Transcript anxietyonline-a-case-study

A case study of a WebGUI-powered,
online treatment program for
sufferers of anxiety disorders
Who are we?
• SDH Consulting Group
– Patrick Donelan (CTO)
– Andy Smith (CEO)
• Working with WebGUI for 5 years
• Primarily work in the educational and
research sectors providing managed,
hosted solutions built on WebGUI
• 2009 WebGUI contributors of the year
Overview
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What is Anxiety Online (AO)?
What is eTherapy?
Who are the major stake-holders in AO?
AO requirements and how they were met:
– WebGUI solutions
– Extending WebGUI
• Giving back to the community
• Future plans
What is Anxiety Online?
• Anxiety Online is a comprehensive online mental
health service offering information, assessment,
online diagnosis and treatment programs
("eTherapy") for anxiety disorders.
• It is the world's first, fully internet-based
treatment clinic for people with anxiety
disorders.
• AO differs from many other web-based treatment
programs by offering a full service from diagnosis
to treatment without the need for therapist
intervention.
What is eTherapy?
• eTherapy refers to the 'delivery of structured
treatment programs for clinical disorders/
symptoms via the internet with and without
human support’.
• eTherapy has been around in some form or
another for 30 years beginning with formally
organised online support groups as far back
as the early 80s.
Examples of Australian-based
eTherapy programs and services
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eCouch
MoodGYM
CRUfAD
Reach Out
Why eTherapy?
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Accessibility
Service the needs of many
A viable, cheaper alternative
Suits the delivery of structured programs
It works!
Is eTherapy suited to everyone?
• eTherapy is not suited to people in the
midst of a serious crisis.
• eTherapy requires a certain degree of
computer literacy… and an internet
connection.
• eTherapy requires a certain degree of selfmotivation.
The stakeholders
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National eTherapy Centre (NeTC)
Department of Health and Aging
SDH Consulting Group
Procolix
Host Networks
NeTC
• Program developers
• Located at Swinburne University of
Technology
• Made up of
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Researchers
Program writers
Program managers
eTherapists
• Funded by the Commonwealth
Department of Health and Aging
SDH Consulting Group
• Web and software developers
• Handled project from the requirements
gathering, specification through to design,
implementation, training and delivery.
• Key contributors:
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Patrick Donelan (SDH: patspam)
Andy Smith (SDH: andyiomoon)
Colin Kuskie (contractor: perlDreamer)
Kaleb Murphy (contractor)
Plainblack and WebGUI community
Hosting partners
• ProcoliX – provide 24/7 support and
maintenance of the web services. Coarchitects of the server cluster that
powers AO
• Host Networks – Queensland-based,
world-class data centre
AO requirements
• Online diagnosis tool with rich feedback on
33 psychological disorders
• Fully automated delivery of 5 anxiety
disorder treatment programs and 2 training
programs
• Self-help and therapist-assisted program
streams with payment gateway
• SPSS-compatible data collection
• Tailored user experience
AO requirements
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Rich program content (Video, Audio, FLASH)
Interactive tools to assist program delivery
Friendly content-management tools
Message centre
Manager and research portals
Automated reminders
Secure, scalable hosting
Ongoing hosting maintenance and support
AO consumer path
Hooking into
WebGUI’s workflow
engine was crucial
for setting up the
structured pathways
our different user
groups travel
through AO.
Online diagnostic tool (e-PASS)
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Electronic, abridged version of the DSM
Complex branching, tagging and scoring
Built on Kaleb Murphy’s work on Survey
Multiple survey instances concatenated into
one user session
• Able to be completed over multiple sessions
within 24hr period if desired
• Results in rich feedback for consumer and
detailed SPSS data for researchers
e-PASS: sections
e-PASS: Questions
e-PASS: Answers
e-PASS: tagging & scoring
e-PASS: simple branching
e-PASS: complex branching
e-PASS: test suite
e-PASS: front end
e-PASS: final report
Treatment and training programs
• 5 anxiety disorder treatment programs:
– General Anxiety Disorder
– Social Anxiety Disorder
– Obsessive Compulsive Disorder
– Panic Disorder
– PTSD
• Two training programs:
– Therapist
– Supervisor
Tailored summary page
• First thing users see when they login
• Info on last time they logged in, number of
new messages
• Link to next step in their pathway
• Links to e-PASS report, Inbox, and Mood
Monitor
• Consumers, eTherapists, Managers and
Researcher specific links and content
Consumer summary page
Self-help and Therapist-assisted
• Two streams available for each AO program
• Therapist-assisted (TA) consumers have email
access to an eTherapist for a nominal fee
• TA consumers see extra program content
• Programs are 12 weeks in length
• Programs contain program-specific measures
in addition to the main pre and post
assessments
Message centre
• All communications between eTherapists,
managers, researchers and consumers occurs
securely through Message Centre.
• Messages are sent to external email addresses
to inform user of a new message waiting for
them when they next login.
• Built from a number of RFEs and
customisation of WebGUI’s friends network
and implemented by perlDreamer
Message centre - Inbox
Automated messages
• Consumers receive a variety of different
automated messages. E.g.:
– Inactivity
– e-PASS expiry
– Milestones
– New eTherapist mail
• Automated messages are templated and
editable by administrators
• Email and SMS
Data collection
• Custom perl library based on PSPP generates
native SPSS data files for all survey instances
• Custom SPSS reports for major pre and post
assessments
• Custom reports for different research groups
• Database encryption – CRYPT
• Passive analytics
Rich program content
• Dashboard navigation widget
• Prev/Next buttons
• Video and Audio
– Hosted on Amazon cloud
– Delivered by FLASH player
• FLASH “interactives” delivered in a
custom version of Carousel
Video content
Audio content
FLASH content
Interactive tools
• Simple Thingy instances configured to allow
consumers to write diary entries, build lists
and rate experiences before and after
treatment.
• Mood Monitor for capturing weekly ratings of
depression and anxiety (and number of panic
attacks).
• Program managers alerted to “dangerous”
scores
Mood Monitor
Manager portal
• For managing consumers, eTherapists,
Supervisors and Read-only users
• Assigning consumers to eTherapists
• Tracking progress of consumers and
eTherapists in training
• Creating new read-only accounts and
assigning viewing permissions
• All custom code extending WebGUI’s users
and groups system
Consumer tables
eTherapist tables
Secure, scalable hosting
Virtual server configuration
ProcoliX: Maintenance and support
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24/7 Monitoring
Nagios and Cactii
Issue management
Disaster recovery
Change management
– Software upgrades
– Security patches
Why was WebGUI a good fit?
• All necessary content management
features out of the box (add, edit,
delete, RTE)
• Granular user and group system
• Survey and Thingy
• Workflow
• Highly configurable
• Highly customisable
• Sensational community
Giving back to the community
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FilePump
Crypt
Carousel
Passive Analytics
Survey ++
Future plans
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Improved message centre
RCT
Variable length programs
Trans-diagnostics
Mental health portal