Dr. Adam Stewart is a family physician with a passion for developing and implementing tools to improve EMR use. Over the past few months, he has worked closely with our team here at CognisantMD to develop an algorithm on the Ocean Platform to aid in the screening, diagnosis, and treatment of Depression.
The Mental Health Practice Support Program (“Mental Health PSP”) is a project that aligns the CANMATS guidelines for depression with the advanced use of EMR technology in order to improve the treatment of depression. We are pleased to announce that Dr. Stewart’s program, which was completed in conjunction with Lundbeck, is now freely available to all Ocean users.
We asked Dr. Stewart to tell us more about program, how it works, and how it is helping clinicians to provide better care for patients with depression and mental health issues.
Q: What is the goal of the Mental Health PSP?
The ultimate goal of the Mental Health PSP using Ocean Tablets is to increase the effectiveness and efficiency of treating depression. Depression and mental health issues are among the most common reasons that patients seek care. Often it is not purely depression on its own; rather, depression is comorbid with many other chronic conditions. This makes it all the more challenging for the patient to live with, and for the clinician to treat. Accordingly, there is a tremendous need for the Mental Health PSP.
Q: What is the Mental Health PSP and how does it work?
The Mental Health PSP is an automated way to screen patients for mental health concerns, and have the results appear in the patient’s chart. The program works by using a combination of Ocean Tablet rules and eForm rules to automatically load appropriate mental health screening forms for patients to complete when they check in. The program uses a sophisticated algorithm (see flowsheet image) to administer PHQ-2 and PHQ-9, as well as the GAD-7, SDS, BC-CCI, FIBSER, and depression history forms when indicated based on the patient’s responses.
Q: Does the Mental Health PSP automatically screen all patients?
There is conflicting evidence on whether or not all patients should be screened for depression with a PHQ-2. Accordingly, screening can be targeted to only those with certain risk factors (i.e. substance abuse; certain chronic medical conditions such as diabetes, COPD, or chronic pain; family history of depression, etc). The “Pre-PHQ-2” eForm is used to identify these risk factors, based on the patient’s answers. This eForm can be customized to a clinic’s individual preferences.
Q: What are the advantages to using the Ocean-based Mental Health PSP over traditional methods?
The Ocean platform and tablets are an essential component of the Mental PSP. For one, they seamlessly allow for metric-based care to be used in the treatment of depression. Ocean tablets allow validated scales to be quickly completed by the patient, automatically scored and calculated, and then instantaneously imported into the patient’s chart. This is incomparably more efficient that having a patient complete a paper copy of a PHQ-9 and scanning as a PDF into the chart, for example. More importantly, the standardized output from the Tablets allows for data analysis, both for the patient at the point of care, and also from a population health perspective. This type of efficiency and thoroughness would simply not be possible without the Ocean Tablets.
Q: How can other clinics take advantage of the Mental Health PSP?
Any clinic can get involved and benefit from these resources. For clinics that are already using Ocean Tablets, they can start using the Mental Health PSP algorithm immediately – for free. I have posted step-by-step installation instructions, including videos and screenshots on my website.
Q: What advice do you have for clinicians that want to get the most out of this program, the Ocean Platform and their EMR in general?
If users wish to take their EMR efficiency to the “next level”, I recommend building EMR tools (i.e Encounter Assistants, Toolbars, etc.) that allow for efficient and meaningful use of the data generated from the Ocean Tablet algorithm. For example, I have a demonstration video on my website that shows EMR tools that are fully integrated with the algorithm: http://www.