JMIR Publications

ABSTRACT

Background:

Digital health tracking tools intend to change mental healthcare by giving mental health clinicians passively measured patient-generated health data (PGHD) (e.g., data collected from connected devices, mobile applications, and wearables with little-to-no patient effort), providing contextual information on patient behavior and physiology from outside of the clinic with minimal data collection burden. While prior work has sought to understand how passive PGHD may be integrated within clinical workflows, researchers have not sufficiently explored how passive PGHD may reshape clinical decision making.

Objective:

We conducted a qualitative study to understand mental health clinicians’ perceptions and concerns regarding using technology-enabled, passively collected PGHD for clinical decision making. Our interviews sought to understand participants’ current experiences with and visions for using passive PGHD.

Methods:

Mental health clinicians (eg, psychiatrists, psychologists, clinical social workers) providing outpatient services were recruited to participate in semi-structured interviews. Interview recordings were de-identified, transcribed, and qualitatively coded to identify overarching themes.

Results:

12 mental health clinicians (11 psychiatrists and 1 clinical psychologist) were interviewed. Our results showed that participating clinicians had varied experience with, and interest in, using passive PGHD, specifically highlighting the lack of evidence supporting passive PGHD use, as well as gaps in knowledge on how to best integrate passive PGHD alongside more-traditional forms of clinical mental health data. In addition, participating clinicians were only interested in viewing passive PGHD at moments when they could reflect and act on passive data; drawing an analogy to a prescription or lab test, PGHD could be prescribed or ordered at opportune moments to hyperfocus on the relationships between behavior, physiology, and disease for a discrete period of time. Finally, participants called for safeguards to protect patient privacy within passive PGHD data sharing programs, ensuring passive PGHD is only collected and used to support patients’ treatment goals.

Conclusions:

While passive PGHD has the potential to enable more contextualized measurement, this study highlights the need for building and disseminating an evidence base describing how and when passive measures should be used for clinical decision making. Clear evidence would more effectively support the uptake and effective usage of these novel tools for both patients and their clinicians.