Clinician Perspectives and Design Implications in Using Patient-Generated Health Data to Improve Mental Health Practices: Mixed Methods Study (Preprint)

Abstract

BACKGROUND Patient-generated health data (PGHD) has been largely collected through mobile-based health applications (mHealth apps) and wearable devices. PGHD can be especially helpful in mental health, since patients’ illness history and symptom narratives are vital to developing diagnoses and treatment plans. However, the extent of clinicians’ use of mental health-related PGHD is unknown. OBJECTIVE A mixed-method study was conducted to understand clinicians’ perspectives on PGHD and current mental health apps. This approach built on information gathered from semi-structured interviews, workflow analysis, and user-written mental health app reviews to answer the following research questions: 1) What is the current workflow of mental health practice and how is PGHD integrated in this workflow? 2) What are physician perspectives on PGHD and how do they choose mobile apps for their patients? 3) What are the features of current mobile apps in terms of interpreting and sharing PGHD? METHODS The study consisted of semi-structured interviews with 12 psychiatrists and clinical psychologists from a large academic hospital. These interviews were then thematically and qualitatively analyzed for common themes and workflow elements. App-user reviews were then analyzed to understand app features and their usability in comparison to the information gathered from interviews. RESULTS The results showed that PGHD has been part of the workflow, but its integration and use are not optimized. Mental health clinicians supported the use of PGHD but also identified challenges in selecting suitable apps for their patients. From the app review, it was shown that mHealth apps had limited features to support personalization and collaborative care and had data interpretation and sharing issues. Based on the findings, design implications were discussed with the goal of improving PGHD use within and mHealth app design for mental health practice. CONCLUSIONS The study showed that PGHD has not been used optimally in mental health practices. Clinicians expressed concerns regarding how PGHD may be used to improve workflow and how it may be integrated with current EHR systems. Moreover, mental health clinicians also faced challenges in helping their patients choosing appropriate apps. Finally, several design implications were identified from the results of the app review that will be used to drive future research regarding PGHD use in mental health. CLINICALTRIAL None