By Katie Tracy, MSW, LCSW, Project Director
Traditionally, the behavioral health system has been based on what I call “process and structural outcomes,” keeping score on things like how quickly we get a person from initial contact to the initial evaluation, provider-to-client ratios, and so on down the line. But thankfully, the industry’s recent thinking has been shifting to a focus on outcome measures – how well we deliver integrated whole-person care and treatment that leads to a greater opportunity for long-term well-being.
While process and structural outcomes have their place, I have always been an advocate for taking it to the next level and looking at outcome measures. In our Certified Community Behavioral Health Clinic (CCBHC), we have been focused on measurement-based care and looking at ways to structure the evaluation of symptoms, including social drivers of health, given their significant impact on health and well-being.
To give an example, when a potential client comes in with symptoms of depression, we use detailed, pointed questionnaires to assess their depression, then we measure progress against those results to see if their depression reduces over time as a result of their treatment regimen.
Currently, physical healthcare is a little bit ahead of behavioral healthcare as it relates to these types of outcomes, but only because more resources have traditionally been allocated in that area. Nonetheless, working with Integrity House’s senior leadership, we have instituted a workgroup that is actively working to get our electronic health records (EHR) to a place where we can more easily run reports that will better document outcomes. Doing so will help us to ensure that we are not simply putting people into services, but rather we are putting people into specific services that deliver positive results and that they are getting better over time as a result.
Through these protocols, we will look at the entire person, many of whom will present with a number of different diagnoses: depression, anxiety, unhealthy alcohol use, drug use, etc. Concurrently we monitor the client’s physical health indicators, things like high BMI or high blood pressure, in addition to things like monitoring metabolic syndrome for individuals who are being prescribed antipsychotic medications. In doing so, we can provide each individual with the most effective treatment program. And as we document our success in the CCBHC, we will roll out these changes in order to improve care and outcomes throughout the agency. Ultimately, we will create value across the organization by improving outcomes, increasing client satisfaction, and reducing costs.
Another important aspect of producing positive outcome measures in an integrated care setting is coordinating care with other providers, like emergency departments, primary and specialty care providers, and hospital systems. Better connectivity between providers will help to reduce the number of patients returning to hospitals unnecessarily. Working together, we can make sure that transitions of care are smoother and that fewer people fall through the cracks.
All of this is an effort to move the needle for better client outcomes while documenting our results to create an organizational model around integrated care and meaningful outcome measures. Integrity House is rooted in integrated care and wants to demonstrate that even more by exceeding outcome measures expected in our industry.