Progress Monitoring in an Integrated Health Care System: Tracking Behavioral Health Vital Signs

Abstract

Progress monitoring implementation in an integrated health care system is a complex process that must address factors such as measurement, technology, delivery system care processes, patient needs and provider requirements. This article will describe how one organization faced these challenges by identifying the key decision points (choice of measure, process for completing rating scale, interface with electronic medical record and clinician engagement) critical to implementation. Qualitative and quantitative data will be presented describing customer and stakeholder satisfaction with the mental health progress monitoring tool (MHPMT) as well as organizational performance with key measurement targets.

Designing Health Information Technologies for Uptake: Development and Implementation of Measurement Feedback Systems in Mental Health Service Delivery

“…This collection of articles reflects projects in which new technologies or capabilities were developed (e.g., Bruns, Hyde, Sather, Hook, & Lyon, this issue; Steinfeld et al, this issue) as well as examples of adapting existing technologies to meet local needs (e.g., Lyon, Wasse et al, this issue; Nadeem, Cappella, Holland, Coccaro, & Crisonino, this issue). In addition, the articles present process (e.g., Bruns et al, this issue; Gleacher et al, this issue; Lyon, Wasse et al, this issue; Nadeem et al, this issue;) and outcome (e.g., Bickman et al, this issue; Gleacher et al, this issue; Steinfeld et al, this issue) data from MFS development and implementation efforts that reflect the full range of success; from the decommissioning of the Contextualized Feedback System due to ongoing technological and cost issues (Bickman et al, this issue), to moderate uptake of the Team Management System WrapLogic (Bruns et al, this issue), and to 90% penetration of a the mental health progress monitoring tool embedded within the electronic health record at Group Health Cooperative (Steinfeld et al, this issue). …”

“…Steinfeld and colleagues (this issue) highlight the importance of emphasizing the clinical utility of the measurement tool to be featured in a MFS. This led to their development of the mental health progress monitoring tool (MHPMT) – a combination of established measures (e.g., Patient Health Questionnaire) and new items (e.g., regarding therapeutic alliance) deemed relevant to the majority of their population.…”

“…Most of the contributions in this special section reflect freestanding MFS technologies, and only the Steinfeld et al paper (this issue) describes the integration of MFS capabilities into an existing electronic health record (EHR) technology. As noted by Lyon, Wasse et al (this issue), the lack of MFS integration within the existing electronic health record is likely a key barrier to adoption, implementation, and sustainment.…”

“…Importantly, these functions do not necessitate a freestanding system. Although MFS technologies often exist as stand-alone products, they may also be integrated into other HIT, such as electronic health records (Douglas, Button, & Casey, 2014; Steinfeld, Franklin, Mercer, Fraynt, & Simon, this issue). MFS have seen rapid proliferation, with close to 50 such systems identified (Lyon, Lewis, Boyd, Hendrix, & Liu, this issue).…”

Digital technology and clinical decision making in depression treatment: Current findings and future opportunities

“…Integrating tools that support MBC for depression with existing EHRs could greatly enhance the reach and efficiency of MBC while reducing provider burden (Gleacher et al, 2016; Steinfeld, Franklin, Mercer, Fraynt, & Simon, 2016). …”