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Celuppi IC, Mohr ETB, Felisberto M, Rodrigues TS, Hammes JF, Cunha CL, Wazlawick RS, Dalmarco EM. Ten years of the Citizen's Electronic Health Record e-SUS Primary Healthcare: in search of an electronic Unified Health System. Rev Saude Publica 2024; 58:23. [PMID: 38922270 PMCID: PMC11196093 DOI: 10.11606/s1518-8787.2024058005770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 12/08/2023] [Indexed: 06/27/2024] Open
Abstract
OBJECTIVE Contextualize the adherence to the Prontuário Eletrônico do Cidadão (PEC - Citizen's Electronic Health Record) by Brazilian municipalities and the evolution of the electronic strategy of the Unified Health System (e-SUS) for Primary Healthcare (PHC) during its 10 years. METHODS This descriptive study added information on adherence to the use of medical records extracted from the database of the Secretaria de Atenção Primária à Saúde (SAPS- Primary Healthcare Secretary) of the Federal Government between 2017 and 2022. We analized the number of computerized basic healthcare units that used some electronic medical records, the number of those that used simplified data collection (SDC), and those that implemented the citizen's electronic health record (PEC) in the same period. A descriptive synthesis of the functionalities and modules implemented in the system during its 10 years of development was also carried out. RESULTS The adherence of Brazilian municipalities to the PEC has grown exponentially in the last five years, going from 8,930 healthcare units in 2017 to 26,091 in 2022. As expected, while the main functionalities and improvements developed in this decade sought to implement new flows and modules of administrative, clinical care, and care management processes and health service administration, improving aspects of usability and technological infrastructure of the application architecture was also crucial for the success of the system. CONCLUSIONS In 2023, the milestone of a decade will be celebrated since the beginning of health records implementation by Brazilian municipalities, marked by technological and infrastructure challenges and improvements and new functionalities that highlight the technological evolution of the e-SUS PHC system and strategy. Despite many other tools, the PEC is arguably Brazil's leading electronic medical record today, as it has always invested in evolution, updating itself in technological and usability opportunities.
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Affiliation(s)
- Ianka Cristina Celuppi
- Universidade Federal de Santa CatarinaCentro TecnológicoLaboratório BridgeFlorianópolisSCBrasilUniversidade Federal de Santa Catarina. Centro Tecnológico. Laboratório Bridge. Florianópolis, SC, Brasil
- Universidade Federal de Santa CatarinaCentro de Ciências da SaúdeFlorianópolisSCBrasilUniversidade Federal de Santa Catarina. Centro de Ciências da Saúde. Programa de Pós-Graduação em Enfermagem. Florianópolis, SC, Brasil
| | - Eduarda Talita Bramorski Mohr
- Universidade Federal de Santa CatarinaCentro TecnológicoLaboratório BridgeFlorianópolisSCBrasilUniversidade Federal de Santa Catarina. Centro Tecnológico. Laboratório Bridge. Florianópolis, SC, Brasil
- Universidade Federal de Santa CatarinaCentro de Ciências da SaúdeFlorianópolisSCBrasilUniversidade Federal de Santa Catarina. Centro de Ciências da Saúde. Programa de Pós-Graduação em Farmácia. Florianópolis, SC, Brasil
| | - Mariano Felisberto
- Universidade Federal de Santa CatarinaCentro TecnológicoLaboratório BridgeFlorianópolisSCBrasilUniversidade Federal de Santa Catarina. Centro Tecnológico. Laboratório Bridge. Florianópolis, SC, Brasil
- Universidade Federal de Santa CatarinaCentro de Ciências da SaúdeFlorianópolisSCBrasilUniversidade Federal de Santa Catarina. Centro de Ciências da Saúde. Programa de Pós-Graduação em Farmácia. Florianópolis, SC, Brasil
| | - Thiago Serafim Rodrigues
- Universidade Federal de Santa CatarinaCentro TecnológicoLaboratório BridgeFlorianópolisSCBrasilUniversidade Federal de Santa Catarina. Centro Tecnológico. Laboratório Bridge. Florianópolis, SC, Brasil
| | - Jades Fernando Hammes
- Universidade Federal de Santa CatarinaCentro TecnológicoLaboratório BridgeFlorianópolisSCBrasilUniversidade Federal de Santa Catarina. Centro Tecnológico. Laboratório Bridge. Florianópolis, SC, Brasil
| | - Célio Luiz Cunha
- Universidade Federal de Santa CatarinaCentro TecnológicoLaboratório BridgeFlorianópolisSCBrasilUniversidade Federal de Santa Catarina. Centro Tecnológico. Laboratório Bridge. Florianópolis, SC, Brasil
| | - Raul Sidnei Wazlawick
- Universidade Federal de Santa CatarinaCentro TecnológicoLaboratório BridgeFlorianópolisSCBrasilUniversidade Federal de Santa Catarina. Centro Tecnológico. Laboratório Bridge. Florianópolis, SC, Brasil
- Universidade Federal de Santa CatarinaCentro TecnológicoDepartamento de Ciências da ComputaçãoFlorianópolisSCBrasilUniversidade Federal de Santa Catarina. Centro Tecnológico. Departamento de Ciências da Computação. Florianópolis, SC, Brasil
| | - Eduardo Monguilhott Dalmarco
- Universidade Federal de Santa CatarinaCentro TecnológicoLaboratório BridgeFlorianópolisSCBrasilUniversidade Federal de Santa Catarina. Centro Tecnológico. Laboratório Bridge. Florianópolis, SC, Brasil
- Universidade Federal de Santa CatarinaCentro de Ciências da SaúdeFlorianópolisSCBrasilUniversidade Federal de Santa Catarina. Centro de Ciências da Saúde. Programa de Pós-Graduação em Farmácia. Florianópolis, SC, Brasil
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Ramachandran M, Brinton C, Wiljer D, Upshur R, Gray CS. The impact of eHealth on relationships and trust in primary care: a review of reviews. BMC PRIMARY CARE 2023; 24:228. [PMID: 37919688 PMCID: PMC10623772 DOI: 10.1186/s12875-023-02176-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 10/11/2023] [Indexed: 11/04/2023]
Abstract
BACKGROUND Given the increasing integration of digital health technologies in team-based primary care, this review aimed at understanding the impact of eHealth on patient-provider and provider-provider relationships. METHODS A review of reviews was conducted on three databases to identify papers published in English from 2008 onwards. The impact of different types of eHealth on relationships and trust and the factors influencing the impact were thematically analyzed. RESULTS A total of 79 reviews were included. Patient-provider relationships were discussed more frequently as compared to provider-provider relationships. Communication systems like telemedicine were the most discussed type of technology. eHealth was found to have both positive and negative impacts on relationships and/or trust. This impact was influenced by a range of patient-related, provider-related, technology-related, and organizational factors, such as patient sociodemographics, provider communication skills, technology design, and organizational technology implementation, respectively. CONCLUSIONS Recommendations are provided for effective and equitable technology selection, application, and training to optimize the impact of eHealth on relationships and trust. The review findings can inform providers' and policymakers' decision-making around the use of eHealth in primary care delivery to facilitate relationship-building.
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Affiliation(s)
- Meena Ramachandran
- Bridgepoint Collaboratory for Research and Innovation, Lunenfeld-Tanenbaum Research Institute, Sinai Health, 1 Bridgepoint Dr, Toronto, ON, M4M 2B5, Canada.
- School of Physical and Occupational Therapy, McGill University, 3654 Promenade Sir-William-Osler, Montreal, QC, H3G 1Y5, Canada.
| | - Christopher Brinton
- Bridgepoint Collaboratory for Research and Innovation, Lunenfeld-Tanenbaum Research Institute, Sinai Health, 1 Bridgepoint Dr, Toronto, ON, M4M 2B5, Canada
- Michael G. DeGroote School of Medicine, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4L8, Canada
| | - David Wiljer
- Education Technology Innovation, University Health Network, 190 Elizabeth St, Toronto, ON, M5G 2C4, Canada
- Department of Psychiatry, University of Toronto, 155 College St, Toronto, ON, M5T 3M6, Canada
- Institute for Health Policy, Management and Evaluation, University of Toronto, 155 College St, Toronto, ON, M5T 3M6, Canada
- Centre for Addiction and Mental Health, 1000 Queen St W, Toronto, ON, M6J 1H4, Canada
| | - Ross Upshur
- Bridgepoint Collaboratory for Research and Innovation, Lunenfeld-Tanenbaum Research Institute, Sinai Health, 1 Bridgepoint Dr, Toronto, ON, M4M 2B5, Canada
- Dalla Lana School of Public Health, University of Toronto, 155 College St, Toronto, ON, M5T 3M6, Canada
| | - Carolyn Steele Gray
- Bridgepoint Collaboratory for Research and Innovation, Lunenfeld-Tanenbaum Research Institute, Sinai Health, 1 Bridgepoint Dr, Toronto, ON, M4M 2B5, Canada
- Institute for Health Policy, Management and Evaluation, University of Toronto, 155 College St, Toronto, ON, M5T 3M6, Canada
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Zimmermann R, Konjufca J, Sakejo P, Kilonzo M, Quevedo Y, Blum K, Biba E, Mosha T, Cottin M, Hernández C, Kaaya S, Arenliu A, Behn A. Mental Health Information Reporting Assistant (MHIRA)-an open-source software facilitating evidence-based assessment for clinical services. BMC Psychiatry 2023; 23:706. [PMID: 37784115 PMCID: PMC10544613 DOI: 10.1186/s12888-023-05201-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 09/18/2023] [Indexed: 10/04/2023] Open
Abstract
Evidence-based assessment (EBA) in mental health is a critical aspect of improving patient outcomes and addressing the gaps in mental health care. EBA involves the use of psychometric instruments to gather data that can inform clinical decision-making, inform policymakers, and serve as a basis for research and quality management. Despite its potential, EBA is often hindered by barriers such as workload and cost, leading to its underutilization. Regarding low- and middle-income countries (LMIC), the implementation of EBA is recognized as a key strategy to address and close the prevalent mental health treatment gap.To simplify the application of EBA including in LMIC, an international team of researchers and practitioners from Tanzania, Kosovo, Chile, and Switzerland developed the Mental Health Information Reporting Assistant (MHIRA). MHIRA is an open-source electronic health record that streamlines EBA by digitising psychometric instruments and organising patient data in a user-friendly manner. It provides immediate and convenient reports to inform clinical decision-making.The current article provides a comprehensive overview of the features and technical details of MHIRA, as well as insights from four implementation scenarios. The experience gained during the implementations as well as the user-feedback suggests that MHIRA has the potential to be successfully implemented in a variety of clinical contexts and simplify the use of EBA. However, further research is necessary to establish its potential to sustainably transform healthcare services and impact patient outcomes.In conclusion, MHIRA represents an important step in promoting the widespread adoption of EBA in mental health. It offers a promising solution to the barriers that have limited the use of EBA in the past and holds the potential to improve patient outcomes and support the ongoing efforts to address gaps in mental health care.
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Affiliation(s)
- Ronan Zimmermann
- Psychiatric University Hospitals of Basel, Basel, Switzerland.
- Faculty of Psychology, University of Basel, Basel, Switzerland.
| | - Jon Konjufca
- Faculty of Psychology, University of Basel, Basel, Switzerland
- University of Prishtina "Hasan Prishtina", Pristina, Kosovo
| | - Peter Sakejo
- Muhimbili University of Health and Allied Sciences, Dar Es Salaam, Tanzania
| | - Mrema Kilonzo
- Faculty of Psychology, University of Basel, Basel, Switzerland
- Muhimbili University of Health and Allied Sciences, Dar Es Salaam, Tanzania
| | - Yamil Quevedo
- Millennium Institute for Depression and Personality Research (MIDAP), Santiago, Chile
| | - Kathrin Blum
- Institute for Implementation Science in Health Care, University of Zurich, Zurich, Switzerland
| | | | | | - Marianne Cottin
- Millennium Institute for Depression and Personality Research (MIDAP), Santiago, Chile
- Universidad Finis Terrae, Santiago, Chile
| | - Cristóbal Hernández
- Millennium Institute for Depression and Personality Research (MIDAP), Santiago, Chile
- Universidad Adolfo Ibáñez, Santiago, Chile
| | - Sylvia Kaaya
- Muhimbili University of Health and Allied Sciences, Dar Es Salaam, Tanzania
| | | | - Alex Behn
- Millennium Institute for Depression and Personality Research (MIDAP), Santiago, Chile
- Pontificia Universidad Católica de Chile, Santiago, Chile
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Schultebraucks K, Blekic W, Basaraba C, Corbeil T, Khan Z, Henry BF, Krawczyk N, Rivera BD, Allen B, Arout C, Pincus HA, Martinez DM, Levin FR. The impact of preexisting psychiatric disorders and antidepressant use on COVID-19 related outcomes: a multicenter study. Mol Psychiatry 2023; 28:2462-2468. [PMID: 37069343 PMCID: PMC10107583 DOI: 10.1038/s41380-023-02049-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 03/01/2023] [Accepted: 03/23/2023] [Indexed: 04/19/2023]
Abstract
Pre-existing mental disorders are linked to COVID-19-related outcomes. However, the findings are inconsistent and a thorough analysis of a broader spectrum of outcomes such as COVID-19 infection severity, morbidity, and mortality is required. We investigated whether the presence of psychiatric diagnoses and/or the use of antidepressants influenced the severity of the outcome of COVID-19. This retrospective cohort study evaluated electronic health records from the INSIGHT Clinical Research Network in 116,498 individuals who were diagnosed with COVID-19 between March 1, 2020, and February 23, 2021. We examined hospitalization, intubation/mechanical ventilation, acute kidney failure, severe sepsis, and death as COVID-19-related outcomes. After using propensity score matching to control for demographics and medical comorbidities, we used contingency tables to assess whether patients with (1) a history of psychiatric disorders were at higher risk of more severe COVID-19-related outcomes and (2) if use of antidepressants decreased the risk of more severe COVID-19 infection. Pre-existing psychiatric disorders were associated with an increased risk for hospitalization, and subsequent outcomes such as acute kidney failure and severe sepsis, including an increased risk of death in patients with schizophrenia spectrum disorders or bipolar disorders. The use of antidepressants was associated with significantly reduced risk of sepsis (p = 0.033), death (p = 0.026). Psychiatric disorder diagnosis prior to a COVID-19-related healthcare encounter increased the risk of more severe COVID-19-related outcomes as well as subsequent health complications. However, there are indications that the use of antidepressants might decrease this risk. This may have significant implications for the treatment and prognosis of patients with COVID-19.
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Affiliation(s)
- Katharina Schultebraucks
- Department of Psychiatry, NYU Grossman School of Medicine, New York, NY, USA.
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA.
| | - Wivine Blekic
- Department of Psychiatry, NYU Grossman School of Medicine, New York, NY, USA
| | - Cale Basaraba
- Area Mental Health Data Science, New York State Psychiatric Institute, New York, NY, USA
| | - Tom Corbeil
- Area Mental Health Data Science, New York State Psychiatric Institute, New York, NY, USA
| | - Zain Khan
- Department of Biomedical Engineering, Columbia University, New York, NY, USA
| | - Brandy F Henry
- Rehabilitation and Human Services, Educational Psychology, Counseling, and Special Education, College of Education Consortium on Substance Use and Addiction, Social Science Research Institute, Pennsylvania State University, State College, PA, USA
| | - Noa Krawczyk
- Center for Opioid Epidemiology and Policy, Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Bianca D Rivera
- Center for Opioid Epidemiology and Policy, Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Bennett Allen
- Center for Opioid Epidemiology and Policy, Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Caroline Arout
- Department of Psychiatry, Columbia University Irving Medical Center and New York State Psychiatric Institute, New York, NY, USA
| | - Harold Alan Pincus
- Department of Psychiatry, Columbia University Irving Medical Center and New York State Psychiatric Institute, New York, NY, USA
- Irving Institute for Clinical and Translational Research, Columbia University, New York, NY, USA
- Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Diana M Martinez
- Department of Psychiatry, Columbia University Irving Medical Center and New York State Psychiatric Institute, New York, NY, USA
- Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Frances R Levin
- Department of Psychiatry, Columbia University Irving Medical Center and New York State Psychiatric Institute, New York, NY, USA
- Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
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Kariotis TC, Prictor M, Chang S, Gray K. Impact of Electronic Health Records on Information Practices in Mental Health Contexts: Scoping Review. J Med Internet Res 2022; 24:e30405. [PMID: 35507393 PMCID: PMC9118021 DOI: 10.2196/30405] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 09/14/2021] [Accepted: 01/13/2022] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND The adoption of electronic health records (EHRs) and electronic medical records (EMRs) has been slow in the mental health context, partly because of concerns regarding the collection of sensitive information, the standardization of mental health data, and the risk of negatively affecting therapeutic relationships. However, EHRs and EMRs are increasingly viewed as critical to improving information practices such as the documentation, use, and sharing of information and, more broadly, the quality of care provided. OBJECTIVE This paper aims to undertake a scoping review to explore the impact of EHRs on information practices in mental health contexts and also explore how sensitive information, data standardization, and therapeutic relationships are managed when using EHRs in mental health contexts. METHODS We considered a scoping review to be the most appropriate method for this review because of the relatively recent uptake of EHRs in mental health contexts. A comprehensive search of electronic databases was conducted with no date restrictions for articles that described the use of EHRs, EMRs, or associated systems in the mental health context. One of the authors reviewed all full texts, with 2 other authors each screening half of the full-text articles. The fourth author mediated the disagreements. Data regarding study characteristics were charted. A narrative and thematic synthesis approach was taken to analyze the included studies' results and address the research questions. RESULTS The final review included 40 articles. The included studies were highly heterogeneous with a variety of study designs, objectives, and settings. Several themes and subthemes were identified that explored the impact of EHRs on information practices in the mental health context. EHRs improved the amount of information documented compared with paper. However, mental health-related information was regularly missing from EHRs, especially sensitive information. EHRs introduced more standardized and formalized documentation practices that raised issues because of the focus on narrative information in the mental health context. EHRs were found to disrupt information workflows in the mental health context, especially when they did not include appropriate templates or care plans. Usability issues also contributed to workflow concerns. Managing the documentation of sensitive information in EHRs was problematic; clinicians sometimes watered down sensitive information or chose to keep it in separate records. Concerningly, the included studies rarely involved service user perspectives. Furthermore, many studies provided limited information on the functionality or technical specifications of the EHR being used. CONCLUSIONS We identified several areas in which work is needed to ensure that EHRs benefit clinicians and service users in the mental health context. As EHRs are increasingly considered critical for modern health systems, health care decision-makers should consider how EHRs can better reflect the complexity and sensitivity of information practices and workflows in the mental health context.
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Affiliation(s)
- Timothy Charles Kariotis
- School of Computing and Information Systems, University of Melbourne, Parkville, Australia
- Melbourne School of Government, The University of Melbourne, Carlton, Australia
| | - Megan Prictor
- Melbourne Law School, University of Melbourne, Carlton, Australia
- Centre for Digital Transformation of Health, University of Melbourne, Parkville, Australia
| | - Shanton Chang
- School of Computing and Information Systems, University of Melbourne, Parkville, Australia
| | - Kathleen Gray
- Centre for Digital Transformation of Health, University of Melbourne, Parkville, Australia
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Kernebeck S, Busse TS, Jux C, Dreier LA, Meyer D, Zenz D, Zernikow B, Ehlers JP. Evaluation of an Electronic Medical Record Module for Nursing Documentation in Paediatric Palliative Care: Involvement of Nurses with a Think-Aloud Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:3637. [PMID: 35329323 PMCID: PMC8954648 DOI: 10.3390/ijerph19063637] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 03/04/2022] [Accepted: 03/14/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND Paediatric palliative care (PPC) is a noncurative approach to the care of children and adolescents with life-limiting and life-threatening illnesses. Electronic medical records (EMRs) play an important role in documenting such complex processes. Despite their benefits, they can introduce unintended consequences if future users are not involved in their development. AIM The aim of this study was to evaluate the acceptance of a novel module for nursing documentation by nurses working in the context of PPC. METHODS An observational study employing concurrent think-aloud and semi-structured qualitative interviews were conducted with 11 nurses working in PPC. Based on the main determinants of the unified theory of acceptance and use of technology (UTAUT), data were analysed using qualitative content analysis. RESULTS The main determinants of UTAUT were found to potentially influence acceptance of the novel module. Participants perceived the module to be self-explanatory and intuitive. Some adaptations, such as the reduction of fragmentation in the display, the optimization of confusing mouseover fields, and the use of familiar nursing terminology, are reasonable ways of increasing software adoption. CONCLUSIONS After adaptation of the modules based on the results, further evaluation with the participation of future users is required.
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Affiliation(s)
- Sven Kernebeck
- Department of Didactics and Educational Research in Health Science, Faculty of Health, Witten/Herdecke University, 58448 Witten, Germany; (T.S.B.); (C.J.); (J.P.E.)
| | - Theresa Sophie Busse
- Department of Didactics and Educational Research in Health Science, Faculty of Health, Witten/Herdecke University, 58448 Witten, Germany; (T.S.B.); (C.J.); (J.P.E.)
- PedScience Research Institute, 45711 Datteln, Germany; (L.A.D.); (D.M.); (B.Z.)
| | - Chantal Jux
- Department of Didactics and Educational Research in Health Science, Faculty of Health, Witten/Herdecke University, 58448 Witten, Germany; (T.S.B.); (C.J.); (J.P.E.)
| | - Larissa Alice Dreier
- PedScience Research Institute, 45711 Datteln, Germany; (L.A.D.); (D.M.); (B.Z.)
- Department of Children’s Pain Therapy and Pediatric Palliative Care, Faculty of Health, School of Medicine, Witten/Herdecke University, 58448 Witten, Germany
| | - Dorothee Meyer
- PedScience Research Institute, 45711 Datteln, Germany; (L.A.D.); (D.M.); (B.Z.)
- Department of Children’s Pain Therapy and Pediatric Palliative Care, Faculty of Health, School of Medicine, Witten/Herdecke University, 58448 Witten, Germany
| | - Daniel Zenz
- Smart-Q Softwaresystems GmbH, Lise-Meitner-Allee 4, 44801 Bochum, Germany;
| | - Boris Zernikow
- PedScience Research Institute, 45711 Datteln, Germany; (L.A.D.); (D.M.); (B.Z.)
- Department of Children’s Pain Therapy and Pediatric Palliative Care, Faculty of Health, School of Medicine, Witten/Herdecke University, 58448 Witten, Germany
- Pediatric Palliative Care Centre, Children’s and Adolescents’ Hospital, 45711 Datteln, Germany
| | - Jan Peter Ehlers
- Department of Didactics and Educational Research in Health Science, Faculty of Health, Witten/Herdecke University, 58448 Witten, Germany; (T.S.B.); (C.J.); (J.P.E.)
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Monteith S, Glenn T, Geddes J, Whybrow PC, Achtyes E, Bauer M. Expectations for Artificial Intelligence (AI) in Psychiatry. Curr Psychiatry Rep 2022; 24:709-721. [PMID: 36214931 PMCID: PMC9549456 DOI: 10.1007/s11920-022-01378-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/15/2022] [Indexed: 01/29/2023]
Abstract
PURPOSE OF REVIEW Artificial intelligence (AI) is often presented as a transformative technology for clinical medicine even though the current technology maturity of AI is low. The purpose of this narrative review is to describe the complex reasons for the low technology maturity and set realistic expectations for the safe, routine use of AI in clinical medicine. RECENT FINDINGS For AI to be productive in clinical medicine, many diverse factors that contribute to the low maturity level need to be addressed. These include technical problems such as data quality, dataset shift, black-box opacity, validation and regulatory challenges, and human factors such as a lack of education in AI, workflow changes, automation bias, and deskilling. There will also be new and unanticipated safety risks with the introduction of AI. The solutions to these issues are complex and will take time to discover, develop, validate, and implement. However, addressing the many problems in a methodical manner will expedite the safe and beneficial use of AI to augment medical decision making in psychiatry.
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Affiliation(s)
- Scott Monteith
- Michigan State University College of Human Medicine, Traverse City Campus, Traverse City, MI, 49684, USA.
| | | | - John Geddes
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
| | - Peter C. Whybrow
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles (UCLA), Los Angeles, CA USA
| | - Eric Achtyes
- Michigan State University College of Human Medicine, Grand Rapids, MI 49684 USA ,Network180, Grand Rapids, MI USA
| | - Michael Bauer
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus Medical Faculty, Technische Universität Dresden, Dresden, Germany
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