Integrating Primary Care with Mental Health

• Individualized feedback
• Real-time reports
• Support the five A's. – Ask, Advise, Assess, Assist, Arrange
• Quickly improve rates of depression identification for behavioral health
  consultants and providers.
• Alerts for out-of-range scores sent to the EMR and BHC’s improve
  collaboration with mental health agencies, while improving patient care.
• Helps to meet AAAHC depression reporting requirements.
• This validated Quick PsychoDiagnostic (QPD) Panel, designed for primary care settings, is reimbursable with CPT 96101 & 96103.
• Patients self-assess DSM-IV questions in 6.5 minutes in Spanish or English.
• The QPD Panel validated against the SCID (Structured Clinical Interview for DSM-IV) prints real-time reports with diagnosis comments.
• Electronic Interview for, "Occult suicidality in an emergency department population."
• Computerized feedback to emergency physicians improves rates of identification and psychological referral for suicidial ideation.

In addition to suicide, these psychiatric disorders are screened in the QPD:
Major Depression Dysthymic Disorder Bipolar Disorder Generalized Anxiety Disorder Panic Disorder	Posttraumatic Stress Disorder Alcohol/Substance Abuse Bulimia Nervosa Somatization Obsessive Compulsive Disorder

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Supporting Cultural Changes and Structural Changes
– Closing the Quality Chasm

Redesigning primary care by separating acute care from planned management of chronic conditions … care for diabetic patients … is the most widely spread example. Some studies show that organizational cultures that support teamwork and quality improvement may contribute to achieving high-quality care.  (BMC Health Services Research article, “Organizational Culture, team climate and diabetes care in small office-based practices P.2)

Optimize patient time and reduce provider’s burden

• Tablets are non-threatening and may provide the only source of information when the patient is unresponsive to questions about mood or denying significant depressive symptoms.
• Quickly improve rates of depression identification for behavioral health consultants and CHC providers. Alerts for out-of-range scores sent to the EMR and BHC’s improve collaboration with mental health agencies, while improving patient care.
• With electronic tablets, patients/residents self-assess to reflect their acuity level of  function, social, and mental status. Helps to classify Medicare and Medicaid residents into Resource Utilization Groups (RUG-III).

Process
MA's enter the resident ID# then patient/resident answer questions on the portable tablet. Results sent via web-docking station instantly compile each persons data. Real-time reports are trended. Researchers, off-site, easily import data into Excel for analysis.

Helps to meet JACHO and AAAHC depression reporting requirements. 

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Zung Anxiety Report

• Create a suite of custom tools for multimodal therapy
• Shifts care from relatively high-cost labor units (Nurse, Provider) to relatively low-cost labor units (MA).
• Time is one the major factors hindering counseling in primary care - Efficient first-line treatment asks patients to self-assess screening questions. Patient’s response to a few questions from depression, diabetes, pain or other questionnaires will trigger the appropriate questionnaire.
• There are many possibilities for combining assessments to Increase the amount and accuracy of information for providers.
  [Check our Research Tools]
• Fine-tune the custom tools to support screening strategies - Combine instruments, assess, add screening questions, check your data correlations and re-assess tools. One low price includes unlimited assessments. License fee may apply for non-public domain instruments.

[Example Survey]
Diabetes Type 2 research using Zung Anxiety Scale:

• Depressive symptoms in patients with type 2 diabetes … opportunities to improve the outcomes in the course of routine care (NCBI Pub, author Shah BM et.al)
• RESULTS: Depressive symptoms (Zung SDS score > or =50) were identified in 72.1% of patients. Overall, 13% of the patients with a diagnosis of depression (based on patient charts) were not receiving treatment. [review]
• Real-time reports provide FRAMES and addresses adherence
  (FRAMES - Feedback about personal risk, Responsibility of patient, Advice to change, Menu of strategies, Empathetic style, and promote Self-efficacy.)