benjamin druss md, mph knowledge network summit october 3, 2013
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Improving health and healthcare for mental health consumers: from research to practice and back again. Benjamin Druss MD, MPH Knowledge Network Summit October 3, 2013. - PowerPoint PPT PresentationTRANSCRIPT
IMPROVING HEALTH AND HEALTHCARE FOR MENTAL HEALTH CONSUMERS: FROM RESEARCH TO PRACTICE AND BACK AGAIN
Benjamin Druss MD, MPHKnowledge Network SummitOctober 3, 2013
1. Journal of the American Statistical Association Mar 1932;27(177A):160-174. 2. BMJ. 2011 Sep 13;343:d5422 3. 3. Nord J Psychiatry. 2012 Apr;66(2):97-106. Epub 2011 Aug 23.
A Widening Gap: Trends in Studies of Excess Mortality in Schizophrenia1
1970s 1980s 1990s1
1.5
2
2.5
3
3.5
4
Arch Gen Psychiatry. Oct 2007;64(10):1123-1131
Life Expectancy
Psychiatry Res. 2010 Apr 30;176(2-3):242-5Med Care. 2011 Jun;49(6):599-604
No Mental Disorder Any Mental Disorder General Population
Any Mental Disorder Public Sector
404550556065707580
Preventable Causes of Death
N Engl J Med. 2007 Sep 20;357(12):1221-8.
Health Care; 10%
Health Behav-iors; 40%
Genetics; 30%
Social/ Env-iornmental;
20%
Risk FactorsLifestyle
Medications
Chronic Medical Illnesses
A Public Health Approach
Primary Prevention
Wellness programs
Environmental Policies
Secondary Prevention Tertiary Prevention
TreatmentScreening
FOUR CORNERS WELLNESS PROGRAM
Four Corners seeks to build upon the supportive capacity of the CCSB to expand the scope of wellness and whole health services.
LET’S GET PHYSICAL! o Healthy Breakfasts Provided By Peerso Have YOU had Your Annual Physical?o Nationally Distributed Cookbooko Integrated Healthcare Peer Blogo Certified Fitness instructoro Cooking Demonstrationso Relaxation Roomo Walking Groupso Fitness Room
WELLNESS GROUPSo Stress
Managemento
Recovery/Wellness
o Healthy Living o Leisure Skills o WHAM
COMMUNITY BASED PROGRAMS
o Intensive Case Management
o Linkage To Specialty Careo Home Based
Assessmentso Community Outreacho CSI Services
LET’S GET PHYSICAL!
Schizophrenia and Bipolar Disorder Measure Set for HEDIS 2013Measure Name First-Year Results for
Medicaid HMOs
Adherence to Antipsychotic Medications for Individuals with Schizophrenia
58.5%
Diabetes Screening for People with Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications
78.0% (Glucose or HbA1c test)
Diabetes Monitoring for People with Diabetes and Schizophrenia
67.8%
Cardiovascular Monitoring for People with Cardiovascular Disease and Schizophrenia
77.6%
Building a Health Home for People with SMI
REFER
Buy: The VA Integrated Care Clinic
Refer: The Primary Care Access, Referral and Evaluation (PCARE) Project
NIMH R01MH070437
Costs
0
2000
4000
6000
8000
10000
Tota
l Co
st (
$)
Cont rolCase Cont rolCase1-year 2-year
Probability of cost offset: 92.3% or 96.1% excluding extreme outliers
Medicaid Health Home State Plan Amendments
Rent
NIMH R01MH070437
SAMHSA PBHCI Program
1. Funded by NIMH R34MH078583\2. Lorig K et al. Med Care. 2001 Nov;39(11):1217-23.
Engaging Patients in Health Care
NIMH R01MH090584
Supporting Health Homes with IT
Registries and Measured Care
Patients: Personal Health Records
Going Mobile
MOBILE PERSONAL HEALTH RECORD
mPHR
Medical Records
Medications
Appointments
Messages
Health Goals
Building Data Infrastructure
Next Steps
A Virtuous Cycle
Evidence-Based Practice• Investigator-developed interventions
Practice-Based Evidence• Community-developed interventions