College Students Tackle PTSD at First DC Hackathon

Event shows the potential of Hackathons to quickly build sophisticated open source apps for Veterans health care

More than 50 college students from across the world gathered this previous weekend at HackDC 2015, the first Hackathon dedicated to crowdsourcing innovative ways to address the serious problem of Post-Traumatic Stress Disorder (PTSD) by creating mobile applications and solutions. The event, which started on Friday, went through Sunday afternoon. Held at the Richard J. Ernst Community Cultural Center in the Annandale Campus of the Northern Virginia Community Colleges (NVCC), HackDC 2015 provided the participants with access to food, sleeping facilities, and showers so that they could work straight through the weekend.

The expectations of the Hackathon organizers were met, and in fact, exceeded, as the 13 different teams presented an array of innovative ideas and tools. The event was the brainchild of Dr. Yan Chow, Chief Innovation Officer of LongView Technology Solutions, a company with a long history of coming up with innovative health IT solutions for the federal government.

The Hackathon addressed one of the most serious issues facing Veterans, military personnel, and the nation as a whole, the result of decades of uninterrupted warfighting. Despite significant research and programs developed by the Department of Defense (DoD) and the Department of Veterans Affairs (VA), Veterans and active duty servicemen continue to suffer from access to care and treatment issues.

PTSD is a chronic medical condition that follows exposure to traumatic or life-threatening events, such as combat and assault. Up to 3.6 million Veterans experience flashbacks, poor concentration, insomnia, anger, and exaggerated responses to triggers, which can lead to alcohol and drug abuse, and suicide. The toll is immense. An estimated 22 Veterans and 3 to 4 active duty servicemen commit suicide every day. In total more than 100,000 have committed suicide in the past 14 years.

HackDC 2015 awards ceremonyHackDC 2015 was unusual in many ways. As noted, it went straight through the weekend so the students could work on their projects through the night (and there were loads of food and drinks including an ice chest full of Red Bull). It also had multiple presentations on various topics which the students found very helpful.

They had access to tools and a set of open VA systems that had not been easily available to the public before. And most important, there was a large number of volunteers who shared their knowledge and experience with the developers. Volunteers included Veterans, clinical psychologists and psychiatrists from the VA, the military’s Walter Reed hospital, and the private sector, as well top software developers from the VA.

The volunteers played a critical role in the success of the event. Nearly a dozen Veterans joined the students throughout the Hackathon. Some of the Veterans stayed through the night to be there in case students had questions or needed any help, advice or encouragement. Same for the clinicians. Lt. Col (ret) Hon Pak, Chief Medical Officer of Longview told Open Health News that some of the clinicians stayed up working with the students as late as 4:00 AM on Saturday morning. The volunteers provided real-world knowledge to the students about PTSD and served as advisors and sounding boards during the development of their apps.

Dr. Pak himself exemplified the kind of support the students received. Pak is the former Chief Information Officer and Chief Medical Informatics Officer for the U.S. Army Medical Department (AMEDD) and the U.S. Army Medical Command (MEDCOM). Previous to that he was the Chief of the Advanced Information Technology Group of the Telemedicine & Advanced Technology Research Center (TATRC). Dr. Pak could be seen throughout the event going from team to team working with the students and helping them out any way they needed.

One student pointed out that the volunteers helped clarify many of the misconceptions they had about PTSD. He told Open Health News that his father had been in combat in the Middle East and had returned with severe PTSD. The student said he paid out of his pocket to travel across the country so he could find a way to help his dad. At the Hackathon he was able to sit down and talk to many clinicians who taught him that there were multiple facets and complications to PTSD that went far beyond what he had experienced with his father. He, as well as all others we spoke to, were very grateful for all the volunteers did and what they taught them. Dispelling the misconceptions early on let them focus their knowhow on addressing the real issues.

Team "The Cure"The Outcome

The innovations that the teams came up were presented on Sunday afternoon and judged by a panel of experts as well as by the audience itself. There were two major objectives: one was for mobile applications for Veterans and their family members, and the other was mobile apps for clinicians. In the end, many of the teams designed apps that would provide solutions for both.

A total of 13 teams were present. There were some very creative and innovative apps and ideas presented. Some of the apps were already up and running and had their code submitted to Github. A great achievement considering that the participants had only 36 hours to work on them.

Some of the salient ideas include:

• Using social media to build support communities and to reach out to friends, family and therapists when there is a need. Several apps were designed to build these communities and allow those suffering from PTSD to keep journals and allow selected entries to be shared with those they chose. The apps the students presented contained capabilities that would allow other members of the social media community to support and encourage them when needed. They can also be used to enable direct interaction with clinicians and medical professionals. Spencer Coursen, one of the Veterans helping out, told Open Health News that the idea of using Facetime for direct communication with therapists came up late Saturday night. It was enthusiastically received, but it was too late to be added to the apps that were being programmed. The idea of being able to have face-to-face contact with a therapist at the moment such contact is needed, and not days or weeks later, will likely be part of the next Hackathon.
• Using wearables, in particular the Pebble, to monitor the status of those facing PTSD. Several of the wearable apps focused on the sleep cycle. Turns out there are several body rhythms, such as heart beat, that can be monitored to show signs of distress. One of the key problems with PTSD is nightmares, or “night terrors” as they are often referred to. These can be triggered by many things. The idea is to defuse these nightmares as they start. Wearables can help with that, alerting loved ones of the onset of a nightmare as well as service dogs who have been shown to have a great calming effect on their owners. They can also trigger electronic devices that could play soothing music, for example.
• Several of the teams focused on using algorithms and artificial intelligence to improve the diagnosis of PTSD and to monitor conditions as they change. One of the teams reviewed the questionnaires currently used to diagnose PTSD and found them to be too limited. “Mostly questions with yes and no answers,” they told the audience. They believe this approach is limited and does not allow Veterans to fully express what they are going through. Their solution was an interactive app that used algorithms and artificial intelligence to analyze responses and phrase questions based on the responses interactively. These tools can help clinicians, but they can also help Veterans. One of the points made is that many Veterans do not know that they have PTSD and/or are afraid to go to therapy. An app that can help self-diagnose PTSD could be a big help in getting them to them to talk about their situation and seek treatment.

Team "SafetyNet"The Awards

Awards were handed out following the presentations. Below are the Hackathon awards, in addition to those awards, several of the sponsors also gave out awards.

Best Mobile Application for Veterans & Families – $1,500
Team: SafetyNet

• Ellen Korcovelos – Virginia Commonwealth University, Virginia
• Gerard Briones – Virginia Commonwealth University, Virginia
• Aaron Throckmorton – Virginia Commonwealth University, Virginia
• David Igou – Virginia Commonwealth University, Virginia

Best Mobile Application for Clinicians – $1,500
Team: The Cure

• Tyler Skluzacek – Macalester College, Minnesota
• Damola Adediran – University of Maryland, Baltimore County, Maryland
• Sarah Kirby – University of Maryland, Baltimore County, Maryland
• Sravya Kalva – George Mason University, Virginia
• Brian Burack

Most Impressive Technical Hack – $1,000
Team: StressLess

• Bryan Hoyle – George Mason University, Virginia
• Lilas Dinh – George Mason University, Virginia
• Claire Cecil – George Mason University, Virginia
• Bryon Bacon – George Mason University, Virginia
• Mark McCaskey – George Mason University, Virginia

Best Overall Hack – $1,000
Team: Team Rocket

• JR Cabansag – Thomas Jefferson H.S. for Science & Technology, Virginia

People’s Choice – $500
Team: Team Terrors (the team has decided to donate their prize to veteran causes)

• Tara Seth – Northern Virginia Community Colleges at Annandale, Virginia
• Robert Truong – George Mason University, Virginia
• Hunter Jozwiak – George Mason University, Virginia
• Anthony Delorie

The Sponsors

In addition to LongView and OSEHRA, HackDC 2015 was sponsored by several companies. These included Exact Data, Red Hat, PwC, Infor, Optum, IBM, Pebble, and Emotiv. These companies brought experts to the conference to give lectures throughout the Hackathon on the most modern and powerful technologies. In addition, there were workshops on resume writing and career opportunities, including workshops on the science and technologies opportunities for women. This was quite relevant as more than a quarter of the participants were women and most of the team presentations were led by the women in the teams.

IBM, for example, sent a 6-person team to the Hackathon and a provided IBM Bluemix, a development/runtime platform to help the teams rapidly build and deploy backends for the mobile apps that they were building, as well as access to IBM Watson cognitive computing services. IBM’s Wolfgang Kulhanek, leading Cloud Technical Architect for IBM’s Digital Cities initiative, told Open Health News that IBM team members helped participants on their business ideas and how to implement these ideas best, as well as answering questions about the IBM Bluemix platform and integrating their apps with IBM Watson. He was proud to point out that “during the final presentations about half of the teams built something leveraging IBM Watson or were thinking about integrating it in a future version of their app.”

Drs. Yan Chow and Hon Pak

The Outcome

Participants from every group represented told Open Health News that the event had been a success, in fact most expressed that it had exceeded their expectations. As it wrapped up, one could see the students making sure they had contact information, not just from each other, but also from the Veterans who had helped them, the clinicians, and even representatives from the companies present.

Hackathon organizer Dr. Yan Chow told Open Health News that "we decided to launch HackDC as an experiment in open innovation in health care because it's been shown in other areas that such an approach can bring unfiltered, fresh, and innovative new ideas to solving very tough problems.” Pointing out that while “Hackathons do not produce finished products,” the “prototypes that come out of an intense, compressed product development cycle from participants who are passionate, creative, and enthusiastic can surprise and even delight the judges.” Dr. Chow concluded that “this was indeed what happened at HackDC 2015."

Dr. Seong K. Mun, President and CEO of OSEHRA, a co-sponsor of the event said that the Hackathon “was an excellent example of a new community being brought together to tackle important issues.” Dr. Mun also praised LongView, an OSEHRA Corporate Member, for doing “an excellent job facilitating this event comprised of experts and developers who all worked very hard and demonstrated their ability to collaborate.”

IBM’s Kulhanek echoed Dr. Mun’s thoughts. He told Open Health News that “the event was fantastically well organized by Longview.” Kulhanek said that “the infrastructure, the food, and the support were absolutely some of the best I've seen at any Hackathon. He said that he found the “presence of experts other than IT experts, such as clinicians and Veterans, to be absolutely fantastic.” Kulhanek emphasized that “it is not often that during these Hackathons the eventual users and customers actually take time out of their busy days to consult with the teams.” He concluded that there were quite a few solutions that showed promise and hoped that “the teams can continue building and improving them.”

Highest praise, however, came from the Veterans that participated in the Hackathon. Noah Kanter, an Army Veteran, said "it was great to see how motivated the teams were in addressing the problem,” adding that “what really impressed me was their earnest desire to learn about us, the Veterans, and what we would like to see as end-users.” Spencer Coursen told Open Health News “as a veteran who has watched one of my brothers succumb to the emotional trauma of war, it was an honor for me to be able to play a part in this event.” Coursen points out that “less than 1% of our society has served in the armed forces, yet soldier suicide makes up more than 20% of the national suicide rate.”

According to Coursen, “the innovation that LongView inspired through this event is exactly what is needed to combat the very real impact that PTSD has on our nation’s heroes,” pointing out that “the coupling of developers with Veterans, and Veterans with clinicians, and clinicians with developers had a breadth of scope on the brainstorming of ideas that went above and beyond the positive impact I think any of us had first envisioned.”

Coursen continued “after the initial keynote discussion by Dr. Lisa Carlin, the number of impassioned discussions that fellow Veterans and I had with the developers with reference to our own experiences really hit home with a lot of the developers.” He said that at the end of the event, “more than a few participants came up to us, thanking us for answering their questions so candidly,” adding that “for some of the developers, the significant pivot point in their developmental process came from these inspired discussions with clinicians and Veterans working together toward a common goal.”

Coursen concluded “what I think was perhaps most impactful from this event, was the opportunity for these applications to not only help clinicians in the treatment of PTSD, but also how these applications may serve as the gateway to treatment for those Veterans still fighting a personal war long after they have left the battlefield,” emphasizing that “beyond the community that came together, beyond the sleepless nights and the cheers of the awards, we all came together to make a real difference.”

The Broader Picture

There is more to the story that just the Hackathon. LongView’s initiative in organizing this event was the next logical step in the open source, collaborative efforts taking place to provide Veterans with innovative health solutions. LongView received support from the senior leadership of the VA, which is consistent with the open source philosophy that the VA has adopted. While the press keeps focusing on the challenges the VA is facing caring for more than a million Veterans wounded in the past 14 years of wars (with minimal funding increases from Congress), they are missing the real story, which is the VA’s embrace of open source principles, including transparency and collaboration, to solve the challenges the agency is facing.

Among the stories that the mainstream media is not reporting is the publication last fall of an information technology policy memorandum that mandates a thorough evaluation of "Open Source Software (OSS) solutions when [the] VA acquires software." The policy also mandates VA staffers to consider the use of open source "development practices when VA develops software." Improving and developing software through Hackathons is fully consistent with the guideleins of this policy memorandum.

More recently VA Secretary Robert A. McDonald articulated a clear strategy for the VA’s technology efforts based on open source, crowdsourcing and agile development during his keynote speech at the 2015 OSEHRA Open Source Summit in Bethesda, MD on July 30. In addition, McDonald is communicating his commitment to openness and transparency at the VA through the continuing funding of OSEHRA.

These public/private sector collaborative efforts, which are being channeled through the OSEHRA organization, were detailed in this report from IBM’s Center for The Business of Government, it is a case study on how an organization can help the government work with the private sector in open innovation. HackDC 2015 was clearly the next step in this sequence.

Conference participants told Open Health News that they hope that Hackathons like HackDC 2015 can communicate the message that the open source, collaborative approach is the right approach and can be used to solve the kinds of health challenges that Veterans as well as active duty military personnel face every day.