The purpose of this Phase II Small Business Technology Transfer (STTR) project is to complete development and evaluate usability and effectiveness of the Wraparound Team Monitoring System (Wrap-TMS), a web- based, electronic behavioral health information system (EBHIS) for the most widely implemented care coordination model in children's behavioral health, the wraparound process. The wraparound process is the only defined, research-based, individualized care coordination process for these children and youth and their families. Wraparound is now implemented for over 100,000 youths annually in nearly 1,000 sites in the U.S. However, despite increased emphasis in health care on use of health information technology to improve efficiency, service quality, and accountability, to date no flexible, locally configurable EBHIS has been developed for wraparound. Moreover, though wraparound is now considered """"""""evidence-based,"""""""" implementation in the real world often fails to conform to standards of fidelity and/or use objective data to guide management, supervision, and clinical decision making. Availability of such a system will support efficiency, implementation quality and fidelity, and outcomes for youths enrolled in wraparound. In our Phase I STTR project, we successfully specified, developed, programmed, and established the feasibility, utility, reliability, and commercialization potential of Wrap-TMS. Wrap-TMS now features functionality for data entry, management, and basic reporting for the full array of data and information elements needed to manage an integrated care coordination initiative for youths with serious emotional and behavioral disorder (SEBD). In light of our success in Phase I, subsequent partnerships with federal agencies, and inquiries of interest from several states and over 20 provider and managed care organizations, in this Phase II STTR we will: (1) Complete revisions based on Phase I feedback, and expand the information management and reporting capacities of Wrap-TMS, including """"""""Drag and Drop"""""""" reporting, program-level aggregate reports, clinical alerts and treatment recommendations from functional assessments, and costs and service tracking;(2) Develop and test support technologies for Wrap-TMS dissemination, including Wrap-TMS User's Manual, quality assurance and support desk models, web-based Wrap-TMS training curriculum, interoperability frameworking infrastructure, and touch screen apps for tablets and smart phones;(3) Continue iterative learnability and usability testing, via lab-based testing and bug tracking of the system and its online user's manual, as well as live tests with real-world end users;and (4) Conduct a randomized controlled effectiveness study comparing n=20 wraparound facilitators who use Wrap-TMS serving n=80 families to 20 non-user staff serving 80 families on practitioner, implementation, and youth/family outcomes.

Public Health Relevance

This project will complete development and evaluate usability and effectiveness of the Wraparound Team Monitoring System (Wrap-TMS), a web-based, electronic behavioral health information system (EBHIS) for the most widespead care coordination model in children's behavioral health, the wraparound process. Wrap-TMS will provide an important health information technology (HIT) resource to hundreds of wraparound sites nationally, and reinforce efficiency, effective teamwork, model fidelity, decision making, use of evidence-based practices, and positive outcomes. The rigorous randomized control study will provide important information for the children's mental health field about the effects of EBHIS on implementation and outcomes. The project will serve as an important part of the effort to bridge the research to practice gap in children's behavioral health, be a critical component of the federal emphasis on better coordination of care for complex populations, and facilitate needed research on care coordination for youths with serious emotional and behavioral disorders.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Small Business Technology Transfer (STTR) Grants - Phase II (R42)
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Special Emphasis Panel (ZRG1-HDM-K (10))
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Haim, Adam
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Accountability Solutions, LLC
Santa Fe
United States
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Bruns, Eric J; Hook, Alyssa N; Parker, Elizabeth M et al. (2018) Impact of a Web-Based Electronic Health Record on Behavioral Health Service Delivery for Children and Adolescents: Randomized Controlled Trial. J Med Internet Res 20:e10197
Bruns, Eric J; Hyde, Kelly L; Sather, April et al. (2016) Applying User Input to the Design and Testing of an Electronic Behavioral Health Information System for Wraparound Care Coordination. Adm Policy Ment Health 43:350-68