There are several issues that need to be addressed. They are not unlike the current system though which is siloed in many cases. Interoperability with the EMR's that are used by the treatment team would be a primary issue that can be addressed. Having appropriate releases of information shared by the primary and secondary treating providers would be a significant assistance in coordinating care--this rarely occurs now without use of digital tools so addressing this would be a significant advance. Being able to share laboratory and imaging data any testing and medication information are also significant positives. Ideally having the patient develop a behavioral health advance directive and share it with all treating providers and advocates could be a great add for a digital interface.
The product itself would need to be evidence based and have a "meaningful use" in the therapy and tracking of progress such as a digital workbook on tasks to do between therapy sessions that is then reported to the therapist to address during the session to see where barriers to progress lie.

Telemedicine has revolutionized the access to behavioral health services in rural and not easily accessible areas. This can also bring crisis services to those areas as well and thereby "catch" decompensations early and ideally prevent adverse outcomes. W. Beecroft M.D.

Tools for patients to administer and submit patient-reported outcome measures (PROMs) can save staff time, assist in collecting valid data (many of these were developed for self-administration and get paraphrased when completed by interview), and facilitate information flow for asynchronous care such as depression collaborative care management. One challenge is working out the hardware and software details in concert with the electronic medical record (integration rather than interfacing) as well as with clinician workflows (the overall "choreography") to assure that the information flow is harmonized with a rational process of care that drives productive clinical engagement. Interfaced and not integrated collection systems can divert staff attention away from their primary information and record sources, and poorly positioned channels of information flow compete poorly for staff attention and do not set the collaborative care effort up for success.

Good morning: In our experience the treating provider or system needs to integrates the digital tool in the treatment. This needs to be addressed with he patient as part of the routine of the interactions/sessions. it could be the "homework" that is required between formal therapy sessions or tracking of movements or logging their thoughts(journaling) that is done as a component of the treatment itself. It will also need to be statused during the session and genuinely be incorporated into the therapy. if left to the patient to just "work" their program without interaction with the therapist then the interest seems to fall off rapidly and they don't seem to continue use. W. Beecroft

Good afternoon. Telemedicine offers the opportunity to provide meaningful access to clinical care that many communities have struggled to find, engage in, and embrace. It also creates an opportunity to develop new strategies to identify needs, and link families to support services that can improve 'social determinants of health' that impact their daily lives, and ultimately their health outcomes. Digital tools much create ways to integrate this information into the platform that allows for patients to use easily, and for providers to easily access and incorporate into the patient visit, notes, etc.