Chronic Mental Health: Improving Outcomes through Ambulatory Care Coordination

描述（由申请人提供）：适当和及时的护理协调有助于改善慢性精神疾病患者的行为健康结果。该项目将展示农村和城市提供者之间的健康信息交流如何改善门诊患者护理协调和治疗环境的安全性。 目前，没有电子通信，行为健康提供者无法跟踪患者从精神病院、保护性监护或危机心理健康到城市或农村社区环境中的各种提供者的整个治疗路径。等待服务或药物调整增加了慢性精神疾病患者面临的问题。 健康信息技术被认为是有效实施行为健康慢性病护理模式的关键。将通过为该地区制定和实施健康信息交换（HIE）来提高内布拉斯加州东南部精神病患者的安全性和治疗质量。 HIE将在为精神疾病患者提供服务的提供者护理团队之间及时获取患者信息。反过来，这将通过提供基本的电子信息来协调行为健康提供者、初级保健医生、农村医院和紧急行为健康系统之间的患者护理，从而改善护理的连续性，这将改善精神疾病患者的长期健康结果。 关于行为健康提供者之间的健康信息交换如何改善护理协调，特别是对于在住院和门诊之间过渡的患者，知之甚少。该项目将通过三项研究促进行为健康信息交流的知识： * 行为健康环境中技术接受的提供者障碍; * 行为医疗保健技术的接受和采用;以及 * 健康信息交换对临床结果的影响。 这个形成性和总结性的研究计划探讨了预先设想的障碍，采用的意图，实际采用和临床结果。

DESCRIPTION (Provided by Applicant): Appropriate and timely care coordination contributes significantly to improved behavioral health outcomes for patients with chronic mental illness. This project will demonstrate how health information exchange between rural and urban providers can improve ambulatory patient care coordination and safety across treatment settings. Currently, without electronic communication, behavioral health providers are unable to follow the entire treatment path of patients from mental hospitals, protective custody, or crisis mental health holds to various providers in the urban or rural community settings. Waiting for services or medication adjustments increases the problems faced by people with chronic mental illness. Health information technology is believed to be critical for efficient implementation of behavioral health chronic care models. Increasing safety and enhancing quality of treatment for mentally ill patients in southeast Nebraska will be achieved through the development and implementation of a Health Information Exchange (HIE) for the region. An HIE will create timely access to patient information between and among the provider care team serving an individual with a mental illness. This, in turn, will improve the continuum of care by providing basic electronic information to coordinate patient care between behavioral health providers, primary care physicians, rural hospitals, and the emergency behavioral health system that will improve the long-term health outcomes of individuals with mental illness. Little is known about how health information exchange among behavioral health providers improves care coordination, particularly for patients transitioning between inpatient and outpatient settings. This project will contribute to knowledge of behavioral health information exchange through three studies: * Provider barriers to technology acceptance in the behavioral health setting; * Behavioral healthcare technology acceptance and adoption; and * Impact of health information exchange on clinical outcomes. This formative and summative research plan explores pre-conceived barriers, intention to adopt, actual adoption, and clinical outcomes.