Thomas R. Zastowny, PhD Healthcare Consultant and Psychologist OPEN MINDS Institute for Behavioral Health Informatics Fall 2007
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1 BEHAVIORAL HEALTHCARE IN THE INTERNATIONAL COMMUNITY: Science, Practice, Policy, and Initiatives on the ground Thomas R. Zastowny, PhD Healthcare Consultant and Psychologist OPEN MINDS Institute for Behavioral Health Informatics Fall 2007
2 A Perspective My experience conducting business in a variety of countries over the last 12 years Existing data and scientific publications Conferences and Seminars Discussions and writings with colleagues across the globe Active participant and developer in entrepreneurial efforts with a variety of health care start-up and venture firms
3 META TRENDS changing our world Cultural Modernization Economic Globalization Universal Connectivity Transactional Transparency Social Adaptation David Pearce Snyder, 2004, THE FUTURIST
4 Global Context Great Economic Disparities High Prevalence of Communicable Disease Social Disruptions-War, political instability Lack of Family cohesion Poor Law enforcement
5 Global Context..and Great scarcity, inefficiency, and inequity of behavioral health care services..
6 Themes & Examples 01. Use of Evidence Based Practice and Promising Practices (Cochrane Group) & clinical themes of rehabilitation, recovery & resilience 02. Emergency Response Teams (a.k.a. Kenyon International & Mental Health First Aid- Australia) 03. Quality Focused organizations such as ISQUA-International Society for Quality in Health Care 04. Integration of Systems of Care- (e.g., Primary care and behavioral health care)
7 Themes 05. Telemedicine and the infusion of patient based Technologies into care settings 06. Cultural sensitivity, awareness and true cultural integration 07. Use of Patient Reported Outcomes (ISOQOL- International Society for Quality of Life Research)- HRQOL, Satisfaction, Perceived Efficacy, Adherence, and Perceived Efficacy 08. Recognition that many medical Illness have Biobehavioral roots and are amenable to change & use of Multi-diagnostic systems-( Treating the Whole patient )
8 Themes 09. Expansion of Accreditation systems as a marker and driver of quality (ISO,EFQM,JCI) 10. Improved mixing of epidemiologic methodologies and clinical practices. 11. Financing and reimbursement strategies are complex and variable, and continue to evolve Pay for Performance 12. Greater recognition of integration of sometimes disparate systems of Quality Assurance, Performance Improvement and Outcomes Management.
9 SUMMARY,OPPORTUNITY, & COMMENT True and treated prevalence of behavioral health problems will never be equal As integration of health care systems (e.g., Behavioral & Medical) increase more opportunities will be available;-in many places such services already exist-rochester NY Primary Care & Behavioral Health Integration Sites
10 SUMMARY,OPPORTUNITY, & COMMENT Accreditation and Regulatory review demands stimulate the market and open the door to true quality assessment and improvement opportunities Consider the Illnesses of Depression and Substance Abuse-particularly alcohol which are good examples of almost universal recognition and established treatment efficacy-(fleming s work, Alcohol Research & Health, 1999;)
11 SUMMARY,OPPORTUNITY,& COMMENT Measurement advances, in almost every area, have been significant and much more available via Web and other electronic platforms Stronger integrations and thoughtful planning approaches to new programs integrating primary, secondary and tertiary intervention & prevention efforts. Selected Resources: WHO, TREAT-NET United Nations Office on Drugs and Crime, ISQUA, World Mental Health Congress, Centre for International Mental Health, World Federation for Mental Health, International Mental Health Division within the Institute of Psychiatry-King s College of London
12 THANK YOU! Thank You! Thomas R. Zastowny, PhD.
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