研究您的工作：在大规模综合行为健康服务中开发心理治疗跟踪数据库

Study What You Do: Developing a Psychotherapy Tracking Database in a Large-Scale Integrated Behavioral Health Service

——原载《家庭医学年鉴》2023年第21卷增刊2——

<The Annals of Family Medicine> 2023, 21, (Suppl 2)

【摘要】目的：许多有行为健康挑战的人在初级保健中接受服务，综合行为健康 (IBH) 计划可以帮助增加获得循证干预的机会。IBH 计划可以从整合标准化跟踪数据库中获益良多，这些数据库允许实施基于测量的护理来评估患者、临床医生和实践水平的结果。我们描述了 Mayo Clinic 儿科和成人初级保健心理治疗跟踪数据库的开发和整合。方法：IBH实践领导者指导开发了一个大型心理治疗跟踪数据库，该数据库不断从 Mayo Clinic 的电子健康记录系统中填充。该数据库捕获了许多患者变量，包括人口统计、行为健康和物质使用问题、使用的心理治疗原则以及自我报告的症状。我们检索了 2014 年 6 月至 2022 年 6 月期间参加 Mayo Clinic 儿科和成人初级保健心理治疗项目的患者的当前数据。结果：跟踪数据库包含16,923 名成人患者和 6,298 名儿童患者的数据。成年患者的平均年龄为 43.2 岁 (SD 18.3)，88.1%为非拉丁白人，66.7% 为女性。儿科患者的平均年龄为 11.6 岁 (SD 4.2)，82.5%为非拉丁白人，56.9% 为女性。我们提供数据库在临床、教育、研究和管理领域的实际应用示例。结论：心理治疗跟踪数据库的开发和整合支持临床医生沟通、患者结果检查、实践质量改进工作以及临床相关研究。我们对 Mayo Clinic 的 IBH 数据库的描述可以作为其他 IBH 实践的模型。

【关键词】综合行为健康、基于测量的护理、电子健康记录、健康信息学、质量改进、健康指标、心理健康、心理治疗、初级保健、多学科研究、患者护理团队、人口健康

        [Abstract] Purpose: Many individuals with behavioral health challenges receive services in primary care, and integrated behavioral health (IBH) programs can help increase access to evidence-based interventions. IBH programs can benefit substantially from integrating standardized tracking databases that allow for the implementation of measurement-based care to evaluate patient-, clinician-, and practice-level outcomes. We describe the development and integration of Mayo Clinic’s pediatric and adult primary care psychotherapy tracking database. Methods: IBH practice leaders directed the development of a large psychotherapy tracking database that continuously populates from Mayo Clinic’s electronic health record system. The database captures numerous patient variables including demographics, behavioral health and substance use issues, psychotherapy principles used, and self-reported symptoms. We retrieved current data for patients empaneled in Mayo Clinic’s pediatric and adult primary care psychotherapy programs from June 2014 to June 2022. Results: The tracking database contained data for 16,923 adult patients and 6,298 pediatric patients. The mean age of adult patients was 43.2 years (SD 18.3), 88.1% were non-Latine White, and 66.7% identified as female. The mean age of pediatric patients was 11.6 years (SD 4.2), 82.5% were non-Latine White, and 56.9% identified as female. We provide examples of practical applications of the database across clinical, educational, research, and administrative domains. Conclusions: The development and integration of a psychotherapy tracking database supports clinician communication, examination of patient outcomes, practice quality improvement efforts, and clinically relevant research. Our description of Mayo Clinic’s IBH database may serve as a model for other IBH practices.

[Key words] integrated behavioral health, measurement-based care, electronic health records, health informatics, quality improvement, health metrics, mental health, psychotherapy, primary care, multidisciplinary research, patient care team, population health

英文原文： Anne I. Roche, Samuel T. Savitz, Sydney S. Kelpin, Jocelyn Lebow, Nathaniel Lombardi, Olivia E. Bogucki, Aaron A. Kurtzhals, Maureen S. Drews, Sarah T. Trane, Jay-Sheree Allen, Mark D. Williams and Craig N. Sawchuk (2023). Study What You Do: Developing a Psychotherapy Tracking Database in a Large-Scale Integrated Behavioral Health Service. The Annals of Family Medicine February 2023, 21 (Suppl 2) : 49-55.

https://doi.org/10.1370/afm.2927

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