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首页> 外文期刊>BMC Medical Informatics and Decision Making >Implementation of eMental Health care: viewpoints from key informants from organizations and agencies with eHealth mandates
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Implementation of eMental Health care: viewpoints from key informants from organizations and agencies with eHealth mandates

机译：实施电子卫生保健：具有电子卫生保健任务的组织和机构的主要信息提供者的观点

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Background The use of technology such as computers, tablets, and smartphones to improve access to and the delivery of mental health care (eMental Health care) is growing worldwide. However, despite the rapidly expanding evidence base demonstrating the efficacy of eMental Health care, its implementation in clinical practice and health care systems remains fragmented. To date, no peer-reviewed, key-informant studies have reported on the perspectives of decision-makers concerned with whether and how to implement eMental Health care. Methods From September to November 2015, we conducted 31 interviews with key informants responsible for leadership, policy, research, and/ or information technology in organizations influential in the adoption of technology for eMental Health care. Deductive and inductive thematic analyses of transcripts were conducted using the Behavior Change Wheel as an organizing framework. Frequency and intensity effect sizes were calculated for emerging themes to further explore patterns within the data. Results Key informant responses ( n =?31) representing 6 developed countries and multiple organizations showed consensus on common factors impacting implementation: individual and organizational capacities (e.g., computer literacy skills [patients and providers], knowledge gaps about cyber security, limited knowledge of available services); motivational drivers of technology-based care (e.g., extending care, data analytics); and opportunities for health systems to advance eMental Health care implementation (e.g., intersectoral research, rapid testing cycles, sustainable funding). Frequency effect sizes showed strong associations between implementation and credibility, knowledge, workflow, patient empowerment, electronic medical record (EMR) integration, sustained funding and intersectoral networks. Intensity effect sizes showed the highest concentration of statements (>10% of all comments) related to funding, credibility, knowledge gaps, and patient empowerment. Conclusion This study provides previously unavailable information about key informant perspectives on eMental Health care implementation. The themes that emerged, namely the need to intensify intersectoral research, measure/monitor readiness to implement, define cost-utility benchmarks, raise awareness about available technologies, and test assumptions that ‘proven’ technologies will be easily integrated can inform the design and evaluation of eMental Health care implementation models.
机译：背景技术在世界范围内，越来越多地使用诸如计算机，平板电脑和智能手机之类的技术来改善对精神卫生保健（eMental Health care）的获取和提供。然而，尽管迅速扩展的证据证明了eMental Health Care的有效性，但其在临床实践和卫生保健系统中的实施仍然是零散的。迄今为止，尚无关于同行评议的关键信息研究报告有关决策者是否以及如何实施电子卫生保健的观点。方法从2015年9月至2015年11月，我们进行了31次主要访谈，采访了那些对采用电子卫生保健技术具有影响力的组织的领导，政策，研究和/或信息技术。笔录的演绎和归纳主题分析是使用“行为改变轮”作为组织框架进行的。计算了新兴主题的频率和强度效果大小，以进一步探索数据中的模式。结果代表6个发达国家和多个组织的关键信息提供者回答（n =？31）对影响实施的常见因素达成了共识：个人和组织能力（例如，计算机素养技能[患者和提供者]，关于网络安全的知识空白，对网络安全的了解有限）可用服务）;基于技术的护理的动机驱动力（例如扩展护理，数据分析）;卫生系统促进电子卫生保健实施的机会（例如，跨部门研究，快速测试周期，可持续资金）。频率效应的大小显示出实施与信誉，知识，工作流程，患者授权，电子病历（EMR）集成，持续的资金支持和部门间网络之间的紧密联系。强度效应大小显示与资金，信誉，知识差距和患者授权相关的陈述集中度最高（>所有评论的10％）。结论这项研究提供了以前关于eMental Health Care实施的关键信息视角的信息。出现的主题，即需要加强跨部门研究，衡量/监控实施的准备情况，定义成本效用基准，提高对可用技术的认识以及测试“易于验证”的技术将易于集成的假设可以为设计和评估提供信息。电子卫生保健实施模型。

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