JMIR Publications

ABSTRACT

Background:

The collaborative care model is a well-established system of behavioral healthcare within primary care settings. There is potential for digital and mobile technology to augment the collaborative care model to improve scalability, efficiency, and clinical outcomes.

Objective:

This review aims to summarize the current state of research into the ability of digital and mobile health to augment the CCM, highlight important challenges and limitations, and explore areas for further investigation. Specifically, we conducted a scoping review to determine 1) what digital and mobile technologies have been studied to augment the collaborative care model; 2) their acceptability and feasibility and 3) their effects on clinical outcomes.

Methods:

The review included cohort and experimental studies of digital and mobile technologies used to augment the collaborative care model. Studies examining primary care without collaborative care were excluded. A literature search was conducted on four electronic databases (MEDLINE, Embase, Web of Science, Google Scholar). The search results were screened in two stages (title/abstract screen, followed by full text review) by two reviewers.

Results:

3508 non-duplicate records were identified; 18 were included in the analysis. Most studies used a combination of novel technologies. The range of digital and mobile health technologies used included mobile apps, websites and web-based platforms, interactive voice recording, mobile sensor data. No studies identified by this review used social media or wearable devices. Studies that measured patient and/or provider satisfaction reported positive results, though some types of interventions increased provider workload and engagement was variable. In studies where clinical outcomes were measured (n=6) there were either no differences between groups or differences were modest.

Conclusions:

The use of digital and mobile health technology in CCM is still limited. Digital technology was the most successful when it was integrated into the existing workflow without relying on patient or provider initiative. The effect of digital and mobile health technologies on clinical outcomes in CCM remains unclear and requires additional clinical trials. To advance the use of digital and mobile health in CCM we introduce a forward-looking conceptual framework for augmenting collaborative care with a focus on improving access to care, remote patient monitoring, and enhanced treatment. Clinical Trial: N/A