Digital and Mobile Health Technology in Collaborative Behavioral Health Care: Scoping Review.

Khatiya Moon,Michael Sobolev,John M Kane

doi:10.2196/30810

Abstract

BackgroundThe collaborative care model (CoCM) is a well-established system of behavioral health care in primary care settings. There is potential for digital and mobile technology to augment the CoCM to improve access, scalability, efficiency, and clinical outcomes.ObjectiveThis study aims to conduct a scoping review to synthesize the evidence available on digital and mobile health technology in collaborative care settings.MethodsThis review included cohort and experimental studies of digital and mobile technologies used to augment the CoCM. Studies examining primary care without collaborative care were excluded. A literature search was conducted using 4 electronic databases (MEDLINE, Embase, Web of Science, and Google Scholar). The search results were screened in 2 stages (title and abstract screening, followed by full-text review) by 2 reviewers.ResultsA total of 3982 nonduplicate reports were identified, of which 20 (0.5%) were included in the analysis. Most studies used a combination of novel technologies. The range of digital and mobile health technologies used included mobile apps, websites, web-based platforms, telephone-based interactive voice recordings, and mobile sensor data. None of the identified studies used social media or wearable devices. Studies that measured patient and provider satisfaction reported positive results, although some types of interventions increased provider workload, and engagement was variable. In studies where clinical outcomes were measured (7/20, 35%), there were no differences between groups, or the differences were modest.ConclusionsThe use of digital and mobile health technologies in CoCM is still limited. This study found that technology was most successful when it was integrated into the existing workflow without relying on patient or provider initiative. However, the effect of digital and mobile health on clinical outcomes in CoCM remains unclear and requires additional clinical trials.

Highlights

There are more people who could benefit from behavioral health services than can be served by the currently existing resources for care [1,2]
This study found that technology was most successful when it was integrated into the existing workflow without relying on patient or provider initiative
This review aims to summarize the current state of research into the ability of digital and mobile health to augment the collaborative care model (CoCM), highlight important challenges and limitations, and explore areas for further investigation

Summary

Introduction

Background There are more people who could benefit from behavioral health services than can be served by the currently existing resources for care [1,2]. Mood and anxiety disorders are highly prevalent in the general population [3,4]. These disorders are disabling to individuals and burdensome to communities, resulting in increased service use, loss of productivity, and poorer outcomes for pre-existing medical conditions [5,6,7]. Novel approaches are needed to improve the scale, delivery, and cost efficiency of behavioral health care. The collaborative care model (CoCM) is a well-established system of behavioral health care in primary care settings. There is potential for digital and mobile technology to augment the CoCM to improve access, scalability, efficiency, and clinical outcomes

Methods

Results

Discussion

Conclusion