Outcomes

“I believe psychiatrists should use standardized clinical rating scales because it is good medical practice that our patients need. Standardized measurements would enable all psychiatrists to use the same language relating to severity of illness, response, or remission.”

Henry A. Nasrallah, MD

“Psychiatry is the only medical discipline in which quantified measurements of outcome are not the standard of care. In mental health clinical settings, outcomes evaluations are typically based on unstructured interactions that yield unquantified judgments of progress. This is at variance with other areas of medical care in which outcome is partially determined by a change of a numerical value. […] In treating psychiatric disorders, standardized, quantifiable outcome measures exist for psychiatric disorders, yet they are rarely used in routine clinical practice.”

M. Zimmerman, MD

CarePaths Assessment Center provides psychometrically sound instruments, both self-report and clinician-rated, for assessment and outcomes monitoring. Instruments are applicable to the full range of psychiatric treatment including monotherapies such as pharmacotherapy and psychotherapy, as well as psychotherapy. Instruments cover such clinical domains as symptom distress, diagnosis, side effects, therapeutic alliance, and patient satisfaction.

The system is designed to make outcomes tracking feasible by automating data collection and providing real time feedback to clinicians. Automated processes include auto generated emails to clients to take follow up questionnaires, reminders to clinicians that follow up assessments are needed, and real time feedback reports to clinicians and clients. The patient portal enables clients (and/or parents and significant others) to take assessments online, thus largely eliminating the burden on clinical staff for data collection.

There are now over 30 instrument s in the Assessment Center including such widely used instruments as:

OQ 45, YOQ, HAM-D, BPRS, PHQ-9, Multnomah, Young Mania Scale, Wenders ADHD Scale

and many more. Instruments in the system are applicable to all mental health patients from the client with mild, transient disturbance to clients with severe and persistent mental illness (SPMI). The system is designed to enhance treatment outcomes by providing meaningful feedback in real time to clinicians on the patient specific level as well as to clients.

Outcomes assessment–the measurement of patient change in response to treatment–is the cornerstone of the CarePaths Assessment Center programs. These programs go beyond measurement and are concerned with accountability–providing evidence of the effectiveness and value of services; and quality improvement–improving outcomes across an entire system of care. At the core of these outcomes management programs is the use of standard measures to assess patient change during treatment and at post treatment follow-up. A recent series of controlled studies, made possible by advances in technology, have shown that it is possible to significantly improve outcomes by providing clinicians with real time feedback about their patient’s progress in treatment. Thus, outcomes management programs do more than simply reflect the clinical status quo; they provide a dynamic means to continuously improve the quality of those services by improving the outcomes of patients one patient at a time.