Our Inspiration

Too many people have been affected by mental health crises. It is estimated over 400 million people in the world are not being effectively treated for their mental health disorders (Top Barriers to Mental Health Treatment, 2020). In the US, less than half of the adults suffering from mental illness are receiving treatment, which can take up to 11 years to begin. With suicide being the second leading cause of death, it is no wonder that someone is suffering for that long (Halford, 2020).

Mental health issues hit too close to home for all of our team members. We are guessing it may be for you, too. Because of this, we chose track 3: Improving Patient Care for this Datavant Hackathon. Our hearts are centered around creating the biggest change for those suffering invisibly from mental health crises. Our tagline is Have a Heart for Your Mind, and that is exactly what we intend to do!

There seems to be a disconnect between those needing support and the limitations that qualified health care providers can offer. We want to bring the heart of this matter to the forefront of people’s minds. Whether it’s a lack of data for underserved populations or post-crisis reporting, the rate of mental health challenges is rising and we can change this.

With September being Suicide Prevention Month, and September 10th being World Suicide Prevention Day, our team prepared to build our project by envisioning a world in 5 years where critical data can quickly flow in multiple streams within a healthcare ecosystem. A place where patients can choose when and how to share their data to help save their lives. And where they can play a more important role in their own recovery from the comfort of their own homes.

What could our world look like when patients and their care teams can fully realize the potential of leveraging technology? Could we start detecting high-risk situations sooner?

Well, the future is here! It is time to start looking at the change we can create now. The growing trends toward innovative mental health services for Veterans create a potential impact far outlasting our lives. We thought it would be world-changing to bridge the gap between Veteran Affairs (VA) services and the home environment of our military. This potential impact includes 19 million US Veterans with mental health conditions being the third most frequently diagnosed category of conditions at the VA, for men and women (Department of Veterans Affairs Mental Health Services: Need, Usage, and Access and Barriers to Care, n.d.). We want to honor those who have served the many by first focusing on Veterans, their military communities, and then the general population over the next 5 years.

_Could there be a better way to care for our Veterans? Can technology be used to intervene, even stop, a mental health crisis from occurring? …and maybe even save a life or two! _

The answer is YES! Most impressively, the change that needs to take place can happen within the privacy of the Veterans’ own homes. What came of our inspiration is Wavy Zone.

What Wavy Zone Does

Armed with just a smartphone and a wearable, our Veterans can start winning the battle today for improving their mental health. Wavy Zone is an application with the capabilities to leverage Datavant’s Switchboard by adding an extra layer of digital therapeutics from real-time biofeedback, monitoring of stress levels, and push notifications that lead our Veterans through mixed reality (MR) exercises in mindfulness. Using the Switchboard, Wavy Zone can bring in personalized data and keep its information flowing in the present tense. The app connects to any preferred wearable measuring and analyzing data continuously throughout the day. Wavy Zone fills the gap to complete the SwitchBoard's holistic patient overview by shedding light on what happens in between doctor's appointments. It has the potential to start learning patients’ patterns and identifying high-risk situations over time.

Better yet, Wavy helps gather data where the medical ecosystem is bare, including underserved Veteran populations like women Veterans and transgender groups. For those living in rural areas without access to care or for Veterans that do not feel safe going to the VA, Wavy becomes a helping hand in starting to get the care they need.

Using Datavant’s switchboard, all the collected data from Wavy Zone can be delivered to the VA’s Computerized Patient Record System. With this data, the VA can better fulfill the mandates set forth by the Office of The Army Surgeon General in the Pain Management Task Force Final Report of May 2010 (Pain Management Task Force, n.d.). In this report, a new standard of care is envisioned taking a more holistic approach. One in which stress is addressed from a whole-person perspective, including home life, everyday stress levels, and emotional well-being. This is where wellness care is going, and Wavy is right in the zone!

To complete the loop of better patient care for our Veterans, Wavy then sends push notifications to nudge Veterans when it’s time to do stress-reducing exercises based on the wearable data. The Veteran is prompted to put on their Hololens and sit back and relax as a forest grows around them. The more they relax, the more nature surrounds them. Now, Veterans can create a therapeutic environment in their homes with mixed reality. Implicit learning becomes a constant tool they can use in any environment when practiced consistently.

How We Built It

We first wanted to know if we could build an integration with FitBit and the HoloLens using Unity. It was key to our project so that we could bring real-time monitoring together with mixed reality in the home environment. Once that was successful, we felt confident enough to build out Wavy Zone app using Wep App. Next, we wanted to know if we can integrate with Datavant's Switchboard. Once we knew the information could be exchanged, we built a cloud environment where the data from the FitBit and the HoloLens could be passed through. Then, the biofeedback data from the wearable could be sent to the Wep App after the patient has done the relaxation exercises. This created a continuous loop of data that kept filling in the end-user's experience. Finally, our circle of improving patient care was complete from the healthcare provider's and the patient's experience.

Check out our GitHub here

Challenges We Had

The hardest challenge was planning how to keep the video concise and within the 3-minute limit. There is so much more our team wants to share and show!

The next challenge was integrating with Fitbit and combining the HoloLens for our mixed reality experience. Working with wearables can be finicky. And trying to tell wearables what to do takes patience. But our team was persistent and accomplished a good demonstration of our capabilities.

The final challenge was recording our song Home for Our Heroes. The music and powerful lyrics became our rally cry throughout the process and we knew we had to persevere till the end! We all sang the song so much, we really wanted to get it just right. There was no doubt we were looking for that creative edge to drive the message home. We think we accomplished that after several hours of laying down the track and polishing it till it really shined!

Accomplishments

We are incredibly proud of our solution between the Datavant Switchboard and the VA electronic health records system (CPRS). Also, the collaboration between FitBit and the HoloLens.

Our proudest moments have come from our song Home for Heroes that we especially created and recorded for the Datavant Hackathon. Home for Heroes tells the story of Veterans struggling with Post-Traumatic Stress Syndrome (PTSD) and the need to feel at home in their bodies, with their families, and in their environment. Tiffany Snider, one of our team members and former Marine Sergeant, sings the song to all the Veterans needing someone to talk to, someone they can be real with and honest about their struggles. The song introduces the idea that we, as human beings, may not be able to fully understand what Veterans suffer from, but we can relate through shared experiences (shared data and real-time interventions, as Wavy Zone suggests). The song champions the ability of Veterans to overcome their destructive mental health patterns by accepting help from others when support is offered. The song continues by relating to the real-life challenges Veterans face coming home from the battlefield. They often feel like there is no place for them and they can only be seen as heroes when not labeled as “crazy” or “weak.” The repeated chorus changes by the end to signify that our society has finally found a way to create a Home for Heroes where there is a place for everyone.

We want to send a special thanks to Tai at Seven Studio and Tony at Asylum Studio for their support and expertise in our project!

Here are the lyrics so that you can sing along! Home for Our Heroes

I can't see where you're comin' from But I know just what you're runnin' from And what matters ain't the who's baddest but the Ones who stop you drowning in your sadness

When you feel like you're feeling now And doin' things just to please your crowd When I reach out like the way I do And I suffer but I ain't gonna leave you 'cause

This ain't no place for our heroes This ain't no place for our Veterans This ain't no place for our heroes This aint no place for you to call home

This ain't no place for our heroes This ain't no place for our Veterans This ain't no place for our heroes This aint no place for you to call home

Everytime I close my eyes I hear you say that you are fine But you still self destruct on the inside Lets be real, talk to me Its time to heal and be set free

This is our place for heroes This is our place for our Veterans This is our place for heroes This is the place for you to call home

This is our place for heroes This is our place for our Veterans This is our place for heroes This is the place for you to call home

What We Learned

We learned staggering statistics that solidified our choice to focus on improving patient care, especially for Veterans. The VA serves 8.76 million veterans per year at more than 1,700 health care sites throughout the United States. Not all veterans, however, are eligible for care through the VA. For “combat Veterans” that are eligible, may only receive services for 5 years (Department of Veterans Affairs Mental Health Services: Need, Usage, and Access and Barriers to Care, n.d.). While the Veteran Affairs (VA) is increasing its funding and services to be more effective and inclusive, not all Veterans utilize VA healthcare services because of a shortage of mental healthcare workers, long wait times for services (which can be up to 3 years), and military cultural stigma. And, “...women may be deterred from using the VA due to perceptions that the VA lacks care that is sensitive to women’s health.” We also learned that women Veterans are the least likely to seek mental health services from the VA (Hausman, 2019).

We also learned that “Demographic data on veterans not using VA health services are often difficult to come by because there is no standardized way of tracking all service members once they separate from the military. Because data on veterans not using VA services are not often collected…” (Department of Veterans Affairs Mental Health Services: Need, Usage, and Access and Barriers to Care, n.d.)

Scalability

Understanding the lack of demographic data helped us create a scalability plan based on the “Veterans Integrated Service Networks (VISN).” Network # 16 of the South Central VA Health Care Network is the largest population of veterans in the area. It contains the states of Arkansas, Louisiana, and Mississippi, as well as parts of Texas, Missouri, Alabama, and Florida. VISN 16 is projected by the VA to remain the most populated VISN for the next 25 years (Department of Veterans Affairs Mental Health Services: Need, Usage, and Access and Barriers to Care, n.d.)

Wavy Zone plans to deploy our focus on the Veterans Integrated Service Networks (VISN) region 16 by targeting key relationships will VAs within the network. We will be holding live and virtual demonstrations of our project to diversified groups of healthcare providers, along with targeting Veteran-owned businesses within the communities of region 16. We also hope to create a partnership with Fitbit, Apple Watch, Garmin, and Whoop to provide Veterans with wearables free of charge as a way to gain momentum in the use of real-time monitoring capabilities.

What we learned from our interviews with information security officers at the Veteran Affairs (VA) was invaluable to understanding their unique electronic health records needs. The VA uses a system called Computerized Patient Record System (CPRS) with plans to integrate fully with Cerner within the next 10 years. Using this information, we asked a Datavant Senior Vice President of Engineer, Sasi Mukkamala, to better understand the switchboard’s capabilities to extract and send de-identified data in many different formats. Once we were assured our vision was possible to leverage the switchboard to get more relevant information to the VA, we knew we could build the communication.

What's Next for Wavy Zone

Wavy Zone is looking forward to continuing the work to create synergist strategies with better science, more accurate data, and interdisciplinary treatments with the hopes of better understanding PTSD and how to unlock the personal root causes of mental illness. Our hope is that Wavy Zone will create a windfall of benefits for our Veterans, their military communities, the health care providers that serve them, and the great communities across the US. We are already thinking of ways to better identify high-risk situations for Veterans by combining wearable data with patient self-reporting in a newer version of the app.

Wavy’s next steps are to include more treatment and recovery features for female Veterans, military sexual trauma, and transgender inclusiveness. The scalability of this application to include all people groups, including those who provide services as mental health workers that endure endless crisis interventions that often fail, takes Wavy Zone past a five-year lifespan to decades beyond this hackathon. This is our vision for Wavy Zone. Join us in the making of this vision into a mixed- REALITY!

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