eHealth Use on Acute Inpatient Mental Health Units: Implementation Processes, Common Practices, and Barriers to Use

Area of Science:

• Mental Healthcare Technology
• Digital Health Interventions
• Psychiatric Inpatient Care

Background:

• Electronic health (eHealth) is a growing area in mental healthcare.
• Patient-facing eHealth use in psychiatric inpatient settings is not well understood.
• This study addresses the gap in knowledge regarding eHealth adoption in inpatient mental health units.

Purpose of the Study:

• To examine current practices, barriers, and implementation factors of patient-facing eHealth in Veteran Health Administration (VHA) acute mental health inpatient units.
• To identify desired and successfully used eHealth technologies.
• To understand contextual differences between high and low success eHealth implementation sites.

Main Methods:

• Quality improvement project utilizing surveys and interviews with staff from VHA acute mental health inpatient units (n=49 from 37 sites).
• Surveys assessed current/desired eHealth use and barriers.
• Interviews explored contexts of eHealth use in high- and low-success sites.

Main Results:

• Less than 20% of inpatients used any eHealth technology.
• Tablets and video chat were the most desired and successfully used technologies.
• Barriers included limited Wi-Fi, staffing, and infrastructure; high-success sites differed in risk/benefit analysis and support.

Conclusions:

• Patient-facing eHealth is underutilized in inpatient mental health settings due to significant barriers.
• Successful implementation necessitates internal champions, external guidance, manageable workloads, and a reevaluation of eHealth's risk-benefit ratio.
• Addressing infrastructure and staffing is crucial for expanding eHealth in psychiatric inpatient care.