Barriers and facilitators of videoconferencing psychotherapy implementation in veteran mental health care environments: a systematic review

Muir, Samuel; Boer, Kathleen de; Nedeljkovic, Maja; Meyer, Denny

doi:10.1186/s12913-020-05858-3

“…Virtual care health technologies such as synchronous and asynchronous telehealth, mobile applications, text-messaging applications, wearable/implantable biosensors, and patient-generated health data deployed in the setting of an integrated electronic health record (EHR) with and advanced analytic capabilities create the potential for huge benefits in the delivery and coordination of clinical care (Brown et al, 2014 ; Hermes et al, 2019 ; Hilty et al, 2019 ; Keyworth et al, 2018 ; Rathbone & Prescott, 2017 ). Barriers to implementation of virtual care include systemic barriers at the organizational level (governance models, lack of guidance regarding clinical integration), environmental (low levels of digital health literacy, lack of understanding of benefits, lack of training, learning new workflows), lack of infrastructure (poor wi-fi, lack of logistics for supplying equipment and access, poor integration of EHR systems), logistical barriers (scheduling, staffing), lack of resources (space, equipment, funding, time), challenges with collaboration (bureaucratic delays, communication), and policy issues (Armstrong et al, 2018 ; Hilty et al, 2018 ; Maheu et al, 2018 ; Muir et al, 2020 ; Torous et al, 2018 ; Zhou et al, 2019 ).…”

Section: Introductionmentioning

confidence: 99%

“…Implementation science, including the analysis of barriers and facilitators of adoption, provides a conceptual framework to systematically identify and evaluate strategies in order to identify the most effective and efficient implementation strategies (Kirchner et al, 2020 ; Morris et al, 2011 ; Nilsen, 2015 ). Facilitators of virtual care adoption include clinical staff (dedicated clinicians, experience with innovation, motivation, training), other staff (champions, coordinators, leadership support, external facilitators), and having an implementation strategy (tailored approach, pilot sites, standardized procedures) (Armstrong, 2019 ; Armstrong et al, 2020 ; Gould et al, 2019 ; Muir et al, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

Results and Lessons Learned when Implementing Virtual Health Resource Centers to Increase Virtual Care Adoption During the COVID-19 Pandemic

Armstrong

¹

,

Wilck

²

,

Murphy

³

et al. 2021

J. technol. behav. sci.

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Implementation efforts to increase adoption of health technologies (e.g., telehealth, mobile health, electronic health records, patient portals) have commonly focused on increasing the adoption of specific health technologies in specific service lines. To facilitate adoption of multiple health technologies across a hospital setting, four Virtual Health Resource Centers (VHRCs) were established to provide clinical adoption support to healthcare staff and patients in four hospitals in a large healthcare system. This study spanned a 3-year period, with the first half including pre-implementation efforts, and the second half involved in implementation efforts. In order to compare sites to the national population, a binomial regression was used which allowed for adjustment of relevant covariates (e.g., differences in number of enrollees, level of complexity of facility). The pre-implementation phase and the initial year-and-a-half of the implementation phase resulted in an increase in internal facilitators’ knowledge and skills of virtual care technologies, an increase in facilitator and site capacity, and high levels of adherence to implementation strategies were maintained across sites. Virtual care utilization increased across all sites and across the healthcare system during the implementation phase; however, a comparison to the increase in national level virtual care utilization metrics yielded no meaningful difference. While many implementation strategies aim to increase the adoption of a particular health technology product (e.g., a particular app or remote monitoring use case), the establishment of VHRCs may increase efficiencies in delivery of virtual care training and consultation to healthcare staff and patients, which may increase capacity and decrease barriers to adoption. However, due to the impact of the COVID-19 pandemic on the need for rapid adoption of technology and decreased in person care and services, it is not yet known the longer term impact that the establishment of VHRCs may have on the sustained adoption of health technologies.

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“…O tipo de tecnologia utilizada pode ser um facilitador do atendimento remoto, o que foi observado por meio da utilização de plataformas de fácil manuseio, às quais professores e alunos já estavam habituados. Entretanto, há de se ressaltar que os alunos que habitam em áreas de maior vulnerabilidade tiveram dificuldades de acesso a essas plataformas, o que interferiu na oferta de cuidado 32 . Além da facilidade de adaptação à tecnologia, a existência prévia da estrutura do serviço, com uma equipe de profissionais já formada, fez com que a implementação fosse mais rápida e possibilitou sua manutenção 33 .…”

Section: Discussionunclassified

Implementação de teleatendimento em saúde mental para estudantes de Medicina durante a pandemia da Covid-19

Liberal

¹

,

Bordiano

²

,

Lovisi

³

et al. 2021

Rev. bras. educ. med.

28

0

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Introduction: The COVID-19 pandemic can be considered a severely stressful event and trigger negative repercussions on the mental health of medical students, such as psychological distress and the development or worsening of mental disorders, harming the academic, social and professional life of these students. As a result of the interruption of classes and the social distancing measures advocated by health agencies during the pandemic, the mental health care sector for medical students at the Federal University of Rio de Janeiro (UFRJ) needed to cancel the face-to-face care at the Clementino Fraga Filho University Hospital in early March 2020 and think of other forms of mental health care for these students. Experience report: This is an experience report about the implementation of telemental health care for medical students at UFRJ during the pandemic, for the continuity of mental health care program using remote assistance, started in late March 2020. The service is being offered by a team of five psychiatrists, a psychologist and a social worker, all university employees. Discussion: The teleservice has served as an important space for listening and embracement in face of these students’ psychosocial demands, whose challenge consists in overcoming some barriers that hinder the availability of and access to mental health services on the university campus, including the preservation of the doctor-patient relationship, the guarantee of confidentiality and quality, and the offer of a space for mental health care when the physical presence is not possible. Conclusion: Despite the difficulties inherent in the rapid process of implementing this service, the potential of technology to help the population at this critical moment is perceived, especially regarding the attention to the mental health of specific groups, such as medical students. The telehealth represents a potential for learning and change in the ways how the access to care is offered, with the perspective of bringing benefits to the students’ mental health, even after the current period of the pandemic, with the goal of expanding these services to other courses of the UFRJ.

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“…The type of technology used can facilitate remote care, which was observed through the utilization of easyto-use platforms, which teachers and students were already accustomed to. However, it should be noted that students who live in areas of greater vulnerability had difficulties in accessing these platforms, which interfered with the provision of care 32 .…”

Section: Discussionmentioning

confidence: 99%

Implementation of a telemental health service for medical students during the COVID-19 pandemic

Liberal

¹

,

Bordiano

²

,

Lovisi

³

et al. 2021

Rev. bras. educ. med.

3

0

View full text Add to dashboard Cite

Introduction: The COVID-19 pandemic can be considered a severely stressful event and trigger negative repercussions on the mental health of medical students, such as psychological distress and the development or worsening of mental disorders, harming the academic, social and professional life of these students. As a result of the interruption of classes and the social distancing measures advocated by health agencies during the pandemic, the mental health care sector for medical students at the Federal University of Rio de Janeiro (UFRJ) needed to cancel the face-to-face care at the Clementino Fraga Filho University Hospital in early March 2020 and think of other forms of mental health care for these students. Experience report: This is an experience report about the implementation of telemental health care for medical students at UFRJ during the pandemic, for the continuity of mental health care program using remote assistance, started in late March 2020. The service is being offered by a team of five psychiatrists, a psychologist and a social worker, all university employees. Discussion: The teleservice has served as an important space for listening and embracement in face of these students’ psychosocial demands, whose challenge consists in overcoming some barriers that hinder the availability of and access to mental health services on the university campus, including the preservation of the doctor-patient relationship, the guarantee of confidentiality and quality, and the offer of a space for mental health care when the physical presence is not possible. Conclusion: Despite the difficulties inherent in the rapid process of implementing this service, the potential of technology to help the population at this critical moment is perceived, especially regarding the attention to the mental health of specific groups, such as medical students. The telehealth represents a potential for learning and change in the ways how the access to care is offered, with the perspective of bringing benefits to the students’ mental health, even after the current period of the pandemic, with the goal of expanding these services to other courses of the UFRJ.

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Barriers and facilitators of videoconferencing psychotherapy implementation in veteran mental health care environments: a systematic review

Cited by 19 publications

References 58 publications

Results and Lessons Learned when Implementing Virtual Health Resource Centers to Increase Virtual Care Adoption During the COVID-19 Pandemic

Results and Lessons Learned when Implementing Virtual Health Resource Centers to Increase Virtual Care Adoption During the COVID-19 Pandemic

Implementação de teleatendimento em saúde mental para estudantes de Medicina durante a pandemia da Covid-19

Implementation of a telemental health service for medical students during the COVID-19 pandemic

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