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NEW ORLEANS — Ubiquitous connectivity is a personal and professional requirement in this digital age, but assessing the myriad mobile technologies available can be daunting. Steven Chan, MD, Clinical Informatics Fellow at the University of California, San Francisco, attempted to shed some light on telehealth in his presentation at the 2017 Psych Congress this week and provided instructions for how clinicians can connect with their psychiatric patients.1
Recognizing the types of digital consumer is necessary for ensuring optimal use of digital tools. Digital immigrants are those individuals who are slow to adapt technology. They tend to use the Internet as a secondary information source and prefer hard copy information to virtual files. These individuals tend to learn slowly and methodically. Conversely, digital natives are efficient at multitasking and are often fast to accommodate new and different processes and products. They often prefer graphics to text, and the text they consume should be in small packages. Digital natives often learn quickly, and can master information presented to them in a random fashion.
Once a patient’s digital usage type has been identified, a digital product can be identified or developed to ensure efficient and effective transfer of information. According to research conducted with psychiatric outpatients, 58% reported owning a smartphone, approximately 71% accepted the use of a smartphone to manage their mental health, and younger patients reported preference for using apps.2 Although efficacy has not yet been determined in randomized clinical trials, even patients with severe mental illness can be expected to use digital interventions.3
Numerous advantages exist to the use of health technology. Digital connectivity overcomes location, transport, and provider availability challenges. Virtual communication is often more cost effective that in-person interactions. As part of the Institute for Healthcare Improvement’s Triple Aim objective, the economic value of telehealth coupled with improved population health and better patient satisfaction contributes to positive change in the healthcare system.4 Anticipated benefits include lower cost of psychiatric care, including lower clinician operating costs; higher rates of healthcare utilization; and fewer missed appointments due to greater ease of patient access to virtual care.
Caution is important when using health technology in psychiatric practice. HIPAA compliance must be ensured when using email or social media platforms. Institutional requirements — including IT, legal, and risk — should be assessed and enforced. As with nondigital clinical care, boundaries and rules among clinicians and patients must be established and respected. “We are the gatekeepers for our patients, our consumers, and our communities,” remarked Dr Chan.
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1. Chan S. Connected health technologies and mobile apps for mental health. Presentation at: Psych Congress; September 16-19, 2017; New Orleans, LA.
2. Torous J, Chan C, Tan SY-M, et al. Patient smartphone ownership and interest in mobile apps to monitor symptoms of mental health conditions: a survey in four geographically distinct psychiatric clinics. JMIR Ment Health. 2014;1(1):e5.
3. Naslund JA, Marsch LA, McHugo GJ, Bartels SJ. Emerging m-health and e-health interventions for serious mental illness: a review of the literature. J Ment Health. 2015;24(5):321-332.
4. Institute for Healthcare Improvement. The IHI Triple Aim. Available at: http://www.ihi.org/Engage/Initiatives/TripleAim/Pages/default.aspx. Accessed September 17, 2017.