SBIR-STTR Award

The wraparound service model (WSM) is an individualized care planning and management process for children and youth with serious emotional and behavioral disorders (SEBD) that is implemented in nearly 1000 sites in the United States. The purpose of this Phase I Small Business Technology Transfer (STTR) proposal is to develop and pilot test a web-based monitoring and feedback system (MFS) that will support decision management and overall implementation of WSM. The Wraparound Team Monitoring System (Wrap-TMS) will consist of four assessment components that are linked by theory and research to achievement of improved fidelity and outcomes of WSM: (1) Goal Setting and Tracking, (2) Team Functioning, (3) Family Connection to Natural and Community Supports, and (4) Youth Outcomes. Each Wrap-TMS component will have a manageable number of inputs (5-8) that make it feasible for staff persons and supervisors. The MFS will produce client-level ""dashboard"" reports to support fidelity and clinical decision-making by WSM staff and teams, as well as program-level reports that aggregate these data to meet evaluation and quality improvement needs. During this Phase I STTR project, the research team will determine the feasibility and utility of the proposed Wrap-TMS and its prototype reporting features. During the project, the research team will: (1) Conduct user testing of the four components that comprise the Wrap-TMS with a diverse group of users nationwide;(2) Assess psychometrics of Wrap-TMS items and scales;(3) Pilot test and evaluate the utility of the ""team dashboard"" reporting function of Wrap-TMS with actual WSM teams;(4) Pilot test and evaluate utility of a prototype program-level reporting function of the Wrap-TMS;and (5) Use results from all the above activities to determine additional methods for supporting Wrap-TMS dissemination and develop a Phase II STTR proposal and commercialization plan. This project is highly innovative in that it will mobilize research on WSM and MFS technologies to provide an important function that is needed but not currently available to hundreds of WSM sites nationally: A clinical decision support technology that facilitates delivery of high-quality, model-adherent wraparound care management. By developing such technologies for use by provider organizations, state and local oversight agencies, managed care entities, regional and national trainers, and researchers, this project will serve as an important part of the effort to bridge the ""research to practice"" gap, while also facilitating research on this model and this population.

Public Health Relevance:
This Phase I STTR project will develop and pilot test a web-based monitoring and feedback system (MFS) that will support decision management and overall implementation of the wraparound service model (WSM), an individualized care management intervention for children with serious emotional and behavioral disorders. Such a system will mobilize research on WSM and MFS technologies to provide an important function that is needed but not currently available to hundreds of WSM sites nationally: A clinical decision support technology that facilitates delivery of high-quality, model-adherent WSM. By developing such technologies for use by provider organizations, state and local oversight agencies, managed care entities, regional and national trainers, and researchers, this project will serve as an important part of the effort to bridge the ""research to practice"" gap, while also facilitating research on this model and this population.

Thesaurus Terms:
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The purpose of this Phase II Small Business Technology Transfer (STTR) project is to complete developmentand 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 carecoordination model in children's behavioral health, the wraparound process. The wraparound process is theonly defined, research-based, individualized care coordination process for these children and youth and theirfamilies. 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 improveefficiency, service quality, and accountability, to date no flexible, locally configurable EBHIS has beendeveloped 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 guidemanagement, 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 STTRproject, 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 anintegrated care coordination initiative for youths with serious emotional and behavioral disorder (SEBD). In lightof our success in Phase I, subsequent partnerships with federal agencies, and inquiries of interest from severalstates and over 20 provider and managed care organizations, in this Phase II STTR we will: (1) Completerevisions based on Phase I feedback, and expand the information management and reporting capacities ofWrap-TMS, including 'Drag and Drop' reporting, program-level aggregate reports, clinical alerts and treatmentrecommendations from functional assessments, and costs and service tracking; (2) Develop and test supporttechnologies for Wrap-TMS dissemination, including Wrap-TMS User's Manual, quality assurance and supportdesk models, web-based Wrap-TMS training curriculum, interoperability frameworking infrastructure, and touchscreen apps for tablets and smart phones; (3) Continue iterative learnability and usability testing, via lab-basedtesting and bug tracking of the system and its online user's manual, as well as live tests with real-world endusers; and (4) Conduct a randomized controlled effectiveness study comparing n=20 wraparound facilitatorswho use Wrap-TMS serving n=80 families to 20 non-user staff serving 80 families on practitioner,implementation, and youth/family outcomes.

Thesaurus Terms:
Abnormal Coordination;Accountability;Base;Behavior;Behavior Disorders;Behavioral Health;Businesses;Caring;Child;Child Mental Health;Childhood;Clinical;Clinical Assessments;Clinical Decision-Making;Clinical Services;Commercialization;Community Practice;Complex;Cost;Data;Data Element;Decision Making;Development;Diagnosis;Diagnostic Services;Drops;Educational Curriculum;Effectiveness;Electronics;Elements;Emotional;Emotional Disorder;Enrollment;Evaluation;Evidence Base;Evidence Based Practice;Family;Family Member;Federal Government;Feedback;Flexibility;Funding;Goals;Health;Health Information System;Health Information Technology;Health Resources;Healthcare;Improved;Information Management;Interest;Internet;Interoperability;Lead;Life;Light;Managed Care;Manuals;Marketing;Meetings;Member;Mental Health;Modeling;Monitor;Online Systems;Outcome;Perception;Phase;Population;Process;Programs;Provider;Psychometrics;Public Health Relevance;Quality Assurance;Randomized;Randomized Controlled Trials;Recommendation;Reporting;Research;Research And Development;Research Infrastructure;Research To Practice;Resources;Satisfaction;Schedule;Schools;Services;Site;Small Business Technology Transfer Research;Specific Qualifier Value;Standardize Measure;Stream;Success;Supervision;Surveys;System;Tablets;Technology;Technology Transfer;Telephone;Testing;Touchscreen;Training;Usability;Validity And Reliability;Work;Youth;