The Journal of the Arkansas Medical Society Issue 1 Vol 115 - Page 13

A 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 L O O K AT 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 jkettlewell@afmc.org. 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 JULY 2018 • 13