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澳大利亚心理健康服务改革的技术支持解决方案:影响评估。

Technology-Enabled Solutions for Australian Mental Health Services Reform: Impact Evaluation.

作者信息

LaMonica Haley M, Milton Alyssa, Braunstein Katharine, Rowe Shelley C, Ottavio Antonia, Jackson Tanya, Easton Michael A, Hambleton Ashlea, Hickie Ian B, Davenport Tracey A

机构信息

Brain and Mind Centre, The University of Sydney, Camperdown, Australia.

InnoWell, Camperdown, Australia.

出版信息

JMIR Form Res. 2020 Nov 19;4(11):e18759. doi: 10.2196/18759.

Abstract

BACKGROUND

Health information technologies (HITs) are becoming increasingly recognized for their potential to provide innovative solutions to improve the delivery of mental health services and drive system reforms for better outcomes.

OBJECTIVE

This paper describes the baseline results of a study designed to systematically monitor and evaluate the impact of implementing an HIT, namely the InnoWell Platform, into Australian mental health services to facilitate the iterative refinement of the HIT and the service model in which it is embedded to meet the needs of consumers and their supportive others as well as health professionals and service providers.

METHODS

Data were collected via web-based surveys, semistructured interviews, and a workshop with staff from the mental health services implementing the InnoWell Platform to systematically monitor and evaluate its impact. Descriptive statistics, Fisher exact tests, and a reliability analysis were used to characterize the findings from the web-based surveys, including variability in the results between the services. Semistructured interviews were coded using a thematic analysis, and workshop data were coded using a basic content analysis.

RESULTS

Baseline data were collected from the staff of 3 primary youth mental health services (n=18), a counseling service for veterans and their families (n=23), and a helpline for consumers affected by eating disorders and negative body image issues (n=6). As reported via web-based surveys, staff members across the services consistently agreed or strongly agreed that there was benefit associated with using technology as part of their work (38/47, 81%) and that the InnoWell Platform had the potential to improve outcomes for consumers (27/45, 60%); however, there was less certainty as to whether their consumers' capability to use technology aligned with how the InnoWell Platform would be used as part of their mental health care (11/45, 24% of the participants strongly disagreed or disagreed; 15/45, 33% were neutral; and 19/45, 42% strongly agreed or agreed). During the semistructured interviews (n=3) and workshop, participants consistently indicated that the InnoWell Platform was appropriate for their respective services; however, they questioned whether the services' respective consumers had the digital literacy required to use the technology. Additional potential barriers to implementation included health professionals' digital literacy and service readiness for change.

CONCLUSIONS

Despite agreement among participants that HITs have the potential to result in improved outcomes for consumers and services, service readiness for change (eg, existing technology infrastructure and the digital literacy of staff and consumers) was noted to potentially impact the success of implementation, with less than half (20/45, 44%) of the participants indicating that their service was ready to implement new technologies to enhance mental health care. Furthermore, participants reported mixed opinions as to whether it was their responsibility to recommend technology as part of standard care.

摘要

背景

健康信息技术(HITs)在提供创新解决方案以改善心理健康服务提供情况及推动系统改革以实现更好成果方面的潜力日益得到认可。

目的

本文描述了一项研究的基线结果,该研究旨在系统监测和评估将一种健康信息技术,即InnoWell平台,应用于澳大利亚心理健康服务的影响,以促进该健康信息技术及其所嵌入的服务模式的迭代优化,从而满足消费者及其支持人员以及健康专业人员和服务提供者的需求。

方法

通过基于网络的调查、半结构化访谈以及与实施InnoWell平台的心理健康服务机构的工作人员举办的研讨会收集数据,以系统监测和评估其影响。使用描述性统计、Fisher精确检验和可靠性分析来描述基于网络调查的结果,包括各服务机构之间结果的变异性。半结构化访谈采用主题分析进行编码,研讨会数据采用基本内容分析进行编码。

结果

从3家主要的青少年心理健康服务机构(n = 18)、一家为退伍军人及其家属提供的咨询服务机构(n = 23)以及一条为受饮食失调和负面身体形象问题影响的消费者提供的热线服务机构(n = 6)的工作人员处收集了基线数据。通过基于网络的调查所报告的情况,各服务机构的工作人员一致同意或强烈同意,将技术作为其工作的一部分是有益的(38/47,81%),并且InnoWell平台有潜力改善消费者的治疗效果(27/45,60%);然而,对于其消费者使用技术的能力是否与InnoWell平台作为其心理健康护理一部分的使用方式相匹配,存在较少的确定性(11/45,24%的参与者强烈不同意或不同意;15/45,33%持中立态度;19/45,42%强烈同意或同意)。在半结构化访谈(n = 3)和研讨会上,参与者一致表示InnoWell平台适用于他们各自的服务机构;然而,他们质疑各自服务机构的消费者是否具备使用该技术所需的数字素养。实施的其他潜在障碍包括健康专业人员的数字素养以及服务机构对变革的准备情况。

结论

尽管参与者一致认为健康信息技术有潜力为消费者和服务带来更好的结果,但服务机构对变革的准备情况(例如现有的技术基础设施以及工作人员和消费者的数字素养)被指出可能会影响实施的成功,不到一半(20/45,44%)的参与者表示他们的服务机构准备好实施新技术以加强心理健康护理。此外,对于推荐技术作为标准护理的一部分是否是他们的责任,参与者的意见不一。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b758/7714649/f3868b9b16b4/formative_v4i11e18759_fig1.jpg

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