Implementing a Digital Tool to Support Shared Care Planning in Community-Based Mental Health Services: Qualitative Evaluation

Abstract

Background Mental health services aim to provide recovery-focused care and facilitate coproduced care planning. In practice, mental health providers can find supporting individualized coproduced care with service users difficult while balancing administrative and performance demands. To help meet this aim and using principles of coproduction, an innovative mobile digital care pathway tool (CPT) was developed to be used on a tablet computer and piloted in the West of England. Objective The aim of this study was to examine mental health care providers’ views of and experiences with the CPT during the pilot implementation phase and identify factors influencing its implementation. Methods A total of 20 in-depth telephone interviews were conducted with providers participating in the pilot and managers in the host organization. Interviews were audio recorded, transcribed, anonymized, and thematically analyzed guided by the Consolidated Framework for Implementation Research. Results The tool was thought to facilitate coproduced recovery-focused care planning, a policy and organizational as well as professional priority. Internet connectivity issues, system interoperability, and access to service users’ health records affected use of the tool during mobile working. The organization’s resources, such as information technology (IT) infrastructure and staff time and IT culture, influenced implementation. Participants’ levels of use of the tool were dependent on knowledge of the tool and self-efficacy; perceived service-user needs and characteristics; and perceptions of impact on the therapeutic relationship. Training and preparation time influenced participants’ confidence in using the tool. Conclusions Findings highlight the importance of congruence between staff, organization, and external policy priorities and digital technologies in aiding intervention engagement, and the need for ongoing training and support of those intended to use the technology during and after the end of implementation interventions.

Acceptability of a technology-supported and solution-focused intervention (DIALOG+) for chronic depression: views of service users and clinicians

“…On the other hand, some clinicians expressed concerns about the impact of technology on therapeutic alliance and interpersonal dynamics. Similar worries were previously reported by the clinicians testing DIALOG+ with service users with psychosis [15] and those implementing a digital mobile CPT tool [22]. Such views amongst clinicians are well known as barriers to the adoption of technologyenhanced services [33,34].…”

“…The clinicians felt that the intervention made the process of designing care plans more transparent and facilitated co-production of the treatment plans. Similar observations were reported by the clinicians' involved in the study of the implementation of a mobile digital care pathway tool (CPT) [22]. Clinical orientation towards increasing involvement of service users in decision making has been shown to improve satisfaction with the care decisions [23] and reduce decisional conflict [24].…”

A Semiautomated Classification System for Producing Service Directories in Social and Health Care (DESDE-AND): Maturity Assessment Study

“…This pandemic has also shown the relevance of computer modeling, care navigation systems, real-time dashboards, and interactive decision support systems to guide evidence-informed policy. However, to be effective, rapid response digital systems should go beyond traditional semantic interoperability across data sets, and move toward a common coding and counting of service provision (availability, bed capacity, and workforce) from a whole system’s perspective (health, social, housing, employment, education, and justice) [ 3 - 5 ]. This harmonization effort should follow a service ecosystem approach [ 6 ] and focus on the comprehensive assessment of the overall local and regional service availability and capacity as it has also been underscored by the pandemic [ 1 ].…”

Innovative digitale Versorgungsformen zur Personalisierung der stationsäquivalenten Behandlung in der alltäglichen Lebenswelt bei schweren psychischen Erkrankungen [Innovative digital forms of service delivery for personalized crisis resolution and home treatment for people with severe mental health problems]

“…Nur vereinzelt wurde berichtet, dass die Anwendung digitaler Interventionen in der aufsuchenden Behandlung im Bereich der Gerontopsychiatrie vielversprechend sein könnte (Tropea et al, 2019). Allerdings wurden auch hier Implementierungshürden ambulatorischer Intervention beschrieben, die bereits zu einem frühen Stadium der Umsetzung der digitalen StäB erkannt und überwunden werden müssen (Pithara et al, 2020).…”