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My Own Health Report (MOHR) Project (Previously PRO Project) Goal: Integrate Patient Reported Behavioral Health Domains into Routine Primary Care Practice. Roshan Bastani, PhD, Beth Glenn, PhD, Russ Glasgow, PhD CPCRN Spring Virtual Meeting April 15, 2013.
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My Own Health Report (MOHR) Project (Previously PRO Project) Goal: Integrate Patient Reported Behavioral Health Domains into Routine Primary Care Practice Roshan Bastani, PhD, Beth Glenn, PhD, Russ Glasgow, PhD CPCRN Spring Virtual Meeting April 15, 2013
Round 2 of Funding: Nine Sites Funded (5 PBRN; 4 FQHC)Name change: My Own Health Report (MOHR)Pragmatic Trial • Cluster randomized trial of 9 pairs of clinics (5 PBRN; 4 FQHC) • Study was designed to maximize flexibility and adoption (e.g., clinics with different levels of HIT use, experience with QI) • Standard delivery of automated assessment tool, feedback, goal setting materials, and suggestions for follow-up • Delivery of these components is customized to each setting • Study goal: sustainable, routine implementation of MOHR assessment and intervention VT 1 PBRN VA 3 PBRNs CA 1 PBRN 1 FQHC NC 1 FQHC TX 2 FQHCs
Design of Pragmatic Trial Early Implementation Sites (4 FQHC, 5 PBRN) Intervention (Provider & Patient Feedback Reports + F. U) Patient Experiences Survey (n = 300) Optional: 2nd MOHR Assessment (only for those who completed MOHR) MOHR Assessment (all non-acute adult visits for 3-4 months, n = ~300) Delayed Implementation Sites (4 FQHC, 5 PBRN) Intervention (Provider & Patient Feedback Reports + F. U) Arrow = between group comparison Patient Experiences Survey (n = 300) Implementation of MOHR Tool Months 0 1 2 3 4 5 6 7 8 9 10 11 12
MOHR Online Assessment Tool: Developed by Alex Krist (VCU)(Transfer of “co-ordinating center” from UCLA to VCU)
Screenshots from MOHR Online Assessment Tool
Design of Pragmatic Trial Early Implementation Sites (4 FQHC, 5 PBRN) Intervention (Provider & Patient Feedback Reports + F. U) Patient Experiences Survey (n = 300) Optional: 2nd MOHR Assessment (only for those who completed MOHR) MOHR Assessment (all non-acute adult visits for 3-4 months, n = ~300) Delayed Implementation Sites (4 FQHC, 5 PBRN) Intervention (Provider & Patient Feedback Reports + F. U) Arrow = between group comparison Patient Experiences Survey (n = 300) Implementation of MOHR Tool Months 0 1 2 3 4 5 6 7 8 9 10 11 12
Patient Experience Survey (PES) 20 item survey to be administered 2-8 weeks post-visit Eligibility for PES: all patients reporting for non-acute care visits during implementation period for both clinics within each pair (regardless of MOHR use) The PES assesses patient perceptions regarding: • Assessment of the specific health behavior and psychological domains related to recent clinic visit • Collaborative goal-setting within each domain • Clinic/provider follow-up for each domain • Quality of clinic/provider communication • Patient-centeredness of care provided by their clinic
Study Outcomes Summary • Between group comparison • Patient Experiences Survey • Within group implementation outcomes: • REACH: % eligible patients completing the health assessment • Follow-up health assessment: only for patients who complete online and provide email address • Contextual assessment • Cost assessment