Camacho Erica, Torous John
Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
J Ment Health. 2022 Dec;31(6):816-824. doi: 10.1080/09638237.2021.1922634. Epub 2021 May 30.
Treatment programs for early-course psychosis are evidence-based interventions that provide specialty care to improve outcomes in patients. Digital technologies offer the potential to augment services and meet the growing demand for care.
We introduce a framework to guide the assessment of site readiness for technology and their ability to successfully introduce, implement, and sustain digital technology use. While broader in use that early course psychosis, we focus on this use case to introduce the theory and clinical application.
Adapting the replicating effective programs framework, we present an early psychosis focused model. Considering the unique opportunities and challenges of these programs, we present a five-stage evaluation framework. Informed by our clinical experience and recent literature, we present tools and examples to help programs plan and execute successful technology implementation.
The AACCS framework is comprised of five stages: (1) Access (e.g. identifying access to and comfort with technology), (2) Align (e.g. understanding aspects technology can augment), (3) Connect (e.g. customizing technology to stakeholder needs), (4) Care (e.g. implementing technology into treatment), and (5) Sustain (e.g. creating sustainable services). Site visits revealed patients have access to digital tools and are open to implementation into care, while staff prefers digital skills training.
This framework assists programs in identifying clinical targets to be augmented with technology, stages of implementation, and recommendations for sustaining meaningful technology use.
早期精神病治疗项目是基于证据的干预措施,为患者提供专科护理以改善治疗效果。数字技术有潜力增强服务并满足日益增长的护理需求。
我们引入一个框架,以指导对技术应用场所准备情况及其成功引入、实施和持续使用数字技术能力的评估。虽然该框架的应用范围比早期精神病更广,但我们聚焦于此用例来介绍相关理论和临床应用。
我们改编了复制有效项目框架,提出了一个针对早期精神病的模型。考虑到这些项目的独特机遇和挑战,我们提出了一个五阶段评估框架。基于我们的临床经验和近期文献,我们给出了工具和示例,以帮助项目规划和执行成功的技术实施。
AACCS框架由五个阶段组成:(1)获取(例如确定对技术的获取途径和熟悉程度),(2)协调(例如了解技术可增强的方面),(3)连接(例如根据利益相关者需求定制技术),(4)护理(例如将技术应用于治疗),以及(5)维持(例如创建可持续的服务)。实地考察显示患者能够使用数字工具并且愿意将其应用于护理,而工作人员则更喜欢数字技能培训。
该框架有助于项目确定可通过技术增强的临床目标、实施阶段以及维持有意义的技术使用的建议。