3Q's for QI |Q&A with Dr. Dana Steidtmann
Nov 25, 2024
Using patient-reported outcome measures to guide clinical care is associated with improved outcomes and widely regarded as a best practice in mental health. However, many systems have struggled to routinely adopt the practice. In an article in Psychiatric Services, IHQSE alumni and members of the University of Colorado Department of Psychiatry describe how they used technology to address major barriers to using this best practice in their design and implementation of the Measurement-Assisted Care (MAC) program. In MAC, patient-reported outcome measures are automatically attached to patient eCheck-in and clinician documentation templates nudge clinicians to view and discuss the responses during visits. MAC increased the availability of patient-reported outcome measures from 5% to 60%+ of patient visits with more than 90% of clinicians reporting the information was useful. We spoke with lead author and IHQSE graduate Dr. Dana Steidtmann about how this work took shape and the potential impact it could have on mental healthcare and other care settings.
- Tell us about your approach to this project?
This effort grew out of a demonstration project by Department of Psychiatry faculty as we participated in the IHQSE Certificate Training Program, along with guidance from our fabulous IHQSE coach, Dr. Katie Raffel. We knew early in the program that we wanted to work on increasing the use of patient-reported outcomes in our outpatient mental health clinics. We were also aware that systems have really struggled with adoption of the practice due to a range of tricky barriers with a big one being administrative burden. We took our time to consider the viewpoints of stakeholders and how to meet their needs including interviewing patients, clinicians and clinical staff. As we began considering solutions, we focused on how to make it as easy as possible for patients to provide information and for clinicians to access it during the visit. In that regard, our stakeholders suggested that integrating our workflow with the electronic health record (EHR) would be vital for program success. From there, we were extremely fortunate to have team members with expertise in clinical operations and health informatics who really helped us consider how to make integration with the EHR a reality.
- Why is this work important?
Mental health problems like depression and anxiety are extremely common and can be debilitating. Although effective treatments are available, wait times tend to be long because systems do not have enough capacity to meet the need. The practice of using patient-reported outcomes is a systems-based intervention that has been shown to help people recover more fully and quickly. So most importantly, this practice can help patients get more effective mental health care. Because of the enhanced efficiency, we would also expect to create capacity in the system to reduce wait times and help more people.
- How do you think this will impact healthcare?
Because of the improved mental health outcomes associated with using patient-reported information to guide care, many systems are looking for sustainable ways to incorporate the practice into their usual care processes. In the paper, we describe a relatively simple yet comprehensive program for doing so along with considerations for systems to tailor to their own context. If/as other systems adopt similar methods, I hope the paper will stimulate collaboration and discussion about a variety of ways we can support the use of this best practice in mental health care.
Click to read the full article in Psychiatric Services (opens in new window).