Table 3.

Recommendations arising from these findings.

Recommendation
Recommendations when considering impact of digital tools on staff and services	Staff fears around the role of technology in service delivery need to be discussed up front and addressed when considering incorporating digital tools in services. E.g., normalizing concerns, problem-solving solutions/safeguards, and providing evidence to alleviate concerns in a supportive, nonconfrontational manner are important.
	Training staff in using digital tools is equally as important as training service users, not just in practical terms but also by way of increasing clinician confidence and familiarity with digital technologies.
	Organizational support with a clear plan for implementing technological innovations is required, with targets in the implementation plan that are assessed and measured.
	Implementing of digital systems needs to be simple and uncomplicated and improve clinical workflows rather than hinder and increase clinical workflows.
Recommendations when considering impact of digital tools on Service users	Although ownership rates of mobile phones in psychosis are comparable to the general population (43), for those who do not have access to smartphones, services might consider loaning phones to negate the digital divide.
	Digital products need to be made available in multiple languages as well as in different mediums (e.g., audio and video) to not further facilitate social exclusion in an already-marginalized group.
	Digital systems should use schedule and prompts to engage services users with the products and consider using social media platforms to facilitate connection and communication with others.
	Emphasize to services/staff the positive aspects of digital systems (e.g., increased access to support; improved social inclusivity; more ecologically valid reporting of symptoms/distress; reduced stigma; digital technology is often more user-friendly for “digital natives” and the preferred method of communication for this group).
Data security, safety, and risk	Digital systems need to adhere to strict data management procedures, ensuring that systems are secure and safe. Services need to describe in clear and simple terms how digital data will be stored and who will have access to these data.
	A clear procedure for managing risk, especially in the context of real-time data workflow streams, is needed.
	At a minimum, simple features like emergency contacts built into digital systems may help both staff and service users feel supported when clinicians are not able to respond to immediate signs of risk.
Impact of digital systems on relationships	Blended approaches to implementing digital systems into services may be more acceptable to clinicians than stand-alone digital products.