Attention Deficit HyperactivityDisorder (ADHD): Survey Report

In the spring of 2016, the New Hampshire Pediatric Improvement Partnership (NHPIP) conducted an online survey of NH pediatric and family practice clinicians to understand practice patterns, comfort level, and support needs relative to caring for pediatric patients with Attention Deficit Hyperactivity Disorder (ADHD). Of the clinicians surveyed, 138 responded yielding a 13% response rate

Koinonia

The ProfessionFaculty and Student Development Staff as Partners in Education, Barry Loy Is it Okay to Struggle as Student Development Professionals?, Terry Williams Conference SpotlightLeading Ladies: Transformative Biblical Images for Women\u27s Leadership, Jeanne Porter Mi Abuelito, Tom Neven Campus EventsQuestions Without Answers, JR Kerr Book ReviewsLet Your Life Speak, reviewed by Dana Forbes Mountains and Passes, reviewed by Jeff Doyle FeaturesThe President\u27s Corner Editor\u27s Diskhttps://pillars.taylor.edu/acsd_koinonia/1009/thumbnail.jp

Telehealth and Mobile Health Applied To IntegratedBehavioral Care: OpportunitiesFor Progress In New Hampshire

This paper is an accompanying document to a webinar delivered on May 16, 2017, for the New Hampshire Citizens Health Initiative (Initiative). As integrated behavioral health efforts in New Hampshire gain traction, clinicians, administrators, payers, and policy makers are looking for additional efficiencies in delivering high quality healthcare. Telehealth and mobile health (mHealth) have the opportunity to help achieve this while delivering a robust, empowered patient experience. The promise of video-based technology was first made in 1964 as Bell Telephone shared its Picturephone® with the world. This was the first device with audio and video delivered in an integrated technology platform. Fast-forward to today with Skype, FaceTime, and webinar tools being ubiquitous in our personal and business lives, but often slow to be adopted in the delivery of medicine. Combining technology-savvy consumers with New Hampshire’s high rate of electronic health record (EHR) technology adoption, a fairly robust telecommunications infrastructure, and a predominately rural setting, there is strong foundation for telehealth and mHealth expansion in New Hampshire’s integrated health continuum

Integrating Behavioral Health & Primary Care in New Hampshire: A Path Forward to Sustainable Practice & Payment Transformation

New Hampshire residents face challenges with behavioral and physical health conditions and the interplay between them. National studies show the costs and the burden of illness from behavioral health conditions and co-occurring chronic health conditions that are not adequately treated in either primary care or behavioral health settings. Bringing primary health and behavioral health care together in integrated care settings can improve outcomes for both behavioral and physical health conditions. Primary care integrated behavioral health works in conjunction with specialty behavioral health providers, expanding capacity, improving access, and jointly managing the care of patients with higher levels of acuity In its work to improve the health of NH residents and create effective and cost-effective systems of care, the NH Citizens Health Initiative (Initiative) created the NH Behavioral Health Integration Learning Collaborative (BHI Learning Collaborative) in November of 2015, as a project of its Accountable Care Learning Network (NHACLN). Bringing together more than 60 organizations, including providers of all types and sizes, all of the state’s community mental health centers, all of the major private and public insurers, and government and other stakeholders, the BHI Learning Collaborative built on earlier work of a NHACLN Workgroup focused on improving care for depression and co-occurring chronic illness. The BHI Learning Collaborative design is based on the core NHACLN philosophy of “shared data and shared learning” and the importance of transparency and open conversation across all stakeholder groups. The first year of the BHI Learning Collaborative programming included shared learning on evidence-based practice for integrated behavioral health in primary care, shared data from the NH Comprehensive Healthcare Information System (NHCHIS), and work to develop sustainable payment models to replace inadequate Fee-for-Service (FFS) revenues. Provider members joined either a Project Implementation Track working on quality improvement projects to improve their levels of integration or a Listen and Learn Track for those just learning about Behavioral Health Integration (BHI). Providers in the Project Implementation Track completed a self-assessment of levels of BHI in their practice settings and committed to submit EHR-based clinical process and outcomes data to track performance on specified measures. All providers received access to unblinded NHACLN Primary Care and Behavioral Health attributed claims data from the NHCHIS for provider organizations in the NH BHI Learning Collaborative. Following up on prior work focused on developing a sustainable model for integrating care for depression and co-occurring chronic illness in primary care settings, the BHI Learning Collaborative engaged consulting experts and participants in understanding challenges in Health Information Technology and Exchange (HIT/HIE), privacy and confidentiality, and workforce adequacy. The BHI Learning Collaborative identified a sustainable payment model for integrated care of depression in primary care. In the process of vetting the payment model, the BHI Learning Collaborative also identified and explored challenges in payment for Substance Use Disorder Screening, Brief Intervention and Referral to Treatment (SBIRT). New Hampshire’s residents will benefit from a health care system where primary care and behavioral health are integrated to support the care of the whole person. New Hampshire’s current opiate epidemic accentuates the need for better screening for behavioral health issues, prevention, and treatment referral integrated into primary care. New Hampshire providers and payers are poised to move towards greater integration of behavioral health and primary care and the Initiative looks forward to continuing to support progress in supporting a path to sustainable integrated behavioral and primary care

Planning for Project ECHO in New Hampshire

Assuring a healthy New Hampshire requires making sure that all of the state’s residents can get the right care in the right place at the right time. Yet, access to timely, effective health care is not always a given in our state, especially for vulnerable populations. Health and community care workforce shortages, long distances to care, and social, economic, and cultural barriers make accessing care challenging for many. The Project ECHO Model™ is an evidence-based method using web-based teleconferencing to link specialist teams with community-based sites to help community providers improve their ability to manage complex conditions. It has been proven to improve health care outcomes for vulnerable populations with limited access to care because of socioeconomic factors or geography. The New Hampshire Project ECHO® (Extension for Community Healthcare Outcomes) Planning for Implementation and Business Sustainability Project (Planning for Project ECHO in NH) undertook a planning process to inform how to best to develop Project ECHO at UNH to serve New Hampshire health and community care providers and ultimately improve access to effective, timely care. Planning for Project ECHO in NH also developed a business and sustainability plan for long-term success of the UNH Project ECHO Hub and an evaluation plan for measuring efficacy. Planning for Project ECHO in NH included: A Project ECHO Needs Assessment and Prioritization Process, including review of existing needs assessments in the field; a stakeholder survey of health and community care providers conducted by the New Hampshire Citizens Health Initiative (Initiative); and analysis of data from the NH Comprehensive Health Information System (NH CHIS), NH’s all-payer claims database (APCD). A business and sustainability plan including Key Informant Interviews, an environmental scan, and a template for business sustainability planning to identify funding sources and structures to sustain Project ECHO in NH. A framework for Project ECHO evaluation