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Pay for Performance is coming to medicine. Is it coming to behavioral health? Jeb Brown, a long time champion of outcomes in behavioral health, thinks it is long overdue. He argues, “The reality of Therapist Effects means that clinicians differ in their outcomes and the value of their services. From the point of view of a health plan, employer or other payer, some clinicians have more value than others. Identification and referral to highly effective clinicians results better outcomes for patients and greater payback to the health plan and employer in the form of improved productivity and reduced medical costs.” (See http://www.clinical-informatics.com).
In Current Psychiatry, the lead editorial by psychiatrist Henry Nasrallah, is entitled “Long overdue: Measurement-based psychiatric practice.” (See http://www.currentpsychiatry.com/article_pages.asp?AID=7480) Nasrallah argues that good psychiatric and behavioral practice should use of standard instruments to measure symptoms of psychiatric illness in order to monitor and calibrate treatment.
One of the reasons routine use of outcomes has not gained traction in behavioral health is the data collection problem: how to quickly and easily collect outcomes data. The emergence of Electronic Health Records makes it much easier to routinely collect outcomes data, especially through the use of patient self-report instruments automatically administered through a patient portal.
Technology may provide a practical means to initiate the era of measurement-based behavioral practice.
