Accessible eHealth in the interactive age

The progression of ehealth solutions has long been stifled by the lack of affordable and accessible IT infrastructure that would assist researchers and healthcare professionals to develop, deliver and evaluate their own ehealth programs. The team at the Centre for Biopsychosocial and eHealth Research and Innovation (CBeRI) have responded by developing practical and cost effective ehealth solutions.

Current ehealth researchers can often re-invent the wheel for minor variations within their field of research and unnecessarily stretch deadlines and budgets. In response, Professor Britt Klein,

CBeRI director and trailblazer in the ehealth field, aims to unify fragmented ICT infrastructures to generate integrated platforms accessible to health professionals, patients and researchers alike.

CBeRI are developing an interactive ehealth platform that augments mobile technologies (including smartphones and tablets) and portable biometric devices (such as a FitBit®) in order to empower consumers and clinicians to monitor and manage wellbeing.

"Ultimately, our aim is to provide treatment and wellbeing programs that include 24/7 real time monitoring and which acknowledge the complex interactions of a person's life," Professor Klein discloses. "We need to get better at taking into account what is happening biologically, psychologically and environmentally, in real time and over time, and the inclusion of biometric data with self-report data can help us to better achieve this."

In 2015 a CBeRI study gathered over 60,000 hours of biometric data (including heart rate, physical activity levels, skin temperature, and sleep activity) that was aligned to over 5000 mood surveys completed via an App, five times a day. Key psychological-biological-neurological markers taken from mental health questionnaires, blood, saliva and neuro-cognitive tests were also measured before and after the trial. Using this information to build complex algorithms, FedUni are building a platform that blends connectivity, accessibility and flexibility to allow real-time, adaptive responses to people — wherever and whenever their symptoms take hold.

The user's biometric information is measured by a FitBit-style device and transferred securely to the ehealth platform alongside information reported by the user. When the analysed data predicts a pattern of decline in the user's wellbeing, the system will send them a friendly message offering appropriate suggestions or interventions. "The combination of biometric and self-report wellbeing data can provide considerably greater insight than we've been able to provide people with before. It should allow the person to make more informed decisions around their own health," Professor Klein reports.

"We will be adding the biometric device option to some of our current programs such as LIFE FLeX in a few months time."

CBeRI's LIFE FleX web and mobile program for depression and anxiety will soon demonstrate the innovative incorporation of a biometric device to support traditional methods. The current LIFE FLeX program focuses on building core psychological and biological 'life skills', combining standard cognitive behavioural therapy with newer, evidence-based intervention techniques that are biologically focused — for example lifestyle-based interventions such as increasing physical activity — to provide a more comprehensive and integrated treatment.

"Preliminary LIFE FLeX data illustrates that our treatment effects are higher, and the dropout rates considerably lower, than evaluations of previous fully automated programs. We are also noticing a larger uptake by men and members of socially diverse populations. The initial results are very encouraging, so we expect even greater results once the biometric feature is added," notes Professor Klein.

Through additional funding, philanthropy, and commercial partnerships, Professor Klein foresees extraordinary possibilities facilitated by CBeRI 's work. "We plan to provide health professionals and researchers access to the platform so they can use it within their own professional practice or for research. We envisage a small, annual licensing fee arrangement to cover software maintenance and improvement."

In addition to anxiety and depression, the predictive analysis and 'real-time' response of the CBeRI approach is applicable to a range of conditions such as chronic pain or insomnia. It could also be used to assist in identifying triggers to certain behaviours in dementia patients, or offset the build-up of aggression experienced by people with violent tendencies.

The collegial-minded decision to make the FedUni platform accessible to others will allow clinicians and researchers to spend less time and money developing practice and research specific software, and more time formulating solutions. True to the Centre's aims, CBeRI is creating engaging eHealth technologies that are customisable and scalable, with far-reaching scope and global possibilities.