The Journal of the Arkansas Medical Society Issue 1 Vol 115 | Page 13
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C L O S E R
AFMC quality improvement specialists
work with clinicians to provide individ-
ualized technical assistance, including:
• Increase knowledge of screening
instruments and billing for alcohol
and depression screeners
• Build knowledge around using
EHR to capture screenings and
incorporate them into work flows
• Identify benefits of and how to
use screens
• Discuss required or requested
process-improvement tactics
In addition to technical assistance,
practices are provided with multiple
resources developed over the scope
of work. Many of the patient handouts
and clinician guidance tools were
developed at the request of partici-
pating clinicians. Examples of tools
developed and adopted by the BHLAN
team include: (in English and Spanish)
• Depression Zone and Alcohol Use
Disorder Zone tools
• Patient brochures to help
self-identify AUD and
depression symptoms
• PHQ-9 and AUDIT tools for
patients and providers
• Low-literacy patient a ids and
patient tools
The TMF QIN-QIO hosts quarterly
behavioral health webinars. Recent
programs have included: motivational
interviewing, alcohol misuse screen-
ings and pharmacologic management
of depression. Network members have
access to a virtual community to dis-
cuss and share best practices, promote
improvement strategies, and stimulate
networking and sustainability.
IMPROVING BEHAVIORAL
HEALTH CARE QUALITY
The 2016 quality strategy included
an objective to improve quality of
NUMBER 1
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Q U A L I T Y
A CLOSER LOOK AT QUALITY
and access to behavioral health
care. In support of this objective,
the TMF QIN-QIO recruited cohorts
of existing providers in Arkansas,
Missouri, Oklahoma, Puerto Rico and
Texas to work within the Behavioral
Health project. They were asked to
participate in a Special Innovation
Project focusing on treatment of
depression and AUD. The project also
focused on integrating behavioral
health into primary care through
Project ECHO (Extension for Com-
munity Healthcare Outcomes) and
the Mental Health Integration model.
Project ECHO connects specialist
teams at an academic hub with
primary care clinicians in local rural
communities. The TMF QIN-QIO has
partnered with the Dell Medical
School at The University of Texas
at Austin to provide behavioral
health subject matter experts. These
experts mentor clinicians and give
feedback on patient cases. At the
core of the initiative are weekly
teleECHO clinics where clinicians
develop skills needed to treat specific
behavioral health conditions.
Practitioners have agreed to make
the following changes to their treat-
ment of depression and AUD, based
on teleECHO clinic participation:
• Change their treatment method
or approach
• Make pharmacological changes
• Use more screenings and/or
change how screenings are used
• Implement motivational
interviewing
Most participating practitioners
have indicated a positive outcome in
their practices, based on this grant.
The Behavioral Health project will
continue to grow through August
2019 to provide informative resources
and assistance to providers. The TMF
QIN-QIO plans to present awards to
providers in the top percentiles of de-
pression and AUD screening and con-
tinue Project ECHO education clinics.
Additionally, the TMF QIN-QIO plans
to launch radio and video campaigns
to increase patient awareness and ac-
ceptance of mental health screening.
By joining the network, your orga-
nization will receive access to free re-
sources and training to help increase
Medicare beneficiaries’ screening
rates for depression and AUDs. Net-
work resources can also help primary
care practices reduce the 30-day re-
admission rate and increase follow-up
care for patients discharged from IPFs.
To learn more about the benefits
of joining or to join, go to http://
www.tmfqin.org and hover over the
Networks tab to access the Behavioral
Health page. The Resource Center tab
provides access to a wide variety of
tools and articles. To learn more about
the projects, contact Julie Kettlewell,
Arkansas’ state program director, at
[email protected]. s
Ms. Moore is the project director,
TMF Health Quality Institute.
REFERENCES
1. Mental Health Facts and Numbers, Na-
tional Alliance on Mental Illness http://
www2.nami.org/factsheets/mentalill-
ness_factsheet.pdf
2. SF Jencks, MV Williams, EA Coleman
Rehospitalizations among patients in
the Medicare fee-for-service program
The New England Journal of Medicine
2009, April 2; 360: 1418-28
3. National Council on Alcoholism and
Drug Dependence, Inc. https://www.
ncadd.org/about-addiction/alcohol/
facts-about-alcohol
4. H O’Connell, AV Chin, C Cunningham, B
Lawlor. Alcohol use disorders in elderly
people – redefining an age old prob-
lem in old age. British Medical Journal.
Vol. 327(7416);2003 Sep 20
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