Implementation of Digital Mental Health Tools in Ambulatory Care Coordination (Illinois)

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Tailored implementations of digital mental health interventions have the potential to improve the coordination of mental health services in ambulatory care settings and to increase access to these services.

Project Details - Ongoing

Summary:

Patients with both physical and mental health conditions often require care coordination from care managers (CMs). However, many CMs report lacking sufficient training and resources to support patients with their mental health, particularly depression, which is more common among adults with chronic medical conditions. This gap is exacerbated by limited specialty mental healthcare resources, long waitlists for services, and other barriers to care. Despite the availability of evidence-based, digital mental health (DMH) technologies to guide CMs, DMH implementation is often unsuccessful in real-world, ambulatory care settings due to technological obsolescence after lengthy research trials and incompatibility with existing clinical workflows.

To address this issue, researchers at Northwestern University will adapt and implement a DMH intervention to increase access to and improve coordination of mental health services in an ambulatory care setting as well as develop an implementation guide to support replication and sustainability in other healthcare systems.

The specific aims of the research are as follows:

  • Adapt a digital mental health platform and service model to address implementation barriers within care coordination. 
  • Develop and subsequently optimize a multicomponent implementation strategy. 
  • Conduct a randomized rollout effectiveness-implementation trial of the DMH platform and a sustainment pilot period in the four regional teams of the Ambulatory Care Coordination service. 

To achieve these aims, the research team will employ a user-centered design approach to adapt an existing DMH platform and service model, including design feedback workshops and usability testing with CMs and patients. The research team will also convene a Stakeholder Advisory Board to iteratively develop and refine a set of implementation strategies to inform the rollout of a rapid-cycle randomized trial to assess the efficacy of the DMH intervention. The intervention will be evaluated based on efficacy, reach, acceptability, feasibility, fidelity, adoption, and cost compared to treatment as usual. Following the trial, the research team will transition all key implementation functions to the study site’s CM staff and monitor intervention effectiveness during a 6-month sustainment pilot. Lessons learned will be compiled into an implementation guide for use by other integrated healthcare systems.

The findings of this research will demonstrate the utility of tailored approaches to implementing DMH technologies and inform potential scaling of such interventions into a broader range of healthcare settings.