The project described was supported by Funding Opportunity Number CMS-1c1-12-0001 from Centers for Medicare and Medicaid Services, Center for Medicare and Medicaid Innovation.

Its contents are solely the responsibility of the authors and do not necessarily represent the official views of HHS or any of its agencies.

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NCH HCIA Tele-Behavioral Health Update

Dr. Becky Baum, Nationwide Children’s Hospital 6/28/2013

The project described was supported by Funding Opportunity Number CMS-1c1-12-0001 from Centers for Medicare and Medicaid Services, Center for Medicare and Medicaid Innovation.

Its contents are solely the responsibility of the authors and do not necessarily represent the official views of HHS or any of its agencies.

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Overview

• Triple-P Online (TPOL) E-therapy

• Lync • MyChart • Duet

Engagement

• HealthSpot • Creating Opportunities for Personal

Empowerment (COPE) Direct Care

The project described was supported by Funding Opportunity Number CMS-1c1-12-0001 from Centers for Medicare and Medicaid Services, Center for Medicare and Medicaid Innovation.

Its contents are solely the responsibility of the authors and do not necessarily represent the official views of HHS or any of its agencies.

………………..……………………………………………………………………………………………………………………………………..

TPOL Pilot Background • Evidence-based intervention for parents of children ages

2-12 with disruptive behavior

Goal • Provide access to psychosocial intervention for families

otherwise unable to access non-pharmacologic treatment

Progress • Began 4/2013 with 9 providers in NCH clinic with large

percentage of patients from non-contiguous counties

The project described was supported by Funding Opportunity Number CMS-1c1-12-0001 from Centers for Medicare and Medicaid Services, Center for Medicare and Medicaid Innovation.

Its contents are solely the responsibility of the authors and do not necessarily represent the official views of HHS or any of its agencies.

………………..……………………………………………………………………………………………………………………………………..

TPOL Weekly Code Assignment Go Live: April 15, 2013

Assigned 1 1 4 3 0 4 8 2 0 3 0

# of weeks 1 1 1 1 1 1 1 1 1 1 1

**Control Limits deviate from standard because data dispersion (i.e., variation) in one or more baselines is too large (or too small) to meet usual u-Chart statistical assumptions.

0

1

2

3

4

5

6

7

8

9

Wee

k 1

Wee

k 2

Wee

k 3

Wee

k 4

Wee

k 5

Wee

k 6

Wee

k 7

Wee

k 8

Wee

k 9

Wee

k 10

Wee

k 11

Cod

es A

ssig

ned

Triple P Access Codes Assigned per week

Baseline Mean(s) Baseline Period Control Limits Goal(s)

Week

Chart Type: u-Chart (modified)**

Triple P Access Codes Assigned per week

Wee

k 11

Wee

k 10

Wee

k 1

Wee

k 2

Wee

k 3

Wee

k 4

Wee

k 5

Wee

k 6

Wee

k 7

Wee

k 8

Wee

k 9

The project described was supported by Funding Opportunity Number CMS-1c1-12-0001 from Centers for Medicare and Medicaid Services, Center for Medicare and Medicaid Innovation.

Its contents are solely the responsibility of the authors and do not necessarily represent the official views of HHS or any of its agencies.

………………..……………………………………………………………………………………………………………………………………..

TPOL Weekly Activation

Activated 1 1 0 1 0 0 2 0 0 2 2

# of weeks 1 1 1 1 1 1 1 1 1 1 1

0

0.5

1

1.5

2

2.5

3

3.5

4

4.5

Wee

k 1

Wee

k 2

Wee

k 3

Wee

k 4

Wee

k 5

Wee

k 6

Wee

k 7

Wee

k 8

Wee

k 9

Wee

k 10

Wee

k 11

Activ

ated

Triple P Access Codes Activated per week

Baseline Mean(s) Baseline Period Control Limits Goal(s)

Week

Chart Type: u-Chart

Triple P Access Codes Activated per week

Wee

k 11

Wee

k 10

Wee

k 1

Wee

k 2

Wee

k 3

Wee

k 4

Wee

k 5

Wee

k 6

Wee

k 7

Wee

k 8

Wee

k 9

The project described was supported by Funding Opportunity Number CMS-1c1-12-0001 from Centers for Medicare and Medicaid Services, Center for Medicare and Medicaid Innovation.

Its contents are solely the responsibility of the authors and do not necessarily represent the official views of HHS or any of its agencies.

………………..……………………………………………………………………………………………………………………………………..

Next Steps Potential solutions • Incentives • Enrollment during

office visit

Challenges • Internet Access • Check-in Calls • Web Browser Issues • Low activation rates

The project described was supported by Funding Opportunity Number CMS-1c1-12-0001 from Centers for Medicare and Medicaid Services, Center for Medicare and Medicaid Innovation.

Its contents are solely the responsibility of the authors and do not necessarily represent the official views of HHS or any of its agencies.

………………..……………………………………………………………………………………………………………………………………..

Lync Background • Videoconferencing program to connect families with Parent

Partner post-discharge

Goal • Improve 30 day mental health follow up rate after discharge • Improve CIS scores

Progress • Go-live 7/2013

The project described was supported by Funding Opportunity Number CMS-1c1-12-0001 from Centers for Medicare and Medicaid Services, Center for Medicare and Medicaid Innovation.

Its contents are solely the responsibility of the authors and do not necessarily represent the official views of HHS or any of its agencies.

………………..……………………………………………………………………………………………………………………………………..

MyChart Background • Patient portal that provides communication with NCH providers

and survey completion

Goal • Improve 30 day mental health follow up rate • Improve CIS scores

Progress • Go-live 7/2013

The project described was supported by Funding Opportunity Number CMS-1c1-12-0001 from Centers for Medicare and Medicaid Services, Center for Medicare and Medicaid Innovation.

Its contents are solely the responsibility of the authors and do not necessarily represent the official views of HHS or any of its agencies.

………………..……………………………………………………………………………………………………………………………………..

HealthSpot Background • Telemedicine platform to increase access to behavioral health

services

Goal • Reduce behavioral health readmissions • Improve 30 day mental health follow up • Improve CIS scores

Progress • Go live 10/2013

The project described was supported by Funding Opportunity Number CMS-1c1-12-0001 from Centers for Medicare and Medicaid Services, Center for Medicare and Medicaid Innovation.

Its contents are solely the responsibility of the authors and do not necessarily represent the official views of HHS or any of its agencies.

………………..……………………………………………………………………………………………………………………………………..

COPE Background • Brief Cognitive Behavioral Therapy (CBT) intervention to reduce

depression, anxiety and disruptive behavior symptoms in children

Goal • Increase 30 day mental health follow up rate after behavioral

health admission

Progress • Investigating partnership with OSU College of Nursing to provide

services via telehealth • Go-live 12/2013

The project described was supported by Funding Opportunity Number CMS-1c1-12-0001 from Centers for Medicare and Medicaid Services, Center for Medicare and Medicaid Innovation.

Its contents are solely the responsibility of the authors and do not necessarily represent the official views of HHS or any of its agencies.

………………..……………………………………………………………………………………………………………………………………..

Duet Background • Smartphone application to improve care for children and

adolescents after behavioral health admission

Goal • TBD

Progress • Development pending arrival of new faculty member

summer 2013