by John Torous, MD
BOSTON, MA – Digital psychiatry – using new mobile and connected technologies towards mental health and wellness – offers tremendous potential. Everyday it seems we read about new smartphone apps, wearables, and virtual reality tools that promise to improve mental health. At last count, there were over 10,000 mental health apps! But beyond the excitement, and often hype, what is the reality? What can technology really do today that may improve mental health care?
To answer questions like this, we need to do research and measure how these new technologies work in real world settings for both mental health providers and those whom they serve.
OpenNotes is a new concept that helps us use technology in a new way, and in this study we aimed to explore what implementing it into a busy mental health clinic looks like and what that experience means for others hoping to soon do the same.
Although we know that psychiatric patients are also primary care patients, the impact of sharing notes around psychiatric care had not been looked at specifically in a psychiatric outpatient setting. A study of which we are coauthors published in ScienceDirect offers pilot evidence as well as clinician and patients’ perspectives on implementing OpenNotes in a busy outpatient psychiatry clinic.
In the study, 15 mental health clinicians, including psychiatrists, a nurse practitioner, and social workers, offered 568 of their patients immediate access to clinical notes through the hospital online patient portal over a 20-month period. Thirty percent, or 117, of the study patients read their notes, and 52 patients completed an exit survey about their experience with OpenNotes. Survey results indicated patients found that access to their visit notes helped them better remember care plans, adhere to medication regimens, and make the most of clinical appointments.
Clinicians reported that OpenNotes did not significantly increase their workload or lead to complications in the treatment relationship. However, almost all of the clinicians believed this was a function of patient selection for the study, which excluded many with psychotic illnesses and severe personality disorders.
While it is a mistake to over-interpret the results of this pilot study, the results do suggest that offering select patients easy access to psychiatry notes is not “toxic” and in fact may improve treatment in an outpatient setting in an academic medical center.
It is hoped that the results will spur more interest and research in OpenNotes for psychiatry.
John Torous, MD, is co-director of the Digital Psychiatry Program at Harvard-affiliated Beth Israel Deaconess Medical Center in Boston and a member of APA’s Committee on Mental Health Information Technology. Follow him on Twitter at @JohnTorousMD.
Pamela Peck, PsyD, is clinical director in the Department of Psychiatry at Beth Israel Deaconess Medical Center.
Parts of this post are re-blogged from PsychNews.