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E!12014 Adjusted Level of Effective Care (ALEC): closing the access and treatment gaps in mental health care

Alternative title: Laveste Effektive Omsorgsnivå (LEON; [eng. ALEC]): Redusere gapet mellom tilbud og etterspørsel i psykisk helsevern

Awarded: NOK 4.4 mill.

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Project Period:

2018 - 2021

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BRAIVE (internet based CBT [iCBT] and Mental health care specialist) and FRISQ (eHealth systems developer) have a joint vision to improve psychiatric care accessibility, continuity and effectiveness through a highly scalable mHealth system that delivers stepped care that adapts and adjusts care allowing for patient's symptom fluctuations. With stepped care, at every moment, each patient gets the right level (self-help or assisted) and amount of care, resulting in a combination of lower costs/patient, better health outcomes, and higher total care output. mCBT content, delivered through a smartphone, can help lower symptom severity and distress in all mental disorders, but the care protocol needs to be personalized to be most effective. The project has resulted in the development and launch of product functionality allowing clinicians and patients to share information and carry out assisted and blended treatment trajectories on Braive's treatment programs. Throughout the project, the complete Adjusted Level of Effective Care (ALEC) model has been designed, modulated and incorporated into FRISK care to meet varying treatment needs. With the treatment codes implemented, FRISQ can take on the obligations as the 'coordinator' in the 'Pakke-forløp' initiative launched during the project period. FRISQ is waiting for DIPS its solution to be integrated with DIPS. This process has been delayed due to the transition from DIPS Classic to DIPS Arena, which has taken a lot of both DIPS's and LDS IT department's resources during the project period. Braive's platform and iCBT programs have been implemented at Lovisenberg and are today used in practice across LDS's various DPSs as part of their regular treatment offer to their patients.

Prosjektet har resultert i en videreutvikling av en plattform hvor klinikere og pasienter på en enkel og sikker måte nå kan dele informasjon og gjennomføre assistert og blandede behandlingsforløp med utgangspunkt i Braive sine behandlingsprogram. Den fullstendige Adjusted Level of Effective Care (ALEC) modellen har gjennom prosjektet blitt utformet, modulert og inkorporert i FRISK care for å kunne møte varierende behandlingsbehov. Braive sin plattform og iCBT programmer har blitt implementert hos Lovisenberg og benyttes i dag i praksis på tvers av LDS sine ulike DPS'er som en del av deres ordinære behandlingstilbud til deres pasienter. Med Lovisenberg sin etablering av e-klinikk, implementeringen av Braive samt gjennom kunnskapen opparbeidet gjennom prosjektet er Lovisenberg i ferd med å etablere seg som et kompetansesenter innen internettbasert terapi i Norge.

ALEC will enable a step-change improvement of BRAIVE and FRISQs systems capabilities towards providing the level of care that global health authorities recommend for patients with depression and anxiety. Today, to our best knowledge, there are no commercially available eHealth solutions that deliver stepped care for mental health by informing therapists on symptom progression in outpatients with mild to moderate depression or anxiety. Accordingly, ALEC results will be significant market innovations. BRAIVEs mobile Mental Health Check (MHC) and mCBT contents will build on 30+ years of scientific research on the positive and wide-ranging effects of CBT for mental disorders. The use of these contents in both remote/self-help and onsite care will increment the delivery options of what is already a recommended treatment protocol. Thus, a radical improvement in access will be enabled by our CBT delivery system, which promotes continuous care from the patient's perspective, without being cumbersome for clinicians who supervise treatment. From healthcare professionals' perspective, individualized patient support and symptom aggravation reporting (as part of the MHC) will be a major breakthrough and it will help prioritize clinical resources to where they can have the highest impact in the stepped care model. In sum, ALEC will enable, for the first time ever in the market, delivery of cost-effective, accessible, non-stigmatizing and timely support to patients diagnosed with depression and anxiety that today's public health system does not support due to incapacity to scale. The product will integrate with existing EPRs, allowing for scalability and fast rollout.

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