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显著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卫生信息交流如何改善门诊病人护理的协调和跨治疗环境的安全性。 目前，如果没有电子通信，行为健康提供者无法跟踪从精神病院、保护性拘留或危机精神健康中心到城市或农村社区环境中的各种提供者的患者的整个治疗路径。等待服务或药物调整会增加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护理模式的关键。内布拉斯加州东南部精神病患者治疗的安全性和质量将通过开发和实施该地区的健康信息交流系统(HIE)实现。 HIE将在为精神疾病患者提供服务的提供者护理团队之间创建对患者信息的及时访问。这反过来将通过提供基本的电子信息来协调行为卫生服务提供者、初级保健医生、乡村医院和紧急行为卫生系统之间的患者护理，从而改善护理的连续性，从而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，人们知之甚少。该项目将通过三项研究促进对行为健康信息交流的了解： *提供者在行为健康环境中对技术接受的障碍； *行为保健技术的接受和采用；以及 *卫生信息交流对临床结果的影响。 这项形成性和终结性的研究计划探讨了预先设定的障碍、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.