Technology to Facilitate Consumer Self-Care and Consumer Choice in the Behavioral Health Field

Using Technology to Facilitate Consumer Self-Care & Consumer Choice in the Behavioral Health Field

Health care is evolving toward consumer-directed models, where consumers have a more active voice in deciding what treatment they receive, how they receive it, and who provides the treatment. Ann Doucette, Ph.D., Research Professor, Director of The Evaluators’ Institute and Executive Director of the Midge Smith Center for Evaluation Effectiveness, at The George Washington University in Washington, DC, presented her research on consumer-driven care and consumer-driven treatment planning at the 2008 Institute for Behavioral Health Informatics.

Dr. Doucette has worked with federal and state organizations, universities, community groups, public schools, commercial health plans, and foundations regarding evaluation management and design, analytic modeling, assessment, testing and measurement in the areas of health and behavioral health care, school reform (urban and minority education), social systems and social policy. She has developed several assessment measurement approaches using Item Response Theory (IRT) to generate measures having greater precision using brief, less burdensome instrumentation, which have the potential to lead to computer-adaptive applications and real-time data usage.

At the Institute for Behavioral Health Informatics, Dr. Doucette and her colleague Toby Martin, Ph.D., Senior Research Associate, The George Washington University, discussed the evolution of the health care system beyond the individual practitioner/provider to a more consumer-directed approach. What is needed, they said, is data that supports quality management:

From This:	To This:
Compliance driven data collection	Outcome-based monitoring
Rule and regulation driven administration	Goal-driven management
“Best guess” decision-making	Data-based decision-making
Preference to distinct professional roles	Cooperation across professional roles
System reacts to need	Need is anticipated
Information is withheld	Information is disseminated, transparent

The goal is to have an outcome-based management framework with Clinically Informed Outcomes (CIOM©), and continuous quality improvement. The objectives for the research include:

Providing consumers a voice in assessing their own therapeutic progress and improvement
Enhance treatment/service outcomes through consumer reported progress, and training and educational supports for treatment teams
Establish a practice-based evidence approach that identifies effective treatments and interventions provided by treatment teams
Provide alerts to counselors, therapists, case managers when consumers report unexpected deterioration or unidentified problems

To collect information concurrent with treatment, the consumer completes a brief questionnaire at selected standardized intervals (e.g. each treatment session, once a week, every other week, etc...) to monitor perceived improvement, quality of the therapeutic alliance, expectations of treatment, openness to change, optimism and hopefulness, recovery, and social support. Data is collected both during treatment and follow-up. Profiles are established based on the consumer questionnaire data. The treatment team is alerted about consumer status (improvement, stability, deterioration) and the likelihood of prematurely leaving treatment.

Armed with this data, the treatment team can then reconsider the diagnosis, assess the quality of the therapeutic relationship, use motivational techniques to increase consumer engagement in treatment and examine available social resources. Clinically-Informed Outcomes (CIOM©) management results in consumer-directed care – the treatment is responsive to what the consumer is experiencing and consumers have an active voice in identifying improvement and areas that continue to be problematic.

For more information, members of The OPEN MINDS Circle may access Dr. Doucette’s full presentation from The 2008 Institute for Behavioral Health Informatics, "Outcome-Based Management, Clinically-Informed Outcomes (CIOM©)." This presentation is free to all Circle members for the next thirty days.

Not a member? Click here to to register, it’s free and easy.

For more information on technology and self-care, Premium members of the OPEN MINDS Circle may also wish to access "Veterans Care Coordination Home Telehealth Program Cut Hospitalizations by 19%." This article, from January's OPEN MINDS On-Line News, discusses Veterans with chronic health conditions enrolled in the Veterans Health Administration.

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