JMIR Publications

ABSTRACT

Background:

Mental and behavioral disorders affect approximately 28% of the adult population in Germany per year, with treatment being provided through a diverse healthcare system. Yet, there are access and capacity problems in outpatient mental health care. One innovation that could be able to reduce these barriers and improve the current care situation are mobile Health (mHealth) apps (in Germany called “Digitale Gesundheitsanwendungen” (DiGA)). DiGA are certified apps reimbursed by statutory health insurance (SHI) funds. They are evaluated before use, e.g., by proving their medical benefit in clinical studies, or admitted for usage within the concept of Coverage with Evidence Development. The majority of the DiGA currently included in the "DiGA directory" are approved for use with mental disorders. However, the low and stagnant usage numbers point to barriers to their uptake and integration within the German healthcare system. The analysis of concepts for the implementation and integration is important to find effective ways to realize the potential of these apps in mental healthcare.

Objective:

The scoping review aims to identify concepts and frameworks for the successful integration of mHealth apps into international healthcare systems and how they can be adapted and transferred to DiGA used in the German healthcare system.

Methods:

The scoping review followed the methodological frameworks for scoping reviews by Arksey and O´Malley. The scientific databases PubMed, Embase, and PsycInfo were searched. A two-stage (title and abstract, followed by full text) screening process was con-ducted by two different reviewers independently.

Results:

A total of 3,711 publications were identified. Of these, 20 were included in the review, with three additional studies identified through a targeted search. Results are presented in accordance with the PRISMA-ScR checklist. The literature identified through this scoping review provides an overview of a variety of aspects regarding mHealth apps for mental disorders and the integration into healthcare systems. There are different general, organizational, legal and technical requirements to create a suitable environment, providing the necessity for specific concepts for integration and implementation of mHealth apps. We identified regulatory concepts, e.g., directories for mHealth apps and care-related concepts, e.g., training and support of medical professionals. The generated evidence contributes to improved and user-oriented structures and processes, potentially resulting in better support of patients by mHealth apps.

Conclusions:

There is already evidence showing mHealth apps are effective in helping patients with mental disorders. To realize these potentials mHealth apps need to work within the structures and processes of healthcare systems. Therefore, this scoping review provides insights on the integration of mHealth apps into (outpatient) mental healthcare.