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With 300 Interventions a Month During COVID, the TryCycle Recovery App a Critical Digital Tether

January 19, 2022

The cliche that “there’s an app for that” has meant a strong record of success for many outpatients at Rushford. A Hartford HealthCare Center of Excellence, and a leader in substance use prevention and treatment for more than 40 years, Rushford has been recognized by the Connecticut Department of Mental Health and Addiction Services for its research-based treatment models and proven prevention initiatives. Rushford has now added virtual programming to its roster of successes, as data from its just-completed three-year, $1.5 million grant from the Substance Abuse and Mental Health Services Administration (SAMHSA). The grant, awarded in 2018, allowed the facility to add virtual health and digital access to its care programs, long before the COVID pandemic made those features a staple in healthcare. The grant paid for the equipment and staff training needed to provide Rushford’s outpatient community with increased access to care, ranging from check-ins with Recovery Support Specialists to group therapies and the addition of a mobile app called TryCycle. Melissa Monroe, clinical director at Rushford, said that the time when a person transitions from inpatient to outpatient treatment “can be the highest risk for overdose or death, either accidental or by suicide.” The grant gave these patients access to TryCycle, which allowed patients to check in “in the moment” and engage with care providers. The grant also provided funding to hire two Recovery Support Specialists (RSS). An RSS is someone who often times has had lived experience, and now provides support for anyone coming into an Emergency Department or other entry point for treatment. The RSS staff is so successful that Rushford has since added two more. “Since 2018 we have had more than 7,000 clinical interventions using our digital tool,” Monroe said. “Our system has had many unfortunate deaths by suicide and overdose but not one of those clients was engaged with our RSS team, not one death in three years.” Monroe noted that at the start of the pandemic, in March 2020, they were averaging 25 interventions a month. Currently the average is around 250 a month, and in December it was more than 300. “I am not sure how we would have retained clients during the beginning of the pandemic if we didn’t have the digital services and the RSS team we had in place,” Monroe said. “When the pandemic started, we easily moved everyone over to telehealth because we had everything in place.” TryCycle works as a “digital tether” between clinicians and their patients. In the spaces between scheduled visits and in-person appointments, TryCycle can increase communication and improve engagement. Patients use the app to gauge how they are feeling about their substance use and any triggers they might be experiencing, as well as on their mental health. Clinicians, including RSS, are notified in real time and can respond appropriately. Monroe said more than 1,300 patients have been added to the app since 2018, and around 150 active patients are using TryCycle at least 1-2 times/week. Data indicates that program retention (completing the program successfully) of TryCycle users over non-users is:

  • 40.2  percent at 30 days.
  • 53.7 percent at  60 days.
  • 31.8 percent at 90 days.
Patient stories also show that the app has had a major, lifesaving impact on outpatient treatment. In one such story, a client used TryCycle to self-report thoughts of Self-Harm, Sleep Trouble, Tiredness and Poor Appetite nearly every day. This input triggered a High Risk alert to the care team. The Recovery Support Specialist (RSS) reviewed the real-time data in TryCycle, observing that the client had expressed suicidal ideation in the app's journal section. The client wrote, “I’m worried that my passive thoughts are turning into more than just ideations; I’ve started to come up with a plan.” The RSS responded quickly and was able to get the client to the Emergency Department (ED). The client continued to use the app while in the ED to dialogue with the treatment team. This client credited the TryCycle app and the RSS team for saving her life.” Monroe said that connections via the app aren’t all dire emergencies, and clients use it to convey good news as well, including notes like “I had my baby!” to “I’m back from vacation and feeling good.” “It’s provided a whole new level of engagement with patients,” she said.