Toward hybrid mental health care: an early health technology assessment based on stakeholder analysis and economic simulations
Abstract Objectives Combining digital and traditional treatment elements as part of a hybrid care delivery model may strengthen the sustainability of mental health care. However, implementation problems permeate efforts of digitalizing routine care. The objective of this formative study is to explore current unmet stakeholder needs and the potential value of hybrid care models for the treatment of severe mental disorders, in order to guide further research and inform practical implementation strategies. Methods We applied Step Up, an early health technology assessment (eHTA) framework. We performed (a) a template analysis of qualitative data from a stakeholder workshop mapping unmet needs, potential effects of hybrid care models, and conditions relevant for implementation and (b) exploratory economic simulations of the impact of increasing video consultation use in routine services on quantitative sustainability parameters. Results The template analysis revealed stakeholder-anticipated value from hybrid care models across all domains: patient, clinician, and next-of-kin user experiences; clinical variables; organizational setup; and economy. Two recommendations for enhancing implementation were identified: promoting nuanced perceptions of digitalized care and developing clinician incentives. The simulations demonstrated that a moderate increase in video consultations may impact clinical capacity, as well as economic and environmental sustainability. Conclusions This study provides early decision support concerning hybrid care models during the conceptual stage of service innovation. It reveals that conservative changes toward digitalized practices can create new opportunities for organizing services and have a substantial impact on sustainability parameters. Successful implementation across clinical contexts requires continuous consideration of the clinician user perspective, starting from the conceptual phase.