1. Medical Informatics : Moving the Tipping Point of Behavioral Health Integration Susan D. Wiley, MD Vice Chairman, Dept. Psychiatry Maryanne Peifer, MD, MSIS, Associate Medical Director, Clinical Informatics Gail Stern, MSN, Administrator, Dept. Psychiatry Lehigh Valley Health Network Allentown, PA 18103 Collaborative Family Healthcare Association 13 th Annual Conference October 27-29, 2011 Philadelphia, Pennsylvania U.S.A. Session # D5a October 29, 2011 1:30 PM

2. Faculty Disclosure We have not had any relevant financial relationships during the past 12 months.

3. Need/Practice Gap & Supporting Resources Successful Behavioral Health Integration requires the means to measure: Cost effectiveness Quality enhancements Service enhancements Impact on patients and providers Growth for the network

4. Objectives: Upon completion of this presentation the participant will be able to: Describe strategies and challenges in measuring behavioral health integration. Identify critical indicators of Service, Quality, People, Growth and Cost. Quantify differences between primary care practices with and without behavioral health integration. List changes in practice behaviors which follow measurement of those behaviors.

5. Expected Outcomes Participants will be able to make use of features of EMR for measurement of BHI. Participants will be able to evaluate methods of measurement of BHI to utilize in their own settings. Participants will appreciate how measurement and feedback can alter provider behavior.

6. Learning Assessment A learning assessment is required for CE credit. Attention Presenters: Please incorporate audience interaction through a brief Question & Answer period during or at the conclusion of your presentation. This component MUST be done in lieu of a written pre- or post-test based on your learning objectives to satisfy accreditation requirements.

7. Moving the Tipping Point of BHI Quality Enhancements Improved Access Cost Effectiveness

8. Private Practice Settings Trexlertown: EMR, suburban, 7 MD Hamburg: EMR, rural, 5 MD Moselem Springs: EMR, rural, 6 MD Training Settings: Pleasant Valley: EMR, rural setting, 3 MD Lehigh Valley Family Practice: paper chart, urban setting, 2 MD + NP Family Health Center: EMR, urban, 10 MD + 2 NPs Lehigh Valley Health Network BHI: Primary Care Settings

9. LVHN BHI: Specialty Care Settings Adolescent Medicine Neuroscience Center Weight Management Cancer Center Bereavement & Hospice

10. Key Definitions “Treatment as Usual”: Multidisciplinary group psychiatric practices: psychiatrists, psychologists, social workers & nurse providing MH services. “Comparison Practices”: Family Medicine practices with comparable demographics but without BHI: “Experimental Practices”: Family Medicine practices with comparable demographics AND BHI

11. LVHN Performance Pillars Service, Quality, Growth, People and Cost.

12. Data Sources Electronic Medical Record: Centricity Scheduling Software: IDX Billing Software: EPSI Patient Survey Provider Survey

20. Patient Survey

21. Questions: What aspects of behavioral integration would you want to measure? Are there other questions that you would like to look at in the domains of: Quality, Growth, Cost, Service and People? What behaviors are you seeking to increase in your providers?

22. Conclusions: Medical Informatics is a powerful tool for investigating the value and costs of Behavioral Health Integration. Data can be used to point out deficiencies, identify problems and track progress towards programmatic goals. Measurement is a powerful tool for communicating about BHI to all stakeholders.

23. Session Evaluation Please complete and return the evaluation form to the classroom monitor before leaving this session. Thank you!