The BHL Software: An IT tool supporting PC-MHI care management and collocated collaborative care

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The BHL Software An IT tool supporting PC-MHI
care management and collocated collaborative care

• Erin Ingram, BA
• Senior Research Associate
• VISN 4 MIRECC

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BHL Software What is it?

• Software package developed to support measurement
  based care, including care management and
  Collocated Collaborative
• Aids in tracking patient contacts and treatment
  progress
• Assists with quality assurance and quality
  improvement

VISN 4 MIRECC
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Does it interface with CPRS?

• Stand alone software
• Software generates progress notes
• Coming Soon (in VA timeline) next version (V5)
  will interface with CPRS

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BHL Software Features

• Flexible and User-friendly
• Adaptable decision support
• Patient Tracking Tools
• Supports measurement based-care
• Progress notes creation
• Workload and clinical outcome data easily
  available

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Potential PCMHI Components supported by BHL
software

• Watchful waiting
• For Veterans who are subsyndromal
• Care management/ Brief treatment
• Depression, anxiety, alcohol, pain, PTSD
• Medication adherence and side effects, symptoms
• Referral management
• Tracking and facilitating treatment engagement

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Structured Interviews

• Core triage/initial assessment
• Watchful Waiting
• prompted for weekly contacts to track PHQ-9
  scores
• Built in algorithm for referral to care
  management
• Care Management (Brief Treatment) Interview
• Intended for tracking and supporting measurement
  based care

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Initial Triage Assessment Core Interview

• Phone or in person
• 20-25 minutes
• Array of mental health symptoms and substance use
• Helps determine next step in treatment
• Output patient letter, provider report, baseline
  data

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Core Interview Assessments

• Demographics
• Current MH care
• Financial status
• Social support
• Blessed Orientation-Memory-Concentration (gt55 yrs
  or head injury)
• Mini International Neuropsychiatric Interview
  (psychosis, mania, GAD, panic)
• Depression assessment PHQ-9
• PTSD Checklist (PCL-c)
• Anxiety assessment GAD-7 (optional)
• Brief Pain Inventory Interference scale
• Current Psychotropic/Pain medications
• 5-item Paykel scale for suicidal ideation
• Alcohol use (7 day follow-back)
• Illicit substance use
• Depression history
• Work Limitations questionnaire (optional)
• SF-12 (optional)

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Easy to Navigate
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Core Summary Page Interview Results
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Clinical Report

• Generates report for clinical chart into a Word
  document
• Available for each completed interview

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Care Management Interview

• For tracking follow-up contacts
• 6 optional domains
• Depression PHQ-9
• Anxiety GAD-7
• PTSD PCL-c
• Pain BPI for pain interference
• Alcohol 7-day time line follow-back
• Referral Management to track engagement in
  specialty care

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Enrollment into CM interview
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Changing the Symptom Domains
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Tracking Symptoms Overtime
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Care Management Summary
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Patient Level Reports

• Progress Note Creation for all interviews
• Treatment plan
• Results of all assessments
• Patient letters and Progress reports
• Patient education
• Visual of treatment
• progress

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Patient Tracking Panel Management
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Tracking Contact Dates Date Categories

• (a) Appointment
• trumps all dates
• Time indicates appt versus target date
• (c) Last Contact made
• (o) Episode Open date
• Indicates to you that you have not attempted to
  contact this patient yet or set an appt/target

VISN 4 MIRECC
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Reports available to help track active patients

• Active Patient listings - excel spreadsheet of
  active patients
• Aggregate data on active patients enrolled in the
  Core interview, Watchful Waiting and Care
  Management
• Upcoming appointment reports
• Supervision Reports excel spreadsheet of
  flagged patients

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Outcome Data How is our program doing?
OUTCOME DATA Available at the program, clinic,
Primary Care Provider and staff level
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Who should have access to the software?

• Anyone on the PC-MHI team
• PC-MHI nurse care managers
• PC-MHI social workers
• PC-MHI psychologist
• PC-MHI psychiatrists and CRNPs
• Psychology/health technicians
• Other possibilities health behavior coordinator
• Helps to track patient contacts and symptoms for
  both CM and CC services

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User Classifications General versus
Administrative

• General users of the software have access to
• All patient tracking features
• All clinical reports
• Administrative reports on their own workload
• Administrative users additional access
• Program users, clinics and clinicians into
  software
• Program decision support preferences for triage
  interview
• All options for administrative reports

VISN 4 MIRECC
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How do I describe the software to my IT
department?

• Commercial product (not Class software)
• Does not interface with CPRS
• NET thick client desktop application
• Interacts with a SQL Server backend database
• Application is executed from end user desktops
  via a windows network share over the local area
  network

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Resources

• BHL SharePoint Site https//vaww.visn4.portal.va.
  gov/networks/BHL/default.aspx
• BHL Software Manuals
• Example Cheat Sheets for services
• BHL Software Support -wkly conference call
• Tuesdays, 2pm EST
• 1-800-767-1750, Access code 31307
• To request the software, contact me at
• erin.ingram_at_va.gov
• 215-823-5800 x12895

VISN 4 MIRECC