JMIR Publications

ABSTRACT

Background:

Digital health applications (Digitale Gesundheitsanwendungen, DiGA) were integrated into the German statutory health care system in 2020, and can be prescribed by physicians and psychotherapists. Nevertheless, their utilization within routine care, particularly in the treatment of mental disorders, remains limited. Previous research suggests that a lack of information and knowledge among health care providers and patients may contribute to these difficulties.

Objective:

This study aimed to explore the perspectives of stakeholders on the information-related aspects of DiGA implementation in outpatient mental health care in Germany. This included investigating the current level of information, information needs, suitable information providers and potential approaches to improve information provision.

Methods:

We conducted semi-structured interviews with experts representing stakeholder groups relevant to DiGA in outpatient mental health care in Germany. Participants were recruited using purposive stakeholder sampling. Potential participants were identified through existing professional contacts and web-based searches, and were subsequently approached by email. The web-based interviews were conducted via Microsoft Teams between September and November 2023. The transcripts were analyzed using qualitative content analysis based on Kuckartz, combining deductive and inductive category development.

Results:

A total of 13 interviews with 14 participants were conducted, comprising 5 health care provider representatives, 4 statutory health insurance representatives, 4 DiGA developer representatives, and 1 patient representative. The findings were grouped into 3 main themes: perceived information status, improvement of the information status, and information suppliers. Representatives of health care providers described a general awareness of DiGA but said they lacked more detailed knowledge required to assess and compare individual applications. They also perceived information gaps among patients. Participants distinguished between general information on aspects such as regulatory requirements and organizational processes and more detailed product-specific information. Different potential information suppliers were associated with different opportunities and problems, particularly regarding expertise, objectivity, available resources, and the ability to provide product-specific information.

Conclusions:

The findings indicate that information-related challenges in the implementation of DiGA extend beyond general awareness. Health care providers and patients may require accessible information with different levels of detail, while the source of information also appears relevant. Addressing these different information needs may support the integration of DiGA into outpatient mental health care. Clinical Trial: This study was funded by the Innovation Fund of the German Federal Joint Committee (Gemeinsamer Bundesausschuss; funding code: 01VSF22029).