Background: Globally, there are fundamental shortcomings in mental health care systems, including restricted access, siloed services, interventions that are poorly matched to service users’ needs, underuse of personal outcome monitoring to track progress, exclusion of family and carers, and suboptimal experiences of care. Health information technologies (HITs) hold great potential to improve these aspects that underpin the enhanced quality of mental health care. Objective: Project Synergy aimed to co-design, implement, and evaluate novel HITs, as exemplified by the InnoWell Platform, to work with standard health care organizations. The goals were to deliver improved outcomes for specific populations under focus and support organizations to enact significant system-level reforms. Methods: Participating health care organizations included the following: Open Arms–Veterans & Families Counselling (in Sydney and Lismore, New South Wales [NSW]); NSW North Coast headspace centers for youth (Port Macquarie, Coffs Harbour, Grafton, Lismore, and Tweed Heads); the Butterfly Foundation’s National Helpline for eating disorders; Kildare Road Medical Centre for enhanced primary care; and Connect to Wellbeing North Coast NSW (administered by Neami National), for population-based intake and assessment. Service users, families and carers, health professionals, and administrators of services across Australia were actively engaged in the configuration of the InnoWell Platform to meet service needs, identify barriers to and facilitators of quality mental health care, and highlight potentially the best points in the service pathway to integrate the InnoWell Platform. The locally configured InnoWell Platform was then implemented within the respective services. A mixed methods approach, including surveys, semistructured interviews, and workshops, was used to evaluate the impact of the InnoWell Platform. A participatory systems modeling approach involving co-design with local stakeholders was also undertaken to simulate the likely impact of the platform in combination with other services being considered for implementation within the North Coast Primary Health Network to explore resulting impacts on mental health outcomes, including suicide prevention. Results: Despite overwhelming support for integrating digital health solutions into mental health service settings and promising impacts of the platform simulated under idealized implementation conditions, our results emphasized that successful implementation is dependent on health professional and service readiness for change, leadership at the local service level, the appropriateness and responsiveness of the technology for the target end users, and, critically, funding models being available to support implementation. The key places of interoperability of digital solutions and a willingness to use technology to coordinate health care system use were also highlighted. Conclusions: Although the COVID-19 pandemic has resulted in the widespread acceptance of very basic digital health solutions, Project Synergy highlights the critical need to support equity of access to HITs, provide funding for digital infrastructure and digital mental health care, and actively promote the use of technology-enabled, coordinated systems of care.

中文翻译：

---

告知集成数字和临床心理保健的未来：项目协同的结果综合

背景：在全球范围内，精神卫生保健系统存在根本性缺陷，包括访问受限、服务孤立、干预措施与服务使用者的需求不匹配、未充分利用个人结果监测来跟踪进展、排斥家人和照顾者以及体验不佳的关心。卫生信息技术 (HIT) 在改善这些支持提高精神卫生保健质量的方面具有巨大潜力。目标： Project Synergy 旨在共同设计、实施和评估新的 HIT，以 InnoWell 平台为例，与标准医疗保健组织合作。目标是为重点关注的特定人群提供更好的结果，并支持组织实施重大的系统级改革。方法：参与的医疗保健组织包括： Open Arms–Veterans & Families Counseling（在新南威尔士州的悉尼和利斯莫尔 [NSW]）；新南威尔士州北海岸青少年顶空中心（Port Macquarie、Coffs Harbour、Grafton、Lismore 和 Tweed Heads）；蝴蝶基金会的全国饮食失调热线；基尔代尔路医疗中心加强初级保健；和 Connect to Wellbeing North Coast NSW（由 Neami National 管理），进行基于人群的摄入和评估。澳大利亚各地的服务用户、家庭和护理人员、卫生专业人员和服务管理人员积极参与 InnoWell 平台的配置，以满足服务需求，识别优质精神卫生保健的障碍和促进者，并突出显示集成 InnoWell 平台的服务路径中潜在的最佳点。然后在各自的服务中实施本地配置的 InnoWell 平台。采用混合方法，包括调查、半结构化访谈和研讨会，来评估 InnoWell 平台的影响。还采用了涉及与当地利益相关者共同设计的参与式系统建模方法，以模拟平台的可能影响，并结合考虑在北海岸初级卫生网络内实施的其他服务，探索由此产生的对心理健康结果的影响，包括自杀预防。半结构化访谈和研讨会被用来评估 InnoWell 平台的影响。还采用了涉及与当地利益相关者共同设计的参与式系统建模方法，以模拟平台的可能影响，并结合考虑在北海岸初级卫生网络内实施的其他服务，探索由此产生的对心理健康结果的影响，包括自杀预防。半结构化访谈和研讨会被用来评估 InnoWell 平台的影响。还采用了涉及与当地利益相关者共同设计的参与式系统建模方法，以模拟平台的可能影响，并结合考虑在北海岸初级卫生网络内实施的其他服务，探索由此产生的对心理健康结果的影响，包括自杀预防。结果：尽管对将数字健康解决方案整合到心理健康服务环境中获得了压倒性的支持，并且在理想化的实施条件下模拟的平台产生了有希望的影响，但我们的结果强调，成功的实施取决于卫生专业人员和服务对变革的准备程度，以及当地服务水平的领导力、技术对目标最终用户的适用性和响应能力，以及关键的是，可用于支持实施的资助模式。还强调了数字解决方案的互操作性和使用技术协调医疗保健系统使用的意愿的关键位置。结论：尽管 COVID-19 大流行已导致非常基本的数字健康解决方案得到广泛接受，但 Project Synergy 强调了支持公平获得 HIT、为数字基础设施和数字精神卫生保健提供资金以及积极促进使用技术支持，协调的护理系统。