JMIR Publications

ABSTRACT

Background:

Outpatient mental health care in Germany is facing challenges. Innovative approaches are required to sustain a high quality of care, particularly in light of challenging financial circumstances of the German health care system. Since September 2020, selected mHealth apps, so called Digital Health Applications [DiGA], are reimbursable by the German statutory health insurance. Almost half of all DiGA are focused on mental disorders. DiGA are a low-threshold offering with the potential to improve the care of mental disorders. Utilization numbers show that DiGA have not been fully established yet.

Objective:

The analysis presented here is part of the mixed-methods study DiGAPsy (“Realizing the Potential of Digital Health Applications in Outpatient Mental Health Care”, funding code: 01VSF22029). The object of our study is a comprehensive analysis of the barriers to the implementation of DiGA in outpatient mental health care. The article primarily focuses on aspects relating to DiGA information and barriers within this field.

Methods:

Expert interviews were conducted with representatives of relevant stakeholder groups in the area of DiGA, including patients, health care providers, DiGA developers and SHI funds. The interview guidelines were based on a scoping review that had been completed previously. The interviews were audio visually recorded and transcribed. A qualitative content analysis was then performed using MAXQDA.

Results:

A total of thirteen expert interviews were conducted. Three key themes concerning information-related challenges in the DiGA implementation process were identified: (1) current level of information, (2) improvement of the information status, and (3) information suppliers. Overall, the current level of information about DiGA remains low. While the general population is largely unfamiliar with DiGA, most health care providers are at least somewhat aware, though their knowledge tends to be superficial. For health care providers, product-specific information, particularly concerning clinical evidence, is viewed as highly important. Information suppliers also play a critical role. For example, DiGA developers are intrinsically motivated, but the information they deliver is often met with skepticism by health care providers.

Conclusions:

The findings highlight notable gaps in product-specific knowledge about clinical evidence among health care providers. For the adoption process trusted informations are critical. Addressing these information gaps will be essential for DiGA to establish in German health care, and may help other countries to implement mHealth apps into their health care systems.