Development, Usability Testing, and Effectiveness Evaluation of the Wraparou

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PROJECT SUMMARY The purpose of this Phase II Small Business Technology Transfer (STTR) project is to complete development and evaluate usability and effectiveness of the Wraparound Team Monitoring System (Wrap-TMS), a web- based, electronic behavioral health information system (EBHIS) for the most widely implemented care coordination model in children's behavioral health, the wraparound process. The wraparound process is the only defined, research-based, individualized care coordination process for these children and youth and their families. Wraparound is now implemented for over 100,000 youths annually in nearly 1,000 sites in the U.S. However, despite increased emphasis in health care on use of health information technology to improve efficiency, service quality, and accountability, to date no flexible, locally configurable EBHIS has been developed for wraparound. Moreover, though wraparound is now considered "evidence-based," implementation in the real world often fails to conform to standards of fidelity and/or use objective data to guide management, supervision, and clinical decision making. Availability of such a system will support efficiency, implementation quality and fidelity, and outcomes for youths enrolled in wraparound. In our Phase I STTR project, we successfully specified, developed, programmed, and established the feasibility, utility, reliability, and commercialization potential of Wrap-TMS. Wrap-TMS now features functionality for data entry, management, and basic reporting for the full array of data and information elements needed to manage an integrated care coordination initiative for youths with serious emotional and behavioral disorder (SEBD). In light of our success in Phase I, subsequent partnerships with federal agencies, and inquiries of interest from several states and over 20 provider and managed care organizations, in this Phase II STTR we will: (1) Complete revisions based on Phase I feedback, and expand the information management and reporting capacities of Wrap-TMS, including "Drag and Drop" reporting, program-level aggregate reports, clinical alerts and treatment recommendations from functional assessments, and costs and service tracking; (2) Develop and test support technologies for Wrap-TMS dissemination, including Wrap-TMS User's Manual, quality assurance and support desk models, web-based Wrap-TMS training curriculum, interoperability frameworking infrastructure, and touch screen apps for tablets and smart phones; (3) Continue iterative learnability and usability testing, via lab-based testing and bug tracking of the system and its online user's manual, as well as live tests with real-world end users; and (4) Conduct a randomized controlled effectiveness study comparing n=20 wraparound facilitators who use Wrap-TMS serving n=80 families to 20 non-user staff serving 80 families on practitioner, implementation, and youth/family outcomes.