This spring, we’ll release “Innovating Michigan Healthcare: Lessons from Funding Technology in Health Since 2015,” an in-depth report on how the Health Fund is supporting technology-based projects. Our new series, “Tech Tuesdays”, reveals some of our stories from the field—examples of Health Fund grantees incorporating technology in noteworthy and effective ways. This is the first Tech Tuesday installment!
Wayne State University
High Touch – High Tech (HT2)
2017 Behavioral Health Grant Round
Examining how pregnant women use behavioral health services provides a telling glimpse into how barriers to care manifest. While financial or geographic obstacles often prevent patients from accessing resources, these aren’t the only factors. Research shows that individuals suffering from mental health or substance use disorders frequently avoid seeking services due to attitudinal barriers, such as public, perceived, and self-stigmatizing attitudes about seeking help. This raises important questions about how to provide mental health services to vulnerable people, beyond simply providing access.
Wayne State University (WSU) provides an answer to these questions with their High Touch High Tech (HT2) initiative. HT2 uses a tablet-administered tool, the Mommy Checkup app, to screen expectant mothers for mental health and substance use-related risk. Patients in two rural prenatal clinics in Grayling and Alpena would go through the screening while in the waiting room prior to an appointment. Designed for easy uptake by clinics and intuitive use by patients, Mommy Checkup sends data directly to clinicians without any additional time spent in the clinic. Following prenatal checkups, providers can use the app to send text messages providing additional insight into a patient’s unique needs and encourage them to seek additional treatment if necessary.
About halfway through the funding period, HT2 has succeeded in increasing behavioral health service use among a population that was previously hesitant to seek it out. This success is attributable to a range of factors. First, Mommy Checkup is easily integrated into existing workflows at each clinic, thanks in part to the app’s simplicity and WSU’s decision to provide brief motivational information versus a complex intervention. Because it’s universally and proactively administered, the tool is reaching a high proportion of at-risk women, rather than only reaching those who self-identify or are otherwise flagged through less systematic means.
Along with emphasizing ease-of-use for patients and providers, the implementation approach allowed clinic staff to take more direct ownership for its uptake and success. By administering the screening tool in the clinic waiting rooms, front desk staff had the opportunity to participate directly in care, allowing direct collaboration with clinicians and more effective integration of the technology into existing practices.
WSU’s success integrating Mommy Checkup was bolstered by the relatively small clinics they chose for the pilot, as smaller entities can be quicker to revise their workflows. However, the model does appeal to larger health systems, as evidenced by Munson Healthcare’s commitment to use Mommy Checkup in each of its prenatal clinics.
After seeing the project’s success and replicability, the Health Fund is providing additional funding to support regional expansion. Part of MDHHS’s efforts to reduce infant mortality, the expansion will bring HT2’s model into prenatal clinics throughout the Upper Peninsula and counties in Michigan’s thumb.