EPV673
How a Clinician-Designed Digital Tool Improves Adherence to Measurement-Based Care and Clinical Outcomes in Psychiatry
Y. Park 1, A. Vian-Lains 2 3,*, R. Frontini 3, C. Costa 3, S. Baptista 3, L. Nedel 3, F. Silva 4, A. Shahdid 5, N. Kennedy 2
1School of Medicine , RCSI, 2Highfield Healthcare, Dublin, Ireland, 3Neuroscience and Mental Health Clinic, 4Internal Medicine, Red Cross Hospital, Lisbon, Portugal, 5Ireland's Centre for Applied AI, University College Dublin, Dublin, Ireland
Introduction: Measurement-based care (MBC) uses patient-reported outcomes to guide treatment. Despite its robust evidence in improving engagement and outcomes it remains under-implemented due to time and workflow barriers. Tailored digital tools may enhance feasibility by automation of assessments and integration into workflows.
Objectives: To describe the design, implementation and clinical outcomes of Psymap, a clinician-developed software supporting MBC implementation.
Methods: Psymap is a web-based application that evolved from a Python script originally developed and refined over two years by one of the team’s psychiatrists. It streamlines MBC by integrating sociodemographic data, patient-reported outcome measures, and clinician-administered assessments into a single digital platform with automated scoring algorithms and interpretive text to support clinical evaluation. Psymap was introduced over 15 months in a private outpatient service. Patients completed validated digitized assessments. The tool produced patient-friendly summaries (Figure 1), automated documentation, and stored data securely. Baseline-to-endpoint (12 months or last observation) changes in PHQ9 and GAD7 were analysed. Patients who completed Psymap assessments at ≥90% of their visits were classified as High-Frequency Assessment (HFA) and the remainder as Low-Frequency Assessment (LFA). Kaplan–Meier and one-way ANOVA analyses compared rates of response (≥50% PHQ9 reduction) and remission (PHQ9<5), time to remission and mean score change across groups.
Results: 728 patients completed 1,798 assessments; 349 with ≥2 assessments were analysed. Psymap use at first visit rose from 37.7% to 96%. Higher use correlated with greater reductions in PHQ9 and GAD7 scores (r=–0.16, r=–0.18; p<.001). The HFA group (n=153) showed higher response (48% vs 33%) and remission (33% vs 19%) rates (χ²=8.9, χ²=8.1; p<.01). Kaplan-Meier analysis showed response and remission curves differed significantly (log-rank=5.9 and 6.0; p<.05); mean time to response was 80 vs 140 days. (Figure 2) Mean time to remission was 210 days for the HFA group, while the LFA group did not achieve 50% response. One-way ANOVA showed greater PHQ9 (–5.67 vs –4.08; F=4.55, p<.05) and GAD7 (–6.01 vs –3.89; F=9.16, p<.01) reductions in HFA vs LFA. (Figure 3) No adverse events were reported. Feedback highlighted improved clinician workflow and patient engagement.
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Conclusions: Psymap is a feasible, scalable digital platform integrating MBC into routine practice. Consistent use was associated with improvement in depression and anxiety outcomes. Clinician-led, workflow-oriented digital tools may help overcome barriers to MBC implementation in psychiatry.
Disclosure of Interest: Y. Park: None Declared, A. Vian-Lains Shareolder of: AVL developed and owns the Psymap software, R. Frontini: None Declared, C. Costa: None Declared, S. Baptista: None Declared, L. Nedel: None Declared, F. Silva: None Declared, A. Shahdid: None Declared, N. Kennedy: None Declared