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Dale Jarvis

Dale Jarvis and Associates

Show Me the Outcomes!

February 4, 2014 | Community Impact | Comments
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Show Me the Outcomes-Based Care!

We began our Behavioral Health Center of Excellence Crowdsourcing Project to address the reality that we are quickly moving into a phase of healthcare reform where providers and health plans are placed into one of two buckets:

Bucket 1: The work we do makes a measurable difference in people’s lives and we can demonstrate our excellent outcomes and high success rates with data (using validated clinical instruments).

Bucket 2: We can’t make the above statement either because we aren’t measuring well (but we believe we provide great care) or we have started tracking outcomes and we’re not as great as we thought.

The reason for this bucketing process is simple. Our high healthcare costs and poor health status pushes us past the point where business as usual can continue. Purchasers can no longer afford to contract with health plans, and payors can no longer afford to contract with providers that lack outcome data or are known to be poor performers.

Which bucket best describes you (if you are a provider or health plan)? Which bucket best describes your provider or health plan (if you are wearing your client hat)?

When it comes to outcomes-based care, the behavioral health field has gotten itself behind a big eight ball — not because of a lack of measures or measurement tools, but because of the field’s inability to reach consensus on what outcomes are most important and what tools to use. This may be our field’s biggest Achilles heel as health policy experts, health plans and medical providers cement the idea that behavioral health is essential to health, numerous treatments are effective, and people do recover — if they get the right services and supports. This leads us to draft Element 2: what makes a behavioral health center of excellence.

Element 2: Excellent Outcomes

“Take responsibility for making sure I receive the best possible health care.” (Oregon PCPCH Principles)

A behavioral health center of excellence is known for achieving results for clients. The organization can measure what is important to clients and achieve excellent outcomes on those measures. The organization uses a treat-to-target, team-based care approach to achieve these successes at the client level. The client, with support from their care team, identifies their care goals — at least one clinical and one personal. Outcome tools relevant to the clinical goals are used to collect baseline information and measurable targets are set. Professional and self-care plans are developed, drawing from scientific evidence about the client’s unique background, conditions, and goals. Frequent measurement is made, and if a client isn’t reaching their targets, the clinical and self-care plans are changed. A central repository houses all collected data, which is then evaluated on a regular basis and used to continuously improve care.

Today’s questions…

Tell us what you think.

  • Note: I am sidestepping standardization of outcome measures and outcome tools. Do you think it’s possible for the provider community to move toward excellence without national consensus on outcomes?
  • I believe that moving to a treat to target/team-based care approach (as defined above) is absolutely essential to achieving excellence. Do you agree? Why or why not?
  • What are the most important behavioral health outcome measures and outcome tools an organization should put in their clinical toolbox to demonstrate effectiveness?
  • Does your electronic health records system support “client-level outcome data collected in a central repository, evaluated on a regular basis and used to continuously improve care”?
P.S.

If you haven’t seen the behavioral health center of excellence draft concept paper, you can download it here. If you haven’t downloaded the behavioral health center of excellence study guide, get it here.

P.S.S.

Bring your colleagues into this crowdsourcing project. Share posts and your view with them on Facebook and Twitter using the hashtag #WhatIsExcellence.

P.S.S.S.

Read all blogs from this project by clicking here.