CommonGround - Shared Decision Making

Competition Finalist

This entry has been selected as a finalist in the
Patients | Choices | Empowerment competition.

We are people in recovery from major mental disorders like schizophrenia and bipolar disorder. We developed a web application to help amplify the voice of people with psychiatric disorders during medication visits with psychiatrists. Our application gives hope for recovery and empowers people to participate in shared decision making about medication treatment with psychiatrists.

About You

Organization: Pat Deegan, PhD & Associates, LLC Visit websitemore ↓↑ hide↑ hide

Section 1: You

First Name

Patricia

Last Name

Deegan

Organization

Pat Deegan, PhD & Associates, LLC

Country

United States, MA, Essex County

Section 2: Your Organization

Organization Name

Pat Deegan, PhD & Associates, LLC

Organization Website

Organization Phone

+1-978-463-7654

Organization Address

P.O. Box 208, Byfield, MA 01922, USA

Is your organization a

For‐profit

Organization Country

United States, MA, Essex County

Your idea

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Name Your Project

CommonGround - Shared Decision Making

Country and state your work focuses on

United States

Describe Your Idea

We are people in recovery from major mental disorders like schizophrenia and bipolar disorder. We developed a web application to help amplify the voice of people with psychiatric disorders during medication visits with psychiatrists. Our application gives hope for recovery and empowers people to participate in shared decision making about medication treatment with psychiatrists.

Innovation

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What makes your idea unique?

What makes our idea unique is that we eliminate the waiting rooms in doctors' offices. In today's healthcare system, there is no time to wait in waiting rooms. Those of us diagnosed with mental illness are dying 25 years younger than non-diagnosed Americans! We must get active. We must prepare to talk with our doctor and make informed medical decisions about our healthcare.

Before the appointment our web application helps us create a health report for the doctor. The health report tells the doctor how we have been doing since the last appointment. It tells the doctor what we are doing to help ourselves, how we are using prescribed medicine, what our goals for treatment are, and what our concerns about medicine are. Most importantly, our health report includes a Power Statement that helps the doctor focus, not just on symptom reduction, but on our recovery goals.

Our health report works like an amplifier, succinctly telling our doctor a story about how we are doing. That way, there is more time in the 15-20 appointment to quickly get to areas of concern and to make shared decisions about the next steps in our treatment. The web application also links us to information about treatment options and self care, based on the answers we give. This helps because many of us don't get to see therapists or case managers. We also get to watch videos of people in recovery and get hope that we too can recover.

The web application also works like assistive technology. It helps us organize our thinking into a story of how we are doing. It amplifies our story through a 1-page health report that the doctor can understand. Other staff on our treatment team can also view our health report and link to information about how to help us. In this way our voice is amplified throughout the mental health system so that everyone is focusing on our goals, as expressed in our own words.

This is empowerment in action!

Do you have a patent for this idea?

Impact

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What impact have you had?

Our web application to support shared decision making is being used by 5,000 people with psychiatric disabilities in public sector mental health in the U.S. Our goal is to make the CommonGround web application, with it's message of hope and empowerment, available to the poorest of the poor and the sickest of the sick in the mental healthcare system. That is our mission.

Problem

Most people, including professionals, feel that people with serious mental illnesses such as schizophrenia, can't be involved in shared decision making. For those of us on Medicaid, psychiatric appointments last only 15-20 minutes. Research has shown enormous health disparities for our vulnerable population. We are dying on average, 25 years younger than non-diagnosed peers.

When doctors use our CommonGround web application they are able to enter shared decisions 75% of the time. That's because CommonGround empowers us to speak up and be heard. It works like an amplifier and helps to keep the doctor on track with our recovery goals. The web application also give us hope for our recovery by linking us to videos of real people who have recovered. Their stories of hope and resilience give us hope for recovery. The web application also connects us to information about our treatment options and how we can manage our disorder more effectively.

Actions

We are a very small company of 3 full time, and 2 part time people. Despite our size, over the last year we have succeeded in getting 7 community mental health centers, one state hospital and 2 peer centers to use our web application. We currently have over 5,000 users in MA, KS, OK and PA. We have partnered with Dartmouth Psychiatric Rehabilitation Center to research the efficacy of our intervention. We have been listed by the Agency for Healthcare Research and Quality as a practice innovation (http://www.innovations.ahrq.gov/content.aspx?id=2870). We have published numerous articles about our intervention in professional journals. We are constantly in the field testing and developing the web application based on feedback from users.

Results

Doctors using the CommonGround web application hear the voice and concerns of mental health services users. 14,000 Health Reports have been created by CommonGround users and psychiatrists have entered shared decisions 75% of the time. This demonstrates that shared decision making is feasible in public sector mental health, despite severe time constraints in the 15 minute medication visit.

The web application is assistive technology as well. It helps people organize a concise story and to express their concerns about treatment while also linking people to information to support recovery.

What will it take for your project to be successful over the next three years? Please address each year separately, if possible.

We are a mission drive group and we are not business people. However, in the upcoming year we have to find a sustainable business model. Public sector mental health services are broke. The state budgets are in crisis and the public safety net is being shredded by budget cuts.

Our web application costs about 2 dollars per user per month and we need consultants to help us formulate a plan to disseminate it widely. As we do that, we are also doubling in size in the next year with 8 more mental health centers lined up to use the application!

In year 2 we need to develop an online implementation support so that mental health centers can implement the use of the application on their own, at no additional expense for training.

In year 3 we will develop new features for the web application to streamline its implementation.

What would prevent your project from being a success?

In our opinion, when we help one person get empowered to speak up about their healthcare, we are a success. So it's hard to fail! We are a really small company doing great things.

Sometimes we get concerned that some will catch on to our idea and distort it for marketing purposes. It is really important that shared decision making remain free of marketing.

How many people will your project serve annually?

1001‐10,000

What is the average monthly household income in your target community, in US Dollars?

$100 ‐ 1000

Does your project seek to have an impact on public policy?

Yes

Sustainability

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What stage is your project in?

Operating for 1‐5 years

In what country?

United States

Is your initiative connected to an established organization?

Yes

If yes, provide organization name.

Pat Deegan, PhD & Associates, LLC

How long has this organization been operating?

1‐5 years

Does your organization have a Board of Directors or an Advisory Board?

Does your organization have any non-monetary partnerships with NGOs?

No

Does your organization have any non-monetary partnerships with businesses?

No

Does your organization have any non-monetary partnerships with government?

No

Please tell us more about how these partnerships are critical to the success of your innovation.

n/a

What are the three most important actions needed to grow your initiative or organization?

1. We need a good business development plan that can focus our web application development on the current opportunities regarding healthcare reform and the integration of behavioral health and physical health.

2. We need help interpreting the information in our database and feeding it back to our sites in ways that allow them to improve their implementation of shared decision making through the web application.

3. We need to develop online tutorials to help public sector sites implement the web application in their organizations. We want to explore online learning collaborative models that will eliminate implementation costs.

The Story

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What was the defining moment that led you to this innovation?

The defining moment that led Pat and her collaborators to develop the CommonGround web application was seeing so many people with psychiatric disabilities die 25 years younger than non-diagnosed peers in America. Medical decisions about treatment are also personal decision. We must be empowered to have a voice in our treatment, even if we have a diagnosis of mental illness!

Tell us about the social innovator behind this idea.

Pat Deegan is a person who was diagnosed with schizophrenia at 17 years old. She made her recovery and went on to get a PHD in clinical psychology. Her speaking and trainings are in great demand but have limited impact. Pat wanted to incorporate the principles of recovery and empowerment into a tool that changed how mental health professionals, and patients worked together in-vivo. The CommonGround web application is that innovation!

How did you first hear about Changemakers?

Friend or family member

If through another, please provide the name of the organization or company

50 words or fewer

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175 weeks ago Patricia Deegan said: Thanks Gail. We often hear that people get much more involved in the psychiatric consultation when CommonGround is available. It both ... about this Competition Entry. - read more >
175 weeks ago said: I am an adult psychiatrist and had the privilege of working for almost 2 years using Common Ground at TCV MHMR, a busy adult outpatient ... about this Competition Entry. - read more >
175 weeks ago Patricia Deegan said: Thanks John. The Power Statement is proving to be a powerful self-advocacy tool that helps the psychiatrist get on board with our ... about this Competition Entry. - read more >
175 weeks ago said: At Consumer Quality Initiatives, a community research and evaluation org. in Mass. We helped to assess consumer experiences of using CG ... about this Competition Entry. - read more >
175 weeks ago said: At Consumer Quality Initiatives, a community research and evaluation org. in Mass. We helped to assess consumer experiences of using CG ... about this Competition Entry. - read more >
175 weeks ago said: At Consumer Quality Initiatives, a community research and evaluation org. in Mass. We helped to assess consumer experiences of using CG ... about this Competition Entry. - read more >
176 weeks ago Patricia Deegan said: Hi Leigh Ann. Thanks for your post. What a great story. Makes all this hard work worth it! CommonGround does help people engage with ... about this Competition Entry. - read more >
176 weeks ago Patricia Deegan said: Hi Holly. Thanks so much for your comment. I think you are right. We carefully crafted CommonGround to insure emphasis on wellness ... about this Competition Entry. - read more >
176 weeks ago Patricia Deegan said: Hey Darlene. Thanks for your comment. We agree that CommonGround can play a key part in the integration of mental health in physical ... about this Competition Entry. - read more >
176 weeks ago said: Our collaboration with the common ground program has been a valuable asset in the work that we do. As an example: A new person to our ... about this Competition Entry. - read more >