Team 3, AtoZ Team Members (in order of presentation):
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1 Team 3, AtoZ Team Members (in order of presentation): Angie Ribera, Interim Chair, Physiology & Biophysics, SOM Jed Friedman, Prof, Pediatrics, SOM Doug Coatsworth, Prof, Human Dev/Family Studies, CSU Huntington Potter, Director Alzheimer s Ctr, Neurology, SOM Kristin Artinger, Assoc Prof, Craniofacial Biology, SOD Ingrid Binswanger, Assoc Prof, Gen Int Med, SOM David Goff, Dean, School of Public Health
2 Project: How might our institution s response to health care reform be shaped by innovation in our approaches to patient care and community wellness? Our recasting of the project Manageable size/scope Focus on mental health Provide better access to care and effective interventions
3 Why mental health? Affordable Care Act (ACA) includes mental health care, comparable to coverage for physical ailments (parity) Clear need in Colorado (e.g., high suicide rates) Important to University on basis of need in CO as well as potential lead-in to other services Generalizable (next slide)
4 Generalizable concepts Alternative model for delivery of health care Task shifting of personnel who deliver health care Use mobile health (mhealth) technology for assessment, feed back and increased communication between provider and clinic Be able to conduct outcomes research (e.g. CREW)
5 Acknowledgements Marshall Thomas, Depression Center Stefannie Emerson and Tyler Leishman, UPI Jonathan Woodcock, Director of Memory and Dementia Clinic Michael Kahn, CREW and EPIC Sheana Bull, Colorado School of Public Health Our LITeS colleagues CCTSI and LITeS leadership
6 Mental Health Care Challenges in CO Poor reimbursement rates Waiting list 3-4 mo up to 2 yrs Service gap (need for para-professionals) Better access in geographic areas of need
7 Disruptive Innovations New or Different Business Models Simple, Affordable, Convenient Disruptive Innovations in Mental Health New Models of Delivery Technology, e.g., Telehealth ehealth, mhealth Decentralization Locations: Everyday settings in the community
8 Depression Center Unable to meet Community needs Long waiting lists; untreated patients Examining new models Tele-health collaboration with CO Access Community systems of care Alternative models Possible outreach through Little Clinics
9 Cognitive Assessment The Affordable Care Act mandates a Medical Annual Wellness Visit, including a brief cognitive assessment. The Alzheimer s Association convened a panel of experts who designed a brief algorithm for detecting cognitive impairment. If impairment is detected, person is referred for further tests. The UPI/Mini Clinics could carry out the Annual Wellness Visit.
10 UPI/The Little Clinic The Little Clinic (TLC): mini health clinic, located in King Soopers grocery store, and affiliated with CU Health Partners 12 in Denver Metro area in accessible locations Low Cost and easily accessible health care There is a strong need in our community Can expand to telehealth, etc. UPI hopes to partner for referrals and clinical trials
11 Leverage Clinical Data for Research Compass (neé CREW, Clinical Research Enterprise Warehouse) Single unified, campus-wide data source Provides strong opportunity for comparative effectiveness and other patient-centered outcomes research Funded by UCH/Children s Hospital, health plans, UPI, and School of Medicine Directed by Michael Kahn All EPIC clinical data will funnel into CREW, but The Little Clinic data not connected
12 Recommendations & Action Plan Enhanced collection of data on mental health of community residents served by TLC/UCH collaboration Development of data integration between TLC data in eclinicalworks into UCH EPIC Care Elsewhere Strengthen mental health capacity of TLC and UCH
13 Recommendations & Action Plan Integrate mental health and behavior screening into operations of TLCs - Train community health workers to integrate memory and depression screening into TLC - Screen for mental health problems at TLC - Deliver brief behavioral counseling to mild cases at TLC - Integrate Tele/E/m health approach to monitor and support behavioral health - Refer more severe cases to UCH - Conduct Outcomes research
14 AtoZ Summary How might our institution s response to health care reform be shaped by innovation in our approaches to patient care and community wellness? Build on TLC partnership for mental health as example of alternative delivery system to enhance access and efficiency. Task-shifting Technology Strengthen data systems for outcomes research
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