The BHL Software: An IT tool supporting PC-MHI

care management and collocated collaborative care

Erin Ingram, BA

Senior Research Associate

VISN 4 MIRECC

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BHL Software: What is it?

Software package developed to support measurement based care, including care management and Collocated Collaborative

Aids in tracking patient contacts and treatment progress

Assists with quality assurance and quality improvement

Does it interface with CPRS?

Stand alone software Software generates progress notes Coming Soon (in VA timeline): next version

(V5) will interface with CPRS

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BHL Software Features

Flexible and User-friendly Adaptable decision support Patient Tracking Tools Supports measurement based-care Progress notes creation Workload and clinical outcome data easily

available

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Potential PCMHI Components – supported by BHL software

Watchful waiting• For Veterans who are subsyndromal

Care management/ Brief treatment• Depression, anxiety, alcohol, pain, PTSD

• Medication adherence and side effects, symptoms

Referral management• Tracking and facilitating treatment engagement

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Structured Interviews

Core – triage/initial assessment Watchful Waiting

• prompted for weekly contacts to track PHQ-9 scores

• Built in algorithm for referral to care management Care Management (Brief Treatment) Interview

• Intended for tracking and supporting measurement based care

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Initial Triage Assessment: Core Interview

Phone or in person 20-25 minutes Array of mental health symptoms and

substance use Helps determine next step in treatment Output: patient letter, provider report,

baseline data

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Core Interview: Assessments Demographics Current MH care Financial status Social support Blessed Orientation-Memory-Concentration (>55 yrs or head injury) Mini International Neuropsychiatric Interview (psychosis, mania, GAD, panic) Depression assessment: PHQ-9 PTSD Checklist (PCL-c) Anxiety assessment: GAD-7 (optional) Brief Pain Inventory Interference scale Current Psychotropic/Pain medications 5-item Paykel scale for suicidal ideation Alcohol use (7 day follow-back) Illicit substance use Depression history Work Limitations questionnaire (optional) SF-12 (optional)

Easy to Navigate

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Core Summary Page: Interview Results

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Clinical Report

•Generates report for clinical chart into a Word document

•Available for each completed interview

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Care Management Interview

For tracking follow-up contacts 6 optional domains:

• Depression: PHQ-9• Anxiety: GAD-7• PTSD: PCL-c• Pain: BPI for pain interference• Alcohol: 7-day time line follow-back• Referral Management: to track engagement in

specialty care

Enrollment into CM interview

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Changing the Symptom DomainsChanging the Symptom Domains

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Tracking Symptoms OvertimeTracking Symptoms Overtime

Care Management Summary

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Patient Level Reports Progress Note Creation for all interviews:

• Treatment plan• Results of all assessments

Patient letters and Progress reports• Patient education • Visual of treatment

progress

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Patient Tracking: Panel Management

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Tracking Contact Dates – Date Categories

(a) = Appointment • trumps all dates • Time indicates appt versus “target date”

(c) = Last Contact made (o) = Episode Open date

• Indicates to you that you have not attempted to contact this patient yet or set an appt/target

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Reports available to help track active patients

Active Patient listings - excel spreadsheet of active patients

Aggregate data on active patients enrolled in the Core interview, Watchful Waiting and Care Management

Upcoming appointment reports Supervision Reports – excel spreadsheet of

flagged patients

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OUTCOME DATA: Available at the program, clinic, Primary Care Provider and staff level

Outcome Data: How is our program doing?

Who should have access to the software?

Anyone on the PC-MHI team• PC-MHI nurse care managers• PC-MHI social workers• PC-MHI psychologist• PC-MHI psychiatrists and CRNPs• Psychology/health technicians• Other possibilities: health behavior coordinator

Helps to track patient contacts and symptoms for both CM and CC services

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User Classifications: General versus Administrative

General users of the software have access to:• All patient tracking features• All clinical reports• Administrative reports on their own workload

Administrative users – additional access:• Program users, clinics and clinicians into software• Program decision support preferences for triage

interview• All options for administrative reports

How do I describe the software to my IT department?

Commercial product (not Class software) Does not interface with CPRS NET thick client desktop application Interacts with a SQL Server backend

database Application is executed from end user

desktops via a windows network share over the local area network

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Resources BHL SharePoint Site:

https://vaww.visn4.portal.va.gov/networks/BHL/default.aspx

• BHL Software Manuals• Example Cheat Sheets for services

BHL Software Support -wkly conference call• Tuesdays, 2pm EST• 1-800-767-1750, Access code: 31307#

To request the software, contact me at: • erin.ingram@va.gov • 215-823-5800 x12895#