and Director of the Autism and Neurodevelopment Program the UCSF Benioff Children’s Hospital, was equally impressed by the technology, saying, “I am very excited about what Med SmartCapture will be able to do for patient care and communication between parents, educators and providers so that we are all putting our integrated energies in the same direction to help the kids we are working with.”
Behavior Imaging Solutions provides an online HIPAA-conforming consultation platform (called Behavior Connect) where caregivers and doctors can upload and annotate video data of a child’s behavior, along with other medical records and notes. In this system, videos of behavior can be captured even after the fact thanks to Behavior Imaging’s time-buffering video capturing software. Med SmartCapture is yet another application for this internationally-used technology.
Learn about the Behavior Connect Platform and applications:
– Multiple Problems, One Innovative Solution
– Naturalistic Observational Diagnostic Assessment (NODA)
– Pharmaceutical Clinical Trials
– Clinical Staff Support, Training, Evaluation
USA Today Covers the Diagnostic Assessment study to be initiated at SARRC later in 2013. http://www.usatoday.com/story/news/nation/2013/04/13/autism-application-faster-diagnosis/2080247/
(From 4/22/2013 email put out by the American Telemedicine Association) – There has been increasing attention to the rise of “Big Med”–a term coined by Atul Gawande in the August 2012 edition of The New Yorker (NewYorker.com). The term relates to the accelerating trend in mergers, acquisitions and affiliations that are taking place throughout healthcare. Coupled with this is the use of new approaches in the delivery of care that adapts strategies used in retail and other sectors.
The trend is leading to major shifts in healthcare. Dr. James Weinstein, the President and CEO of Dartmouth-Hitchcock has stated: “My vision is that we’re going to have 15 major (healthcare) systems in this country. We can’t support 5,000 hospitals, all going of them doing their own thing.” The shift goes beyond health systems. According to estimates by Accenture, about 39 percent of doctors nationwide are independent, down from 57 percent in 2000.
One of the interesting aspects around this is the increased use of telecommunications technology in making such changes possible. For example, Mayo Clinic’s CEO, John Noseworthy has set a goal of the Clinic touching the lives of 200 million patients by the year 2020. This will take place through Mayo’s “Care Network” that seeks to affiliate and provide “e-consults” to patients in affiliated hospitals throughout the country. Noseworthy has stated: “Our model has been that the patients come to us. Increasingly, going forward … we also wish to extend the reach of the Mayo Clinic, taking our knowledge, taking our experience, and sharing it with others.”
Another approach being used is the use of telemedicine allowing health system’s to share the expertise of specialists and subspecialists throughout their entire system. A leading example of this is Mercy, based in St. Louis, Missouri. Mercy, the sixth largest Catholic health care system in the U.S. serves more than 3 million people annually. It is currently in the process of building a $90 million virtual care center along with a new specialty hospital and corporate offices. The center will enable Mercy to consolidate various telemedicine services at one site. Mercy estimates that using the center to provide shared specialty services and coordinated care with more service sites and easier access can reduce the cost of an emergency room visit alone by $4,000 per patient.
Lynn Britton, the CEO of Mercy, is speaking at the ATA 2013 Opening Plenary Session, where he will discuss his institution’s experience with telemedicine, as well as the key drivers behind his decision to invest heavily in telehealth.