Approaches for Departments, Schools, and Health Systems to Better Implement Technologies Used for Clinical Care and Education

Abstract

Rapidly shifting how health care and business are managed, technology can enormously impact the quality of service care delivery, education/training, faculty development, and administration in academic health centers [1, 2]. While the shift to include technology is consistent with the Institute of Medicine’s health professional education movement, the question is how to efficiently do that in a metric-, data-, and reimbursement-driven care era [3–5]. Leaders of departments, schools, and health systems are obliged to understand the external forces at play related to health care, which push for “faster, cheaper, better” services [6, 7]. Technology creates challenges to overcome such as clinical competence, as well as uncertain cost and operational requirements [4]. To date, the most widely researched and implemented technology in psychiatric settings has been telepsychiatry (TP; video) or telebehavioral health (TBH). Randomized controlled trials show that TBH is effective and comparable to in-person care via a variety of models [8–11]. Guidelines by the American Telemedicine Association in 2013 and 2017 [12, 13] provide clinical, administrative, and technical contexts. Psychiatric leaders must now also consider social media, mobile health, apps, and other technologies—each associated with assorted benefits, risks, and costs. This paper is designed to help leaders “step back” and broadly envision how academia and technology may reasonably interface. If psychiatric faculty and administrators fail to technologically progress, young professionals may opt toward other technology-hip areas of medicine, and clinical boundary and privacy violationsmay becomemore common. This paper complements the curricular and competency papers [14–18], which provide more operational, concrete examples for faculty, residents, and administrators. This paper aims to help readers in three ways: