New Frontiers in Healthcare and Technology: Internet-and Web-Based Mental Options Emerge to Complement In-Person and Telepsychiatric Care Options

Abstract

Background: Web and Internet-based resources are remarkably popular with the public, patients and others as a way to access mental health information, tools for self-care, advice/consultation from a professional, and providerdirected treatments.Objective: This paper provides a framework of a spectrum that includes person-centered health education options (conceptual endpoint), patient and caregiver-centered mental health care interventions (evidence-based literature review), and more formal provider-directed treatments (conceptual endpoint). Methods:The evidence-based literature review was focused on treatment studies, using a minimum of three key words and the 1996-2015 period, resulting in 13,612 articles. This was reduced to 388 (title words used), to 125 (abstracts for methods, design, and outcomes) and 40 (evidence-based criteria of guidelines). Results:Technology is frequently used, is readily accessible and satisfies persons, patients, and caregivers. Its impact on openness to engage with others and begin self-care appears very positive; its ability to help people change behaviors and engage additional clinical services appears modest, though this is inadequately evaluated. Formal treatments over the Internet, asynchronous care models, or traditional video-based synchronous services are as good as or better than in-person services, though an incomplete range of services has been evaluated. Relatively few treatment studies assess outcomes, compare in-person and e-MentalHealth care, and or compare technology-based care options to one another; hybrid models of care have emerged, but have rarely been studied. Conclusions:For persons or patients not in care, use of the internet for common, non-acute problems appears to work, though a one-time clinical evaluation may help them place options in context. Clinicians and patients should specifically plan how to use technology and exercise sound judgment, based on guidelines when available. More research is needed on the application of new technologies to clinical care, with randomized trials and health services studies for effectiveness suggested. Internet-based mental health (MH) education and services are on the rise, as more patients, caregivers, and MH providers are using the Internet. This is driven by consumers or persons at-large, before they become patients in traditional services, and transitions our thinking from clinic-based care past patient-centered care to person-centered care known as participatory medicine [19][20][21]. MH-related, technology-based services exist on a continuum: self-help/support groups -well-prepared materials for patient psychoeducation and provider professional education -tips for assessment and selfcare (e.g., depression) -informal provider consultation online -asynchronous communication with providers -MH services with professionals like teleMH ((TMH) care or; Internet-based cognitive behavioral treatment (CBT) [22][23][24][25][26][27][28][29][30]. New Frontiers in Healthcare andConsumers, patients, caregivers and provi...

Human Behavior with Mobile Health: Smartphone/ Devices, Apps and Cognition

“…The review of the literature was conducted as per previously described methods 1,6 using title word searches within the MEDLINE, PubMed, PsychInfo, Embase, Science Citation Index, Social Sciences Citation Index, Telemedicine Information Exchange databases, Centre for Reviews and Dissemination and The Cochrane Library Controlled Trial Registry databases for the period of May 2003 to May 2018. Primary words: apps, behavior, cognition, cognitive, devices, function, mobile, patient, practice, quality, satisfaction, service, smartphones, and technology.…”

“…24 Mental health promotion in children and adolescents is increasing, too (e.g., Kindertelefoon (www.kindertelefoon.nl). 6 mH Approaches and Themes mH is able to incorporate qualities often associated with conventional health communication methods, such as personalization, tailoring, interactivity, and message repetition at a relatively low cost. 25 An estimated 69% of the U.S. adult population track at least 1 health indicator, such as activity, weight, or symptoms 26 at home or within primary care.…”

“…Broad areas of research are clinician-to-clinician, clinician-to-patient and patient as mobile compared to stationery. Clinicians need a framework 6 and skills/competencies 1 to meet needs of consumers, patients, caregivers and other providers related to technology. mH and other technologies alter care in terms of communication, boundaries and privacy/confidentiality.…”

“…But they have been adjusted so specific patient groups (e.g., "Fear Fighter", computer guided self-exposure approach to treat phobia/panic disorder; e.g., PTSD Coach from the National Center for Telehealth and Technology to learn about and manage trauma). 6 Exposure therapy is effective for phobia/panic, but some patients prefer technology and qualified therapists are scarce; this increases healthcare efficiency. Soldiers prefer to complete psychometric measures (e.g., Patient Health Questionnaire or PHQ-9) and other military population measures by iPhone rather than paper or computer due to its interface, portability, and convenience.…”

“…[4][5] mH, telemedicine and other services are considered part of a telehealth or e-health (eH) spectrum of care, including e-behavioral health (eBH). [6][7] Traditional telehealthcare services have been provided synchronously by video conferencing 7 or asynchronously. 8 mH and its corresponding mobility components are central to healthcare monitoring and alerting systems, clinical and administrative data collection, record maintenance, delivery programs, medical information awareness, detection and prevention systems, drug-counterfeiting and theft.…”