Division of Hospital Medicine, Clinical Informatics, University of California, San Francisco, San Francisco, CA, USA.
Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA.
Curr Psychiatry Rep. 2018 Aug 28;20(10):85. doi: 10.1007/s11920-018-0954-3.
Mental health clinicians should understand how technologies augment, enhance, and provide alternate means for the delivery of mental healthcare. These technologies can be used asynchronously, in which the patient and the clinician need not be communicating at the same time. This contrasts with synchronous technologies, in which patient and clinician must communicate at the same time.
The review is based on research literature and the authors' clinical and healthcare administration experiences. Asynchronous technologies can exist between a single clinician and a single patient, such as patient portal e-mail and messaging, in-app messaging, asynchronous telepsychiatry via store-and-forward video, and specialty patient-to-provider mobile apps. Asynchronous technologies have already been used in different countries with success, and can alleviate the psychiatric workforce shortage and improve barriers to access. Multiple studies referred to in this review demonstrate good retention and acceptability of asynchronous psychotherapy interventions by patients. Asynchronous technologies can alleviate access barriers, such as geographical, scheduling, administrative, and financial issues. It is important for clinicians to understand the efficacy, assess the ethics, and manage privacy and legal concerns that may arise from using asynchronous technologies.
心理健康临床医生应了解技术如何增强、提升和提供替代的精神卫生保健服务方式。这些技术可以异步使用，即患者和临床医生不必同时进行交流。这与同步技术形成对比，在同步技术中，患者和临床医生必须同时进行交流。
本综述基于研究文献以及作者的临床和医疗保健管理经验。异步技术可以存在于单个临床医生和单个患者之间，例如患者门户电子邮件和消息传递、应用内消息传递、通过存储转发视频进行异步远程精神病学，以及专门的患者与提供者移动应用程序。异步技术已经在不同国家成功应用，可以缓解精神科劳动力短缺问题，并改善获取服务的障碍。本综述中提到的多项研究表明，患者对异步心理治疗干预措施的保留率和可接受性良好。异步技术可以缓解获取障碍，例如地理、日程安排、行政和财务问题。临床医生了解疗效、评估伦理问题以及管理可能因使用异步技术而产生的隐私和法律问题非常重要。
