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利用实施科学将数字心理健康干预措施整合到常规护理中,作为实践研究网络的一部分。

Leveraging Implementation Science to Integrate Digital Mental Health Interventions as part of Routine Care in a Practice Research Network.

机构信息

Reliant Medical Group, OptumCare, Harvard Medical School, Worcester, MA, USA.

Reliant Medical Group, OptumCare, Worcester, MA, USA.

出版信息

Adm Policy Ment Health. 2024 May;51(3):348-357. doi: 10.1007/s10488-023-01292-9. Epub 2023 Aug 24.

Abstract

The supply / demand issue in behavioral health care is a well-established fact, and the mental health toll of the COVID-19 pandemic continues to add challenges to an already taxed system. Existing healthcare models are not set up to adequately address the increasing mental health related needs. As such, innovative models are needed to provide patients with access to appropriate, evidence-based behavioral health care within routine clinical care. This paper introduces Precision Behavioral Health (PBH) as an example of such a model. PBH is an innovative, digital first care delivery model that provides an ecosystem of evidence-based digital mental health interventions to patients as a frontline behavioral health treatment within routine care in a large multispecialty group medical center in the United States. This paper describes the implementation of PBH within a practice research network set-up as part of an integrated behavioral health department. We will present how our team leveraged the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance; "What is RE-AIM?," n.d.) implementation science framework, which emphasizes the design, dissemination, and implementation processes at the individual, staff, and organizational levels, to prioritize key implementation constructs to enhance the successful integration of PBH within routine care. We describe how each of these constructs were operationalized to aid data gathering for rapid evaluation and lessons learned. We discuss the benefits of these types of initiatives across multiple stakeholders including patients, providers, organizations, payers, and digital intervention vendors.

摘要

行为保健中的供需问题是一个既定事实,COVID-19 大流行对心理健康造成的影响继续给本已紧张的医疗系统带来挑战。现有的医疗模式无法充分满足日益增长的心理健康相关需求。因此,需要创新模式,以便在常规临床护理中为患者提供获得适当、基于证据的行为保健的途径。本文以 Precision Behavioral Health(PBH)为例,介绍了这种模式。PBH 是一种创新的、以数字化为主导的护理交付模式,在美国一家大型多专科医疗中心的常规护理中,为患者提供基于证据的数字化心理健康干预措施的生态系统,作为一线行为健康治疗。本文描述了在实践研究网络设置中实施 PBH 的情况,该网络是综合行为健康部门的一部分。我们将介绍我们的团队如何利用 RE-AIM(Reach、Effectiveness、Adoption、Implementation、Maintenance;“什么是 RE-AIM?”,n.d.)实施科学框架,该框架强调了个体、员工和组织层面的设计、传播和实施过程,以优先考虑关键的实施结构,以促进 PBH 在常规护理中的成功整合。我们将描述如何实现这些结构,以帮助收集数据,进行快速评估和总结经验教训。我们将讨论这些类型的计划对包括患者、提供者、组织、支付方和数字干预供应商在内的多个利益相关者的益处。

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