One of the biggest challenges in the Behavioral Health industry, or any medical industry, is that it is hard to quantify the quality of care and progress being made.
There are so many subjective factors. The person being served has their experiences, the administrator may have biases, and the different professionals providing treatment have different interpretations.
That’s where measurement based care (MBC) comes in to help you make better treatment decisions from patient data.
While measurement based care is used for all types of medical treatment it is especially helpful for providing quality behavioral health care.
In this guide, you’ll learn:
- What measurement-based care is
- 5 key components to successful implementation
- The top data collection and measurement based care tools
- Benefits of implementing measurement-based care
- Overcoming obstacles (paperwork, training, & more)
What Is Measurement Based Care?
Measurement-based care is the process of carefully making treatment decisions based on the treatment data & feedback of patients. Data is used to track progress and improve patient outcomes.
5 Key Components To Successful Measurement Based Care
While measurement-based care is complex, it all comes down to a few simple steps. There are five key components to a successful measurement-based care program:
Collection of Data
Determine which form of assessment will be best for the person you serve such as self-report questionnaires or in-person assessments during sessions. Collecting results weekly or between every session results in better outcomes.
Collect data at intake, before appointments, or between appointments as needed. Continuous data collection and monitoring can help makes decisions clear and point to areas that need improvement.
Review of Scores
After collecting all numerical and graphical scores over a period of time, analyze any data that is alarming or repetitive. Here you can look at graphs for any declines or increases in symptom scores.
It is important to know where you are starting from and set goals. This way when you review these scores you have a comparative variable and can keep track of progress.
Collaboration
One of the biggest advantages of measurement-based care is the collaborative aspect. Review the results with the person you are serving during sessions and allow them to reflect on any progress they’ve made, their challenges, and their goals.
This may not only give you new insight but encourage their engagement in their recovery.
Examine Results
Now that you have the quantitative numbers from the questionnaires and the qualitative data from the person you served it is time to examine it all together.
Examine any patterns in progress or how you are in relation to the goals you set. From there you can determine if a change in course is needed. Tip: This data can also be used to aid your mental health marketing efforts.
Take Action
Act on the results by making the necessary changes to improve results and continue towards your goals. This may mean making small adjustments to their specific treatment or larger systemic changes.
You are continuously going through these 5 components, assessing, testing, and reviewing progress to alter treatment and improve outcomes.
Essential Measurement Based Care Tools
Using data is key for consistent data measurement throughout medical professionals and treatments. When collecting qualitative data in a way that requires answers from the person you serve, it is crucial to keep it simple.
The first step is to collect the reported symptoms with symptom rating scales like:
- Personal Health Questionnaire 9 (PHQ-9) – a self-administered, longer questionnaire to assess depression.
- Personal Health Questionnaire 2 (PHQ-2) – consists of the first two elements of PHQ-9 to screen for depression before being fully evaluated with the PHQ-9.
- General Anxiety Disorders 7 (GAD-7) – a seven-item simple initial screening tool for generalized anxiety disorder.
- Primary Care Screen For Post-Traumatic Stress Disorder (PTSD-5) – identifies if the person served has had exposure to traumatic events and their probability of PTSD.
- Concise Health Risk Tracking (CHRT-7) – a self-report that measures suicidal severity and risk.
- Quick Inventory of Depression Symptomatology (QIDS-16) – rates depression symptom severity based on mood, sleep, and risk of suicide.
- Social Phobia Inventory (SPIN) – 17-item self-report for social anxiety disorders rating symptoms such as fear and avoidance.
- Quality of Life and Enjoyment (Q-LES-Q) – shows how the treatment is affecting the quality of life of the person you serve when they are more functional.
- Work and Social Adjustment Scale (WSAS) – see how symptoms are affecting the person you serve in their daily lives.
You can distribute assessments in-person before sessions or digitally through the patient portal or EMR secure email 24 hours in advance of appointments. This decision will depend on the likelihood of engagement and if the person you serve has the ability to self-report.
Benefits Of Implementing Measurement Based Care
The use of measurement based care benefits both behavioral health professionals and the people they serve. It is a powerful tool that can improve outcomes resulting in a stronger community and business.
1. Improves Care & Experience
Having data also allows you to personalize care for the people you serve. There is no exact linear line for mental health recovery, therefore you need to be able to continuously reassess treatment.
You can also use data to open up communication with the people you serve because you have all of their information readily available. As opposed to having to ask them if they remember how things went during their last visit you can have the information and discuss their progress.
measurement-based care is a very collaborative experience and therefore you and the person you serve can share decision-making allowing them to buy into the process.
2. You Can Learn From It To Inform Clinical Decisions
Data provides insight that is objective across all care teams. Monitoring changes and patterns in symptoms can provide insight into opportunities and predict outcomes.
This can help improve interventions, services, and staff training. Patterns can suggest the person you serve may need medication management, who needs to stay longer in inpatient or whos ready for outpatient, or who may terminate treatment.
3. Objectivity and Reliability
When you can compare numbers instead of qualitative input you can evaluate progress from visit to visit. All information will be measured the same no matter who administers or interprets the reports.
This is important to overcoming subconscious biases medical professionals or observers may have.
This is especially helpful in behavioral health where the person you serve’s input is mostly based on their experiences. measurement-based care helps you set a standard that can be compared.
4. Manage Off-Track Members
With measurement-based care, you can assess patterns to see if clients are going off-track and may be likely to discontinue treatment. If you see these patterns you can then adjust treatment to fit their needs in real-time.
measurement-based care monitors symptom reduction and deterioration allowing you to make adjustments, and improve retention.
Learning from the data you can evaluate treatment effectiveness to pinpoint areas where the people you serve may be going off track. Implementing successful measurement-based care practices drastically reduces rates and improves outcomes.
5. Increase Engagement
Measurement based care is proven to help increase the engagement of the people you serve. It empowers them with more transparency and visibility into their results and the chance to collaborate.
Opening the door for the people you serve to communicate their goals and make decisions enhances communication and participation.
6. Build Relationships With Stakeholders
While behavioral health is all about helping the people you serve, as an organization you may have some stakeholders you need to report to. By collecting baseline data of the people you serve before they start with you and proof of improvement, you can have the objective evidence you need.
Additionally, third parties may reward or penalize your organization for its lack of proof of improved care.
Medicare and Medicaid are requiring payers and providers to have objective documentation of improvement. Payers want proof to give support, you need to show that new services can reduce costs and improve outcomes before giving reimbursement.
Overcoming Obstacles
Now while measurement-based care can help your organization become incre3dibly successful, when not implemented correctly you can hit roadblocks.
Tedious Paperwork
One of the biggest obstacles clinics often face with doing assessments on paper is the costs and time that go into managing and manually analyzing data trends.
Finding the right digital questionnaire can that can embed in electronic health records (EHR) while still keeping data secure is crucial. This can completely streamline the scoring, charting, and tracking processes.
Lack of Training in Measurement Based Care
Another area organizations may face roadblocks is utilizing the data they have collected. They are not training their staff to adopt and incorporate the results into their regular practices.
They need to be trained to be able to change their plan when recovery isn’t linear and they need to create a new solution.
Future Considerations
- Monitor Routinely – the successful practice of MCB includes routine monitoring throughout treatment.
- Person-Centered Approach – the only way to be able to fully get data on the symptoms and condition of the people you serve you need to involve them.
- Timeliness is Key – in order to get accurate data, it needs to be collected during or right before sessions.
- Implement the Right Technology – tech enables medical professionals to collect more data from patients outside of the clinic, saving time at point of care.
C4 Can Help You Navigate Measurement Based Care
Need help with change management, implementing measurement based care in your programs, or analyzing data for your behavioral health organization? Our consultants are here to help!
Our highly-qualified team stays up to date with behavioral health best practices, knows proven strategies for measurement-based care implementation, and has the skill set to help train your team.
Our mission is to help organizations like yours advance their visions and create sustainable success. We empower your team to create solutions that can reach your short-term and long-term goals.
C4 Consulting has the tools and knowledge to incorporate measurement-based care effectively into your organization. Request a free consultation to see how we can help you!
