In a lot of ways, the future has arrived with answers….now if we can figure out what to do with the answers; we may end up in better mental health.
I Googled “gene scans” and the first thing that came up is a company that sells such things, deCODEme. I can give them 2,000 of my hard earned dollars and they promise information to guide my life in areas from heart health to male pattern baldness (too late, check my picture).
A saliva test can tell us a lot about our susceptibility to certain diseases. I had a minor heart attack a few years ago, which may have been averted had I known earlier in life about my genetic leaning toward that problem. Evidently my father’s side of the family is where I inherited the heart disease problem from, and those relatives have remained mysterious and unknown to me. Although we know that sort of thing can “run in the family” I had no clue of a possible heart problem, so a gene scan may have helped me.
A friend didn’t realize diabetes ran in her extended family; perhaps she could have avoided or at least delayed the need for daily injections with a lifestyle change…if she knew of her genetic inclination toward the disease. Nutrition and exercise go a long way in preventing all sorts of physical health problems, and avoiding some foods can improve our immediate mental health. I quit caffeinated coffee and I immediately felt better, less anxious. Perhaps a diet change would have helped my friend.
A genetic test can nudge us toward lifestyle changes that can help us stay physically healthier, but can the test unveil mental health needs? If it can, what changes could I make in my life to avoid mental health problems?
I find the possibility of how this information can fit into our overall health maintenance is terribly interesting, and could augment how mental health professionals treat consumers. It’s a snap to connect a scan of the gene or printed readout of results into the Electronic Health Record (EHR). In the future, this could be a reliable map to help us avoid mental health problems or lessen severity of those problems. Having the genetic clues on the professional’s computer could guide therapy and medication, helping the professional zero in on problems and treatment solutions much more quickly. That sounds like something of value in this fast-paced instant-gratification world.
I can see a future that imports the gene scan results into the EHR, which automatically reads them and posts alerts in a consumer’s record that they may be susceptible to certain conditions like schizophrenia or depression. Other treatment resources within the EHR already suggest medications for certain conditions, and educational resources are all over the Web. Gene scan technology can be brought into treatment technology with a goal of improving diagnosis methods and providing treatment guidance. It’s nice for a professional to have just the information she needs at her fingertips.
Once again, my vision jumps the gun. The National Institute of Mental Health (NIMH) says that we simply don’t yet know how to read the genetic codes and glean information about our mental health. The body of evidence is too small to provide accurate forecasting. Scientists will need to methodically compare a bundle of gene scans for multiple gene patterns in a bundle of people in order to suggest how gene scans can be valuable in forecasting likelihood of mental illness.
Considerable research is under way, so one thing is certain: The future is near.
Read more →Some days I forget that life is about reveling in the challenge and working to overcome my problems, and just sulk. I imagine many folks are like this, looking for a quick fix, not wanting to work through daily issues or even long term mental health problems.
Is the promise of brain scans such a quick fix in treating mental health problems? Rapid recovery sounds like a pretty good goal.
Thomas Insel, Director of the National Institute of Mental Health (NIMH) thinks brain scans are akin to rocket science of the 1950’s…not ready for prime time. That said, he does acquiesce that brain scans, have some very promising results. He cites the use of MEG, (magnetoencephalography) as being proven over 90% effective in diagnosing Post Traumatic Stress Disorder (PTSD)…sounds pretty effective to me.
One of the problem professionals and consumers have in mental health treatment is getting the right medications for that person. It would be simpler if everybody responded the same way to a single medication, but that’s not how it is. When NIMH researchers studied a specific MEG signal they were successful in predicting which patients would be served well by a new anti-depressent, ketamine. Since it takes a while for many of these sorts of medications to take efffect, this technology seems to be working now to shorten the time of misery.
Using brain scans to work with mental illness is, at the very least, a great example of how technology is expanding into the field. The scan can be read electronically, so the scan or results of the scan can be ported directly into the secure Electronic Health Record (EHR) of the consumer. This is a good thing in viewing the technology as an outcomes tool.
In mental health and addiction treatment, measuring tools like assessments can show improvement or decline of conditions over a period of time, and with the record at a professional’s fingertips on the computer, the consumer gets better treatment. Changes in a consumer’s condition as treatment progresses helps professionals adjust the course of treatment as it’s needed. Historically, these assessments have been a series of questions with answers and impressions scribbled on a piece of paper. The EHR has helped with legibility and being able to graph assessment results, which provides an easy-to-read format to view progress over time.
Is the brain scan such a tool? Oh, I dunno…as far as I know the scan could be a once-in-a-lifetime event, but I doubt it, simply because everything else changes and technology is still exploding in all areas of healthcare.
It is certain that emerging technologies are aimed at higher quality in diagnosing and treating mental health problems. The assessment tools in the EHR have helped professionals and consumers focus on improving specific conditions. Brain scans appear to be another tool that will be added to the mental health professionals’ toolbox that will help shorten the time to recovery. Insel appears unconvinced of widespread applicability of the tool, so more research is required…but it’s coming. I can foresee widespread use of the technology simply because the consumer wants to get better, faster.
Read more →Average wait time from calling a mental health treatment organization for help and actually engaging in treatment with a professional can take a month. A lot of consumers cancel their appointment or just don’t show up.
From what I’ve seen, physical health has that beat.
David Lloyd of MTM Consulting shared this statistic recently in a talk on the web focused on improving quality; I found that an amazing amount of time to wait for help…Who would wait that long? According to Lloyd’s research, not many folks, and I agree, it’s a long time to wait for health, and I know a lot goes on in my mind in a month.
Regardless of whether the consumers who end up not consuming mental health services are classified as No-Shows or cancellations, or somehow justified as exempt from statistics, the fact is that a bundle of folks aren’t getting help. A key to getting the folks who are now not showing up for appointments is simple business logic. If we serve them quicker, with high quality service, for a reasonable price, they’re more likely to make their appointments. Plus, under these conditions, people improve and tell their friends how great the results of treatment at this particular facility were.
Maintaining quality treatment and delivering it quickly boils down once again to streamlining systems, and the best way I’ve found to assure streamlining happens is to tailor the Electronic Health Record (EHR) to guide clinicians through the treatment and documentation processes. If a professional has clear signposts along the way, the policies and procedures placed to improve quality and timeliness of treatment are more likely to be adhered to. Here are a few things that can be done with the EHR to increase the value of treatment in the long haul that are statistically proven to reduce no-shows and help consumers get better.
• Cut time spent on paperwork and redundant entry of consumer data…who likes to answer the same question six times? An effective EHR can save all data that’s entered one time, like the patient’s name, address, reason for coming, medications, etc, and automatically add it to any form that’s shown in a professional’s workflow where it’s needed; tune up the EHR to do this • Decrease the time a consumer spends waiting for help… Lloyd’s statistics show a lot of professionals are very busy with a lot of peripheral activities like catching up on treatment documentation when there are No-Shows; take scheduling out of the professional’s control, schedule people to come in NOW…or at least within ten days and No-Shows dwindle. • Help the professional! Start Collaborative Documentation now: Involve the consumer in writing assessments, treatment plans and progress notes during the session, with the consumer…it improves focus on treatment goals and objectives and gets the paperwork done on time, reducing a facility’s risk of falling out of compliance with state, and federal governments, helps adhere to accreditation rules, and avoids billing audit problems
I know. That’s all well and good, but who has time to do this?
There will never be enough time to do these three simple things. Facilities will need to hire EHR professionals, spending money they don’t have. The money will come as No-Shows dwindle. There are tons of statistics out there that show how great a tool the EHR can be, and the solutions above are proven to work nationwide, in a ton of studies over many years (I cite them a lot).
Now is a good time to start improving treatment using the EHR to help.
Read more →A bundle of concerns erupt when an agency providing mental health or addiction services implements an Electronic Health Record (EHR). Since the only reason these agencies are in business is to improve the consumer’s well being, a question arises: How can the EHR help improve the quality of consumer care?
When I work in mental health and addictions treatment facilities, I see just how tough it is for professionals to envision the EHR as a tool to improve consumer focus on recovery. Expanding the vision of professionals, consumers and even the software implementers to view the EHR as a tool to improve treatment is a team effort, and getting the team cranked up can be a trial.
If the up-front analysis of how people get their work done and such is solid, a professional implementer should get at least some of the software up and running effectively and quickly, and the benefits to improving consumer care should be evident within weeks of use. Professionals and consumers begin focusing more directly on treatment goals and objectives, which are the reasons folks enter treatment anyway.
All too often staff is overwhelmed by the ever-increasing documentation that’s required in treatment, so they view the software implementation as a burden, an expansion of bureaucracy. The complaint is that with all the required documentation, there’s no time to treat the patient. The EHR solution is to document with the patient during the session. Assessments with a lot of check boxes and radio buttons are easy…just walk through the questions one at a time and review the resulting score with the consumer. Treatment Plans can be more daunting because the fast way to write a goal or objective of treatment is to pick it from a drop down box on the screen, and that can lead to cookie-cutter documentation. Progress Notes generate the same concern.
Collaborative documentation with the patient is the answer, not just because you get paid for the time spent documenting the service. The consumer truly participates in her own treatment when discussing what happened in a session; how it relates to one of her reasons for being in treatment, and what she should be concentrating on in recovery before the next session. Mutual creation of the documents is what draws the patient’s attention to reaching their own treatment goals.
Using the EHR to improve treatment is not a new story. I stumbled onto an article comparing the effectiveness of a simple checklist used in treatment on the computer with a checklist on paper. It’s a short story, and to make it even shorter, a “to-do” list on the computer works darn well. The study says that both mood disorder screenings and treatment documentation improved using the computer maintained task list. The article from Dale Cannon and S Allen of the University of Utah, was ancient, from the year 2000.
A successful EHR depends on a successful implementation and “after-care”, to include continuously gaining buy-in from professionals using the system and making it grow to suit needs better. As these folks embrace central scheduling and treatment documentation with the EHR, the implementation, the effectiveness of the software, and possible improvements in treating patients are likely to increase.
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