X Project: Getting Grounded—How Project Chamai Is Poised to Serve Emotional Wellness Needs of Kaiser Permanente Members

Trina Histon, PhD; W Scott Heisler, RN, MBA; Herbert Ozer, LCSW; Paul Castaldo, LCSW
https://doi.org/10.7812/TPP/18-071-01
Abstracts from the Kaiser Permanente 2018 National Quality Conference
From Northwest, Southern California, Program Offices
Background: Project Chamai was launched in 2016 to apply the Xcelerating Learning and Spread (XLS) framework to develop new options for members that are convenient, timely, and affordable. Working in partnership with Kaiser Permanente (KP) Northwest and Southern California and our members, a minimally viable package to support member needs has been developed and is being tested in operations on kp.org. This includes 1) a landing page with emotional wellness content that can be personalized by the member; 2) workflows to enable therapists who work all along the care path to refer to these tools; 3) tools in an online personalized action plan (oPAP) that supports a member’s episode care; 4) small-scale user testing of 3 to 5 online mobile applications to support emotional health.
Methods: At KP it is estimated that 25% of people in Specialty Behaviorial Health have a Patient Health Questionnaire-9 (PHQ-9) score of 10 or less. Project Chamai is primarily for members who are experiencing subclinical symptoms of depression or anxiety that may include but are not limited to sleeplessness, emotional distress, difficulty engaging in social activities, feeling overwhelmed, and difficulty in coping with life transitions. Project Chamai can also be leveraged for members who are in ongoing therapy and Depression Care Management, because cognitive behavioral therapy (CBT) and other evidence-based tools can act as an adjunct to care.
Results: Key insights from the “Understand” phase have been used to inform design principles that in turn led to the development of low- to medium-fidelity prototypes of solutions (new landing page on kp.org, ability to personalize content, tool curation, access to premium applications (CBT, etc) to support members’ emotional needs. Action plans for therapists are also being developed for use in oPAP as part of workflow optimization for mental health and wellness needs. Metrics that matter are part of the human- centered design process and include PHQ-9, and regional tools like Tridiuum (Polaris Health Directions, Wayne, PA) and a collaborative outcomes resource network (ACORN, Salt Lake City, UT) to track clinical outcomes in addition to preference and Web-based metrics to track user experience. Results from the small-scale user testing of mobile applications and online programs will also be shared.
Discussion: XLS provides a robust framework to show a cohesive process to chart the progress of national projects accountability for outcomes at each stage. Using human-centered design ensures that KP is truly delivering person-centered care by working with providers and members to build the solution.
Abstracts from the Kaiser Permanente 2018 National Quality Conference