Patient-facing, Semi-automated, solutions to enhance patient participation in measurement-based care practice standards in a tele-mental health specialty clinic for populations at higher risk for self-harm

Matthew S Price; Hande Christensen; Joy Urquhart; Sarly Butte; Ron Acierno; Deborah M Little

doi:10.1016/j.ijmedinf.2023.105155

Patient-facing, Semi-automated, solutions to enhance patient participation in measurement-based care practice standards in a tele-mental health specialty clinic for populations at higher risk for self-harm

Int J Med Inform. 2023 Sep:177:105155. doi: 10.1016/j.ijmedinf.2023.105155. Epub 2023 Jul 17.

Authors

Matthew S Price¹, Hande Christensen², Joy Urquhart³, Sarly Butte⁴, Ron Acierno⁵, Deborah M Little⁶

Affiliations

¹ Trauma and Resilience Center, Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston; 1941 East Road, Houston TX 7705, USA. Electronic address: matthew.price@uth.tmc.edu.
² Trauma and Resilience Center, Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston; 1941 East Road, Houston TX 7705, USA. Electronic address: hande.christensen@uth.tmc.edu.
³ Trauma and Resilience Center, Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston; 1941 East Road, Houston TX 7705, USA. Electronic address: joy.urquhart@uth.tmc.edu.
⁴ Trauma and Resilience Center, Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston; 1941 East Road, Houston TX 7705, USA. Electronic address: sarly.t.butte@uth.tmc.edu.
⁵ Trauma and Resilience Center, Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston; 1941 East Road, Houston TX 7705, USA. Electronic address: ronald.acierno@uth.tmc.edu.
⁶ Trauma and Resilience Center, Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston; 1941 East Road, Houston TX 7705, USA. Electronic address: deborah.m.little@uth.tmc.edu.

PMID: 37467589
DOI: 10.1016/j.ijmedinf.2023.105155

Abstract

Purpose: Collecting validated surveys that describe symptom severity (measurement based care) during evidence-based psychotherapy is crucial to allow a therapist to tailor the speed and intensity of treatment. COVID clinic closures mandated we create a flexible, remote system to conduct measurement-based care, which was accomplished via RedCap.

Methods: RedCap was used to create a semi-automated workflow allowing all clinically-indicated evidence-based surveys (including the PHQ-9) to be delivered via email to patients; with results automatically sent to their provider. Importantly, indications of suicidal ideation were automatically escalated to the provider.

Results: PHQ-9 completion improved, while provider burden for collecting surveys was greatly reduced; however, depending largely upon initial provider-patient 'training', overall compliance could still be significantly improved.

Conclusion: This workflow gave providers additional information compared to the typical telemedicine environment, and in fact, improved data collection rates over our in-person environment. However, when patients did not complete measures on their own, the burden on providers increased.

Keywords: Evidence-based Medicine; Patient Workflow to Monitor Treatment Success; Provider Compliance; Trauma Clinic.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

COVID-19* / epidemiology
Humans
Mental Health
Patient Participation
Self-Injurious Behavior*
Surveys and Questionnaires

Abstract

Publication types

MeSH terms

Grants and funding