Monday, September 2, 2013
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
Posted by Connie at 9/02/2013 05:47:00 PM