The technology specialist: a 21st century support role in clinical care

Noël, Valerie; Carpenter‐Song, Elizabeth; Acquilano, Stephanie C; Torous, John; Drake, Robert E.

doi:10.1038/s41746-019-0137-6

Cited by 31 publications

(21 citation statements)

References 24 publications

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“…There have been recent efforts to develop frameworks of clinician competencies and app evaluation criteria to help address this problem (Hilty et al 2020 ; Torous et al 2018c ). However, to reduce provider burden, some have suggested the need for technology specialists or digital navigators tasked with introducing apps to patients (Ben-Zeev et al 2015 ; Noel et al 2019 ; Wisiewski and Torous 2020 ). Research is needed regarding how successful such arrangements are in practice.…”

Section: Resultsmentioning

confidence: 99%

Leveraging Implementation Science to Understand Factors Influencing Sustained Use of Mental Health Apps: a Narrative Review

Connolly

Hogan

Shimada

et al. 2020

J. technol. behav. sci.

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Mental health (MH) smartphone applications (apps), which can aid in self-management of conditions such as depression and anxiety, have demonstrated dramatic growth over the past decade. However, their effectiveness and potential for sustained use remain uncertain. This narrative review leverages implementation science theory to explore factors influencing MH app uptake. The review is guided by the integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) framework and discusses the role of the innovation, its recipients, context, and facilitation in influencing successful implementation of MH apps. The review highlights critical literature published between 2015 and 2020 with a focus on depression and anxiety apps. Sources were identified via PubMed, Google Scholar, and Twitter using a range of keywords pertaining to MH apps. Findings suggest that for apps to be successful, they must be advantageous over alternative tools, relatively easy to navigate, and aligned with users' needs, skills, and resources. Significantly more attention must be paid to the complex contexts in which MH app implementation is occurring in order to refine facilitation strategies. The evidence base is still uncertain regarding the effectiveness and usability of MH apps, and much can be learned from the apps we use daily; namely, simpler is better and plans to integrate full behavioral treatments into smartphone form may be misguided. Non-traditional funding mechanisms that are nimble, responsive, and encouraging of industry partnerships will be necessary to move the course of MH app development in the right direction.

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Section: Resultsmentioning

confidence: 99%

Leveraging Implementation Science to Understand Factors Influencing Sustained Use of Mental Health Apps: a Narrative Review

Connolly

Hogan

Shimada

et al. 2020

J. technol. behav. sci.

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“…For any such implementation to be possible, effective ways to monitor responses by clinical caretakers will be important 44 , both to ensure patient safety in the case of critical situations such as explicit statements of suicidality, and to make sure that the automatic processes are trustworthy and continue to generate fair and accurate scores 20 . Nonetheless, for those patients who have access to digital devices, and can operate such devices with minimal supervision, future assessment methods that embrace mobile technologies promise to be of enormous value in psychiatry and may even enhance the bond between patients and clinicians 45 .…”

Section: Discussionmentioning

confidence: 99%

Applying speech technologies to assess verbal memory in patients with serious mental illness

et al. 2020

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Verbal memory deficits are some of the most profound neurocognitive deficits associated with schizophrenia and serious mental illness in general. As yet, their measurement in clinical settings is limited to traditional tests that allow for limited administrations and require substantial resources to deploy and score. Therefore, we developed a digital ambulatory verbal memory test with automated scoring, and repeated self-administration via smart devices. One hundred and four adults participated, comprising 25 patients with serious mental illness and 79 healthy volunteers. The study design was successful with high quality speech recordings produced to 92% of prompts (Patients: 86%, Healthy: 96%). The story recalls were both transcribed and scored by humans, and scores generated using natural language processing on transcriptions were comparable to human ratings (R = 0.83, within the range of human-to-human correlations of R = 0.73-0.89). A fully automated approach that scored transcripts generated by automatic speech recognition produced comparable and accurate scores (R = 0.82), with very high correlation to scores derived from human transcripts (R = 0.99). This study demonstrates the viability of leveraging speech technologies to facilitate the frequent assessment of verbal memory for clinical monitoring purposes in psychiatry.

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“…Machine learning algorithms to process data in real time and present it in a user-friendly and actionable format would be an option, and participants discussed presenting the data as a visual display in the ward’s central nursing office. Embedding a dedicated technology specialist within the clinical team could also be considered [39]. While not raised in the focus groups, there are likely to be numerous practical implementation issues to using remote monitoring technology, such as the financial cost of acquiring and maintaining the technology, and any ongoing training requirements for staff.…”

Section: Discussionmentioning

confidence: 99%

Predicting Inpatient Aggression in Forensic Services Using Remote Monitoring Technology: Qualitative Study of Staff Perspectives

Greer¹,

Newbery²,

Cella³

et al. 2019

J Med Internet Res

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BackgroundMonitoring risk of imminent aggression in inpatient forensic mental health services could be supported by passive remote monitoring technology, but staff attitudes toward the relevance and likelihood of engagement with this technology are unknown.ObjectiveThis study aimed to explore staff views, specifically potential benefits and implementation barriers, on using this technology for monitoring risk of inpatient aggression.MethodsWe conducted semistructured focus groups with nurses in an inpatient forensic mental health service. We used thematic analysis with two independent raters to identify themes and subthemes related to staff attitudes toward passive remote monitoring. We subsequently checked with members to ensure the validity of the themes identified by the raters.ResultsFrom January to March 2019, a total of 25 nurses took part in five focus groups. We identified five main themes, one of which concerned the potential benefits that passive remote monitoring could provide for monitoring risk of aggression. Staff suggested it could provide an early warning of impending aggression and enable support to be provided earlier. The remaining themes concerned implementation barriers, including risks to the users’ physical and mental well-being; data security concerns and potential access by third parties; the negative impact of a constant stream of real-time data on staff workload; and design characteristics and user awareness of the benefits of passive remote monitoring.ConclusionsPassive remote monitoring technology could support existing methods of monitoring inpatient aggression risk, but multiple barriers to implementation exist. Empirical research is required to investigate whether these potential benefits can be realized, and to identify ways of addressing these barriers to ensure acceptability and user engagement.

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The technology specialist: a 21st century support role in clinical care

Cited by 31 publications

References 24 publications

Leveraging Implementation Science to Understand Factors Influencing Sustained Use of Mental Health Apps: a Narrative Review

Leveraging Implementation Science to Understand Factors Influencing Sustained Use of Mental Health Apps: a Narrative Review

Applying speech technologies to assess verbal memory in patients with serious mental illness

Predicting Inpatient Aggression in Forensic Services Using Remote Monitoring Technology: Qualitative Study of Staff Perspectives

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