The Interactive Mobile App Review Toolkit (IMART): a Clinical Practice-Oriented System

The inadequacy of infrastructure for bringing mobile healthcare apps from developers to clinical practitioners has kept the 165,000+ currently available healthcare apps from integration into routine clinical practice. The absence of regulatory and certification processes and the unlikelihood that many apps will be tested with credible clinical trials leaves it up to expert reviews to lead clinicians to high-quality apps. However, most app reviews are not collected in an easily searchable location that facilitates comparison of the merits of alternative apps, and surveys of existing expert reviews reveal a lack of standards for objective and reliable assessments. Furthermore, most published recommendations for apps are not based on their validity or appropriateness for clinical use.This article describes development of the Interactive Mobile App Review Toolkit (IMART), a technology-assisted system for producing verifiable app reviews intended for clinicians and its accompanying evidence-based thesaurus of standards. IMART will present systematized reviews in a searchable, curated library where clinicians can find and compare reviews about apps that are tagged as to the treatment needs of clients/patients and that address how the apps could be integrated into the visitor’s clinical practice.The assessment criteria in the “Digital Health Standards Thesaurus” can be used in reviewing apps and other digital health products, in developing apps, in making decisions about investing venture capital or foundation funds into concepts for new digital health products, and in selecting such products into the “formularies” of third party payers

The mental health professional and the new technologies : a handbook for practice today

In the last two decades, new communication technologies have dramatically changed the world in which mental health professionals and their patients live. Developments such as e-mail, online chat groups, Web pages, search engines, and electronic databases are directly or indirectly affecting most people's routines and expectations. Other developments are poised to do so in the near future. Already, for example, patients are acquiring both good and bad advice and information on the Web; many expect to be able to reach their therapists by e-mail. And already there is pressure from third party payers for providers to submit claims electronically. These technological breakthroughs have the potential to make mental health care more widely available and accessible, affordable, acceptable to patients, and adaptable to special needs. But many mental health professionals, as well as those who train them, are skeptical about integrating the new capabilities into their services and question the ethical and legal appropriateness of doing so. Those unfamiliar with the technologies tend to be particularly doubtful. How much e-mail contact with patients should I encourage or permit, and for what purposes? Why should I set up a Web site and how do I do so and what should I put on it? Should I refer patients to chat groups or Web-based discussion forums? Could video-conferencing be a helpful tool in some cases and what is involved? How do I avoid trouble if I dare to experiment with innovations? And last but not least, will the results of my experimentation be cost-effective? In this wide-ranging and practical handbook, five experts, each with a different vantage point and training, systematically guide readers through the new practice arenas already made possible by current information technologies--ranging from Internet-wired offices to wearable computers--and point to those on the horizon. Throughout, the authors clearly define terminology for the beginner and illuminate their points with rich, clinical vignettes and first-person accounts of the experience of pioneering practitioners. The book includes: *an extensive overview of legal and regulatory issues, such as those raised by the Health Insurance Portability and Accountability Act (HIPAA); *concrete technical, ethical and managerial suggestions summarized in a seven-step Online Consultation Risk Management model; and *"How to" resource lists and sample documents of use to beginners and experienced professionals alike. For better or worse, no mental health professional today can avoid confronting the issues presented by the new technologies. The Mental Health Professional and the New Technologies: A Handbook for Practice Today will enormously simplify the job of thinking through the issues and making clinically, ethically, and legally prudent decisions. Contents: Preface. Introduction to Technology in Mental and Behavioral Health. Technicalities. A Professional Online Presence. Professional Web Site Considerations. Audio & Videoconferencing. Computer-Aided Assessment. Computer-Aided Psychotherapy. Electronic Practice Management and the Computer-Based Patient Record. Legal, Regulatory and Reimbursement Issues. Standards of Practice. Online Consultation: Training. Online Consultation: Referrals, Client Education, and Consent. Online Consultation: Delivering Clinical Care. The Near Future. The Distant Future. Epilogue: A Checklist of Immediate Steps. Appendices: Comparative Studies of Psycho-Technologies in Mental Health. Sample Listserv Guidelines. Draft International Convention for Telemedicine and Telehealth. Patient Consent Form

Findings and Guidelines on Provider Technology, Fatigue, and Well-being: Scoping Review

BackgroundVideo and other technologies are reshaping the delivery of health care, yet barriers related to workflow and possible provider fatigue suggest that a thorough evaluation is needed for quality and process improvement. ObjectiveThis scoping review explored the relationship among technology, fatigue, and health care to improve the conditions for providers. MethodsA 6-stage scoping review of literature (from 10 databases) published from 2000 to 2020 that focused on technology, health care, and fatigue was conducted. Technologies included synchronous video, telephone, informatics systems, asynchronous wearable sensors, and mobile health devices for health care in 4 concept areas related to provider experience: behavioral, cognitive, emotional, and physical impact; workplace at the individual, clinic, hospital, and system or organizational levels; well-being, burnout, and stress; and perceptions regarding technology. Qualitative content, discourse, and framework analyses were used to thematically analyze data for developing a spectrum of health to risk of fatigue to manifestations of burnout. ResultsOf the 4221 potential literature references, 202 (4.79%) were duplicates, and our review of the titles and abstracts of 4019 (95.21%) found that 3837 (90.9%) were irrelevant. A full-text review of 182 studies revealed that 12 (6.6%) studies met all the criteria related to technology, health care, and fatigue, and these studied the behavioral, emotional, cognitive, and physical impact of workflow at the individual, hospital, and system or organizational levels. Video and electronic health record use has been associated with physical eye fatigue; neck pain; stress; tiredness; and behavioral impacts related to additional effort owing to barriers, trouble with engagement, emotional wear and tear and exhaustion, cognitive inattention, effort, expecting problems, multitasking and workload, and emotional experiences (eg, anger, irritability, stress, and concern about well-being). An additional 14 studies that evaluated behavioral, emotional, and cognitive impacts without focusing on fatigue found high user ratings on data quality, accuracy, and processing but low satisfaction with clerical tasks, the effort required in work, and interruptions costing time, resulting in more errors, stress, and frustration. Our qualitative analysis suggests a spectrum from health to risk and provides an outline of organizational approaches to human factors and technology in health care. Business, occupational health, human factors, and well-being literature have not studied technology fatigue and burnout; however, their findings help contextualize technology-based fatigue to suggest guidelines. Few studies were found to contextually evaluate differences according to health professions and practice contexts. ConclusionsHealth care systems need to evaluate the impact of technology in accordance with the Quadruple Aim to support providers’ well-being and prevent workload burden, fatigue, and burnout. Implementation and effectiveness approaches and a multilevel approach with objective measures for clinical, human factors, training, professional development, and administrative workflow are suggested. This requires institutional strategies and competencies to integrate health care quality, technology and well-being outcomes