Leveraging the electronic medical record to measure fidelity to the primary care behavioral health model: Implications for clinical and research pursuits.

Abstract

Health and Human Services (HHS) through a Behavioral Health Workforce Education and Training grant (HRSA-20-089; PI: Jodi Polaha, PhD). The content and conclusions are those of the authors and should not be construed as the official position or policy of, nor should any endorsements be inferred by, HRSA, HHS, or the U.S. government.We thank our clinical informatics partners, Tracy Jones and Yan Lai, who made this work possible.Aubrey R. Dueweke, PhD, served as lead for data curation, formal analysis, investigation, project administration, writingoriginal draft, and writing-review and editing and contributed equally to conceptualization and methodology. Matthew Tolliver, PhD, contributed equally to methodology and writing-review and editing and served in a supporting role for conceptualization, funding acquisition, project administration, and writing-original draft. Allen Archer, BS, served as lead for visualization, contributed equally to data curation, and served in a supporting role for writing-original draft and writing-review and editing. Jodi Polaha, PhD, served as lead for funding acquisition, contributed equally to conceptualization, and served in a supporting role for writing-original draft and writing-review and editing.

Can the electronic medical record provide reliable indicators of primary care behavioral health fidelity? Comparison of accessibility and productivity indicators assessed through observational coding.

“…In a recent article, we outlined the need for convenient approaches to measuring PCBH fidelity and highlighted the potential utility of leveraging the EMR for this purpose. Specifically, we partnered with our organization’s clinical informatics team to build several fidelity metrics into the EMR in a way that would be easily extractable and would not create additional documentation burden for BHCs (see Dueweke et al, 2023 for a full explanation of the process). Essential to the current study, the PCBH fidelity indicators our organization can calculate through routine BHC charting include percentage of behavioral health visits prompted by warm handoffs (accessibility), number of warm handoffs per 4-hr half day (accessibility), and number of patients per 4-hr half day (high productivity).…”

Acta non verba.

“…What else matters in our evaluation of PCBH programs? Think hard about it and choose the few that are most important, and, for goodness sakes, do leverage the electronic health record to collect PCBH measurements (Dueweke et al, 2023). Convert results into action.…”