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一次重大转变:行为健康领域测量反馈系统的快速转换

An EPIC transition: Rapid conversion of a measurement feedback system in behavioral health.

作者信息

Gatto Alyssa J, McNamara Robert S, Ko Hayoung, O'Brien Virginia C, Jones Sydney B, Cooper Lee D, Kablinger Anita S

机构信息

Department of Psychiatry, University of Colorado Anschutz School of Medicine, Aurora, CO, USA.

Children's Hospital Colorado, Aurora, CO, USA.

出版信息

Digit Health. 2025 Aug 6;11:20552076251359133. doi: 10.1177/20552076251359133. eCollection 2025 Jan-Dec.

Abstract

Measurement-based care (MBC), while an evidence-based clinical practice, can be difficult to integrate into behavioral healthcare settings. Even when MBC has been successfully implemented in an organization, there are many challenges that create a need for rapid adaptation. As measurement feedback systems (MFSs) are increasingly hosted on dynamic digital platforms, there is always a risk of technological changes and adaptations, whether the system is prepared for them or not. This point of view is focused on managing organizational changes to continue use of MBC through a case example in adult behavioral healthcare. A hospital policy change, informed by financial considerations, led to the rapid de-implementation of the external MFS platform in favor of a system integrated into the electronic health record (EHR). Our team responsively developed a plan for maintaining MBC through this transition including written guidelines and face-to-face training to support clinical staff, while determining the best way to maintain research gains and collect data in the EHR. This manuscript discusses the challenges in switching MBC platforms and the downstream consequences of this policy change from clinical, training, and research perspectives.

摘要

基于测量的照护(MBC)虽是一种循证临床实践,但可能难以融入行为健康照护环境。即便MBC已在某个组织中成功实施,仍存在诸多挑战,这就需要快速适应。由于测量反馈系统(MFS)越来越多地托管在动态数字平台上,无论系统是否为此做好准备,技术变革与调整的风险始终存在。本观点聚焦于通过一个成人行为健康照护的案例,管理组织变革以持续使用MBC。一项受财务考量影响的医院政策变更,导致外部MFS平台迅速停用,转而采用集成到电子健康记录(EHR)中的系统。我们的团队迅速制定了一项在此次过渡期间维持MBC的计划,包括书面指南和面向临床工作人员的面对面培训,同时确定在EHR中维持研究成果并收集数据的最佳方式。本文从临床、培训和研究角度探讨了切换MBC平台所面临的挑战以及这一政策变更的下游影响。

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Implementing Measurement-Based Care in Behavioral Health: A Review.实施基于测量的行为健康护理:综述。
JAMA Psychiatry. 2019 Mar 1;76(3):324-335. doi: 10.1001/jamapsychiatry.2018.3329.
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Implementation and de-implementation: two sides of the same coin?实施与取消实施:同一枚硬币的两面?
BMJ Qual Saf. 2017 Jun;26(6):495-501. doi: 10.1136/bmjqs-2016-005473. Epub 2016 Aug 10.
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Using Measurement-Based Care to Enhance Any Treatment.运用基于测量的护理来强化任何治疗。
Cogn Behav Pract. 2015 Feb;22(1):49-59. doi: 10.1016/j.cbpra.2014.01.010.

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