mHealth Apps in German Outpatient Mental Health Care: Protocol for a Mixed Methods Approach (Preprint)

BACKGROUND Mental disorders are complex diseases that affect 28% (about 17.8 million people) of the adult population in Germany annually. Since 2020, certain mobile health (mHealth) apps, so-called digital health applications (DiGA), are reimbursable in the German statutory health insurance system. A total of 27 of the 56 currently available DiGA are approved for the treatment of mental and behavioral diseases. An indicator of existing problems hindering the use of DiGA is the rather hesitant prescribing behavior. OBJECTIVE This project aims to develop health policy recommendations for the optimal integration of DiGA into outpatient psychotherapeutic care. The project is funded by the Innovation Fund of the Joint Federal Committee (grant 01VSF22029). The current status quo of the use of DiGA will be analyzed. Furthermore, concepts for the integration of mHealth apps, as well as their transfer into the care process will be investigated. In addition, barriers will be identified, and existing expectations of different perspectives captured. METHODS The project will be based on a mixed methods approach. A scoping review and a qualitative analysis of focus groups and expert interviews will be carried out. Additionally, an analysis of claims data of the statutory health insurance will be conducted. This will be followed by a written survey of insured persons and health care providers. Finally, health policy recommendations will be derived in cooperation with stakeholders. RESULTS The scoping reviews and qualitative analyses have been completed, and the quantitative surveys are currently being carried out. The target number of responses in the survey of insured persons has already been achieved. Furthermore, the analysis claims data of the statutory health insurance is currently being conducted. CONCLUSIONS There is a need for research on how DiGA can be optimally integrated into the care process of patients with mental disorders as evidence regarding the topic is limited and prescribing behavior low. Although the potential of DiGA in mental health care has not yet fully unfolded, Germany serves as a model for other countries regarding reimbursable mHealth apps. This project aims to explore the potentials of DiGA and to describe the organizational, institutional, and procedural steps necessary for them to best support mental health care. INTERNATIONAL REGISTERED REPORT DERR1-10.2196/56205