The BHL Software : An IT tool supporting PC-MHI care management and collocated collaborative care

1. The BHL Software: An IT tool supporting PC-MHI care management and collocated collaborative care Erin Ingram, BA Senior Research Associate VISN 4 MIRECC

2. BHL Software: What is it? • Software package developed to support measurement based care, including care management and Collocated Collaborative • Aids in tracking patient contacts and treatment progress • Assists with quality assurance and quality improvement VISN 4 MIRECC

3. Does it interface with CPRS? • Stand alone software • Software generates progress notes • Coming Soon (in VA timeline): next version (V5) will interface with CPRS

4. BHL Software Features • Flexible and User-friendly • Adaptable decision support • Patient Tracking Tools • Supports measurement based-care • Progress notes creation • Workload and clinical outcome data easily available VISN 4 MIRECC

5. Potential PCMHI Components – supported by BHL software • Watchful waiting • For Veterans who are subsyndromal • Care management/ Brief treatment • Depression, anxiety, alcohol, pain, PTSD • Medication adherence and side effects, symptoms • Referral management • Tracking and facilitating treatment engagement VISN 4 MIRECC

6. Structured Interviews • Core – triage/initial assessment • Watchful Waiting • prompted for weekly contacts to track PHQ-9 scores • Built in algorithm for referral to care management • Care Management (Brief Treatment) Interview • Intended for tracking and supporting measurement based care VISN 4 MIRECC

7. Initial Triage Assessment: Core Interview • Phone or in person • 20-25 minutes • Array of mental health symptoms and substance use • Helps determine next step in treatment • Output: patient letter, provider report, baseline data VISN 4 MIRECC

8. Core Interview: Assessments • Demographics • Current MH care • Financial status • Social support • Blessed Orientation-Memory-Concentration (>55 yrs or head injury) • Mini International Neuropsychiatric Interview (psychosis, mania, GAD, panic) • Depression assessment: PHQ-9 • PTSD Checklist (PCL-c) • Anxiety assessment: GAD-7 (optional) • Brief Pain Inventory Interference scale • Current Psychotropic/Pain medications • 5-item Paykel scale for suicidal ideation • Alcohol use (7 day follow-back) • Illicit substance use • Depression history • Work Limitations questionnaire (optional) • SF-12 (optional) VISN 4 MIRECC

9. Easy to Navigate

10. Core Summary Page: Interview Results VISN 4 MIRECC

11. VISN 4 MIRECC

12. Clinical Report • Generates report for clinical chart into a Word document • Available for each completed interview VISN 4 MIRECC

13. Care Management Interview • For tracking follow-up contacts • 6 optional domains: • Depression: PHQ-9 • Anxiety: GAD-7 • PTSD: PCL-c • Pain: BPI for pain interference • Alcohol: 7-day time line follow-back • Referral Management: to track engagement in specialty care VISN 4 MIRECC

14. Enrollment into CM interview

15. Changing the Symptom Domains VISN 4 MIRECC

16. Tracking Symptoms Overtime VISN 4 MIRECC

17. Care Management Summary

18. Patient Level Reports • Progress Note Creation for all interviews: • Treatment plan • Results of all assessments • Patient letters and Progress reports • Patient education • Visual of treatment progress VISN 4 MIRECC

19. Patient Tracking: Panel Management VISN 4 MIRECC

20. Tracking Contact Dates – Date Categories • (a) = Appointment • trumps all dates • Time indicates appt versus “target date” • (c) = Last Contact made • (o) = Episode Open date • Indicates to you that you have not attempted to contact this patient yet or set an appt/target VISN 4 MIRECC

21. Reports available to help track active patients • Active Patient listings - excel spreadsheet of active patients • Aggregate data on active patients enrolled in the Core interview, Watchful Waiting and Care Management • Upcoming appointment reports • Supervision Reports – excel spreadsheet of flagged patients VISN 4 MIRECC

22. Outcome Data: How is our program doing? OUTCOME DATA: Available at the program, clinic, Primary Care Provider and staff level VISN 4 MIRECC

23. Who should have access to the software? • Anyone on the PC-MHI team • PC-MHI nurse care managers • PC-MHI social workers • PC-MHI psychologist • PC-MHI psychiatrists and CRNPs • Psychology/health technicians • Other possibilities: health behavior coordinator • Helps to track patient contacts and symptoms for both CM and CC services

24. User Classifications: General versus Administrative • General users of the software have access to: • All patient tracking features • All clinical reports • Administrative reports on their own workload • Administrative users – additional access: • Program users, clinics and clinicians into software • Program decision support preferences for triage interview • All options for administrative reports VISN 4 MIRECC

25. How do I describe the software to my IT department? • Commercial product (not Class software) • Does not interface with CPRS • NET thick client desktop application • Interacts with a SQL Server backend database • Application is executed from end user desktops via a windows network share over the local area network

26. Resources • BHL SharePoint Site: https://vaww.visn4.portal.va.gov/networks/BHL/default.aspx • BHL Software Manuals • Example Cheat Sheets for services • BHL Software Support -wkly conference call • Tuesdays, 2pm EST • 1-800-767-1750, Access code: 31307# • To request the software, contact me at: • erin.ingram@va.gov • 215-823-5800 x12895# VISN 4 MIRECC