Forhelse is divided into four work packages; effectiveness, cost-effectiveness, early HTA and implementation. Psychologist Robin Kenter is a researcher and post doc, and the leader of work package 4- Implementation.
We had a chat with Robin about what the responsiblitiy of work package 4 in Forhelse is, and what her thoughts are about health services becoming more digitalized.
What is the goal for the work package you are leading?
-First of all, the goal is to understand what promotes and inhibits the use and implementation of digital mental health services on different levels, Kenter says.
According to Kenter PhD candidate, Beate Standal in work package 4 is already in the process of qualitative exploration of determinants through interviews and focus groups with participants working with digital health services. From this, they hope to answer what therapist and leaders need to reach a more effective implementation, and increased use of guided internet based treatment.
–We hope that what we find can help make internet treatment available to more people who can benefit from it. Through the interviews, we can also gain knowledge about the future use of tailored -made implementation tools that support the work the district psychiatric centers and hospitals are already doing. By using tailored implementation strategies, and research on the effects of these, we will be able to contribute to more sustainable and efficient implementation. This can lead to online treatment becoming a treatment offered similarly to existing offers, and that we reach more people so that the threshold for seeking help is lower, Kenter says.
What benefit do you think this will have for the health service and the health industry?
As of today, many in Norway are well on their way trying and implementing digital psychological health services. Some get good results while others struggle. Everyone tries on their own, and there is little knowledge about effective implementation strategies when it comes to psychological health services.
Offering a new digital intervention requires a lot. For example, you may need to organize in a new way, relate to new work processes, train personnel, think and act in a new way, and create new activities. The introduction of digital mental health services is changing the existing way of offering health services and that makes it more complex, Kenter says.
Kenter further explains that in work package 4 they use Normalization Process Theory (NPT) which focuses on the normalization process in the introduction of digital psychological interventions in the health care system. The theory helps them understand digitalization, challenges in introducing digital mental health services and organizational change as a holistic process.
-Digital mental treatments are proving to have good results in research stages, and they are scalable. It can provide more people with a good option, but we must know how to deliver it in the best possible way, and evaluate any errors and pitfalls in the implementation. In addition, collaboration is important, so that more people benefit from the knowledge. The research that takes place in our work package can hopefully streamline the implementation processes and provide a better outcome. Increased knowledge about the introduction of digital interventions in existing health services is relevant for both health workers, the health sector and society, Kenter adds.
What is your hope for the development of digital health service in the years to come?
-I think digitalization and the introduction of new technology are here to stay. I hope we can move towards personalized and adaptive treatment, so that the right treatment is given to the right person, at the right time. I think technology can contribute to that. In addition, I hope that technology can help reduce the impact of treatment, that patients/users are not overloaded with e.g. questionnaire and reporting “homework”, but that the technology can help with the use of sensor data and digital phenotyping. This way it becomes easier for the patient and the therapist to follow the patient’s symptoms and progress in treatment, says Kenter.
What do you think are the biggest challenges with digitalization of health services?
–The major challenges probably lie in the implementation process. We have been quite good at developing psychological interventions, and the way of doing it includes the end user’s needs and preferences from start to finish.
According to Kenter, there are many effective and user-friendly interventions, but a lot of countries are struggling to implement it as an equal service in the health care system. This seems to be a demanding job not only in Norway, but also all over the world. There are different solutions in different countries.
What end result do you hope for in Forhelse?
-The incidence of mental illness exceeds the health services available today. There are far too few who get access to the mental health services they need. I sincerely hope that through Forhelse we can make quality-assured mental health services easily accessible to those who need them, she adds.
You can read more about work package 4 here