[[06-03-2024]] This is not a new idea [[Book Report - Digital Therapeutics and HOPES]] There are different levels of interventions. *The app elements, such as challenges, rewards and tailored reminders, are all there.*  1. Referencing the “Stepped-Care Model” in the [[Book - Digital Therapeutics for Mental Health and Addiction]] (page 23) ==stepped-care approach== 2. There are different kinds of active or passive users. 3. Essentially, we are saying that we don’t have enough service providers. 4. Instead of waiting for clinicians, Patients can self-help in the meantime. For those who are not ready to see a therapist for interventions, they can try this. # The different steps in the HOPES app. ## **Level 1**  - The user is accessing information from a curated directory sorted based on the different domains of well-being. - The app has an overlay-guided screen that orients new users or informs them about new features. - Additionally, case managers can use the app to provide psychoeducation to their patients. ### Tasks - [ ] Intern helping to collate articles and materials - [ ] I need to read up on the Positive Psychology Index and the domain of well-being so that I can organize the articles and resources accordingly. - This will mean that the way we show "insightful insight" - charts and visualisation according to the domains of well-being. ## **Level 2 - Guided** *References* ![[Book - Digital Therapeutics for Mental Health and Addiction#^5a605b]] *References* ![[Book - Digital Therapeutics for Mental Health and Addiction#^e1f489]] - The user joins a tailored training program to learn skills and information, which may or may not be blended with the care team. - For case managers, I would recommend that patients select some flows to go through when they are at the beginning of the journey.  ### **Tasks** - [ ] Collating work processes from MDT members to understand the interventions given to patients and whether we can deconstruct and rearrange them. - [ ] Can we create a guided programme for the patient to do on the app based on the interventions/psychoeducation that the clinician usually gives to patients? - [ ] Digitalise some of the work processes. - [ ] Need to write, and create this new flow.. - [ ] How do you flow the information back to clinicians? Feedback loop ## IMPORTANT CONSIDERATION 1. How will it potentially change or affect people's work processes? 2. Resistance to change. -- People may feel threaten 1. *I think It's supposed to improve patient care and work for all of us. How can there be no change to how we work, if we want to make a difference?!** ## **Level 3 - Referral/ with human** The care team assigns and prescribes exercises for the patient to complete in person as part of treatment, such as cognitive exercises by the OT and journaling exercises by the therapist. This could be a locked portion of the app. ## ***Level 4*** *Self-paced digital therapeutics* *Could be fully completed without human clinicians?* ----- # **EMA and EMI** Refer to [[20211120 All about EMA and EMI]] 1. EMA and Just In Time (EMI) are separate components triggered based on event and time context.  2. EMA have different uses - ![[20211120 All about EMA and EMI#^441bba]] 3. For example, post-discharge symptoms and mood monitoring (context), poor sleep,  4. Periodic clinical assessment scales- to inform what kind of level 2, or EMI..