Clinical Decision Support Software Guides ADHD Treatments

8 Innovative Health IT Startups

Clinical decision support software can help medical professionals determine which treatments are most effective for individual patients. However, they haven't been used as often with the growing number of children diagnosed with attention deficit hyperactivity disorder (ADHD).

Pediatricians often make the first diagnosis of ADHD, a condition that can lead to ongoing disability, learning, and developmental challenges, and employment hurdles if treated incorrectly or inadequately, experts say. Today, about 11% of American children have been diagnosed with ADHD, according to the Centers for Disease Control, an increase of 42% in eight years. Research indicates that 6.1% of American children take medication for ADHD, but about 20% of children diagnosed with ADHD receive neither counseling nor medication. There is a dearth of data to support the array of available treatments, from prescription drugs to behavioral intervention to nothing, said Jeff Epstein PhD, director of the Center for ADHD at Cincinnati Children's Hospital Medical Center, in an interview.

[Why aren't more doctors using technology to guide treatments? See Clinical Decision Support Needs To Get Smarter.]

Determining which approach is best suited to each patient is a challenge, particularly as patients age, Dr. Janet Munro, CEO and co-founder of Optimal Medicine and managing director of OM France, told InformationWeek.

To address this gap, the company developed Mehealth for ADHD, subscription-based software designed to support diagnosis and treatment decisions. The tool incorporates the American Academy of Pediatrics clinical guidelines and DSM-5 criteria, and this week it became available in a Spanish version.

Typically, doctors ask parents to report on their child's behavior in order to determine whether treatment is helping. Optimal Medicine's Mehealth replaces today's traditional manual processes, which are time-consuming and affect children's lives, Munro said.

"Currently the gold standard is paper-based and can take up to six months to get the patient (most often a student) functioning properly in the classroom," she said. "ADHD isn't just a health issue. It's an educational issue as well. It's really important for the sake of the whole classroom children are managed safely and effectively."

But because the process is so time intensive, doctors and families are often lax about completing follow-up work, said Epstein. Without this insight into a treatment's success, children may be inadequately or wrongly treated, he said. Mehealth's portal enables parents, teachers, and doctors to enter feedback, giving authorized clinicians and family members more clarity into whether and how a particular medication or behavioral therapy is affecting the child.

Pediatrician Dr. Ilan Shapiro said in a statement: "With Mehealth for ADHD, parents are not only involved in the process of assessing their child for ADHD, they are truly able to impact the quality of care their child receives by completing rating scales."

Unlike many electronic health records (EHRs) -- whose access is limited to medical professionals -- ADHD systems must include a broader range of authorized users, said Munro. Otherwise, doctors don't get the full picture of a patient's health or response to treatment, she added.

Although some EHRs authorize parents to see children's information, teachers usually can't, said Epstein.

As usage grows across more practices, Mehealth expects to collect more data from patients. The company deidentifies and anonymizes the information and gives clinicians invaluable, aggregated insight into treatments, said Munro. Practices also can analyze their own patient data, she said. To date, physicians, families, and teachers have used Mehealth more than 10,000 times, according to Optimal Medicine.

"Then, when you start to treat thousands, tens of thousands of patients, what happens is you get a really rich database of information about all the different medications," she said. "If you start to analyze between aggregated, deidentified data... that can inform practices and guide them forward into the best treatment for ADHD."

The owners of electronic health records aren't necessarily the patients. How much control should they have? Get the new Who Owns Patient Data? issue of InformationWeek Healthcare today.