One in every five adults in the U.S. has experienced some form of mental illness including stress, anxiety, and depression. While most of these cases are mild to moderate disorders, nearly 10 million Americans per year suffer from severe mental illness that were developed from these originally less serious mental disorders. In certain scenarios, the diagnosis and treatment of mental disorders may be delayed or not possible due to situational circumstances (e.g., remote sites, disaster areas, military environments, ships at sea, or humanitarian assistance).

The mental health expenditure in 2014 was $203 billion in the U.S. which constitutes 6.9% of all health-related spending, a level expected to be sustained for the next decade. The overall hospital share of mental health spending has dropped from 41% in 1986 to today's 22%, and is expected to continue throughout the next decade. While outpatient care is only half to one third of the cost of the inpatient expense, about 45% of the mental disorder patients have listed high cost as their main barrier to seeking mental disorder treatment.

Digital technology-based mental healthcare is regarded as a natural and ultimate choice for outpatient settings due to its low cost, high accuracy and continuous monitoring and tracking capabilities. As such, enterprises are increasingly interested in intelligent tele-medicine because it is the backbone for a completely new market, namely ?digital wellness? that features the combination of digital technology and mental healthcare. The goal is to provide affordable and high quality mental healthcare. This requires new, trans-disciplinary research to devise medically effective and reasonable solutions.

The Center for Intelligent Tele-Medicine (InTelMed) will devise and deploy biofeedback-control designs to integrate wearable sensors, data analysis, and prescribed intervention/treatment onto the same human smart service platform. From an end-user perspective, flexibility, fashion, and visibility are key form factors. From a technology development point of view, high accuracy (i.e., medical-grade data) and low power design, real-time data analysis algorithms, application and database interfaces are the critical components to create successful biofeedback-based products. Biofeedback-control designs, as pursued by InTelMed, have the potential to improve behavioral health for our nation and drastically cut total outpatient mental healthcare costs, which constitutes 62% of the overall mental healthcare spending.

InTelMed will not only advance science & technology in psychology and physiology, but will also accelerate both knowledge and intellectual property transfer to industry by working closely with the InTelMed Center members. Moreover, for Corporate America to retain a competitive edge as it emerges into the 21st century, it is essential to prepare students to become a desirable workforce: The majority of jobs in an increasingly complex and fast-paced society require knowledge and skills that stem from a quality college education. As such, InTelMed will recruit students from a broad background by engaging them in the biofeedback-controlled sensor technology research, introducing them to internships at member companies and organizations, and expose them to visit and present their work at scientific conferences and workshops. InTelMed will partner with Center members and local and national outreach programs to broaden participation of underrepresented minorities and women in particular.

The Center for Intelligent Tele-Medicine (InTelMed) is committed to research & development in intelligent biofeedback-controlled monitoring and intervening wearable sensor technologies. In particular, InTelMed is concerned with physiological and psychological status and change identification through real-time data acquisition, mining, and analysis. Moreover, the Center focuses on the mitigation of physiological and psychological changes through biofeedback-control for real-time management and intervention. This requires a deep understanding in neurology, mechanisms of stress development, emotion changes, and physiological variations. As such, InTelMed relies on trans-disciplinary collaboration including psychology, physiology, biomedical and electrical engineering, and computer science. Lastly, the Center focuses also on the infusion of newly developed technologies into relevant user groups, such as patients, athletes, soldiers, firefighters, policemen, pilots, astronauts, and business professionals who work in stressful environments.

Continued advances in mobile platform hardware (e.g., smartphones and smart watches) have increased the capability to provide high quality physiology data, local real-time data analysis, and robust connectivity. Such handheld capability is of significant interest to the field of mental disorder treatment and stress management. Inherent portability, connectivity, and affordability would allow use by minimally trained personnel and deployment to areas heretofore considered inaccessible or impractical. Software will be essential for enabling real-time evaluations, tele-diagnosis, and biofeedback-controlled interventions.

Biofeedback-controlled real-time intervention - paired with wearable sensor technologies, prescribed treatment, and data analysis - forms the backbone of "digital wellness", i.e., digital technology-based mental healthcare. Specifically, biofeedback-controlled intervention will help: - Improve accuracy and efficiency: by harnessing new technologies, such as modular low-power wearable sensors, mobile platforms, and cloud or server computing performance, including, but not limited to, communication reliability, data security, and energy efficiency to maintain cutting-edge digital wellness infrastructures. - Manage scalability and complexity: by creating a network of mental healthcare through automatic biofeedback controls and precision/custom-interventions that can help hundreds of thousands of patients simultaneously. - Provide adaptability and agility: by ensuring adaptive and real-time responses to react promptly to patient needs.

In support of the above, InTelMed engages the following emerging technologies as the essential prerequisites for digital wellness: 1. Biofeedback-controlled monitoring and intervening wearable sensor technologies. 2. Physiological and psychological status and change identification through real-time data acquisition, mining, and analysis. 3. Analysis of physiological and psychological changes both in the absence and presence of substance use (e.g., medications, drugs, alcohol), and due to stress. 4. Mitigation of physiological and psychological changes through biofeedback for real-time management and intervention. 5. Cloud-based temporal analysis and correlation models to evaluate the impact of treatments, work environments, team interactions, and environmental changes on the physiological and psychological health and performance. 6. Clinical coach intervention with patients via mobile health technologies to ensure improved wellness through behavioral change. 7. Coaching and training program designs for athletes, soldiers, firefighters, policemen, pilots, astronauts, and business professionals who work in stressful environments.

The charter of InTelMed may serve as an exemplar for other fields of healthcare, such as, but not limited to, ambulatory care, emergency care, intensive care, remote monitoring and home care, and primary care.

Agency
National Science Foundation (NSF)
Institute
Division of Computer and Network Systems (CNS)
Type
Standard Grant (Standard)
Application #
1624631
Program Officer
Dmitri Perkins
Project Start
Project End
Budget Start
2016-07-15
Budget End
2017-12-31
Support Year
Fiscal Year
2016
Total Cost
$15,000
Indirect Cost
Name
University of Pittsburgh
Department
Type
DUNS #
City
Pittsburgh
State
PA
Country
United States
Zip Code
15260