JMIR Publications

ABSTRACT

Background:

To ensure quality care, clinicians need skills, knowledge and attitudes related to technology that can be measured.

Objective:

This paper sought out competencies for mobile technologies and/or an approach to define them.

Methods:

The scoping review was conducted to see if the literature had data on this topic, based on a broad research question, “What skills are needed for clinicians and trainees to provide quality care via mH have they been published, and how can they be made measurable and reproducible to teach and assess them?” The review was done in accordance with the six-stage scoping review process starting with a key word search in Pubmed/Medline, APA PsycNET, Cochrane, Embase, PsycINFO, Web of Science and Scopus. The literature search focused on key words in four concept areas: 1) competencies; 2) mobile technologies; 3) telemedicine mode; and 4) health. Two authors independently, in parallel, screened the search results for potentially relevant studies based on titles and abstracts. The screeners then reviewed the full-text articles for final inclusion based on inclusion/exclusion criteria. Inclusion criteria were: key words used from concept area 1 (competencies) and 2 (mobile technologies) and either 3 (telemedicine mode) or 4 (health). Exclusion criteria included, but were not limited to, key words used from a concept area in isolation, discussion of skills abstractly, outline or listing of what clinicians need without detail, listing immeasurable behaviors.

Results:

From a total of 1232 results, the authors found 78 eligible for full text review and found 14 papers directly relevant to the four key concepts. Though few studies specifically discuss skills, the majority are clinical studies, and the literature includes no lists of measurable behaviors or competency sets for mobile technology. Therefore, a framework for mobile technology competencies was built according to the review, expert consensus and recommendations of the Institute of Medicine’s Health Professions Educational Summit and Accreditation Council of Graduate Medical Education framework. This framework borrows from existing frameworks in telepsychiatry, social media and telebehavioral health, in placing competencies in the domains of patient care, medical knowledge, practice based learning and improvement, systems based practice, professionalism, and interpersonal skills and communication. However, mH also includes clinical decision support, device/technology assessment/selection and information flow management across an electronic health record platform. Since care with mH may have asynchronous components, additional traditional learning, teaching, supervisory and evaluation practices are needed. Curricula with case-, problem- and system-based teaching are suggested for faculty as they are typically more interactive and focused on decision-making and group process to shape skills and attitudes to complement clinical exposure.

Conclusions:

Research is needed on how to customize implementation and evaluation mH competencies in clinical care and training programs and to ensure skill development is linked to quality of care. This will require management of organization change with technology and assessment of how a paradigm shift like mH re-contextualizes digital healthcare, in a complex policy and regulatory environment. Health systems need to manage change and create a positive e-culture. Clinical Trial: Not applicable.