Workshop 6 - Sulik - Pal-Tech

Download Report

Transcript Workshop 6 - Sulik - Pal-Tech

MINNESOTA COLLABORATIVE
PSYCHIATRIC
CONSULTATION SERVICE
L. Read Sulik, MD, FAACAP
Senior Vice President – Behavioral Health Services
Sanford Health
[email protected]
Clinical Associate Professor
Department of Psychiatry, University of Minnesota
Clinical Associate Professor
Department of Clinical Neuroscience, University of North Dakota
S
Background
S
Minnesota background efforts
S
Minnesota 2006 Legislation
S
Minnesota 2010 Legislation to fund statewide psychiatric consultation service
S
Drug threshold workgroup
S
Minnesota Psychiatric Consultation Workgroup
S Children’s Psychiatric Consultation Protocols workgroup
S ADHD subgroup
S Bipolar subgroup
S Differential diagnosis, including trauma, anxiety disorders and disruptive behaviors
subgroup
S Eating disorder subgroup
S Substance abuse subgroup
S Triage subgroup
2
h
M INT?
What is
Mental Health Integration &
Transformation Program
S A partnership w/ Minnesota healthcare organizations and
additional support partners:
S Healthcare Systems: Mayo Clinic, Sanford Health, Prairie Care,
Essentia (5th partner TBD)
S Non-profits: Minnesota Psychiatric Information and Outreach
(MPIO), REACH Institute
S Project Management Consultant
S Videoconferencing Vendor
3
What is the Purpose/Intent of the Minnesota
Collaborative Psychiatric Consultation Service?
S To increase quality and access to children’s mental health services
across the state of Minnesota by…
S Increasing primary care providers’ (PCPs’) skills and willingness to manage
children and adolescents with mild-moderate mental health problems
S Creating linkages and partnerships between primary care and specialty mental
health providers
S Increasing rapid access for selected face-to-face consultations
S Reducing problematic prescribing practices via case-specific support and
consultation
S Building partnerships among Medicaid, private insurers, healthcare
organizations, and providers to facilitate sustainability
4
Why is the Service Needed?
S Traditional CMEs, written guidelines, and “hit-and-run”
workshops and lectures are generally ineffective.
S Evidence-based prescriber training methods need to focus on
skills (not factual knowledge), and must address obstacles
encountered in practice.
S Effective training programs must use collaborative learning
partnerships, vs. “one-down” relationships, and use PCP role
models as co-teachers, similar to those being trained.
5
How Will the Service
Achieve Its Purposes?
S
Targeted outreach to providers;
S
Systematic and regular communications to providers about available services and
training opportunities;
S
Linkage assistance to available services;
S
Hands-on coaching, skills training, and information support;
S
Same-day phone consultation services (both voluntary and mandatory
consultations); and
S
Rapid face-to-face evaluations for “emergent” cases.
6
h
M INT
Innovative Approaches
S Web-based tool that allows providers to identify and
link families to community resources;
S State-of-art video-teleconferencing available at no cost to
internet-linked healthcare providers state-wide;
S “Pathway” to sustainability, with Medicaid codes
approved for use by healthcare providers;
S Creation of primary care “champions” who can in effect
increase the state’s mental health manpower
7
h
M INT
Project Organization
Project Steering Group
L. Vukelich & Associates
Executive Committee
SE Minnesota Region
Western Region
Northeastern Region
Twin Cities - East
Twin Cities - West
Mayo Clinic
Sanford Health
Essentia Health
Prairie Care
TBA (e.g., Allina
Health)
Mayo Clinic subcontracts
to MhINT Partner sites
and other subcontractors
REACH
Soltrite
MPIO
8
Regional Teams
•
•
•
5 regional healthcare system teams, located strategically
across the state
Each team consists of:
• >2 Child/adolescent Psychiatrists (CAPs)
• >1 Triage Mental Health Professional (TMHPs)
• Other support staff as needed
Multiple team members enable cross-coverage within and
across sites
9
Leadership/Planning and Timetables
•
Weekly EC Meetings
•
Co-Chairs: 1 Site Principal, Linda Vukelich
•
Partnership with by-laws guiding the collaboration
•
Subcommittees and Assigned Tasks:
•
Database, Website, REACH adaptations, Electronic Communications,
CAP/TMHP Training, PR/Outreach, Program Evaluation
•
Start-up phase June/July
•
August 1 – December 31, 2012, 3-4 sites only
•
January 1, 2013, and beyond: 5 sites
10
Web-Based Tools
•
h
M INT
(via MPIO) will support the creation of
a web-based tool that allows providers to identify
and link families to available community mental
health resources
• Regularly updated by MhINT Team & MPIO
• Publicly available
11
REACH Training
S Hands-on, with role plays and extensive practice
S 2 days of face-to-face training with 15-30 clinicians, with 2-3
trainers, followed by:
S 6-12 months of twice-monthly phone call consultation and
support, 1-1.5 hours/call
S Individual case presentations, with learning and risk-taking shared
among peers
S 6 years in development, used in NYS, Nebraska, North Carolina
12
HD Video Conferencing over the Internet
• Secure – HIPAA compliant
• PC, Mac, iPad, iPhone & Android
• Can interoperate with traditional
video conferencing technology
13
Video conferencing Services
• Will likely include:
• Training
• Collaboration between and within MhINT
partners and DHS
• Communication between primary care doctors
and specialty mental health providers
• Potentially some patient consultations
14
Consultation Services
S
h
M INT
will not encourage PCP
management of the following:
1. Psychosis
2. Suicidality beyond minimal risk
3. Aggression involving serious
injury to others or serious
destruction of property
4. Clear Bipolar I disorder
5. Substance abuse/dependence
16
Work Flow for Phone Consultations
S Triage mental health professional (TMHP) takes the
initial phone call and responds to calls within their
scope of training and expertise.
S If a child and adolescent psychiatrist (CAP) is
needed/requested, the covering CAP returns the
phone call at scheduled time (same day).
17
HIPAA I
•Voluntary phone calls are consultations to the primary care provider
(PCP), as well as a clinical service to patients.
•PCPs will maintain records of the consultation, and ensure
patient confidentiality and HIPAA-compliance. Protected health
information (PHI) NOT needed for voluntary consults.
•De-identified demographic and clinical information can be used
to provide evaluation of the project.
S
Face-to-Face Consultations
S
Face-to-Face Consultations
S Selected cases will be seen for a face-to-face (or
possibly, telepsychiatric if the patient is
geographically distant) consultation with a
MhINT child/adolescent psychiatrist.
S Face-to-face (FTF) evaluations will be scheduled
within 1-2 weeks with the local child/adolescent
psychiatrist.
20
Face to Face Evaluations are
Consultations Only
S Face to face evaluations are consultations only,
with follow-up as needed by PCPs.
S Patients cannot be followed by CAPs for
ongoing treatment and medication
management.
S PCPs will need to apprise patients and
families about this.
21
Resources & Contact Info
S DHS Website:
http://www.dhs.state.mn.us/main/idcplg?IdcService=GET
_DYNAMIC_CONVERSION&RevisionSelectionMethod=
LatestReleased&dDocName=dhs16_158267
S L. Read Sulik, MD, FAACAP
S
Senior Vice President – Behavioral Health Services, Sanford Health
S
Email: [email protected]
S
Telephone: 701 234 4124
22