Present: Marianne Burke, Kat Cheung, Abby Crocker, Kairn
Kelley (by phone), Rodger Kessler, Ben Littenberg, Connie van Eeghen
Start Up: Ben provided a sneak preview
of Rodger’s and Connie’s data re: behavioral health integration in an early
case study…. Looking good!
1.
Discussion: Rodger
is developing an assessment for primary care offices based on Peak’s Lexicon to
evaluate the level of integration of behavioral health services in primary care
(see previous meetings’ notes) that can be send to CJ Peak for his first
review.
a. Feedback
on language is of interest but not the primary goal.
i.
Group the questions consistently throughout the
assessment (single format)
ii.
Consider breaking down the first domain into smaller
“bites” for future evaluators
iii.
Language around “how often” a characteristic appears
may need to be sensitive to whether there are some populations that have been
focused on, and others that have not
b. Focus
is the tool, overall, to evaluate how well a practice is meeting the
expectations of integrated behavioral health in primary care, to compare among
practices, and to support decisions about future development of BH in a practice.
i.
Seven domains (from Peak’s manuscript), which
contributed to the language used to develop the assessment questions, the
results of which should be reproducible and reliable, either by self-assessment
(eventually) or outside evaluator.
ii.
Domains need to be clearly specified, for example:
1. #5:
protocol for care is the presence of a tool that is used practice-wide (a
characteristic of the practice)
2. #6:
the use of that tool in a customized fashion for specific patients, which must
be shared with either the team, the patient, both, … (a characteristic of the
provider-patient team)
3. #7:
“follow up” may be part of a protocol and be part of a care plan, and may
include follow up services received (e.g. treatment initiation and maintenance);
therefore, it is a characteristic of the care plan. This domain could become an “achievement”
indicator – that the follow up is carried out.
The fact that follow up is part of care plans would belong to Domain #5
and that specific care plans include follow up belongs to Domain #6.
c. How
to operationalize the scoring
i.
Consider adding choices for “Don’t Know” and “Not
Relevant”
ii.
Consider adding comments (at least in early versions of
the assessment)
iii.
Consider a Gutman scale: increasing inclusion of
elements that are all true or not
iv.
Consider averaging the answered questions of each
domain, so Domain #1 does not outweigh all the other domains. These averages can be averaged or summed into
a total score.
v.
Be prepared for two limitations in early phases of this
assessment:
1. Lack
of data in some domains
2. Domains
that do not wind up predicting outcomes, which will still be important as a
focus for aspirations
a. September
5: Abby – Natural History of Opioids projects (no Amanda)
b. September
12: (Amanda late)
c.
Future agenda to consider:
i.
Peter Callas or other faculty on multi-level modeling
ii.
Charlie MacLean: demonstration of Tableau; or Rodger’s
examples of Prezi
iii.
Journal article: Gomes, 2013, Opioid Dose and MVA in
Canada (Charlie)
iv.
Ben: Tukey chapter reading assignments, or other book
of general interest
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