Integrating mobile health into mental health: an exploratory analysis and case series from the digital clinic

BACKGROUND: The COVID-19 pandemic has increased the demand for mental health services but has also imposed new barriers for those seeking care, creating a widespread shortage. As a result, providers are increasingly looking to incorporate technology into mental healthcare. Despite the increased focus on mental health technology in recent years, many new technologies are framed as products rather than clinical tools and fail to be effectively implemented. Digital clinics, hybrids of clinical care and technology, such as a smartphone app, offer a model of how technology can be implemented into mental healthcare. In addition to increasing the need for technology in mental healthcare, the COVID-19 pandemic has also lessened many historical barriers to successful implementation of a digital clinic including regularity restrictions, financial challenges, and the motivations of patients and providers in adding technology into healthcare. Objective: In order to better understand how technology can be incorporated into mental healthcare, the Technology Enabled Care Program (TECC), a digital clinic at Beth Israel Deaconess Medical Center, will be evaluated through the study of a case series. The integrated-Promoting Action on Research Implementation in Health Services (i-PARISH) framework, an implementation science model, will be applied to TECC in order to identify factors important to the larger scale implementation of this digital clinic. METHODS: The TECC program combines eight sessions of face-to-face therapy via telehealth with the use of a mindLAMP, a mental health smartphone app. The app is customizable for each use case and is supported by a 3-member care team containing technology specialists and a therapist. Quantitative data from this program will be investigated and discussed along with information on patients’ qualitative experiences in order to get a better understanding of the successes and areas for improvement in this first implementation of TECC. RESULTS: From the six initial patients who have completed TECC, four were selected to be represented in this case series. One patient was highly engaged with the app and used it on a daily basis throughout the program. Two patients use the app consistently at times but experienced periods of low engagement during their care. A fourth patient struggled with technical issues and their app use was intermittent. Most feedback on the program was positive, but exceptions will be detailed. CONCLUSION: Implementation of the TECC program and mindLAMP app into practice was successful in many regards and these early cases shed light on areas of potential improvement in future iterations of the digital clinic. Moving forward, these results will inform a focus on factors that can increase adoption by patients, clinicians, and healthcare systems