Health Care Technology: The Internet-Based Cognitive Behavioral Therapy

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Introduction

Rapidly developing technology seems to be a viable option to apply in response to high mortality and morbidity from acute and chronic conditions. In healthcare, it is accepted that care quality is a top priority, which ensures that patients receive the required services and recover. The use of the Internet-based cognitive behavioral therapy (iCBT) is one of the technological solutions to continuous care improvement, which is part of routine care in hospitals, namely, psychiatric units (Desai et al., 2017). This paper focuses on exploring the identified technology from the point of the user interface to evaluate its functionality, user experience, and usability.

User-Technology Interface Evaluation

The iCB is a health care technology that provides online access to programs that support patients. Namely, one of the areas of assistance is web-based consultations with specialists, when the necessary questions can be posed and answered. Also, this technology allows for offering materials and instruments that can be used by patients to improve their behavioral and cognitive skills. iCBT is often implemented in patients who are diagnosed with depression, anxiety, and other mental disorders. For example, there are such platforms as MoodGym and Interapy. The current academic evidence shows moderate effectiveness of the identified technology.

In their recent study, Mathiasen et al. (2018) found that iCBT reduces the symptoms of depression and anxiety when the intervention is applied in hospital settings. In turn, Kumar et al. (2017) revealed that patients with mental illnesses and psychiatric comorbidities tended to recover more rapidly. However, many patients showed low adherence levels, which point to the need to evaluate and enhance this technology.

To measure the effectiveness of the iCBT, it is possible to apply an actor-network theory (ANT) that considers that all the elements of a patient information system are closely intertwined. Namely, the system should include a database, manuals, hardware, administrative staff, and so on. The implementation of technology depends on the stakeholders who are enrolled in the system, which makes every case unique (Ballantyne, 2015). Accordingly, the exploration of the relationships between these stakeholders is one of the most representative ways to evaluate the iCBT. Ballantyne (2015) states that the links between human and non-human actors are also important since they compose the so-called heterogeneous network.

Therefore, both of the mentioned aspects should be taken into account during the evaluation of the target technology in terms of its usage in healthcare settings. The user-technology interface assessment is an essential procedure that allows revealing the strengths and weaknesses of a system to recommend relevant improvements.

Speaking of the elements to be evaluated, one should list usability, user experience, and functionality. These concepts correspond to unique aspects of technology, such as interaction, experience, and product. The relationships between patients and technology aimed at providing the former with valuable knowledge and skills to enhance their health outcomes. A person using the iCBT may fail to search for the required information, but his or her actions and experience may be compulsive and biased. In this connection, the identified three elements should be evaluated in combination to make sure that a full picture is considered.

However, it should also be stated that these components are not always interdependent. Even though the level of functionality is not a product characteristic, it can have an impact on usability (Desai et al., 2017). For example, the aesthetics of the interface may attract patients or be the element that prevents further technology usage since it is not intuitive for users.

Usability is an element that refers to the interaction between a user and a product. In the given case, the usability of the technology should be verified in terms of the actual interaction of patients with the system, which can be observed by a nurse. Another way to provide data is to report directly to a healthcare provider. The key issue that was discovered as high is the ability of the product to achieve its initial goal of clarifying information and helping patients to overcome their anxiety and depression (Webb et al., 2017). The criterion of goal facilitation can be supplemented by the extent to which the technology was useful for a certain patient.

A brief questionnaire can be offered to patients after they have completed working with the iCBT. The questions about what were the most important aspects, and how the limitations can be improved should be included. The user comments may contain some notes on the learnability and comprehensiveness of the system. Accordingly, more teaching blocks and manuals can be added to the platform to improve usability (Webb et al., 2017).

User experience is another element that can be understood as wider relationships between the iCBT and its users, which should be used to clarify the personal preferences of patients. It is evident that despite common symptoms of depression and anxiety, patients may have varying needs. Therefore, it is significant to examine personal experience based on emotions and feelings faced by patients while using the technology. The level of comfortability and perceived value of applying the iCBT is currently medium. The intuitive nature of the user interface can be examined to determine any related difficulties.

In terms of the ANT, it seems to be beneficial to analyze whether the technology acts as a “faithful intermediary of the traditional visitation process that would otherwise occur face-to-face” (Ballantyne, 2015, p. 111). Design reductionism is one of the most innovative solutions to adjust the interface so that it would be understandable for any patient (Ballantyne, 2015). Visualization can be adjusted as well to make the user experience more valuable.

Functionality is associated with the product, the iCBT, which includes reliability, maintainability, usefulness, and other features. The evaluation of this element can be performed by task analysis and interface tests. The clinical effectiveness of the given system can be assessed in terms of a series of randomized controlled trials. Currently, the evidence points to the positive impact of the iCBT on recovery rates and symptom addressing (Kumar et al., 2017; Mathiasen et al., 2018). The functions that need to be improved and those that can be added may be clarified in terms of patient feedback.

Conclusion

To conclude, Internet-based cognitive-behavioral therapy (iCBT) is an effective technological solution to helping patients with depression and anxiety. The actor-network theory (ANT) was used to define and examine the selected technology. The review of its core elements showed that the user experience, usability, and functionality of this platform compose its user-interface interactions. It was found that the iCBT has a great potential to become more beneficial to patients, which can be achieved by adding more teaching blocks and manuals, applying design reductionism, and conducting research.

References

Ballantyne, N. (2015). Human service technology and the theory of the actor-network. Journal of Technology in Human Services, 33(1), 104-117.

Desai, A., Zoccatelli, G., Adams, M., Allen, D., Brearley, S., Rafferty, A. M., Robert, G., & Donetto, S. (2017). Taking data seriously: The value of actor-network theory in rethinking patient experience data. Journal of Health Services Research & Policy, 22(2), 134-136.

Kumar, V., Sattar, Y., Bseiso, A., Khan, S., & Rutkofsky, I. H. (2017). The effectiveness of Internet-based cognitive behavioral therapy in the treatment of psychiatric disorders. Cureus, 9(8), 1-14.

Mathiasen, K., Riper, H., Andersen, T. E., & Roessler, K. K. (2018). Guided internet-based cognitive behavioral therapy for adult depression and anxiety in routine secondary care: Observational study. Journal of Medical Internet Research, 20(11), 1-14.

Webb, C. A., Rosso, I. M., & Rauch, S. L. (2017). Internet-based cognitive behavioral therapy for depression: Current progress & future directions. Harvard Review of Psychiatry, 25(3), 114-122.

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