Ellen McGeoch | University of Pennsylvania (original) (raw)
Papers by Ellen McGeoch
Innovations in Digital Health, Diagnostics, and Biomarkers
Introduction There is growing support for the use of integrated measurement-based care to capture... more Introduction There is growing support for the use of integrated measurement-based care to capture symptom data in real time so treatment providers can make informed decisions about intervention strategies for mental health problems, such as depression and anxiety, both of which are known to increase suicide. We examined the potential scalability and effectiveness of a mobile health (mHealth) application with integrated behavioral health functions to capture remote patient-reported measurement of suicidal ideation and overall symptoms of depression and anxiety. Methods This study was an observational retrospective review of deidentified patient data, including symptoms of suicidal ideation, depression, and anxiety as measured by the Patient Health Questionnaire-9 (PHQ-9) or Generalized Anxiety Disorder 7 (GAD-7) scale, which were administered to and completed by patients on a smartphone or desktop application. After controlling for age, sex, and the presence of moderate versus severe...
Journal of general internal medicine, 2018
The design of the Affordable Care Act's (ACA) health insurance marketplaces influences comple... more The design of the Affordable Care Act's (ACA) health insurance marketplaces influences complex health plan choices. To compare the choice environments of the public health insurance exchanges in the fourth (OEP4) versus third (OEP3) open enrollment period and to examine online marketplace run by private companies, including a total cost estimate comparison. In November-December 2016, we examined the public and private online health insurance exchanges. We navigated each site for "real-shopping" (personal information required) and "window-shopping" (no required personal information). Public (n = 13; 12 state-based marketplaces and HealthCare.gov ) and private (n = 23) online health insurance exchanges. Features included consumer decision aids (e.g., total cost estimators, provider lookups) and plan display (e.g., order of plans). We examined private health insurance exchanges for notable features (i.e., those not found on public exchanges) and compared the tot...
Substance Abuse Treatment, Prevention, and Policy
Background: The National Institute on Drug Abuse has identified a persistent research-to-practice... more Background: The National Institute on Drug Abuse has identified a persistent research-to-practice gap in the implementation of evidence-based prevention and treatment programs for substance use disorder. To identify mechanisms to close this gap, we sought to obtain and characterize the range of policy makers' perspectives on the use of research in substance use disorder treatment and coverage decisions. Methods: We conducted open-ended, semi-structured interviews with a purposive sample of eighteen policy makers involved in the delivery of health services. The aim was to identify barriers and facilitators, attitudes, beliefs, and experiences surrounding the use of research related to the treatment and economics of substance use disorder. Results: The analysis generated four themes: 1) policy maker engagement with evidence and researchers; 2) strategic use and usefulness of research; 3) scientific rigor versus relevance; and 4) communication of evidence. Within each theme, the participants identified barriers, facilitators, current practice, and gave their perspectives on "ideal conditions" for research design, conduct and communication. Conclusions: Recommendations for investigators are the following actionable steps: 1) partner with policy makers early in the research process, 2) formulate and use research designs to meet the strategic goals of end-users; 3) systematically test alternative phrasing of scientific terminologyparticularly in the realm of cost effectiveness researchthat allow end users to better understand and repurpose the data; 4) incorporate qualitative research methods to uncover the narratives that explain the context and relevance of evidence; 5) incorporate study designs that prioritize timeliness of results; and 6) promote and reward researcher involvement in policy discussions.
Innovations in Digital Health, Diagnostics, and Biomarkers
Introduction There is growing support for the use of integrated measurement-based care to capture... more Introduction There is growing support for the use of integrated measurement-based care to capture symptom data in real time so treatment providers can make informed decisions about intervention strategies for mental health problems, such as depression and anxiety, both of which are known to increase suicide. We examined the potential scalability and effectiveness of a mobile health (mHealth) application with integrated behavioral health functions to capture remote patient-reported measurement of suicidal ideation and overall symptoms of depression and anxiety. Methods This study was an observational retrospective review of deidentified patient data, including symptoms of suicidal ideation, depression, and anxiety as measured by the Patient Health Questionnaire-9 (PHQ-9) or Generalized Anxiety Disorder 7 (GAD-7) scale, which were administered to and completed by patients on a smartphone or desktop application. After controlling for age, sex, and the presence of moderate versus severe...
Journal of general internal medicine, 2018
The design of the Affordable Care Act's (ACA) health insurance marketplaces influences comple... more The design of the Affordable Care Act's (ACA) health insurance marketplaces influences complex health plan choices. To compare the choice environments of the public health insurance exchanges in the fourth (OEP4) versus third (OEP3) open enrollment period and to examine online marketplace run by private companies, including a total cost estimate comparison. In November-December 2016, we examined the public and private online health insurance exchanges. We navigated each site for "real-shopping" (personal information required) and "window-shopping" (no required personal information). Public (n = 13; 12 state-based marketplaces and HealthCare.gov ) and private (n = 23) online health insurance exchanges. Features included consumer decision aids (e.g., total cost estimators, provider lookups) and plan display (e.g., order of plans). We examined private health insurance exchanges for notable features (i.e., those not found on public exchanges) and compared the tot...
Substance Abuse Treatment, Prevention, and Policy
Background: The National Institute on Drug Abuse has identified a persistent research-to-practice... more Background: The National Institute on Drug Abuse has identified a persistent research-to-practice gap in the implementation of evidence-based prevention and treatment programs for substance use disorder. To identify mechanisms to close this gap, we sought to obtain and characterize the range of policy makers' perspectives on the use of research in substance use disorder treatment and coverage decisions. Methods: We conducted open-ended, semi-structured interviews with a purposive sample of eighteen policy makers involved in the delivery of health services. The aim was to identify barriers and facilitators, attitudes, beliefs, and experiences surrounding the use of research related to the treatment and economics of substance use disorder. Results: The analysis generated four themes: 1) policy maker engagement with evidence and researchers; 2) strategic use and usefulness of research; 3) scientific rigor versus relevance; and 4) communication of evidence. Within each theme, the participants identified barriers, facilitators, current practice, and gave their perspectives on "ideal conditions" for research design, conduct and communication. Conclusions: Recommendations for investigators are the following actionable steps: 1) partner with policy makers early in the research process, 2) formulate and use research designs to meet the strategic goals of end-users; 3) systematically test alternative phrasing of scientific terminologyparticularly in the realm of cost effectiveness researchthat allow end users to better understand and repurpose the data; 4) incorporate qualitative research methods to uncover the narratives that explain the context and relevance of evidence; 5) incorporate study designs that prioritize timeliness of results; and 6) promote and reward researcher involvement in policy discussions.