For modern-day behavioral health practices, measurement-based care provides a great deal of promise. Through the use of outcome measures in their client care, practitioners can see drastic improvements in both their quality of care and bottom lines. But before rushing to implement this approach to behavioral healthcare, a practice needs to consider some essential issues. Addressing these issues early will provide the practice with a tool kit that will allow it to get up and running quickly on measurement-based care.
In assembling its measurement-based care tool kit, a mental health practice should consider the following preliminary questions:
- What outcome measures will you use?
- What technology will enable you to implement this type of care effectively?
- What process will you use to implement measurement-based care?
- What people will you use? Who will be assigned to oversee smooth implementation?
We address each of these questions in detail below.
What Outcome Measures Will You Use?
The foundational question for any practice seeking to utilize measurement-based care is this: What outcome measures will be put in place? Some of the simplest outcome measures to utilize are rating scales, also known as progress monitoring tools. The most commonly used rating tool in behavioral healthcare is PHQ-9, a nine-item questionnaire used to rate a patient’s depression severity. The Kennedy Forum supplement provides a useful list of rating scales for a host of mental and behavioral health conditions, including anxiety, PTSD, substance abuse, and more.
The choice of outcome measures will vary widely from practice to practice. Each practice will have its own types of common clients and conditions seen. For example, many rating tools are specially designed for children and adolescents, so the potential use of those tools will depend on the age of patients generally seen by clinicians. Some rating tools are proprietary, while others are in the public domain, and the choice between those tools may be partly a business decision.
What Technology Should You Use?
The use of EHR software in a practice’s implementation of measurement-based care can be critical. This is because measurement-based care, for all its advantages, can also pose some challenges for clinicians. Administration of the outcome measures is one added burden. In the case of rating tools, the practice must ensure the clients fill out the questionnaires, and that the results are recorded efficiently.
Modern behavioral health EHR software can lessen or eliminate these burdens. This is especially true if the software automates the process for administration of outcome measures.
What Process Will You Use?
A practice also needs to decide on its process for providing measurement-based care. This involves managing the workflow from the time of the client’s first outcome measure until the end of that client’s lifecycle with the practice.
In formulating its own process, the following are some questions for a practice to ask:
- When will outcome measures be administered? At the patient’s initial screening? For each appointment?
- How will the decision be made as to when outcome measures are administered? Will the timing of the measures be based on a clinician-level decision, or will it be based on a practice-wide policy?
- What will be done with the data from the measures?
All of these questions may need to be reconsidered if the client’s treatment plan changes in response to the outcome measure results.
What People Will You Use?
This question boils down to assigning certain roles within the measurement-based care process, as well as deciding on communication chains. The practice must decide who will be responsible for administration of the measures. Who will the results be communicated to, and what will that person do with the information? This issue is especially critical for larger practices with high numbers of clinicians and staff members, where responsibilities and workflow could otherwise become confused and disjointed.
Top Measures to Start with for Measurement-Based Care
The PHQ-9 rating tool has been previously mentioned as the most commonly used outcome measure for behavioral health practices. From the many rating tools to consider, the most commonly used tools are an excellent starting point. To that end, here are the most commonly used outcome measures from the Valant library of rating tools:
- Depression = PHQ-9
- Generalized Anxiety Disorder = GAD-7
- Panic Disorder = PDSS
- PTSD = PCL-C
- Bipolar Disorder = MDQ
- OCD = Y-BOCS
- Alcoholism = AUDIT
- Drug Abuse = NIDA-Modified ASSIST
- ADHD = ASRS
Requirements for Your EHR Software
When deciding on its EHR software, a practice should ensure the software meets the following requirements to effectively provide measurement-based care:
- Robust Library of Outcome Measures: The software should provide access to an extensive library of potential outcome measures.
- Online Administration of Measures: The practice should be able to administer its measures to patients or clients in an online setting, such as via an integrated Patient Portal.
- Mobile-Friendly Measures: Clients should have the ability to complete the rating tools on their mobile devices.
- Integration of Results into Other Forms of EHR: Measurement data should flow into clinical charts automatically, and ideally even into clinician notes, to make patient documentation more efficient.
- Graphic Representation of Data: Measurement data should be able to be displayed graphically, for the ease of interpretation and observation of long-term trends.
- Generate Reports of Aggregate Data: When EHR software can generate reports on aggregate data at a provider or practice level, the benefits are multifold: (1) the practice can improve its performance in client care, (2) the data provides the practice with leverage in its negotiations with payers, since the practice can demonstrate the positive effects of specific outcome measures, and (3) measurement-based care aligns well with the current trend toward value-based contracting.
A behavioral health practice using EHR software without these capabilities will have an uphill battle in implementing measurement-based care.
How Valant Enables Practices to Implement Measurement-Based Care
Valant’s Behavioral Health EHR provides mental health practices with the technology they need to smoothly implement measurement-based care. Our software automates the administration of rating tools, which can be chosen from our extensive library. And the resulting data can be integrated into charts and notes, graphically depicted, and used to generate comprehensive reports. We lead the industry in specialized EHR software for behavioral health, which means we are committed to staying abreast of the trend toward measurement-based care.
Request a demo today to see how Valant can help you complete your measurement-based care tool kit.