eMCARE – Better Health for Young Adults


How healthy are young adults aged 18 to 26?  The surprising and sad truth is that young adults have unusually poor health outcomes, with a worse health profile than the age groups on either side of them. The health issues they often deal with (depression, anxiety, sexually transmitted infections, unintended pregnancies, suicidality, obesity, and poorly managed chronic disease) can have devastating long-term effects, and are associated with hundreds of billions of dollars in societal costs.

Fortunately, the majority of these problems, along with their associated costs, are preventable.  We are currently working with a  seasoned and passionate team of researchers and adolescent care professionals at Children’s Hospital of Pittsburgh and University of Pittsburgh to help do just that.

The project is called eMCARE — eHealth Mobile Technology Connecting Young Adults to Routine Engagement. eMCARE is based on a few things that we know about young adults:

  • A good relationship with a primary care provider has a substantial positive impact on all of the young adult health issues mentioned above.
  • Most young adults do not have a good primary care relationship.
  • Young adults do often show up at the emergency department (ED) with acute health issues.
  • Young adults use text messaging. A lot.

eMCARE takes this handful of simple facts and runs with them. A visit to the ED is often seen as a “teachable moment.” Young adults presenting at the ED are asked to participate in eMCARE. If they agree, they begin to receive a series of text messages that are carefully constructed to convey two simple points without being annoying or bossy:

  1. There are some health issues that you should avoid in order to live well.
  2. These issues are easy to avoid with some simple steps that you can take yourself.

eMCARE provides motivation through a reward system that gives young adults things they are interested in once they take that essential step of seeing, then following up with, a primary care doctor, and encourages them to help their friends do the same.

Our current focus is on a pilot project to build the basic software framework. This phase of the project is being funded by University of Pittsburgh’s Clinical and Translational Science Institute (CTSI) through a competition called the Pitt Innovation Challenge (PInCh). PInCh is one of a series of competitions that CTSI is putting on to supercharge innovation within Pitt’s cutting edge research community (other competitions in the series include ProtoHype and Pain). A couple of us at here NuRelm (Jay Frink and Sam Shaaban) were part of the PInCh team proposing eMCARE.  We were easily lured by the opportunity to meet and work with amazing researchers, and the chance to give back in a meaningful way, and were not disappointed!

eMCARE’s research team is led by Dr. Dana Rofey, a clinical psychologist and health behavior change researcher with extensive clinical and research experience working with adolescents and young adults, and Dr. Elizabeth Miller, Chief of Adolescent and Young Adult Medicine, CHP, an NIH, NIJ and CDC funded researcher with extensive intervention research experience.  Consultants on this phase of the project include Dr. Brian Suffoletto an emergency medicine physician and developer of CaringTXT (a text messaging application to address excessive drinking in YAs, which has been commercialized and is in use in colleges across the country), and Dr. Suresh Srinivasan, the CHP Chief Medical Information Officer and pediatric emergency medicine physician with expertise in embedding innovative technologies within hospital electronic records.

We are working on building the eMCARE software platform now, and will report back on the results in a couple of months!

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