Developing a Computer Application to Prepare Social Workers for Integrated Healthcare

Background and Purpose 

In current U.S. healthcare settings with separate systems of mental and physical healthcare, comorbid behavioral and physical health problems are not effectively detected nor properly treated (Unutzer, Schoenbaum, Druss, & Katon, 2006).  Integrated healthcare is a proposed solution to addressing these disparities and improving outcomes.  Despite the proposed benefits, a significant barrier to integration is the lack of providers with the knowledge necessary to practice in integrated settings (Richardson et al., 2001).  Simply transitioning specialty care clinicians to integrated settings is ineffective due to poor skill fit between specialty mental health clinical practices and integrated care (Blount & Miller, 2009).

Computer application technology may be an effective method to disseminate knowledge essential for social workers to transition to integrated settings.  Benefits of smartphone applications are their intuitive nature, provision of opportunities for self-directed learning, verification of knowledge at the point of care, ability to access information quickly, and notification of upgrades or changes (Brown & Roberts, 2014).  Despite these benefits, a computer application has not been developed to provide the knowledge required for behavioral health providers to practice in integrated healthcare settings.  This study aims to fill this gap by developing a computer application using a method that incorporates user feedback throughout the design process. 

Methods

An internet based tool was developed and tested through a qualitative research design.  Two focus groups and individual interviews were conducted with social work professors and students.  Focus group 1 evaluated faculty members’ perspectives of the application design and usefulness, while focus group 2 explored masters level students’ input into features and benefits for practice.  Individual interviews were conducted with integrated health content experts on the substantive material.  Therefore, the computer application was developed through an iterative process implementing changes after each evaluation using Nielson’s usability heuristics and incorporating changes in development.     

Results

Results from the focus groups suggested that the application looked professional and contained useful information, while also being intuitive to use and beneficial for direct practice. Yet, physical health diagnoses commonly seen in integrated health settings were noted to be missing from the application. Additional concerns from focus groups included needing accessible vital screening measures and more clarity on target populations. Individual interview findings included that the content “hits on some of the really important things”, functionality was “very easy to navigate”, and use for clinical care put “evidence based practice at their finger-tips when they’re working with patients”.  Identified content and navigation concerns were corrected in the application. The final product reflects input from integrated health care social work stakeholders and might serve as a vital strategy to equipping social workers for this work.

Conclusions and Implications

The final version of the application provides an introduction to integrated healthcare concepts, reinforces the integrated nature of physical and behavioral health, and puts evidence based knowledge at the point of care.  Potential benefits to social workers include the ability to access information quickly, maintain previously learned knowledge, and obtain new knowledge.  Additional implications will be presented