A Good Read for Behavioral Healthcare Providers
When I scanned over the first paragraph, I knew that Jill Sederstrom’s article “Clinicians must turn evidence into practice” in Behavioral Healthcare was going to be a good read. So, I got myself a coffee and settled down to enjoy it; I was not disappointed. I recommend you read it too.
As researcher and a clinician, I have sat on both sides of the table in the struggle to create an evidence base that is robust and valid, but also able to inform clinical care. I understand the problem and I’m very pleased to see it so eloquently acknowledged and explored by the author, including interviews with Kelly Clark, MD, President-elect of the American Society of Addiction Medicine, and Melanie Smith, Licensed Mental Health Counselor and Program & Training Manager of the Renfrew Center in Florida.
Some key messages from the article:
- With an emphasis on quality initiatives, the importance of evidence-based practice in behavioral healthcare is growing. Payers “will be evaluating whether facilities are embracing the latest evidence that has been shown to produce optimal patient outcomes. They want the most value for their healthcare dollar.”
- Behavioral healthcare providers must be prepared or the next few years “will become very problematic” for them. But, incorporating evidence into care is not an easy process and it takes time. Facilities need to invest to “translate what’s discovered in a research setting into everyday practice”.
- Evidence-based approaches give clinicians a framework based on empirical data. “We don’t really have a lot of ability to know in the long-term how our patients are doing, [and]…whether or not what we’re doing is the most effective and efficient way to help someone get better”, says Smith.
- Clark points out that evidence-based medicine (or evidence-informed medicine) “lends itself to quality metrics that are population-based and allow clinicians and facilities to see an issue from a broader population-based perspective that provides bench marking opportunities.”
- The clinical trials that are required to bring a drug or device to market often do not represent real world scenarios. Distilling information from claims data or other big data sources can provide “actionable intelligence for clinicians”. “There’s not a lot of information that’s practical and usable for me in my office…” Smith says.
So how can we bring evidence into care? Highlights of the Renfrew Centers’ successful approach are described in the article; they are trailblazing. There is also an opportunity for large and small behavioral healthcare provider organizations to implement evidence-based care without needing to be the pioneers.
As the CEO of a health IT company, I now wrestle with the challenge of helping clinicians (including those who don’t have the band-width to be trailblazers) to deliver evidence-informed medicine to each individual patient.
Digital health solutions are enabling the findings of research to be easily applied in clinical care; incidentally they are also generating a wealth of real-world data that in itself enriches the evidence base and our understanding of optimal treatments.
We can distill the evidence base and protocols derived from it into integrated software that clinicians can use at the point-of-care. We can then capture the clinical characteristics and the symptoms of each individual patient and map them (automatically) against those best-practice guidelines. This generates personalized care recommendations which enable clinicians and patients to together make evidence-informed treatment decisions. By monitoring an individual’s status both at and between clinical consultations (using remote technologies) we can track progress and treatment like never before. We can identify early when things are going awry and come back to the “electronic” protocols to guide care.
The growing database of clinical data generated allows an organization to explore concordance with quality measures and monitor outcomes at a population level. The improved understanding of optimal treatment practices improves care and ensures the best value for each healthcare dollar. That seems like good thing!
My cup of coffee’s finished. Thanks Jill Sederstrom for a great read.