[[050 - Implementation Science Index]] [[Blog - NT and OO is COO My Takeaway from HIMSS 2024]] Title: “My Journey into Digital Health and Mental Health Recovery” 22 Oct 2024 ## Introduction A Mental Health Case Manager’s Journey into the World of Digital Health. A personal reflection on why I got involved in digital health and psychosis recovery, sharing what led me to work on the HOPES project. ## Case Manager Hi, I’m Moses. I was a case manager with the Early Psychosis Intervention Programme (EPIP) in Institute of Mental Health (IMH), Singapore from 2010 - 2022. During my 12 years as a Case Manager, my role involve managing caseloads of patients diagnosed with first episode psychosis. Our programme provided a three-year follow up period for each client in our programme. We act as a point of contact for the patients, their caregivers, the treatment team and other support systems. We also conduct home visits, and provide supportive therapy to the patients. Ideally (but we don’t live in an ideal world), we should have a lower caseload, but at one point, I had the highest case load of 55. It was difficult to juggle the different patients’ needs, and demands and give everyone the attention they all deserves to support them in their recovery. For example, one client may be having early relapse signs, the other having a family conflict, while the other is needing rehospitalisation. It is an exhausting, emotionally and mentally taxing job but at the same time fulfilling, especially when I was able to connect with a client, building a rapport, and seeing them gaining stability, and moving along the recovery journey. ## HOPES [[HOPES Project Index]] Around 2020, i was asked to join a project HOPES, which was lead by Dr Jimmy Lee. He was the head of one of the department in the hospital, and known for his extensive research capabilities and publications. The idea is to explore the use of technology to improve care and management in the severe mental illness segment of Singapore’s population. 

HOPES is a Digital Phenotyping project. Digital phenotyping refers to the collection of behavioral and physiological data through digital devices, like smartphones or fitness trackers, to provide insights into a person’s mental state At that time, HOPES was in the midst of recruiting 100 recently discharged patients diagnosed with psychosis from the ward for an observational study. They would give each patient a fitness tracker and install an app on their phone to capture digital phenotype data and follow up them for six months. Some patients would have relapses. At the end of the study, they would create a models based on the digital phenotype data and signals. The ultimate goal was to develop a predictive model using digital phenotyping data. By analyzing these patterns, we hoped to anticipate potential relapses and intervene before they occurred. The Covid pandemic delayed the completion of the study, but nevertheless, it was completed and the result were published. After the study concluded, the team wanted to move beyond research and apply these findings to real-world clinical settings. If we could detect early signs of mental health deterioration through digital phenotyping, could we then develop solutions for early intervention and relapse prevention? Suppose we have a way to detect changes to patient’s mental state (through Digital phenotyping), can we build a solution to provide early detection, early interventions, then prevent relapses? My involvement was more part time basis on the project team as i still have full time commitment as a case manager. My role was to provide requirements to the project team as they want to design solutions that would meet clinicians’ needs. I have always been know as the “IT guy” in my department because I introduced many useful tools to improve on work processes. That’s why i got “arrowed” to be on this project. it was a natural fit for me to be intersecting different disciplines; psychology, mental health, technology etc. I told Dr Jimmy that In fact, I had envisioned using technology to improve mental health care as far back as 2014. Seeing this project come to life felt like realizing a long-held dream. ![[Pasted image 20241022072655.png]] (A screenshot of an idea I had in 2014) ## Transition In 2022, I wanted a break from patient-facing work, i had a burnout (probably also exacerbated by this whole change brought on by the pandemic). Deciding to take a break from clinical work for a while, I am grateful to be able I was glad to be able to transit fully into the HOPES project in 2022. The project was growing in complexity because it was no longer a research project, we are moving to bring this technology into real clinical applications. There were a lot to be done. Today, although my title is still a Senior Case Manager, my current role involves gathering clinician requirements and communicating these to the development team. I also co-plan features, design operational processes, and train staff on using these new solutions I am no expert, i am learning every day. The switch from a more “empathetic”, “heart”, and “soft” work as a case manager working with patients, to a more “analytic”, “logical”, “brain” work took me a while to adjust. To converse with the folks in the technology sector, our collaborator requires me to speak in a way they can understand. Software, Computer engineering people like to talk like “1” and “0”, “IF this.. then that..”.. Initially i find it really difficult, because I was trained to see things in complexities, ambiguity, no clear answers, everything depends on context, because that’s human, reality. In the past, what seems to me intuitive, or second nature to me, now i feel like i couldn’t express clearly. I noticed that i was developing another side of my personality or my brain, i moved from INFP to being INFJ. I feel we are living in an pivotal moment (But i think every generation believe their time is pivotal). There is an increase demand on healthcare systems around the world. People are living longer. Healthcare is moving from treatment to illness prevention. There is increase accessibility to the use of AI. I am excited to be part of this Project; how can we combine technology to healthcare. I often thought of what the Singapore former master planner Mr Liu Thai Ker, said “To have a mind of scientist, eye of artist, and heart of humanist” Source This blog is not only a personal reflection but also a way to connect with others navigating the intersection of mental health and technology. Together, we can share insights, challenges, and hopefully, contribute to the broader conversation.