2014 Code-A-Thon

Pathways to Sustainable Health


This year’s HTF Code-a-thon event presents a special opportunity for innovators in the mental health space to create solutions and sharpen their skills. Participant teams will come together to generate ideas and crunch code, then pitch their prototypes to judges and peers.

Nearly 19% of Americans suffer from some sort of mental illness; emergency room visits for mental health or substance abuse issues have increased significantly in the past several years.  The Code-a-thon offers groups of hackers, health professionals and researchers an exciting environment to design new approaches that engage and empower patients in the recovery process.

With 250 RSVPs (team building reception and code-a-thon), 11 teams, 9 judges, 14 speakers, 10 mentors, and 30 organizers and volunteers the code-a-thon was a great success and we want to thank each and every one of you for your contributions. The weekend long challenge is being followed by a presentation panel of the winning solutions at the HTF Innovation Conference Pathways to Sustainable Health.

Problem Definition

Overall Mental Health Care General and Specific challenges


  • Poor integration/communication among health care providers (e.g., primary care clinicians and behaviorists, organizations)
  • Medication/treatment adherence
  • Low levels of literacy
  • Loss of patient’s motivation and disconnection between visits
  • Uninsured/underinsured patient populations with the most acute needs
  • Shrinking Medicaid funding
  • No standard documentation protocol


  • Limited quantified evaluation methodologies to diagnose
  • Lack of standard protocols in treating patients
  • Limited/lack of treatmentefficiency quality-control
  • Lack of social support for isolated patients
  • Societal perceptions towards mental illness that continue to persist towards mental illness
  • Uneven adoption of evidence-based therapies

San Francisco General Hospital Case Study : Acute Care Support

Within the Psychiatric Emergency Services, there are severe limitations for clinicians when obtaining a comprehensive history from the patient. Patient history is often inaccurate due to the decompensated psychiatric state of the patient. It is also very difficult and time-intensive for clinicians to get a comprehensive view of a patients mental health history, the physician needs to access three separate databases and read through unstructured data to ascertain a recent history. As this complete medical record only exists in the chart, two different disciplines can’t use it at the same time, causing severe workflow backup.

Mental Health Care in California: Painting a Picture

This report by the California Health Care Foundation provides an overview of mental health in California: disease prevalence, suicide rates, the state’s care delivery system, supply and use of treatment providers, and access to care. The report also highlights available quality data and the most recent data on national mental health care spending. Download the report here.

A Complex Case : Public Mental Health Delivery and Financing in California: This report by the California Health Care Foundation provides an overview of how California’s public mental health system services are financed, administered, and delivered. It is offered as background to inform policy discussions about how public mental health services fit within California’s overall public health care system.  Download the report here.


Challenges of Integrated Care Model

Collaboration of Primary Care Physician  with behavioral health professionals (e.g. nurse or social worker).

  1. Patient completes a behavioral assessment (e.g., includes depression, anxiety assessment);

THE CHALLENGE: low literacy patients. Cognitive impairment due to age or condition.

  1. Assessment is forwarded to primary care doctor, and patient is introduced to the behaviorist.

THE CHALLENGE: this process is influenced by many factors(e.g., poor communication with patient, limited bandwidth of behaviorist).

  1. Patient sees the behaviorist for a first visit, to understand the intervention process

THE CHALLENGE: Even though behaviorists undergo training for this session, there is significant variability in the offered clinical quality-re-training is often needed.

  1. Follow up sessions focus on either (1) giving a brief treatment (2) medication management (not prescription, just checking in on adherence) and (3) facilitating a referral if needed

THE CHALLENGE: to make sure that the clinicians are actually deploying the practices and utilizing access to experts/psychiatrists to address complex scenarios.

Common complaints by behaviorists:

(1) the treatments offered in primary care are not sufficiently good enough for patients; (2) managing complex cases is too hard in 30 minutes; (3) too much paperwork; (4) not enough expert support.

Evaluation Criteria


Conceptual Design Approach (25%):

Ability to articulate targeted pain point(s) around problem space and how conceptual designs address these

  1. Clearly defined use case that matches articulated pain points for problem space.
  2. Use case scenario matches problem definition and proposed solution
  3. How well did the team address the healthcare practitioner’s pain points in providing care to these patients?
  4. How well did the team address the patient’s problem?

Implementation Feasibility (25%):

  1. Feasibility of implementation with the San Francisco Department of Public Health
  2. Business model/scalability/distribution

Technical Feasibility (25%)

  1. Solution provided is technically sound
  2. Plans for a Beta version are clearly laid out on

Creativity and newness of the Idea (10%):

  1. The creativeness of bringing patients and providers closer to create better interactions at the diagnosis stage and ensure engagement in treatment and management phase.

Prototype development stage and Presentation (10%):

  1. Specific delivery and efforts put in place in the two days of the codeathon.
  2. Presentation

Utilization of surveys, datasets and resources provided (5%)

  1. The creative utilization of various APIs, data sets and validated questionnaires to create the innovative solution will be considered in the evaluation.


  • Nancy Hall, Chief Innovation Officer, HIT
  • Jan Gurley, MD; Writer, Speaker, Health Technology advisor from big data to mobile applications.
  • Dennis Israelski, MD; Public Health Advisor
  • George Su, MD; Assistant Professor, UCSF School of Medicine
  • Justin Graham, MD; Chief Innovation Officer, Healthcare at Hearst Business Media
  • Opinder Bawa, VP & CIO at University of San Francisco
  • Shervin Majd, Senior mHealth Partner at Vodafone
  • Patricia Salber, MD- CEO, Health Tech Hatch
  • Doug Trauner, Co-Chair mHealth Task Force, FCC
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