More than 300 million individuals of all ages suffer with depression – a mental health condition that is the leading cause of disability worldwide, according to the World Health Organization. It is the strongest risk factor for suicide. In 2010, worldwide deaths from suicide outnumbered deaths from war, natural disasters and murder.
Each year 26 percent of adults and 20 percent of children have a diagnosable behavioral health disorder, and more Americans receive behavioral health care from Primary Care providers than mental health specialists. Although cases of depression are highly prevalent in primary care settings, they often go undetected.
UCLA Health Tackles Depression
UCLA Health identified a suboptimal depression screening rate among adult patients seen in primary care offices. Consequently, UCLA Health has multiple concurrent efforts, including a collaboration by UCLA primary care and UCLA Division of Population Behavioral Health, to decrease the burden of depression and improve depression screening and diagnosis using health information technology. UCLA Health IT teams identified a number of obstacles within standard workflows contributing to the underperformance in depression screening and follow up care.
To address this, UCLA physician informaticists worked with technical and operational teams to review the existing workflow to screen patients for depression risk and optimized the process with various IT tools within the electronic health record (EHR). This included a web-based screening platform called “Behavioral Health Check-up”, developed by the UCLA Division of Population Behavioral Health, which streamlined data review for depression risk with quick documentation and charging tools.
Utilizing continuous Plan-Do-Study-Act (PDSA) cycles, the team implemented new workflows, developed ongoing training programs, built new web-based and EHR-based tools, and continuously monitored for performance and optimization requests. As a result, these health information and technology-enabled enhancements have led to:
- Optimized universal depression screening rate
- More accurate diagnosis and management of depression and other co-morbidities in primary care
- Increasing referrals to appropriate specialists
- Discrete, searchable, and trackable data
- Improved risk adjusted coding and appropriate charge capture
Most notably, the depression risk screening rate at UCLA Health dramatically increased four-fold within one year, with more than 70 percent of adult patients screened for depression in the primary care setting and more than 90 percent rate of completion of additional follow-up diagnostic evaluation when patients presented positive depression risk. Additionally, UCLA Health is anticipating to recuperate over $80,000 of revenue as a result of the project implementation.
HIMSS Davies Award of Excellence
The HIMSS Davies Award of Excellence recognizes outstanding achievement of organizations that have utilized health information technology to substantially improve patient outcomes and value. The HIMSS Davies Award of Excellence is the pinnacle of the HIMSS Value Recognition Program and highlights organizations promoting health information and technology-enabled improvements in patient and business outcomes through sharing evidence-driven best practices on implementation strategies, workflow design, change management and patient engagement.
“Because UCLA Health continuously seeks to optimize patient care using health information technology, the HIMSS Nicholas E. Davies Award of Excellence provided us an opportunity to recognize and highlight some of our recent successes,” said Kevin Baldwin, MPH, PMP, CPHIMS, informatics portfolio manager, UCLA Health. “We’re thankful for the experience and look forward to continue applying health information technology to enhance our health care system.”
“Behavioral health is a critical component for risk-adjusting patients to ensure they are receiving the proper level of care,” said Jonathan French, CPHIMS, senior director of quality and patient safety initiatives at HIMSS. “UCLA Health has leveraged technology to ensure that its providers are receiving a clearer picture of their patient’s mental health, which allows them to intervene more effectively and improve the overall health of their patients. For this, HIMSS is proud to recognize UCLA Health as a Davies Enterprise Award recipient.”
Learn more about how UCLA Health has embraced the value of health information and technology: explore three award-winning use cases.
See the full list of 2018 Davies Award recipients.