[PC-BH-Integration] Bio/Psycho/SocialAssessment inIntegratedHealthcare settings and Treatment PlanTemplates

[Phil Hirsch PhD]

And then, thinking from a primary care perspective for a moment, can that
type of comprehensive assessment be achieved within the time constraints and
workflows of a busy clinic? Are, or can, most of the instruments be self
administered, automated for scoring and results transferred into the EMR in
real time? And can the primary care team in clinic with no or few BH
specialists in-house be supplied with decision supports to synthesize and
make effective use of the assessment data - also in real time?

Phil Hirsch, PhD
President and Chief Executive
Access Psychiatry Solutions, LLC
P.O. Box 55273
Seattle, WA  98155
206.365.3096
www.accesspsych.com
 
-----Original Message-----
From: pc-bh-integration-bounces at lists101.his.com
[mailto:pc-bh-integration-bounces at lists101.his.com] On Behalf Of Mike
Lardiere
Sent: Thursday, September 15, 2011 9:14 AM
To: [National Council' s Behavioral Health-Primary Care
IntegrationListserve]
Subject: Re: [PC-BH-Integration] Bio/Psycho/SocialAssessment
inIntegratedHealthcare settings and Treatment PlanTemplates

This is actually getting close to a comprehensive assessment and would
suggest also looking at Medicare regs and Joint Commission Ambulatory
Guidelines and add what is missing.  E.g. no indication of Domestic Violence
assessment, assessment sexual violence (either victim or perpetrator),
veterans status, risky sexual behavior etc.

Combining all of these can get us to a complete assessment.

Thanks


Michael R. Lardiere, LCSW
Vice President Health Information Technology and Strategic Development
The National Council for Community Behavioral Healthcare
1701 K St, NW
Ste# 400
Washington, D.C. 20006
202-684-7457 xt 273
301-881-7159 (fax)
914-261-8370 (cell)
MikeL at thenationalcouncil.org


-----Original Message-----
From: pc-bh-integration-bounces at lists101.his.com
[mailto:pc-bh-integration-bounces at lists101.his.com] On Behalf Of Runyan,
Christine
Sent: Thursday, September 15, 2011 11:34 AM
To: [National Council' s Behavioral Health-Primary Care Integration
Listserve]
Subject: Re: [PC-BH-Integration] Bio/Psycho/Social Assessment
inIntegratedHealthcare settings and Treatment Plan Templates

Here is another document that might be helpful as it moves the conversation
from not only screening tools (paper) but towards some universally accepted
metrics thatcan be integrated into electronic records to measure over time.

Tina 

Tina Runyan, PhD, ABPP
University of Massachusetts Medical School Associate Clinical Professor
Fellowship Director, Clinical Health Psychology in Primary Care Dept of
Family Medicine and Community Health 


-----Original Message-----
From: pc-bh-integration-bounces at lists101.his.com
[mailto:pc-bh-integration-bounces at lists101.his.com] On Behalf Of Peter
Fifield
Sent: Thursday, September 15, 2011 10:24 AM
To: [National Council's Behavioral Health-Primary Care IntegrationListserve]
Subject: Re: [PC-BH-Integration] Bio/Psycho/Social Assessment
inIntegratedHealthcare settings and Treatment Plan Templates

We use an augmented version of the Sheehan Disability Scare which is a
1-10 scale measuring perceived function in social, work and family sectors.

-----Original Message-----
From: pc-bh-integration-bounces at lists101.his.com
[mailto:pc-bh-integration-bounces at lists101.his.com] On Behalf Of Holly
Randall
Sent: Thursday, September 15, 2011 9:52 AM
To: pc-bh-integration at lists101.his.com
Subject: Re: [PC-BH-Integration] Bio/Psycho/Social Assessment
inIntegratedHealthcare settings and Treatment Plan Templates

Hello,  Which questionairre are you using for the "percieved function
screening"?  Could you attach a copy?
Thank you,
Holly


Holly Randall, APRN, BC
Associate Director of Behavioral Health Services Lynn Community Health
Center
694 Western Avenue
Lynn, MA 01905
t:781-595-7747
f:781-595-7990


________________________________
From: pc-bh-integration-bounces at lists101.his.com
[pc-bh-integration-bounces at lists101.his.com] On Behalf Of Peter Fifield
[pfifield at familiesfirstseacoast.org]
Sent: Thursday, September 15, 2011 9:35 AM
To: [National Council’s Behavioral Health-Primary Care Integration
Listserve]; pc-bh-integration at nccbh.net
Cc: 'Jenne'
Subject: Re: [PC-BH-Integration] Bio/Psycho/Social Assessment in
IntegratedHealthcare settings and Treatment Plan Templates

We have had much success with offering a behavioral health screening packet
to our initial intake process that includes the DUKE, AUDIT, DAST, PC-PTSD,
PHQ9, GAD7 and an assessment of "perceived" function screeners.  On follow
up visits we use the PHQ9 and GAD7 as our "mental health blood pressure"
measures.  That being said, the most accurate measure for our clinic over
time seems to have been the "perceived function measure" more so than any of
the other standardized tools such as the PHQ and GAD.

peter fifield

________________________________
From: pc-bh-integration-bounces at lists101.his.com
[mailto:pc-bh-integration-bounces at lists101.his.com] On Behalf Of Phil Hirsch
PhD
Sent: Wednesday, September 14, 2011 10:01 PM
To: '[National Council's Behavioral Health-Primary Care Integration
Listserve]'; pc-bh-integration at nccbh.net
Cc: 'Jenne'
Subject: Re: [PC-BH-Integration] Bio/Psycho/Social Assessment in
IntegratedHealthcare settings and Treatment Plan Templates

Shauna (and all):

A few thoughts in reply to your question below:


 1.  Although each agency should evaluate the value of particular
instruments for its use there is also value in working toward some
standardization of tools across integrated settings. For example, the
PHQ-9 is probably the most widely used depression screening (can be
downloaded and used at no cost here
http://www.healthteamworks.org/guidelines/depression.html), AUDIT is highly
valued for problem drinking assessment, the Bipolar Disorder Questionnaire
(BDQ) for that condition;  2.  Healthworks (formerly Colorado Clinical
Guidelines Collaborative) has an interesting and well thought out guideline
for systematic depression treatment which can be downloaded from their
website as well (see link above). I like this type of stepwise guideline in
that it is clear, specific and relatively brief;  3.  Texas Medication
Algorithms Project (TMAP) provides reasonably succinct treatment guidelines
for a number of BH conditions including psychotic disorders;  4.  An example
of an interesting, brief, automated and multi-factoral screening tool and
process that is being used in some health centers with good satisfaction can
be found by going to this website: http://chc.patienttools.com/default.asp
and then clicking the "How it Works" link to the left.

I'm not necessarily recommending or endorsing these particular instruments
but am suggesting that they are good examples of tools that seem to work
well in integrated primary care settings in that they are brief, specific,
directive, easy to implement, usually free and can be scored and results
made available to clinicians "on the spot."


Phil Hirsch, PhD
President and Chief Executive
Access Psychiatry Solutions, LLC
P.O. Box 55273
Seattle, WA  98155
206.365.3096
www.accesspsych.com

________________________________
From: pc-bh-integration-bounces at lists101.his.com
[mailto:pc-bh-integration-bounces at lists101.his.com] On Behalf Of Shauna
Reitmeier
Sent: Wednesday, September 14, 2011 1:38 PM
To: pc-bh-integration at nccbh.net
Subject: [PC-BH-Integration] Bio/Psycho/Social Assessment in Integrated
Healthcare settings and Treatment Plan Templates

Good Afternoon Everyone,

We have recently received some requests for examples of assessment tools and
treatment planning tools that organizations are using in integrated
healthcare settings.  We have been asked for examples from both types of
settings whether located in an FQHC or Primary Care setting and those in a
Community Mental Health Center

Some feedback we have been receiving is that in the bi-directional
integration from the CMHC setting into the FQHC/Primary Care setting the
existing Treatment Plans and Assessment Tools are quite long and do not
necessarily fit well into the short term, solution focused setting for
providing the Mental Health service.

If anyone has examples of these two tools that have passed the necessary
accreditation and CMS reviews, they would be willing to share with the
broader community it would be greatly appreciated.

Thank you so much for your assistance.




Shauna Reitmeier, LLMSW
Contract Administrator
SAMHSA/HRSA Center for Integrated Health Solutions National Council for
Community Behavioral Healthcare
1701 K Street NW, Suite 400
Washington, DC 20006
202.684.7457 ext.271
734.476.7625 cell
202.386.9391 fax
shaunar at thenationalcouncil.org


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