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BackgroundInterest in internet-based patient reported outcome measure (PROM) collection is increasing. The NHS myHealthE (MHE) web-based monitoring system was developed to address the limitations of paper-based PROM completion. MHE provides a simple and secure way for families accessing Child and Adolescent Mental Health Services to report clinical information and track their child’s progress. This study aimed to assess whether MHE improves the completion of the Strengths and Difficulties Questionnaire (SDQ) compared with paper collection. Secondary objectives were to explore caregiver satisfaction and application acceptability.MethodsA twelve-week single-blinded randomised controlled feasibility pilot trial of MHE was conducted with 196 families accessing neurodevelopmental services in south London to examine whether electronic questionnaires are completed more readily than paper-based questionnaires over a 3-month period. Follow up process evaluation phone calls with a subset (n=8) of caregivers explored system satisfaction and usability.ResultsMHE group assignment was significantly associated with an increased probability of completing an SDQ-P in the study period (adjusted hazard ratio, (HR) 12.1, 95% CI 4.7-31.0; p= ConclusionsMHE holds promise for improving PROM completion rates. Research is needed to refine MHE, evaluate large scale MHE implementation, cost effectiveness and explore factors associated with differences in electronic questionnaire uptake.Key practitioner messagesPatient reported outcome measures (PROMs) are considered an important tool for measuring treatment success and outcomes in healthcare systems.Adherence to routine PROM guidance in Child and Adolescent Mental Health Services (CAMHS) remains low, largely driven by limitations associated with paper-based data collection.Paperless monitoring systems (i.e., digital) as an alternative to traditional outcome measure delivery and collection are growing in healthcare settings.Remote questionnaire completion using the myHealthE (MHE) system is feasible and acceptable to caregivers of children accessing CAMHS in South London, yielding a 60.3 % increase in Strengths and Difficulties questionnaire reporting compared to standard practice.More research is required to understand whether MHE implementation affords similar improvements in remote PROM completion at scale and whether electronic questionnaire uptake is equal for different socio-demographic and clinical populations.

This paper reports our experience of developing, implementing, and evaluating myHealthE (MHE); a digital innovation for Child and Adolescents Mental Health Services (CAMHS) which automates the remote collection and reporting of Patient Reported Outcome Measures (PROMs) into National Health Services (NHS) electronic health care records. We describe the logistical and governance issues encountered in developing the MHE interface with patient identifiable information, and the steps taken to overcome these development barriers. We describe the applications architecture and hosting environment to enable it to be operable within the NHS, as well the as the capabilities needed within the technical team to bridge the gap between academic developers and NHS operational teams. We present evidence on the feasibility and acceptability for this system within clinical services and describe the process of iterative development, highlighting additional functions which were incorporated to increase system utility. This article provides a framework with which to plan, develop and implement automated PROM collection from remote devices back to NHS infrastructure. The challenges and solutions described in this paper will be pertinent to other digital health innovation researchers aspiring to deploy interoperable systems within NHS clinical systems.