COBALT

Person holding up a phone with screen displaying "COBALT" and program logo

COBALT

A mental health platform for health care workers

Project status

Implementation
Scale
Spread

Collaborators

Cecilia Livesey, MD 

Lisa Bellini, MD 

Sarah Beck, MA 

Penn Medicine Workforce Wellness Committee 

Judy Shea, PhD 

Courtney Wolk, PhD 

Rachel Kishton, MD 

Nandita Mitra, PhD 

Noelle Ciara, DSW, LCSW, ACM-SW 

Emily Becker-Haimes, PhD 

Department of Psychiatry 

TEAMS Clinic 

Innovation leads

Funding

UnitedHealth Group

External partners

UnitedHealth Group 

Xmog

Opportunity

Mental health needs were disproportionately high among health care workers (HCWs) before the COVID-19 pandemic. However, the rapid spread of the virus forced providers to grapple with additional stressors, including longer shifts, shortages of personal protective equipment, increased mortality and morbidity, and the fear of exposing family members upon returning home.

Emerging evidence indicates that more than two-thirds of frontline HCWs battling COVID-19 will experience psychiatric symptoms, including post-traumatic stress, acute anxiety, substance use, depression, and suicide.

Intervention

COBALT is a web-based platform designed to help HCWs access mental health support easily and on their terms. After completing a self-assessment, users receive personalized recommendations for support most relevant to their needs. 

Resources available to COBALT users include:

  • Articles, podcasts, and worksheets,
  • Group sessions focused on mindfulness, election stress, antiracism, and more,
  • One-on-one help from resilience coaches, therapists, and clinicians, 
  • And urgent intervention for those at highest risk for self-harm.

The platform is equipped with embedded scheduling and telehealth capabilities that are HIPAA compliant. It also offers users the option to log on anonymously in an effort to overcome concerns around how seeking mental health support could impact one’s career.

Impact

COBALT was launched in the spring of 2020 and is available to all Penn Medicine employees. 

As of October 2022, 

  • Users have engaged with nearly 11,000 mental health support resources 
  • 2,500+ people have booked one-on-one support appointments through COBALT
  • 3,000+ people have registered to attend group sessions
  • 300+ people have been screened for self-harm and triaged to the appropriate level of care

Further, COBALT is enabling research investigating the effectiveness of a proactive "pushed" model of care on the platform to support the mental health of Penn Medicine HCWs during the response and recovery phases of the COVID-19 pandemic.

The team has released an open-source version of the platform to enable other institutions to offer mental health services to their workforce. Dartmouth and New York University both plan to launch iterations in the coming year.

Finally, COBALT will be one of the platforms used by Penn Integrated Care, a collaborative clinical care model co-developed by the Department of Psychiatry and Penn Primary Care to seamlessly integrate mental health care into the primary care environment.

Way to Health Specs

Learn more about the platform
Activity monitoring
Arms and randomization
Criteria-based rules
Dashboard view
Device integration
eConsent
EHR integration
Email
Enrollment
Gamification
Incentives
IVR
Multiple languages
Patient portal messaging
Patient-reported outcomes capture
Photo messaging
Remote patient monitoring
Schedule-based rules
Survey administration
Two-way texting
Vitals monitoring

Innovation Methods

Fake back end

It is essential to validate feasibility and understand user needs before investing in the design and development of a product or service. A fake back end is a temporary, usually unsustainable, structure that presents...

Fake back end

It was essential to launch COBALT quickly to ensure that HCWs had somewhere to turn for support at the start of the pandemic. Rather than waiting for technology to be fully developed, we moved from concept to launch within two weeks using a simple webpage that required a lot of manual effort on the backend. While maintaining the fake back...

Fake back end

It is essential to validate feasibility and understand user needs before investing in the design and development of a product or service.

A fake back end is a temporary, usually unsustainable, structure that presents as a real service to users but is not fully developed on the back end.

Fake back ends can help you answer the questions, "What happens if people use this?" and "Does this move the needle?"

As opposed to fake front ends, fake back ends can produce a real outcome for target users on a small scale. For example, suppose you pretend to be the automated back end of a two-way texting service during a pilot. In that case, the user will receive answers from the service, just ones generated by you instead of automation.

Fake back end

It was essential to launch COBALT quickly to ensure that HCWs had somewhere to turn for support at the start of the pandemic.

Rather than waiting for technology to be fully developed, we moved from concept to launch within two weeks using a simple webpage that required a lot of manual effort on the backend. 

While maintaining the fake back end, we identified the functionality needed to onboard providers, host live sessions, generate reminders, gather post-session feedback, share newsletters, and more.

We used these insights to develop a scalable and sustainable version of the platform without disrupting service.

Fake front end

Piloting a fake front end involves putting a simulated version of a product – one that doesn't yet actually perform the intended function – into the hands of intended users so that you can observe if and how it will be...

Fake front end

Before developing new features, we socialized basic prototypes with users. For example, when clinicians told us they wanted control over their profiles, we shared prototypes of what that would look like on the platform. However, we received feedback that the fields provided were too open-ended and time-consuming to complete. This led us to...

Fake front end

Piloting a fake front end involves putting a simulated version of a product – one that doesn't yet actually perform the intended function – into the hands of intended users so that you can observe if and how it will be used in context.
 
A fake front end will help you answer the question, "What will people do with this?"
 
The first successful mobile device was created by an innovator who carried a block of wood around in his pocket to see when and why he pulled it out to pretend using it, revealing both what to build and how to build it.

Fake front end

Before developing new features, we socialized basic prototypes with users.

For example, when clinicians told us they wanted control over their profiles, we shared prototypes of what that would look like on the platform. However, we received feedback that the fields provided were too open-ended and time-consuming to complete.

This led us to design a mad-lib style bio generator and offer pre-populated recommendations with the option to customize at the end.