Implementation of the Flexible Assertive Community Treatment (FACT) Model in Norway: eHealth Assessment Study

Abstract

Background Flexible Assertive Community Treatment (FACT) is a model for treatment of long-term severe mental disorders. This method has become more widespread in Norway. Objective The objective of our study was to examine how the implementation of FACT teams in Norway has been affected by eHealth policy, infrastructure, and regulations. Another objective was to examine existing literature on eHealth interventions and challenges within FACT teams. Methods We have examined Norwegian policy regulating mental health services, laws and regulations, eHealth infrastructure, relevant literature on FACT teams, and current implementation of FACT in Norway. Results FACT teams are a wanted part of the Norwegian service system, but the current eHealth infrastructure makes sharing of data within teams and levels of health care challenging, even if eHealth regulations allow such sharing. This has been shown to be an issue in the current implementation of FACT teams in Norway. There is little or no existing research on the eHealth challenges facing FACT teams. Conclusions Weaknesses in the Norwegian eHealth infrastructure have been a barrier for an easy implementation of FACT teams in Norway. It is difficult to share information between the different levels of health care. We need systems that allow for easy, secure sharing of health information to and between the FACT team members and other involved health care workers.

Flexible Assertive Community Treatment in Rural and Remote Areas: A Qualitative Study of the Challenges and Adaptations of the Model

“…Studies have shown that ACT ( 14 ) and FACT ( 13 ) teams can mitigate the problem of long travel distances using digital meetings, including in situations of crisis management ( 14 ). Both the present study and another Norwegian study ( 74 ), described how virtual tools increased in the FACT teams because to the COVID-19 pandemic, and one might state that the pandemic therefore contributed in this adaption, possibly also in urban regions. However, both studies showed that digital solutions do not work in all situations; this modification is not always a suitable solution in patient care.…”

Experiences and Expectations of Information and Communication Technologies in Flexible Assertive Community Treatment Teams: Qualitative Study

“…During the semistructured interviews, the team leaders and team coordinators in all five teams were interviewed one-to-one using an interview guide. The questions in the interview guide, provided in Textbox 1, were based on previous knowledge of the use of ICT tools in Norwegian FACT teams [9]. The interviews varied in length from 30 to 60 minutes.…”

“…However, there are several different EHR systems in use in primary care. Since most FACT teams are organized as a cooperation between specialist care and one or more municipalities, this leads to several different EHR systems being available for most teams [9]. FACT teams have daily meetings, where they go through their list of patients who require intensive follow-up to keep all team members updated on the patient's status and further treatment plans.…”

“…While the implementation of FACT teams in Norway has largely been a success, several challenges with the ICT tools used by FACT teams have been reported [9]. The aim of this study was to explore the experiences and expectations of FACT teams with the ICT tools that are relevant in their work.…”

Healthcare professionals’ experiences of eHealth in palliative care for older people: challenges, compromises and the price of dignity

“…HCPs are facing challenges in delivering palliative care, including the introduction of new digital health technologies, organizational challenges, fragmented health services, staff shortages, and emotional fatigue (Bessen et al, 2019 ; Bønes et al, 2022a ; Melby & Håland, 2021 ). There is a global shortage amounting to millions of healthcare professionals (Liu et al, 2017 ) and a growing and ageing population (United Nations, 2019 ), with the older population having comorbidities (Guidelines, Network AI, 2020 ; Siemens et al, 2020 ).…”